| | Integrative Medicine and Integrated Health Care Round-up: April 29-May 28, 2009 | |
Summary: Vicki and Ron Simms back ambitious new integrative oncology center at UCLA ... U Virginia adds acupuncture to employee benefits ... California budget crunch sweeps acupuncture, chiropractic, other services out of Medicaid ... Sullivan column presents employer booklet as key guide to health reform ... Cherkin acupuncture-toothpicks study generates significant press ... Minnesota Medical Association dedicates entire monthly magazine to integrative medicine in its state ... NARCCIM research conference draws over 800 from 24 countries ... Massage Research Foundation under Diana Thompson, LMP makes strides in stimulating research in that field ... Tai Sophia Institute: snapshot of a growing budget ... Holistic nurses expand certification offerings ... AANP, the naturopathic professional association, announces new journal and website ... Natural Products Foundation publishes data on the $60-billion that the dietary supplement industry contributes to the economy ... American Botanical Council reports growth of the botanical industry in 2008 to $4.8-billion ... Frank Nicchi, MS, DC elected president of the Association of Chiropractic Colleges ... Researcher Gert Bronfort, DC, PhD honored ... plus transitions for Crites, Schwartz and Corcoran.
Integrative Practice
 Vicki and Ron Simms
On May 22, 2009 a note was issue announcing the dedication of the Simms-Mann UCLA Center for Integrative Oncology.
Annie Coscarelli, PhD is the Center's founding director with integrative
medicine veteran Mary Hardy, MD serving as medical director. Hardy's
work in integrative practice in the Los Angeles area dates back to the
founding of a pioneering program at Cedars-Sinai Medical Center.
Vicki and Ron Simms, the benefactors behind the center, were also instrumental in creating an integrative program for the underserved
at the Venice Family Clinic called the Simms-Mann Health and Wellness Program.
In that program, Hardy also served as the founding medical director. A
robust website on the new oncology center describes the wide array of
services which this ambitious center will offer. Kudos to the Simms for
their ongoing commitment and to Hardy for hanging in through many bumps
in the road!
 Third-Party Payment
University of Virginia Adds Acupuncture to Employee Benefits Package
A release from the University of Virgina
notes that the institution's human resources department has included
new benefits for 2009, including "wellness initiatives and coverage for
acupuncture" in the University of Virginia Health Plan. However, the
acupuncture benefits, described as "alternative medicine" in the
release, have very high co-payment of $30. Employees can have up to 20 visits. The
one-line explanatory note for the benefit is: "Acupuncture, an ancient Chinese healing technique,
has gained scientific acceptance in the West and is widely practiced in the
U.S. by thousands of physicians, dentists, acupuncturists and other
practitioners. It is used for relief or prevention of pain and for various
other health conditions." The release also notes that the wellness initiative "features discounts for memberships in Weight Watchers weight-loss
program; walking and exercise classes and activities; and the 'Quit For
Life' smoking cessation program that augments existing prescription drug
coverage with counseling sessions and nicotine replacement products."
California's unique inclusion of acupuncture by LAcs in Medicaid "falls victim to budget buts"
The budget crisis in California brought the guillotine down on the
"optional benefits" which have been covered for the last decade under
California's Medicaid progrram, MediCal. According to an article in the June 2009 Acupuncture Today, "as of July 1, optional benefits (which include acupuncture,
chiropractic, podiatry, mental health, optometry and dental services)
will no longer be covered under Medi-Cal."
The hit to the acupuncture and Oriental medicine profession may be the
strongest as California was considered a strategic "foot-hold" in government-backed coverage
of AOM services. As noted in the article, the California coverage had figured in the
profession's effort to gain additional inclusion in federal programs,
including those which allow students to pay back their loans through
services to the underserved. Such services, however, must be in
facilities that have Medicaid coverage. The action followed a
roller-coaster year for the AOM field and the legislature on hte issue. A California leader of the AOM profession, Bill
Mosca, LAc, who called the action "the result of a perfect storm" of
budget issues, indicates he does not foresee the benefits being
reinstated this year. Positive action was viewed as requiring a reversal in
California's economic climate.
 Sean Sullivan
 Dan Cherkin, PhD
"Acupuncture for Bad Backs: Even Sham Therapy Works." So headlined a May 12, 2009 Time magazine story. "Toothpicks Match Needles for Acupuncture" ran the headline in the US News & World Report account. The NIH National Center for Complementary and Alternative Medicine softened the shock value, carrying the story this way: "Acupuncture-like treatments improve outcomes compared to usual care for low back pain." Health World Online e-news went with NCCAM for its lead. The story of the recent study, published in the Archives of Internal Medicine, and led by veteran researcher Daniel Cherkin, PhD, was very widely covered and something of a sensation at the May 12-15, 2009 North American Research Conference on Complementary and Integrative Medicine, for which Cherkin chaired the program committee. In the Time piece, Chjerkin is quoted as reflecting: "What is it about the therapeutic experience that really helps people?
This study raises the question that if there are pathways to relief
that work more through mind than through the body, why should it matter
from the perspective of patients?" The Archives article is officially: Cherkin DC, Sherman KJ, Avins AL, et al. A Randomized Trial Comparing
Acupuncture, Simulated Acupuncture, and Usual Care for Chronic Low Back
Pain. Archives of Internal Medicine. 2009;169[9]:858–866.
Comment: I had a chance to speak briefly with Cherkin at the NARCCIM meeting and shared with him my own favored means of receiving acupuncture, which could also shift outcomes: delivery in a group setting. Perhaps I should request that my Communi-Chi professional use toothpicks next time, just to see how that combination works.
 Minnesota Medical Association devotes whole issue of Minnesota Medicine to integrative care
The May 2009 issue of Minnesota Medicine, the publication of the Minnesota Medical Association,
is almost entirely devoted to complementary and integrative medicine.
The issue, timed to coincide with the May 12-15 North American Research Conference on Complementary and Integrative Medicine (NARCCIM) at the Minneapolis Hilton (see story below), highlights the
diverse integrative practice activity in one of the most robust regions
in the nation. The six articles and 4 side-bars include looks at the
integrative medicine residency at the University of Minnesota School of
medicine, portraits of 7 local medical doctors who have taken up integrative
medicine, a portrait of the lone medical doctor on the research staff
at Northwestern Health Sciences University and
the significant integrative programs at Mayo and at Abbott Northwestern
where once 4, but now 400 medical doctors are regularly referring for
integrative services. The stories are all available online here.
Comment: A combination of factors, including institutional leadership, availability of practitioners, educators and researchers, and philanthropic support has made Minnesota one of the two or three most active states in the country for integrative practice. This issue is an opportunity fior those from other states to look into emerging possibilities.
Research
 NARCCIM conference a great success with over 800 attendees from 24 countries
The North American Research Conference on Complementary and Integrative Medicine (NARCCIM) held in Minneapolis, Minnesota, May 12-15, 2009 was a great success. The gathering drew 811 souls from 24 countries. The gathering attracted nearly 250 scientific posters. The conference, sponsored by the Consortium of Academic Health Centers for Integrative Medicine, the consortium of 43 North American institutions, is the second of its kind. The first, in Edmonton in 2006, drew 650 participants. A third is in discussion for 2012. Kudos to Adi Haramati, PhD and his team for the success. And thanks to the George Family Foundation for the promise and grant that allowed planning to kick off in earnest after Edmonton. The Integrator will feature content from the conference in this and coming issues.
 Diana Thompson, LMP
The remarkable progress of the Massage Therapy Foundation in promoting research in the recent years of the leadership of educator-practitioner Diana Thompson, LMP, are highlighted in the May 22, 2009 issue of Massage Today News Update. The advances are described in an interview with Ruth Werner, LMP, who was recently selected as president-elect of the organization. Werner celebrates the changes under Thompson: initiation of a Student and Practitioner Case Report Contest, development of the profession' first Best Practices Symposium, hosting a second "Highlighting Massage in CAM Research" conference schedule for Seattle in May, 2010 (a call for papers has just gone out) and founding International Journal of Therapeutic Massage and Bodywork. The foundation also co-sponsored NARCCIM this year. Says Werner: "I am so grateful to have a full year to work with Diana Thompson, our
current president. Her leadership style is an inspiration to me. Diana
has overseen some amazing growth and projects at the Foundation, and I
can only hope to try to imitate her, at least for a while." Thompson has also been a key force in massage in Washington State since the state passed legislation in 1995 which required health plans to cover massage therapy.
Education
 Tai Sophia: Snapshot of a growing "academic wellness institution"
The Spring 2009 publication of the not-for-profit Tai Sophia Institute offers a snapshot of growth at that ambitious institution. From 2003-2008, enrollment grew from 273 to 444 as the Institute added additional programs. Meantime, operating revenue grew from $6.6-million to $11-million, and expenses from $7.3-million to $10.2-million. The article, an interview with Tim Ambrose, the Institute's new vice president for institutional advancement, notes that while the Institute has a goal of bringing in 35% of revenues from donations, they are "operating at significantly less." No specific numbers are provided in the article. Meantime, Tai Sophia is providing over $400,000 of pro bono services in Baltimore City and Howard County programs serving the underserved.
Comment: This brief Tai Sophia story underscores a significant difference between educational institutions in the complementary and alternative fields (or "academic wellness institution," which Tai Sophia prefers) and conventional academic medical centers. Namely: there is basically no line here for government funding. I have repeatedly discovered that conventional medical educators in integrative medicine have little appreciation of the challenges of building quality institutions without governmental backing, and, frankly, with very little private foundation or philanthropic support yet available. Good luck to Ambrose in changing these trends.
Professions
AHNCC offers new levels of certification in holistic nursing
Beginning in August 2009, the American Holistic Nurses Certification Corporation will begin offering a third-level of certification in holistic nursing, this one for non-Baccalaureate nurses. Applicants must having finished an RN program and have at least one year of full-time practice as a holistic nurse, or 2000 hours of practice over five years. Graduates will be awarded the credential of HN-BC. The other two certificates are for Baccalaureate (HNB-BC) and Graduate Holistic Nurses (AHN-BC, for "Advanced" or Masters level training). The board certifications are recognized by the American Nurses Association.
 AANP joins with natural health publisher to create new online journal
The American Association of Naturopathic Physicians announced May 22, 2009 that it has "joined forces with
veteran natural health publisher Karolyn A. Gazella to create an online journal
for healthcare professionals." The release promises that the Natural Medicine Journal and a website will "feature the latest research on natural health, practical natural
medicine treatment protocols, nutraceutical profiles, and patient information
guides." Medical editor of the journal will be clinician and naturopathic oncologist Tina Kaczor, ND, FABNO. The journal, which will be kicked off at the AANP's annual conference in August, is anticipated to begin publication in the fall of 2009. The plan includes peer-review and pursuance of Index Medicus and Medline status.
 NADA board declines to take a position on first professional doctorate
In their May 2009 newsletter, David Eisen, LAc, speaking on behalf of the board of directors of the National Acupuncture Detoxification Association, shares that NADA has declined to oppose movement in the acupuncture and Oriental medicine field toward a "first professional doctorate" degree. A board member of the Community Acupuncture Network had requested that NADA weigh in on the issue. (See Community Acupuncture Network opposes AOM move toward first professional doctorate, April 25, 2009.) The decision appeared to be based on additional time commitments and priorities, and a question about whether taking on a contentious issue like this was in the NADA mission. NADA did not weigh in on some of the concerns of CAN members that acupuncture is leaving its strength and its roots in this movement up the professional ladder.
Natural Products
 Study shows dietary supplement industry contributes $60-billion annually to economy
A May 27, 2009 release reports that a new study funded by the Natural Products Foundation
has estimated that the total of direct ($22-billion), indirect
($16-billion) and induced effects ($22-billion) of the dietary
supplements industry adds to over $60-billion a year impact on the
national economy in 2006. An overview of the study by Dobson/DaVanzo,
a Washington, D.C.-based healthcare consulting firm, notes that "the
industry has maintained itself at more than 1 percent of total U.S.
health expenditures for at least the last 10 years," thus maintaining a
similar growth rate as the rest of the nation's soaring health costs.
The study also concluded that each direct job in the industry creates
another 2.29 additional jobs, and that the industry contributes over
$10-billion a year in tax revenues.
 American Botanical Council reports 2008 sales of herbs at $4.8-billion
A May 14,
2009 release from the American Botanical Council (ABC) notes that herbal dietary supplement sales in the United States increased slightly
in 2008, reaching a total estimated figure of $4,800,000,000. The report
published in the not-for-profit's quarterly journal
HerbalGram was based on data from multiple market research firms. The authors concluded that total herb
supplement sales rose by nearly 1% over 2007 sales.
People
 Frank Nicchi, MS, DC
Frank Nicchi, DC, MS, president of New York Chiropractic College, has been elected to lead the Association of Chiropractic Colleges (ACC), a consortium of 19 colleges in the United States, Canada, Australia and New Zealand. At NYCC, Nicchi has led the college to become multi-disciplinary through incorporating a variety of new programs, including the Finger Lakes College of Acupuncture and Oriental Medicine and five relationships with Veterans Administration hospital facilities. (For a brief overview of NYCC's outreach, see "Portrait of a Community Network: The New York Chiropractic College," March 19, 2008.) The NYCC release notes that Nicchi also serves on the board of the
Academic Consortium for Complementary and Alternative Health Care (ACCAHC) as
the ACC representative.
 Gert Bronfort, PhD, DC
In an announcement at the International Conference on Chiropractic Research, the Foundation for Chiropractic Edcuation and Research honored Gert Bronfort, PhD, DC as the 2009 Researcher of the Year. He has performed
collaborative research with health care professionals in outpatient and
hospital settings in Denmark and the United States for over 20 years. Bronfort has conducted several
randomized clinical trials for low back, neck and headache conditions for which
he's received nearly $10 million in federal funding. Bronfort is vice president of research at Northwestern Health Sciences University.
Transitions
 Laura Crites, MA, MS
Jeannie Schwartz, the administrator of the Consortium of Academic Health Centers for Integrative Medicine, is leaving the position which she has held since 2005. Schwartz began when the Consortium had 29 members; the rolls have now grown to 43. Schwartz recently helped manage the successful North American Research Conference on Complementary and Integrative Medicine which drew over 800 to Minneapolis May 12-15, 2009.
Kevin Corcoran, CAE, who has served as executive vice president of the American Chiropractic Association since 2005, will be leaving his position, according to a May 2009 release from the professional organization. Corcoran is credited with "acquiring the new association management system that serves as the
centerpiece of ACA’s grassroots patient advocacy campaign, and initiating a
new national education conference. He also helped to spearhead ACA’s
successful effort in 2006 to defeat Senate Bill 1955, which would have severely
undermined states’ rights to set minimum standards for health insurance
plans" ...
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