Strategic change to back board certification

Should "integrative medicine" be a separate MD specialty within the field of medicine? Or should integrative medicine proponents target a broader shift toward integrative medicine as a model for all conventional care, whether primary care of oncology or pediatrics?

The debate has been significant, if relatively sub rosa, over the 15 years of the emergence of integrative medicine. A town and gown divide has existed. The townies, typically practicing holistic MD/DO clinicians, formed the American Board of Holistic Medicine (ABHM) as a certifying body in 1996.

ABIHM leaders prominent on new ABIM board

Dialogue began to link town and gown. In 2008, the former ABHM

• Announcement from the Arizona Center for Integrative Medicine.
  
• List of the founding members of the new American Board of Integrative Medicine. 
• Statement of support from ABIHM board members Victor Sierpina, MD and David Rakel, MD.
• Brief interview with ACIM's Maizes.

Weil: ACIM founder

We are writing to let you know about an important decision that we recently made - a decision that represents a strategic change in direction for our Center.  For many years we have resisted the idea of board certification in Integrative Medicine (IM).  We have always believed that the principles and practices of IM should inform all specialties, rather than be developed into a new field.  In other words, that dermatologists, surgeons, and family physicians alike all need to learn the principles of nutrition and mind-body medicine, and to value the innate healing capacity of the body.  We still hold that belief.

"We have always believed that the principles and practices of IM should inform all specialties, rather than be developed into a new field."

Earlier this year we approached the American Board of Physician Specialties (ABPS) to discuss creating a board in IM. We did so for many reasons; chief among them was to help patients discern who truly has training and expertise in IM.  It is now popular in the marketplace to say you practice IM - yet anyone can say so, whether they studied for an hour, a weekend, or ten years.  

The American Board of Physician Specialties has been providing national board certification since 1953.  They have boards in 17 different specialties including emerging ones like urgent care, hospital medicine, and disaster medicine, as well as more conventional ones like family medicine, internal medicine, emergency medicine, and psychiatry.  

Maizes: ACIM executive director

Unlike the American Board of Medical Specialties (ABMS), which would require approval by every single specialty board, ABPS is interested in creating a single pathway, recognizes fellowship training, and is an innovator. We had hoped the ABMS would consider a Certificate of Added Qualification in IM - such as exists for geriatrics -which can be applied for by different residency specialties; but ABMS is eliminating that concept.

	"It is now popular in the marketplace to say you practice IM - yet anyone can say so, whether they studied for an hour, a weekend, or ten years."

Our goal is to have all graduates of our 1000-hour fellowship become board certified. At the same time we have not relinquished our goal of bringing IM training to all physicians. The success of our Integrative Medicine in Residency makes us comfortable and confident that IM will become a part of all physicians' basic training. This 200-hour program is being used in 22 family medicine and two internal medicine residencies. In 2012 we will begin a pilot in two pediatrics residencies.

This is an exciting step for the field of Integrative Medicine (IM).  Board certification is widely recognized by physicians and the public alike as a critical step in establishing a field.  The first meeting of the American Board of Integrative Medicine will take place in Tampa, Florida, October 10-11.  Over a two-year period, we will set criteria for sitting for the board exam and develop a validated exam.

Below is the list of the founding members of the American Board of Integrative Medicine.

We so appreciate your support!

Warm regards,

Andrew T. Weil, MD                                            Victoria Maizes, MD
Director, Arizona Center                                      Executive Director, Arizona Center
for Integrative Medicine                                       for Integrative Medicine
Clinical Professor of Medicine                                Professor of Medicine,
Jones-Lovell Endowed Chair in                             Family Medicine and Public Health
Integrative Rheumatology

__________________________________

  Statement from ABIHM Leaders on the American Board of Integrative Medicine

Rakel: ABIHM board member

The American Board of Integrative Holistic Medicine (ABIHM) was incorporated in 1996 to certify physicians through a psychometrically validated examination process. Since 2000, when we provided our first exam, we have certified nearly 1500 physicians. The process of educating physicians through our Annual Review Course and our extensive Core Curriculum has established a grounding and common knowledge base for those seeking board certification in integrative holistic medicine. Over the last few years, our Board of Directors has proposed more stringent criteria for board certification in Integrative Medicine (IM). The path of all medical specialties and subspecialties, as they gain more widespread acceptance and growing professional acknowledgment, is to require formal training as one of the conditions of sitting for a board certification examination.

"The ABPS and the U of A have invited several current ABIHM board members to participate in developing this newly formed organization."

A number of educational institutions now offer fellowship programs in IM, and the leader in Integrative Medicine fellowship training has been the University of Arizona's Program in Integrative Medicine. The ABIHM had previously approached the University of Arizona (U of A) to explore the possibility of board certification. Although the U of A was not ready to move forward at that time, they have now taken a leadership role in the formation of a new board to explore this opportunity, and they recently announced that they have contracted with the American Board of Physician Specialties (ABPS) to develop a new board and certification process for those with formal IM training.

	"We recognize that the opportunity for certification of physicians without formal training in Integrative Medicine will end soon."

The ABPS and the U of A have invited several current ABIHM board members to participate in developing this newly formed organization. This new board, with membership derived from the leadership of academic IM programs from across the US, will meet for the first time on October 10 ^th and 11th in Tampa, Florida. At this time the specifications for eligibility in this new certification process have not been created. An important goal of the ABIHM is to support our current active diplomats and to advocate for their eligibility in certifying with this new board. We recognize that the opportunity for certification of physicians without formal training in Integrative Medicine will end soon.

Sierpina: ABIHM board member

We support this process and view it as the logical extension of our efforts over the last 15 years to bring credibility and acknowledgement to this emerging specialty within medicine. As this process unfolds, we will post updates on our website.

Though we have little further information, if you have questions or comments on this new development, please write to our Executive Director, Nancy Sudak, at nsudak@holisticboard.org.

• My younger sister passed a clinic advertising a new integrative medicine MD on a jog and asked if I knew her. I Googled her. Took an herb course in England, a respected one. Involved with the American Herbalist Guild. Hmm, didn't say she was certified. No other evidence of training. Has in her office a variety of body-workers and energy healers, and one licensed acupuncturist. I wrote back: Limited education. Could be good. Who knows.

• Today a local list-serve in Seattle popped out an announcement of a new integrative medicine practice opening in the north end. I checked it. She noted that she'd completed the ACIM Fellowship. I knew something more, felt some reassurance.