Summary: Federal policy makers like US Senators Bernie Sanders, Tom Harkin and Barbara Mikulski who champion integrative medicine and complementary and alternative medicine inserted the phrases “integrative health practitioners” and “integrative health care” in various places in the 2010 Affordable Care Act, including workforce planning. But what exactly did they mean with these terms? The law is not clear. The Integrated Healthcare Policy Consortium (IHPC), the multidisciplinary lobbying group, set up a task force to create a definition in September 2010. On January 13, 2011, IHPC issued a press release entitled “Policy Statement on the National Healthcare Workforce in an Era of Integration.” In it, they offer a definition. IHPC’s policy statement and the definition is printed here in full. I add commentary. Do you agree with this approach?
IHPC policy seeks to clarify ongressional language
What is an “integrative health practitioner”? Is your discipline or field included? Is this another term for a person who practices “integrative medicine”? Does the phrase only include licensed practitioners? What about a nurse who works closely with medical doctors, physical therapists, psychologists, social workers and others in a community clinic? What about a homeopathy or a Yoga therapists? Are these “integrative health practitioners”? What makes a practitioner “integrative”?
On January 13, 2011, the multidisciplinary Integrated Healthcare Policy Consortium took a critical step toward creating clarity. IHPC published a press release entitled “Policy Statement on the National Healthcare Workforce in an Era of Integration” in which IHPC offers a working definition of “integratiuve practitioner.” Here is the release, followed by commentary. Your thoughts?
New Policy Statement to Aid
Credentialing Of Integrative Health Practitioners
This policy statement responds, in part, to a
broadened definition of the healthcare workforce that appears in the new Public
Law 111-148, the Patient Protection and Affordable Care Act of 2010.
IHPC’s Board Chair, Leonard Wisneski, MD (see bio below) stated: “IHPC applauds the use in the Patient Protection and
Affordable Care Act of a definition of the healthcare workforce that includes,
as stated in Section 5101, “…licensed complementary and alternative
medicine providers, integrative health practitioners…” (See full
definition from the law below.)
“Yet, we recognize, that while licensed
complementary and alternative medicine providers can be readily identified as
licensed acupuncturists, chiropractors, massage therapists, naturopathic
physicians, and professional midwives, the term ‘integrative health
practitioners’ has yet to be defined.
“While many health care providers might lay claim
to that title,” said Wisneski, “IHPC’s board concluded that guidance on the
meaning of the term would be helpful to policymakers, health administrators,
insurers and others for whom the term and terrain may be new. The
definition is also the beginning point for clarification of standards,
competencies, and best practices.”
IHPC’s newly adopted policy, “The National
Healthcare Workforce in an Era of Integration,” states:
Seeking a balance between strongly held values of
patient access to health care therapies and professionals of their choice AND
proper recourse if inappropriate or unethical care should occur, IHPC supports
inclusion in the National Healthcare Workforce of:
1) All licensed conventional, complementary and
alternative healthcare providers.
2) All state certified healthcare providers.
3) All nationally certified healthcare providers when
the certification agency is accredited by the National Commission for
Certifying Agencies (NCCA) of the Institute for Credentialing Excellence (ICE).
For healthcare professions that do not yet have state
licensure/certification/registration or national certification, IHPC
strongly encourages them to pursue state licensure/ certification/registration
and/or national certification.
Janet Kahn, PhD, IHPC’s Executive Director emphasized
that, “There are a number of sections of the Patient Protection and Affordable
Care Act that reference integrated healthcare, integrative practitioners and
the like. This may well be new terrain for people working in the many
agencies within the Department of Health and Human Services (DHHS) who will be
responsible for operationalizing the new law. IHPC and its Partners for Health
stand ready to be helpful in this process. Guidelines for credentialing
the category of ‘integrative health provider’ are an essential beginning.
We are prepared to assist in other ways as the process unfolds.”
* About IHPC: The Integrated Healthcare Policy Consortium (IHPC) is
a broad coalition whose Partners for Health represent over 300,000 clinicians
and healthcare educators committed to public policy that supports a
health-oriented, integrated system, ensuring all people access to the full
range of safe and regulated conventional, complementary, and alternative
healthcare professionals. Integrated Health Care describes a coordinated
system in which healthcare professionals are educated about one another’s work
and collaborate with one another, and with their patients, to achieve optimal
well-being for the patient including physical, emotional and spiritual
well-being. Visit www.ihpc.info to
**Dr. Wisneski, dually trained as an endocrinologist and an
acupuncturist has practiced integrative medicine for over 25 years. He is
author of the acclaimed book, “The Scientific Basis of Integrative Medicine,”
Clinical Professor of Medicine at George Washington University Medical Center
and Adjunct Faculty in the Department of Physiology and Biophysics at
Georgetown University where he is a founding member of the Complementary and
Alternative Medicine Curriculum Planning Committee. Dr. Wiskneski holds
fellowship positions in The American College of Physicians, The American
College of Nutrition, and The American Institute of Stress.
About NCCA: The National Commission for Certifying Agencies (NCCA)
was created in 1987 by ICE to help ensure the health, welfare, and safety
of the public through the accreditation of a variety of certification
programs/organizations that assess professional competence. Certification
programs that receive NCCA accreditation demonstrate compliance with the NCCA’s Standards for the Accreditation of Certification Programs, which were
the first standards for professional certification programs developed by the
Definition of the
National Healthcare Workforce used in Section 5101 of the Patient Protection
and Affordable Care Act: “The term ‘health care workforce’ includes all
health care providers with direct patient care and support responsibilities,
such as physicians, nurses, nurse practitioners, primary care providers,
preventive medicine physicians, optometrists, ophthalmologists, physician
assistants, pharmacists, dentists, dental hygienists, and other oral healthcare
professionals, allied health professionals, doctors of chiropractic, community
health workers, health care paraprofessionals, direct care workers,
psychologists and other behavioral and mental health professionals (including
substance abuse prevention and treatment providers), social workers, physical
and occupational therapists, certified nurse midwives, podiatrists, the EMS
workforce (including professional and volunteer ambulance personnel and
firefighters who perform emergency medical services), licensed complementary
and alternative medicine providers, integrative health practitioners,
public health professionals, and any other health professional that the
Comptroller General of the United States determines appropriate.(Bold added.)
Comment: Kudos to the IHPC for taking on this definition. The term “integrative health care practitioner” does not merely reflect licensed practitioners. This would seem to follow the intent of Congress, given the decision to include the category in addition to a long list of professionals including “licensed complementary and alternative medicine providers.” IHPC’s policy strikes a balance on behalf of the public health in urging practitioner groups toward state regulation or, if adverse, toward recognition of their certification program through ICE. Now the work to get this definition into the right hands in federal agencies. It will be interesting to see what kind of traction the definition gets in federal agencies. It will be a good calling card for Wisneski, Kahn and IHPC.