Summary: The AMA's resolution in favor of discrimination against other providers as amended ... Licensed midwives take one from OB-GYNs in New York ... Legislation introduced to get DCs into US Public Health Service ... Samueli Institute links with Joint Chiefs of Staff for magazine supplement on "Total Force Fitness" ... True North shares paradigm with MGMA group ... Cavallo Point hotel-spa and integrative center opens with Bradly Jacobs, MD, MPH in key role ... Massage therapists beat back nasty allegations from local police to protect new law in California ... New integrative dietetics practice group in the American Dietetics Association ... Author-clinician Ilene Serlin, PhD makes headway in introducing whole health practices at APA ... University of Chicago becomes 45th member of the Consortium of Academic Health Centers for Integrative Medicine ... Bastyr now home to a leading midwifery school and Simkin Center doula training ... Mail order Clayton College shuts doors, to delight of naturopathic doctors ... 6th IN-CAM Research Symposium in November 2010 ... Group Health Institute team identifies diverse positive outcomes from CAM-IM not typically captured in studies ... Research finds health in "forest bathing" ... PMG Data Services purchases Innovision ... Holistic Primary Care marks 10th year of publication ... Consumer Reports blasts "dirty dozen" of dietary supplements; Blumenthal responds ... Natural Foods Merchandiser reports modest growth in industry in 2009 ... Briggs and NCCAM in media whipsaw ... Comments on Krakow's "alternative medicine as a free market approach" ... Lewis Bazakos, DC given another significant award, this from New York Chiropractic College ...

Policy

The AMA SOPP approach to inter-disciplinary relations

AMA's resolution in favor of discrimination against other professions as passed in June

The Integrator posted Battle Engaged: MD Specialists Promote Repeal of Non-Discrimination Vs Integrative Practitioners, Others on May 28, 2010. The article regarded a resolution tha

Comment: Pleasing to see that, through the amendments, the AMA House showed great sensitivity to the freedom of choice of SOPP activists. They get to decide whether or not to put 2706 on their agendas. Perhaps this concern for member freedom of choice will mature one day into appreciation of freedoms for patients.

Victory over OB-GYN's in legislative effort

Licensed midwives in victory over the OB-Gyns in New York State

On July 30, 2010 New York Governor David Paterson signed bill A8117b-S5007a which, according to the New York Association of Licensed Midwives (NYALM) "amends the education law to remove the requirement for midwives to have a written practice agreement as a pre-requisite for practice in NY."  After "breezing" through both chambers, the bill

Comment: The OB-GYNs are one group that is sometimes party to the AMA's Scope of Practice Partnership (see AMA SOPP-related article above) that seeks to keep more of medicine under control of medical doctors. This issue in New York, however, did not make the most recent list of areas of AMA SOPP concern. Perhaps they weren't aware until the last moment and so were stuck trying to bully in late. (Thanks to Lou Sportelli, DC for bringing the issue to my attention.)

Green: Powerful sponsor for ACA bill

Chiros have legislation introduced for inclusion in the US Public Health Service Commissioned Corps 

In an August 5, 2010 release, the American Chiropractic Association and the Association of Chiropractic Colleges (ACC) commended US Congressmen Gene Green (D-Texas) and Lee Terry (R-Neb.) for introducing legislation that calls for the appointment of doctors of chiropractic as officers in the U.S. Public Health Service (USPHS) Commissioned Corps.

Military Medicine

Cover of Samueli-Joint Chiefs supllement

Samueli Institute, Office of the Joint Chief of Staff collaborate on special issue of Military Medicine

Admiral Michael Mullen, chairman of the Joint Chiefs of Staff of the U.S. Military has called for "a 21st century definition of fitness that balances performance and readiness with health and well-being." Materials supplied to the Integrator by the Samueli Institute describe how the Institute has collaborated with the Consortium for Human and Military Performance (CHAMP), the Institute for Alternative Futures and the office of the chairman of the Joint Chiefs to respond. The new paradigm is called "Total Force Fitness." The model envisions "an integrated approach to performance, readiness, health and well-being across the domains of military life: spiritual, psychological, behavioral, social, physical, nutritional, medical, and environmental." To highlight the work, Samueli Institute co-sponsored a special Supplement to the August 2010 issue of Military Medicine entitled "Total Force Fitness for the 21st Century: A New Paradigm." The supplement describes "the characteristics of the eight fitness domains" and discusses the challenges presented in implementing a new, multi-dimensional fitness program in the military. Samueli shares that:

" ... The goal of this issue is not to describe the many existing programs or those in development to enhance fitness in the force, as that would be beyond the scope of this effort. It does attempt to provide the foundation for how any fitness program can be evaluated and compared, along with a summary of metrics that can be used for monitoring program effectiveness, and for improving and comparing those programs already in existence."

Model enlightens MGMA group

MGMA hears from integrative center True North on a new paradigm

Lobby of Cavallo Point

High-end Cavallo Point rolls out integrative center led by Bradly Jacobs, MD, MPH

Comment: The question on service rates is this: Do spa-based integrative medical doctors get tipped as well as purveyors of hot stone massages? If not, the gross cost, including tip, for 90 minutes with either a massage therapist or the integrative medical doctor runs about the same. Apparently Resource Based Relative Value Units (RBRVU) have different meaning in a spa environment. Perhaps it's Client Based Relative Value Units, a measure that catapults hot stones into a high end service.

, savvy political work by Mike Schroeder and a grassroots letter-writing campaign led by the state chapter of the American Massage Therapy Association showed the error of the "sample" and of the legislative direction. The attack on the law was effectively gutted. One assessment was that the chiefs simply didn't like giving up the power they held under the previous system. The American Civil Liberties Union also weighed in on behalf of the massage therapists.

Ford: Chairing integrative dietetics section

Dieticians in Integrative and Functional Medicine is a new ADA practice group

Comment: Good for Ford and her colleagues for stimulating this integrative interest in their profession. The ADA has some bad karma to work off, relative to some of its recommendations to the public through the years. This practice association looks like a step in the right direction.

Organization seeks new CEO

AAAOM seeks new chief executive officer

The American Association of Acupuncture and Oriental Medicine sent its members a notice in early July that the organization has begun a search for a new chief executive officer. Former staff member Doug Newton was tapped to fill an interim role. The organization's past executive director,

Comment: I am among those who hoped that the creation of the AAAOM would begin to draw the nation's 26,000 licensed acupuncturists into joining their one, united national association. The potency is significant. If 40% joined (a slightly higher percentage of members than the AMA attracts) and dues were a friendly $250/year, the organization could be thriving on a $2.5-million annual operating budget. For some reasons, the attraction has not happened and membership remains somewhere in the 500-1500 range. Pretty hard to make much difference for a profession with that level of membership. Are AOM practitioners simply not joiners?

Serlin: Urging integrative psychology

Integrative Psychology: Top APA leaders in session on Whole Person Healthcare led by Ilene Serlin

"Integrative therapies have become increasingly popular in clinical and psychotherapeutic settings, complementing traditional medical and psychotherapeutic practices. A whole person approach brings psychologists into a collaborative relationship with other health professionals, and can introduce integrative methods from a uniquely psychological perspective. While integrative psychology is a field that is ripe for clinicians, most clinicians are not trained in how to integrate these techniques into their ongoing therapeutic practices."

Academics

Temple: Heads up U Chicago IM program

University of Chicago joins Consortium of Academic Health Centers for Integrative Medicine

The University of Chicago has become the 45th academic health center to join the Consortium of Academic Health Centers for Integrative Medicine. The director of the program is Leslie Mendoza-Temple, MD. Temple took her medical degree at the University of Santo Tomas Faculty of Medicine and Surgery in the Philippines, and subsequently completed the Fellowship in Integrative Medicine from the University of Arizona.

Myers: Founding mother of midwifery school chairs Bastyr department

Leading Midwifery School and Doula Training Merge with Bastyr University

Clayton: Offered low, low price for doctor wall diploma

Mail-order Clayton College and the Coalition for Natural Health shut their doors

Comment: It is somehow appropriate that the only time I have ever cited QuackWatch as a source is this article on Clayton. As I read about the demise of these symbiotic businesses, I kept thinking about a scorpion I purposefully squashed in a motel room one evening on the Nicaraguan coast. Like some sci-fi invention, when I turned my back, the creature somehow reassembled itself and moved off under the wall. It's hard to believe these blights on natural health care may be gone. As a political colleague once stated regarding an incumbent with a health condition who we were seeking to unseat: Some guys are better off dead. Such a sentiment may disturb one, relative to a fellow human being. It shouldn't relative to these entities.

Research

Verhoef and Boon head up organization

Canadian researchers host 6th IN-CAM Symposium, November 19-21, 2010 in Vancouver, BC

Comment: I have had an opportunity to be involved with Canadian integrative health initiatives twice. Both times have like home. The elevated focus of the Canadians on practical outcomes I attribute to the socialized healthcare mission that is deep in the Canadian system. This I take to be part of the reason that it was the Canadians not their neighbors south of the border who developed the exceptionally useful Outcomes Database. Researchers in the US would be served to be importers of this prioritization and social mission. Upping US attendance at this 6th IN-CAM conference would be a good start.

Cherkin: Part of Group Health team

Outcomes: "Unanticipated benefits of CAM therapies for back pain ..."

"Our analysis identified a range of positive outcomes that participants in CAM trials considered important but were not captured by standard quantitative outcome measures. Positive outcome themes included increased options and hope, increased ability to relax, positive changes in emotional states, increased body awareness, changes in thinking that increased the ability to cope with back pain, increased sense of well-being, improvement in physical conditions unrelated to back pain, increased energy, increased patient activation, and dramatic improvements in health or well-being. The first five of these themes were mentioned for all of the CAM treatments, while others tended to be more treatment specific. A small fraction of these effects were considered life transforming."

Comment: The supposition of positive side-effects has long been part of CAM/IM thinking since many of the whole person approaches impact the person in a systemic way. Yet researchers have rarely stepped up and identified these potential benefits. Congratulations to this group, led by C Hsu. Hopefully researchers will begin to ask these questions. While their fellow researchers might diminish the import of these endpoints, employers will not. The question now: To what punishment should any CAM outcomes researcher be subjected if he/she fails to capture these benefits? Not asking is a sort of reverse negative of garbage in, garbage out.

Japanese forest: Good for your health

"Forest bathing" and the potential benefits of walking barefoot in the dewy grass ...

Author and clinician Mitch Stargrove, ND, LAc sent a fascinating link to a study in Japan. In the research, subjects walked in forested or urban environments, then received the cross-over treatment of the walk in the opposite zone. Salivary cortisol, blood pressure, pulse rate, and heart rate variability were used as indices in examining the influence of the walks.

Comment: I don't typically cover straight research outcomes, but this one merited a mention. I recall learning 30 years ago that Father Sebastian Kneipp, viewed as a founder of naturopathic medicine, recommended a therapy in which patients walked barefoot in the dewy grass. As a sometimes PR person back then, I typically refrained from leading with discussion of this therapeutic approach when trying to awaken in wary parties the potential value of natural health care. This study, had I had it then, might have swayed me to stand up for the German healer's approach. If the subjects in the Japanese study had not only been walking in forests but also been barefoot on dewy grass in those forests, I'm betting that the positive outcomes would have jacked even higher. Side-note: The study underscores again the additional challenge to health for the urban poor. Forest bathing will be a greater challenge in the concrete jungle. Meantime, this study would seem to have a supportive link with the "nature deficit disorder" about which Richard Louv writes in The Last Child in the Woods.

Publications

Lampe: Long time leader a casualty of the purchase

PMG Data Services purchases Innovision, publisher of ATHM, Advances, IMCJ

Minnesota-based PMG Data Services has purchased one of the most significant publishing entities in integrative health care, Innovision Health Media. Innovision publishes Alternative Therapies in Health & Medicine, Advances, and Integrative Medicine: A Clinician's Journal (for which I write a column). The firm's website describes PMG as "a service bureau organization dedicated to helping specialty and trade publications cost-effectively manage their ongoing audience development activities." They add: "Today's successful publisher must rely on ancillary revenue from trades shows, web, list rental and product sales to supplement traditional revenue from advertising and subscriptions." One change: Frank Lampe, the former Innovision vice president and a highly-regarded and well-known presence in the integrative health space is no longer with the firm. Lampe was a co-founder and conceiver of the LOHAS concept.

Comment: It will be interesting to see if the firm moves Innovision toward development of conferences or tradeshows, a business direction Innovision has considered but not directly entered. 

Goldman and Sinclair publication celebrates 10th year

Holistic Primary Care marks 10th year of publication

Holistic Primary Care, a national, ad-based publication that is mailed to over 100,000 physicians nationwide, is celebrating its 10th year anniversary. According to Erik Goldman, editor, the publication will mark the accomplishment with a look back over the past 10 years. In recent years, the firm has added a conference service to its portfolio. Goldman and his partner, publisher Meg Sinclair, choose to focus their growing conference on strategies for business success. The well-received June 2010 meeting was entitled Heal Thy Practice: Transforming Primary Care. 

Comment: To my understanding, this long-time labor of love for Goldman and Sinclair, supplemented in its early years by Goldman's skills and reputation as a medical reporter for mainstream publications, has only recently stabilized as a going operation. That many thousands of the recipients of the publication were not self-described "holistic doctors" suggests that, over time, Goldman and Sinclair have probably quietly educated scores of medical doctors to the potential for more satisfaction in their practice, and success for their patients, from opening up their clinical visions. Congratulation on 10 years!  

Beating up on supplements, again

Blumenthal: Balanced assessment of the report

"Though this article is flawed and incorporates inadequate information on the safety of many of the herbs, it is in numerous ways an improvement over the cover story Consumer Reports ran in May 2004. The previous cover story contained so much erroneous information on herbs that it was readily apparent that the editors had not run the article by anyone with any real experience or expertise in herbal or dietary supplement research. This time, Consumer Reports relied heavily on the Natural Medicines Comprehensive Database as a primary source for much of its information on the safety, and to some extent, some of the potential benefits of some herbs and other dietary supplements."

Growth not bad for a hurting economy

Upbeat release from the 2010 Market Overview from the

• Net profit margins fell to 5 percent in 2009, from 8 percent in 2008.
• Net sales grew 8.9 percent in 2009, but when corrected for store closings and weighted based on the number of stores per category, sales grew only 3.4 percent.
• Total natural products store sales were $33.9 billion in 2009, compared to $32.7 billion in 2008.

Briggs: Whipsawed from all directions

The media whip-sawing of Briggs and NCCAM: Bloggers, Prevention, MSNBC and a response

Comment: Colleagues sometimes urge restraint in my critical perspectives on the direction and priorities of the NIH National Center for Complementary and Alternative Medicine and NCCAM's director, Josephine Briggs, MD. Such urging is usually accompanied by noting how NCCAM is under attack from others. Two items this past month underscore just what a hot-seat Briggs inhabits. First, a polarizing medical doctor blogger who loves to hate everything "CAM" and who has a particular antagonism toward naturopathic medicine took the NCCAM on with an Open Letter to Dr. Briggs. The reason: Briggs planned to attend the 25th annual conference of the American Association of Naturopathic Physicians. Never mind that the NDs are one of the licensed disciplines that NCCAM is charged by Congress to explore.

Next, Prevention magazine included comments from Briggs in an article in which Briggs appeared to be endorsing certain CAM approaches. Given the scrutiny under which she operates, the presentation of her views must have felt particularly damaging. A shovel full of salt hit the wound when the Prevention piece was picked up and broadcast by MSNBC. The title: 9 cures you can trust. Briggs chose to use her NCCAM mailing list to counter

Addendum: I can't resist a comment on the anti-NCCAM blogger's perspective on limiting the stakeholders with whom Briggs should be meeting. How threatening the NDs must feel to them to put Briggs' decision in the same grave category of action as if Obama were to sit down with leaders of the Al-Qaeda.  

Comment: While Cohn's question is an interesting one, the choices being made are clear. First, very few integrative organizations and doctors who can have coverage are choosing to forgo participation in insurance coverage. Second, virtually all licensed CAM fields want the option to be bought in, not only to insurance but also federal programs such as loan-repayment that are linked to insurance. Finally, while one hears talk of how the IM/CAM fields should be defining and shaping new relationships, little of this is actually done. So the question, while interesting, rarely gains much traction.

Bazakos: Honored by New York Chiropractic College

Lewis Bazakos, DC adds NYCC award to long list of distinguished honors

Lewis J. Bazakos, DC, a 1978 graduate of New York Chiropractic College (NYCC) was chosen as the multidisciplinary college's 2010 Distinguished Alumnus.  NYCC president Frank J. Nicchi, MS, DC acknowledged Bazakos for his work in developing and chairing of the