In 2006, I began publishing annual The Integrator Top 10 lists for the emerging field of integrative health and medicine. Since 2011, these have shown up here on The Huffington Post. Links to past blogs are here and at the bottom of this posting. Together these chronicle eight years of policy and action in this popular movement. The 2013 iteration follows.
Battles in implementation of "non-discrimination in health care" (Section 2706)
You'd think in a civilized age "non-discrimination" among licensed professions in health care would be a no-brainer. Yet the year 2013 witnessed continuous battles over Section 2706 of the Affordable Care Act, which bluntly asserts "Non-Discrimination in Health Care." Congress rebuked a federal agency, state agencies applied multiple interpretations, a consortium of seven M.D. specialties filed a bill, H.B. 2817, to chuck it altogether, and three major coalitions of non-M.D. professions let the M.D.s know the back of the bus wasn't okay anymore. This is a rights issue that will likely require a "big honking lawsuit."
Escape Fire! shines light on integrative medicine to resolve the crisis in the medical industry
The documentary Escape Fire! The Fight to Rescue American Health Care may not have lived up to its billing as a guide to find our way out of the woods, as I argue here. Nor did it have the impact as a change agent that its producers wished, as Glenn Sabin shares here. Yet the film not only captured the horrible symptoms of our medical industry's chronically bloating condition but also positioned integrative practices and whole person philosophy as the solution. Leaders of the field love to criticize health reform for not going deep enough. But are we ready to take responsibility for leading the medical industry out of this crisis?
Chiropractors hit trifecta with new Medicare, veterans and residency advances
In the period of one month last summer, the chiropractic profession announced three significant, long-sought advances. Medicare opened a dialogue on treating doctors of chiropractic as a profession, rather than as an "it" of a modality: The agency may begin paying for evaluation and management codes. The U.S. Senate passed an amendment to an omnibus bill to expand the field's services to Veterans. Finally, the Veterans administration announced that it is opening a program of six chiropractic residencies. Each step marks a significant shift from outside, in.
Told you so department: Chelation backed by two NIH-funded studies
The therapeutic intervention that powered economic development in many integrative medicine practices from the 1980s forward is also that which the conventional community has most loved to denigrate: EDTA chelation therapy. The NIH has been derided for spending $30 million on a study. A study in the Journal of the American Medical Association shocked many when it found limited yet positive outcomes. Then a sub-study was published in November that led the director of the NIH National Center for Complementary and Alternative Medicine Josephine Briggs, M.D. to judge that the outcomes "strongly suggest" value for diabetics. Briggs rightly shares that this is a reminder of the "need to keep an open mind in research."
Integrative health and medicine leaders Gaudet and Brimhall in mainstream leadership roles
An ultimate gauge of influence of an externalized movement is the elevation of its leaders into key roles in mainstream organizations. One such example was the election of chiropractic educator Joe Brimhall, DC to chair the powerful accrediting agency, the Northwest Commission on Colleges and Universities. No academic leader from the licensed integrative health disciplines has held such a position. The more pronounced is the rapidly growing emergence of Tracy Gaudet, M.D. as spokesperson on health care transformation via her position as director of the Veteran's office of Patient Centered Care and Cultural Transformation. Her team has successfully placed "whole health" as the focus in the President's Planning Budget for Veterans Health Administration.
Shifting paradigms: Consortium of "CAM" academics puts stamp of health and well-being into key IOM health professions dialogue
Academics from virtually all health professions spent two days at the Institute of Medicine last May imagining a team-based, post-silo era of "transdisciplinary professionalism for health." Thanks to representation on the planning committee by Elizabeth A. Goldblatt, Ph.D., MPA/HA of the Academic Consortium for Complementary and Alternative Health Care, with which I am involved, this workshop on a more desirable future included a welcome, overt focus entitled "health and well-being in transdisciplinary professionalism." Acupuncture and Oriental medicine academic Goldblatt and integrative nursing leader Mary Jo Kreitzer, RN, Ph.D., FAAN led the session. These leaders elevated self-care and health creation to a core focus in this imagining of our future.
Naturopathic doctors lauded by U.S. Senate and recognized as pioneers in integrative medicine
For a first direct Congressional recognition of a profession, the U.S. Senate resolution SR 221 backing Naturopathic Medicine Week was as laudatory an arrival for naturopathic physicians as one could imagine. They were positioned as experts in chronic disease and as a part of the solution to the primary care crisis. This historic federal boost came on the heels of perhaps as satisfying a recognition, by Tracy Gaudet, M.D. (see above). In a speech in Washington, D.C., the academic integrative medicine pioneer and Veteran's leader honored the naturopathic physicians as pioneers in developing an integrative medicine education and practice model. The Veterans Health Administration leader called them "a huge part of the solution" for the nation's healthcare woes.
David Riley, M.D., case reports and Global Advances in Health and Medicine
This was a big year for David Riley, M.D., the co-founder, with Michele Mittelman, RN, MPH, of the fiesty Global Advances in Health and Medicine. The young but already peer-reviewed and indexed journal is emerging as a leading cross-over publication. Global Advances is infused with integrative health and medicine philosophy and practice and partner with key organizations on significant initiatives while also reaching a less sectarian audience. Theme issues included group visits, health coaching and treatment of autism. Meantime Riley, who has long recognized the evidence issues in whole person, multi-agent, individualized treatment, stimulated a broad-based, multi-journal endorsement of the CARE consensus-based case report guidelines as a key evidence platform for all of medicine, including integrative practices.
Integrative health and medicine champion U.S. Senator Harkin announces plans to retire
Champions in high places have lifted the modalities, systems and disciplines associated with integrative health and medicine through the molasses and knives of resistance from the medical industry. None has been more influential than U.S. Senator Tom Harkin (D-IA), the chair of the U.S. Senate Appropriations Subcommittee overseeing health care. That Harkin will not seek re-election in 2014 was big news for the field. Worry, however, is moderated by the knowledge that integrative medicine's other top supporter, Barbara Mikulski (D-MD) has taken over as chair of the entire Appropriations Committee. Time to get those last asks into Iowa's senior senator.
The Academy initiative of ABIHM and Mimi Guarneri, M.D.: new collaborative platform?
An end of year development may have the most significant impact on the field going forward. The American Board of Integrative Holistic Medicine, in partnership with integrative cardiologist Mimi Guarneri, M.D. and her connection to the Calgary-based Taylor Family Foundation, are imagining the development of a multidisciplinary, multi-stakeholder global platform for education, certification and policy advancement for integrative health and medicine. Such a dream is not new. What sets this apart is the relationship with what is rumored to be potentially an 8-digit level of philanthropic investment. This "Academy," is it is being called, could be an exciting engine for unity and growth.
What deserved to be on this list and wasn't? Please comment with your ideas and that, or what was included. Here's to a great 2014!
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