Integrative Medicine, Complementary Alternative Medicine and Health Round-up #49: November 2011

Summary: Integrative community dialogue on board certified integrative MDs and the direction of “integrative medicine” … Congressional Wellness Caucus established with bipartisan backing … Obama names Kahn and Ornish to Advisory Group for National Prevention Council … IHPC’s Partners for Health group expands … Integrative medicine not featured at TEDMED 2011, moves to the Beltway in 2012 … Knutson urges response to US Preventive Medicine Task Force … Dartmouth researcher Davis breaks down $$$ in CAM market … Bastyr reports $136-million of economic impact … CHP Group offers case statement for CAM integration … Steiner Leisure purchases Cortiva Group … Sabin on role of philanthropy in integrative medicine … Chesney in line to chair conventional academic consortium … Acupuncturist Beau Anderson gains faculty appointment at Albert Einstein … Taylor Walsh adds perspective on debate over whether alternative medicine killed Steve Jobs … IAYT’s John Kepner addresses the Group Health findings relative to “sham yoga” … Report on naturopathic profession’s Science & Policy Summit … Chiropractors push inclusion in loan repayment … New Hampshire Republicans cross party line to support mandate to cover naturopathic doctors … Acupuncture Without Borders in tough financial position … American Medical Student Association leader is a naturopathic medical student, SCNM’s Rebecca Snowden … Zunin’s Manakai O Malama, Hawai’i’s most significant integrative center, seeks additional integrative MD/DO … Christina Jackson named the 2011 Holistic Nurse of the Year … Rita Bettenburg takes position at CHP Group

Policy

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Taking lead on board certification

Expansive integrative community
dialogue on effort to create an MD specialty through an American Board
of Integrative Medicine

The September 2011 “strategic change in direction” by
leaders of the Arizona Center for Integrative Medicine to promote recognition of a
board-certified integrative medicine specialty prompted significant, sometimes fractious
dialogue in the integrative practice community. Some
perspectives on the proposed American Board of Integrative Medicine (ABIM) were
captured in Integrator Forum: 20 Voices on Weil/University of Arizona and the American Board of Integrative Medicine.
This diverse grouping of responses included MDs, DCs, NDs, AOM leaders and others,
including two anti-“Quackademic” bloggers. A second set of respondents
contributed after reading the dialogue in the first group. These are captured here:
Forum #2 on the American Board of Integrative Medicine: Quinn, Redwood, Gmeiner, Anderson and Manahan.
The Arizona’s Center’s change in direction is from promoting “integrative medicine” as the
right approach for every branch of medicine to advocating formation
of an integrative medicine specialty. The Arizona Center’s executive director Victoria Maizes, MD clarified that the move is part of a “both/and” focus for the Center.  They are still promoting an overall transformation toward an integrative model. The 20 Voices also stimulated this follow-up discussion by an anti-CAM/IM blogger who celebrates the apparent divisiveness of the move.  

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Daniel Redwood, DC: Balanced remarks

Comment: This is not capital “P” policy but is certainly core policy inside the integrative practice community. The topic is like a natural therapeutic regime that successfully surfaces both entrenched morbidity and abiding hope. My sincere intent
is that the perspectives registered in these Integrator postings
will lead those establishing ABIM to more deeply embrace the emerging
discipline’s most transformational potential. This means an enhanced
focus on the interprofessional education that a
patient-centered approach requires. This will address the critical
interprofessional concerns directly and indirectly note by many. Many who can’t sit for the BCIM are not yet sure that
historic and continuing political-economic suppression of other
disciplines by medical doctors will not be furthered, again, by the emerging
guild of MD-BCIMs. Or, as the framing keeps coming to me, should these professionals listen when they are told we are not like all the others

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US Senator Amy Klobuchar

Congressional Wellness Caucus established, linked to National Prevention Strategy

US Senator Amy Klobuchar(D-MN) and US Representative Erik Paulson (R-MN) have announced the creation of the Congressional Wellness Caucus.
The focus is “to put workplace wellness on the national agenda,”
according to an article on the June kick-off. Despite well-researched
savings associated with wellness programs, “only about 27 percent of
employers with 500 or more employees offer wellness programs and about
43 percent with 10,000 or more do” according to
the
article.
The timing of the creation of the Wellness Caucus was within 2 weeks of the publication of the National Prevention Strategy via the National Prevention Council (see article below).

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Congressman Erik Paulsen

The
caucus, expected to be fully functional by this fall, was referenced in
a November 1, 2011 Congressional briefing that was led by Trust for America’s Health (TfAH). Notably, the executive director of TfAH, Jeffrey Levi, PhD, serves as chair of the Advisory Group on Prevention, Health Promotion and Integrative and Public Health that advises on the above-mentioned National Prevention Strategy. Participants
in the Congressiional briefing included representatives of the Robert Wood Johnson
Foundation, National Business Coalition on Health and the Alliance for a
Healthier Minnesota.
Joining the Minnesota co-founders in the bi-partisan Caucus are Sen. John Thune (R-SD) and Rep. Ron Kind (D-WI). (Thanks to  the Integrated Healthcare Policy Consortium for bringing the November event to my attention.) 

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Janet Kahn, PhD

Obama appoints Janet Kahn and Dean Ornish to the Advisory Group to the National
Prevention Council



In an October 7, 2011 announcement, Barack Obama
appointed Janet Kahn, PhD to the Advisory Group on Prevention, Health Promotion and
Integrative and Public Health
of the National Prevention Council. This was followed by a November 2 announcement of 4 additional members, including Dean Ornish, MD. Kahn has been a
leading advocate for integrative practices and a health-focused delivery system
through her service as executive director of the Integrated Healthcare Policy Consortium which
nominated her for the post. Author-researcher Ornish is well-known for his pioneering research with the Preventive Medicine Research Institute in developing his presently Medicare-covered lifestyle program for reversing atherosclerosis.

Comment: This brings to 4 the number of individuals closely connected to the integrative practice fields to gain
appointment to the Advisory Group. The first were Charlotte Kerr, RSM, BSN, MPH, MAc, an
emeritus faculty member at Tai Sophia Institute and UCLA-based integrative medical doctor Sharon Van Horn, MD. The Advisory Group, charged with assisting the Council in developing the nation’s prevention and
health promotion strategy, was mandated to include integrative practitioners.

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Partners for Health expands

Integrated Healthcare Policy Consortium update: Partners for Health expands

The Integrated Healthcare Policy Consortium (IHPC- www.ihpc.info) is celebrating the appointment of senior associate and past executive director Janet Kahn, PhD, to the Advisory Group of the National Prevention, Health Promotion and Public Health Council. According to an IHPC release from chair Len Wisneski, MD,
Kahn, a researcher and practicing massage therapist, is expected to
have a significant role in shaping the nation’s relationship to
integrative care from her position on the Advisory Group.  Meantime, IHPC has announced new members of its diverse Partners for Health program. The current list includes the following, with those relatively new in italic:

  • American Academy of Pain Management
  • American Association for Acupuncture and Oriental Medicine
  • American Association of Naturopathic Physicians
  • American Massage Therapy Association
  • Bastyr University
  • International Chiropractic Pediatric Association
  • National Association of Certified Professional Midwives
  • National Center for Homeopathy
  • Naturopathic Medical Student Association
  • Oregon College of Oriental Medicine
  • Palmer College Center for Chiropractic Research
  • Sojourners Community Health Clinic 
  • Tai Sophia Institute

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New IHPC Partner

Comment: It is pleasing that Kahn will
continue to work with IHPC in her Senior Adviser capacity. She helped
IHPC accomplish a good deal as executive director in an environment of
great scarcity. Kahn extended herself personally in many ways. She had a
key role in placing licensed complementary and alternative healthcare
practitioners in the nation’s workforce planning, via her home state connection with US Senator Bernie Sanders.
Meantime, this is a nice group of Partners for Health! Here’s a wish
that some philanthropist or corporation with skin in this game will
realize how much fun and value could come from jumping in and empowering
this group with some real cash!

ImageIntegrative medicine at TEDMED 2011 (not), plus a changed venue to influence policy in 2012

I place the TEDMED conference under Policy because of a decision by the new owner of the brand, Jay Walker. The billionaire TEDMED curator known as the founder of Priceline has announced that this influential gathering of medical innovators will be moving next year. TEDMED leaves its cozy, community-enhancing 2009-2011 home at San Diego’s luxury Hotel Del Coronado

for the Kennedy Center in Washington, DC. Explains Walker: “Holding
TEDMED’s annual conference at the health and medicine capital
of the world will amplify the voice of the TEDMED community, bringing
TEDMED to a larger stage where the members of our community can provide a
much-needed national service.” TEDMED 2012 will be in the heart of the nation’s Beltway and also a half-year earlier, April 11-13, 2012.


Under Walker’s leadership this year, integrative medicine saw diminished visibility at TEDMED. The first two years
featured 1-3 presentations from the pantheon of the most visible
integrative medical doctors and authors. Andrew Weil, MD, Dean Ornish, MD, Deepak Chopra, MD, Mehmet Oz, MD and
Mark Hyman, MD each presented, some in multiple years. No integrative MD was on the TEDMED 2011 program for the
estimated 850 participants. Mycologist and author Paul Stamets was as good as it got for integrative practice.  

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Walker: TEDMED curator

Comment: The barrier to entry
for TEDMED is high, at $4000 per person. I was gifted an opportunity to
attend the October 25-28, 2011 meeting. I will report the excitement
and sometimes disturbing trend-lines more fully soon. Walker, whose
passion for the history of innovation is infectious, noted during closing
comments that some attendees had told him that the 2011 iteration “left out the
patient perspective.” Walker said he’d bring it back. Here’s hoping that his concept of innovation is broad enough to include the
substantial cultural innovation engaged by the patient population when human beings as healthcare consumers co-conspired with diverse practitioners to invent the holistic and
complementary and alternative healthcare disciplines. I understand that Walker is personally supportive of integrative medicine. Hopefully TEDMED’s obvious high-tech strengths will have more high-touch balance in 2012.

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Lori Knutson, RN, BC-HN

Knutson calls for community response on academic curriculum for US Preventive Service Task Force


Lori Knutson, RN, BC-HN, is an integrative care educator and the
integrative health leader for the nation’s most significant health
system-based integration initiative, Allina Hospitals and Clinics. Knutson sends notice that the US Preventive Service Task Force (USPSTF) is seeking information on what should be considered
in its “development of academic curriculum as it relates to
prevention
.” I asked Knutson for her perspective on why the integrative health community should participate. She wrote:

“This is a cultural imperative. If we are serious about
influencing the health of our nation and integrating ‘CAM’ in
the tapestry of care then we must not only focus on delivering services and
researching outcomes and best practice. We must
proactively embed this work in academic institutions so
that integrative care/medicine/health is the norm and not the exception for
healthcare provider education. The U.S. Preventive Services Task force is
asking for feedback on how to improve the academic training of healthcare
providers to ensure health promotion and prevention as having equal
relevance to the academic focus on treatment of disease and
illness.  I propose we have an obligation to be active partners in
ensuring this.

The link to the USPSTF is here. The link on the curriculum is here.


Cost & Business

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Mathew David, MPH, DC

NCCAM-funded Dartmouth researcher Mathew Davis reports $$$ in CAM market 

In a paper delivered at the Annual Research Meeting of AcademyHealth, Mathew Davis, MPH, DC reported useful data on the size of the CAM market and consumer spending. According to this article in Family Practice News, Davis found that:

  • visits to chiropractors fell from about 110 million in
    2005 to just under 100 million in 2008
  • spending on CAM services increased from about $8 billion in 2002
    to $8.6 billion in 2008
  • spending on CAM is concentrated in a minority of users, with
    about 25% accounting for 72% of spending
  • heavier spenders (those who spent $520-$10,000 in
    2007) aren’t any sicker than light spenders (those who spent less
    than $87)
  • in 2007, the
    top 10% of users, accounting for almost half of expenditures,
    spent a mean of $2,392.


Davis also reported that for 2007: $165 million was
spent on homeopathy, $271 million on naturopathy, $103 million on
traditional healers, $19 million on ayurveda, $567 million on herbals
and other nonvitamin supplements, $32 million on chelation, and $74
million on hypnosis.
Overall, Davis reportedly concluded that CAM accounts for less than 1% of total
health care spending in the U.S. and
remains largely “remains a cottage industry.”
(Thanks to Glenn Sabin for tipping me to this article.)

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Dan Church, PhD

Bastyr University reports $136-million of economic impact in 2010

An October 12, 2011 release from Bastyr University
announced that a consultant to the multidisciplinary institution in
natural health sciences generated $136-million of economic impact for
Seattle-area community in 2010.  The report from Hebert Research examined economic activity in 5 areas: operations, investment
projects, teaching clinic, spending by students and economic activity generated by local alumni. In the release,
Bastyr president Daniel Church, PhD states: “We
are proud that Bastyr University, which began over thirty years ago as a
fledgling professional school with about 30 students, has experienced the type
of growth reported in this important study.”
Copies of the full report are available through Derek Wing:

dwing@bastyr.edu.

Comment: Brilliant move to commission this report. This is no homeopathic dose.

ImageCHP Group offers concise resource on evidence, cost-effectiveness of CAM

A 20-page resource entitled “Integrating Evidence-Based Complementary and Alternative Medicine into the Healthcare System” is available as a PDF file from Portland, Oregon-based CHP Group.
CHP Group uses the document in its outreach to prospective employer and
insurer clients. CHPs manages networks of chiropractors,
naturopathic doctors, acupuncturists and massage therapists. A key
client is Kaiser Northwest Permanente.
The referenced document, with 32 useful end-notes, seeks to make a case
that “research has demonstrated the clinical effectiveness of many CAM
interventions and recent studies have shown that CAM is cost-effective.”
The firm, co-founded by medical director Chuck Simpson, DC and led by Michelle Hay, CEO, was named Carrier
of the Year at the August 2011 meeting of the Oregon Association of
Health Underwriters
(OAHU) for “exceptional leadership in the
health insurance industry.”

Comment: While published in 2010, this CHP document may be useful to more than one Integrator reader.

ImageMassage education and services firm Steiner Leisure purchases Cortiva Group

On October 12, 2011, Steiner Leisure Limited announced an agreement for the acquisition of the assets of

Cortiva Group.
Cortiva was a venture-backed roll-up of seven of the nation’s most
influential for-profit massage schools with 12 campuses in Arizona,
Florida, Illinois, Massachusetts, New Jersey, Pennsylvania and
Washington. Revenues in 2010 were approximately $24.6
million. Post-closing, Steiner will own
and operate a total of 30 campuses in 14 states with an anticipated
total population of approximately 5,200 students. Steiner president and
CEO
Leonard Fluxman said:
“The acquisition of Cortiva Institute, a well-known participant in the
massage therapy education field and one of our longtime competitors,
would considerably expand and fortify the presence of our Schools
division in the post-secondary massage therapy school market.” The sale price was $33-million.

Comment: Interestingly, this move
brings into one large corporation the 2 branches of the massage field.
Cortiva’s mix has leaned involvement in medical massage, integrated care
and research involvement while Steiner’s core have a focus on the spa
services and cruise ships that are the public corporation’s Steiner’s
forte. Fluxman captures the duality this way: “We look forward to
introducing even more graduates, with increasingly
diverse skill sets, into the growing massage therapy and spa
industries.” Here’s hope there is a vital exchange between the spa and
medical interests.
(Thanks to Jan Schwartz, MA for the link to this story.)


Integrative Centers


ImageArticle surveys role of philanthropists in integrative medicine

Integrative center consultant Glenn Sabin of FON Therapeutics has offered up his reflections on the Evolution of Philanthropy in Integrative Medicine.
He supports applying philanthropic dollars to performing research,
community outreach and for educational purposes. However, while he
believes he “will take some heat for this,” Sabin argues that
philanthropically subsidizing
integrative clinical services “for all but the indigent or those that
cannot afford to pay is unsustainable as a clinic/business model.” He
points out that this can
be “a costly long-term decision that has over time resulted in the
closing of many integrative medicine programs.”

Comment: It is almost impossible to
imagine the integrative medicine movement without thinking of
philanthropy and philanthropists. What other medical fields are as
cobbled to, energized through, and hobbled by, this need? Meantime, as I
note in comments on Sabin’s piece, the creation of the holistic
medicical, naturopathic, chiropractic and other clinics that predated
the invention of integrative centers were and remain of an opposite ilk.
These
necessarily followed the Jim Henson’s toddler’s motto: I can do it. I can do it myself!

Fascinating to consider where we would be now had, say, 50% of the
philanthropic millions used as battering rams to break down the
antagonism in hospitals and academic health systems been re-directed.
What if these dollars were strategically used to empower for those whose
sweat equity created the response to patient demand known as “CAM” and
holism? Some of us are working on this going forward and will be happy
to increasingly find partners! There has clearly been value in top-down philanthropy. Be smart to have some more bottom-up, empowering these other disciplines and and providers toward integrative leadership. 


Academic Medicine

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Margaret Chesney, PhD

UCSF’s Margaret Chesney, PhD in line to chair the Consortium of Academic Health Centers for Integrative Medicine

Integrative medicine leader at the UCSF Osher Center director Margaret Chesney, PhD has been selected as the new vice-chair of the Consortium of Academic Health Centers for Integrative Medicine

(CAHCIM). Chesney was formerly the deputy director of the NIH National
Center for Complementary and Alternative Medicine when founding director Stephen Straus, MD
was in decline with brain cancer. As CAHCIM vice chair, Chesney is
expected to succeed Ben Kligler, MD, MPH in late 2013. Kligler’s term as
chair just began. Adam Perlman, MD, MPH, director of the integrative
medicine program at Duke, just completed his term.

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Beau Anderson, PhD, LAc

Licensed acupuncturist Beau Anderson, PhD, LAc in academic appointment at Albert Einstein medical school

I recently became aware of the appointment of Belinda (Beau) Anderson, PhD, MAOM, LAc as assistant clinical professor at Albert Einstein College of Medicine, Yeshiva University. Anderson, academic dean and research director at Pacific College of Oriental Medicine

(PCOM), New York, is among the first licensed acupuncturists to receive
such an appointment. She shared the following educational
responsibilities that come with the title:


  • As part of an educational exchange program, 1st year Einstein students
    in the Introduction to Clinical Medicine course attend Anderson’s introductory lecture
    about Chinese medicine. They also attend a clinic shift at
    the PCOM student clinic. (In addition, a group of PCOM interns attends an introductory
    lecture followed by a three-hour cadaver dissection lab at Einstein.)

  • Anderson teaches a workshop on stress reduction called “The Use of Integrative
    Medicine” in the clinical examination section of Einstein’s Introduction to Clinical
    Medicine course.
  • Family practice residents at New York Beth Israel, an Einstein-affiliated residency
    program, attend a lecture of Anderson’s and then shadow licensed acupuncturists
    in the PCOM clinic during their 2nd year of training.


Anderson, a researcher by prior professional experience, is also
involved in a series of NIH grant submissions with members of the
Einstein faculty including Paul Marantz, MD and Ben Kligler, MD, MPH.

Comment: Among the pleasures of this
work is noting these historic moments, quiet breakthroughs,
stones dropped in ponds, as the choices of patients and the actions of
professionals begin to be reflected in the practice of institutions.
Kudos to Marantz and Kligler for facilitating this door opening and to Anderson for having the skill sets to step through .

Media

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Steve Jobs

Steve Jobs decision to delay conventional treatment to explore alternative medicine spins through media

“Did alternative medicine kill Steve Jobs?” This question was asked in a
flurry of articles that came out subsequent to the death of Apple
founder Steve Jobs. In fact, search that title and page after page will
show up. One headlines asks more specifically if Vegan quackery” was the culprit.
Jobs chose to explore alternatives before his surgery, allowing the
tumor to grow. The media brouhaha led NIH NCCAM director Josephine
Briggs, MD to publish a comment on it on her Director’s Page. Briggs takes a view that the evidence is not there for using CAM in
lieu of conventional treatment. She adds that complementary approaches
can be useful in the areas of quality of life, giving patients active
participation and
empowerment, and alleviating the symptoms and side
effects.

Integrator columnist Taylor Walsh notes that a CNN feature in
which
Anderson Cooper and Sanjay Gupta discussed
the topic “was very balanced noting that many patients choose
anything-but-surgery treatments.” He adds: “Did
not seem much for the quacklings to latch on to.” Walsh notes that the
discussion on Jobs’ cancer starts on chapter
35, page 452 of Walter Isaacson’s book, “Steve Jobs.” He provides these relevant notes:

  • Jobs, a vegan,
    had “… obsessive diets and weird routines of purging and fasting that he
    had practiced since he was a teenager.”

  • Jobs’
    reluctance to go with surgery when first diagnosed with the pancreatic cancer
    drove his friends and advisors crazy. 
    This included former Intel chairman Andy Grove, who had surgery for
    prostate cancer and overcame it.

  • “Even
    diet doctor Dean Ornish, a pioneer in alternative and nutritional methods of
    treating diseases, took a long walk with Jobs and insisted that sometimes
    traditional methods were the right option. ‘You really need the surgery,’
    Ornish told him.”

  • Once
    diagnosed, in addition to his diet, “he added acupuncture, a variety of
    herbal remedies and occasionally a few other treatments he found on the
    Internet…for a while he was under the sway of a doctor who operated a natural
    healing clinic in southern California that stressed the use of organic herbs,
    juice fasts, frequent bowel cleansings, hydrotherapy, and the expression of all
    negative feelings.”

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Taylor Walsh: Comments on issue

  • When the
    surgery was done 9 months after diagnosis, it involved removal of part of the
    pancreas, which, according to Isaacson’s text, meant his pancreas would would
    produce less protein: “Patients are advised to make sure that they eat
    frequent meals and maintain a nutritious diet, with a wide variety of meat and
    fish proteins as well as full-fat milk products.  Jobs had never done this, and he never
    would.”

  • When Isaacson discussed the book with Charlie Rose last
    week, Rose asked several times basically if anyone was responsible for giving
    Jobs bad health advice.  Isaacson would
    not bite and repeated that Jobs’ health choices reflected his lifelong
    attitudes and lifestyles.

  • In the book he quoted Apple board member Art Levinson,
    also chairman of Genentech: “I think Steve has such a strong desire for
    the world to be a certain way that he wills it to be that way.  Sometimes it doesn’t work.  Reality is unforgiving.”


Taylor Walsh Comments
: “Without wishing to overstate it, Jobs’ experience in some ways
illustrates the state of integrative medicine in the
2000’s: moving toward a rational balance perhaps, but
still characterized by fragmentation and dissonance among the voices of
the
disciplines. Not
everyone can take a walk with Dean Ornish. Even
so, one can only do so much for a hardheaded iconoclast
like Jobs, whose brilliance was often ascribed to perpetual ‘magical
thinking.’


Research

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Karen Sherman, PhD

Sherman/Cherkin Group Health group finds both yoga and stretching better than usual care

The productive Group Health Research Institute group led by Karen Sherman, PhD and  Daniel Cherkin, PhD report that yoga classes are effective in treating low back pain. The study was published as A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain
in Archives of Internal Medicine. However, the researchers concluded that while “yoga
classes were more effective than a self-care book” these were “not more
effective than stretching classes, in improving function and reducing
symptoms due to chronic low back pain.” In both stretching and yoga, benefits were found to last “at least
several months.” I asked Yoga therapist John Kepner, executive director of the International Association of Yoga Therapists, for his perspective on why the yoga classes were not better than stretching classes. He wrote:

“Re sham/stretching and yoga


“1. Karen (Sherman) had a good explanation – that the stretching
classes
were more “Yoga like” than the typical exercise program. “We expected
back pain to ease more with yoga than with stretching, so our
findings surprised us,” Dr. Sherman said. “The most straightforward
interpretation of our findings would be that yoga’s benefits on back
function
and symptoms were largely physical, due to the stretching and
strengthening of
muscles.” But the stretching classes included a lot more stretching
than in most such
classes, with each stretch held for a relatively long time. “People may
have
actually begun to relax more in the stretching classes than they would
in a
typical exercise class,” she added. “In retrospect, we realized that
these
stretching classes were a bit more like yoga than a more typical
exercise
program would be.” So the
trial might have compared rather similar programs with each other.


“2. But note, this study was focused on a very narrow definition of
benefits, (reducing chronic low back pain). Yet the classical goal of
Yoga is mental health, i.e., quieting the mind. The tangible and
demonstrable integration of body breath and mind in a classic Yoga practice is
focused on that. That was not measured here. 


“3. When I ask my personal students the primary reason they come to
Yoga class, the ‘benefits’ if you will, they will not say reducing
pain.  They say ‘defragging’ their brain, which I interpret as
simply expressing the classic ‘quieting the fluctuation of the mind’  in
modern terminology.    


“4. The benefits of Yoga in reducing physical pain could be
interpreted simply as positive ‘side effects’ of the practice -although
they are not very inconsequential to a person in actual pain.” 

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IAYT’s John Kepner: Comments on issue

The Group Health release is here. The publication was accompanied by a commentary from a primary care provider who considered the study an “excellent example of a pragmatic comparative effectiveness trial.” He recommended that physicians refer for the yoga or stretching classes.

Comment: This findings continue an
interesting pattern from the Cherkin-Sherman team. Their examination of
acupuncture found it more effective than usual care, but no more
effective than “sham acupuncture.” An examination of massage therapy
found a focused medical massage effective and
reflection on many of our parts. It is intriguing to see Sherman’s view
that the form or stretching may have tilted toward the more reflective
and mind-slowing experience many find in yoga. Stretching can be a mind-body engagement. Meantime, Kepner’s
perspective is a fun reversal, placing the back pain benefits as positive
side effects of mind-spirit value of the Yoga therapy. A Cherkin-Sherman
paper on positive side-effects is noted here.


ImageReport published on Naturopathic Science & Policy Summit 2011

The Natural Medicine Journal has published a report on the August 2011 Naturopathic Science & Policy Summit led by the Naturopathic Physicians Research Institute (NPRI). Key conclusions:

“1. There was consensus that research toward policy objectives in the
field is essential to the profession’s identity and advancement.
Simultaneously, better focus on critical goals is needed. This means
that research on naturopathic practice, naturopathic physicians and
their patients, and naturopathic medical theory is required, and not
simply studies on single agents and modalities. Broad outcome measures
are necessary to measure the impact of naturopathic medicine on whole
health and prevention, not just biomarkers of disease progression.


“2. The most compelling work has been and will be outcomes studies in
naturopathic practice in comparison to conventional medical models,
particularly on clinical effectiveness, safety, and cost, published in
peer-reviewed journals.”

The participants in the Summit also concluded that
“financial and other resources from the profession must be accessed” to
develop the necessary information. The NMJ is the official publication of the American Association of Naturopathic Physicians, a Summit co-sponsor. (Alignment of interest note: I helped develop this meeting as a member of the NPRI board.)

Professions & Organizations

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US Rep. Bruce Braley

Chiropractors in bill to allow loan repayment for service in under-served areas

A late October newsletter from the American Chiropractic Association (ACA) reminded members
that their help is needed to increase sponsorship for the Access to
Frontline Healthcare Act
(HR 531). The legislation was originally
introduced February 2011 in the US House of Representatives by Rep. Bruce
Braley
(D-Iowa). It would designate certain types of health care
providers
as “frontline” providers. According to the ACA, the association and the
Association of Chiropractic Colleges worked closely with the Braley “to
ensure that chiropractic physicians are specified in the
bill as qualifying for this status.” A draft letter is available at
the ACA’s Legislative Action Center.

New Hampshire Republicans buck leadership to join Democrats in supporting coverage mandate for naturopathic doctors 


The New Hampshire Business Review ran an October 21, 2011 article entitled House panel endorses naturopaths mandate
that documents a break by Republican members against the wish of the Republican
committee chair. These joined with Democrats in a 15-5 vote in support of the
requirement that insurers cover the state’s licensed naturopathic doctors. Debate
broke over mandates versus choice. The deciding argument was that
insurers “already pay for primary care
physicians, so they will be paying for this instead.” A Democrat chimed in
that “insurers would
probably pay less, since naturopathic doctors would be less likely to
prescribe expensive drugs and recommend high-tech medical intervention.

A mandate already exists in nearby Vermont where naturopathic doctors
are also included as Medicaid providers. (Thanks to Pamela Snider, ND
for bringing this article to my attention.)

ImageAcupuncturists without Borders in tight spot financially

In an October 18, 2011 e-blast boldly labeled SUPPORT
NEEDED!
Acupuncturists without Borders (AWB) 
announced that it “had to cut back on our staffing temporarily until we
receive more funds, donations and membership dues.” The organization’s
mission is to “provide
immediate relief and recovery acupuncture services to global
communities that are in crisis from disaster or human conflict.” AWB says it has helped more than 20,000 people recover following
Hurricane Katrina, Iowa floods, California wildfires, Boulder wildfires,
shootings in Tucson, earthquake in New
Zealand and in recent work with traumatized
populations in Nepal, Ecuador, Mongolia, and Haiti as well as Missouri,
Minneapolis, and Springfield, Mass. after the tornadoes of
2011. Presently AWB is operating with the
equivalent of less than one paid full time staff person. Reasons are that “grants we used to get are no
longer available and donations are down due to the recession.” The
organization is urging practitioners to place AWB’s donation kit in
waiting rooms to stimulate patient support.


Image

Rebecca Snowden

Naturopathic student Rebecca
Snowden in leadership role with the American Medical Student Association
(yes, you read that right)

The committee chair for the Medical Professionalism Action Committee
of the American Medical Student Association is a naturopathic medical
student, Rebecca Snowden. The committee’s charge is, according to the web site, “to change how future physicians interact by promoting: professionalism over commercialism; Teamwork over isolation; patient-centered care over physician-centered care; Ethics awareness, integrity and professional development;
and increased physician-in-training access to medical humanities.”
Under Snowden’s direction, AMSA students will find an integrated set of
web-resources on these topics. Under the sub-heading of “Teamwork”, for instance, one sees competencies propounded by the Association of American Medical Colleges and 5 other conventional disciplines side-by-side with those from 5 licensed CAM fields.

ImageSnowden, a medical student at Southwest College of Naturopathic Medicine, explains her role this way: “ND students have been eligible to hold certain leadership
positions in AMSA for a few years now and they have a Naturopathic Medicine Interest Group
for those interested in learning more. They try to help us with
opportunities in their
conference/convention schedules to plug an ND speaker somewhere into the
line
up, such as in [integrative medicine] panels at the conferences).” She
clarifies: “Currently ND students are not accepted as ‘Medical
Student Members’ as MD and DO students are.  We are ‘Supporting
Affiliate
Members.’ This year, there are 5 of
us ND student leaders in AMSA. We are collaborating with NMSA to submit
proposals in March [2012] at the AMSA Convention House of Delegates session
asking for
an AMSA statement on Naturopathic Medicine in their Principles, to
include support for licensure, Medical Student Membership, and an
ND Advisory Board. This work has also
been happening under the mentorship of Bill Benda, MD.”


Miscellaneous

Image

Ira Zunin, MD, MPH

Hawai’i’s most significant integrative center seeks additional primary care MD

Integrator editorial adviser Ira Zunin, MD, MBA, MPH
writes: “Manakai
O Malama
Integrative Health Care Group and Rehabilitation Center is
seeking a
board certified/board eligible family physician or other primary care
provider to
join our group. Enjoy the practice of medicine in a large,
well-established,
dynamic integrative facility. Our philosophy is to bring
together the best of modern medicine and traditional healing arts with
cultural
sensitivity to optimize whole-patient outcomes. The multidisciplinary
team includes: family medicine, women’s health, psychology,
physiatry, physical therapy and acupuncture. This facility is
well-suited for
the Patient-Centered Medical Home (PCMH) and recently completed EMR
transition to
EPIC. The office is open 8-5pm M-F and 8-3pm Saturday. The position is
for a
PT/FT physician.” Contact Ira Zunin
MD Medical Director:
info@manakaiomalama.com

Comment: I recently interviewed Zunin
for a piece on integrative medicine and the PCMH which I expect to publish shortly. Manakai O Malama  appears to
be a national leader in manifesting integrative care in the PCMH
environment. An exceptional opportunity. Zunin’s work was last seen here in
the Integrator:
Ira Zunin, MD and Manakai O Malama: Checking in on a Thriving Integrative Center.  

People

Image

Christina Jackson, RN, BC-HN

Christina Jackson, PhD, RN, AHN-BC is
2011 Holistic Nurse of the Year


The American Holistic Nurses Association has selected Christina Jackson PhD, RN, PNP, AHN-BC as the Holistic Nurse of the Year for 2011. In a release the AHNA noted that Jackson, a professor of nursing at Eastern University in Pa.
“embodies holistic values and is a true leader for holistic education and
approaches to care.” Jackson
has developed holistic nursing curricula and taught
courses. Among these are: Theoretical Foundations in Professional Holistic Nursing;
Psychosocial/ Spiritual Care; Fitness Through Yoga and Pilates; and Holistic
Healthcare for Culturally Diverse Populations: Issues in Women’s Health.

Jackson is certified as a Advanced Practice Holistic Nurse through the
American Holistic Nurses Certification Corporation (AHNCC) since 2004. She is also is
a Certified Holistic Nurse through AHNCC. Eastern’s release on Jackson’s award is here.

Image

Rita Bettenburg, ND

CHP Group hires Rita Bettenburg, ND as assistant medical director

Portland Oregon-based CHP Group (formerly Complementary Healthcare Plans) has hired Rita Bettenburg, ND

as assistant medical director. Bettenburg is the former dean of
naturopathic medicine at National College of Natural Medicine and
president of the Council on Naturopathic Medical Education. The
CHP Group (CHP) offers networks of licensed CAM practitioners (chiropractic, naturopathic, acupuncture, and massage therapy) to health plans and large employers on). Bettenburg assisted the CHP Group over a decade ago in expanding its network beyond chiropractic doctors. 

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johnweeks@theintegratorblog.com
for inclusion in a future Integrator.

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johnweeks@theintegratorblog.com

for inclusion in a future Your Comments Forum.
John Weeks Written by John Weeks

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