|Forum on the IOM: AMI's Richard Sarnat, MD, Leader in Integrative Business, Offers a Report and Musings |
5. A process already in place
in Washington State is the formation of a consensus panel of clinicians to
screen the evidence base for clinical and cost outcomes before any new or
existing treatment or procedure is allowed upon the population’s members. This helps negate the immense industry
pressure (both CAM and conventional) to utilize new treatment modalities, when
they may have no actual clinical and cost effective advantage over the current
best treatment options.
There are other sub-models
that the IPA can use within its population, such as TM for all hypertensive
patients meeting a set criterion, AMI’s integrative chronic pain management program
(as previously reported in the integrator blog), preoperative visualization
techniques, stress management techniques or health coaches, etc. for defined
populations at risk. Obviously, the
primary focus even in disease management should be away from the current model
of pharmaceutical compliance and towards the whole person-healing model of root
While the task of health reform as discussed
above may seem daunting, it is instructive to examine the footsteps of those
who have gone before us on a similar quest.
This is best illustrated by examining the steps taken by Oregon’s
legislators. In 1987, the
Oregon Legislature realized that it had no method for allocating resources for
health care that was both effective and accountable. Over the next two years,
policy objectives were developed to guide the drafting of legislation to address this problem.
These policy objectives included:
that the goal is health rather than health services or health insurance
- Commitment to a public process with structured public
- Commitment to
meet budget constraints by reducing benefits rather than cutting people from
coverage or reducing payments to levels below the cost of care
- Commitment to use available resources to fund
clinically effective treatments of conditions important to Oregonians
- Development of
explicit health service priorities to guide resource allocation decisions
A complete review of Oregon’s methodology in
prioritizing care can be found through this link and in the document:Oregon Health Services Commission.
Prioritization of Health Services: A Report to the Governor and the 74th Oregon
Legislative Assembly. Salem, OR: 2009. DiPrete,
Bob and Darren Coffman. A Brief History of Health Services Prioritization in
Oregon. Mar. 2007. Health Services Commission. 4 Mar. 2009
document is a synthesis of the ideas presented at the integrative medicine Summit and my personal editorial bias, which reflects the distillation of the
many conversations and presentations that I was privileged to have over the
course of this historic event. I intend
to submit this document to Senators Kennedy and Harkin, who will chair the
committee for health care reform, as well as to make it available by Internet
and peer review journal. It is my
sincere hope that it will act as a call to action for all of us who feel passionate
about creating true health care reform.
While imperfect, I do feel that the direction given by this summary of
ideas generated by so many leaders in the health care sector gives us a
workable road map for our immediate and long term future. May the arrow find its target and allow us to
become the society and planet worthy of our heritage.
While imperfect, I do feel
that the direction given by
this summary of
generated by so many leaders
in the health care sector
gives us a
workable road map
for our immediate and long
May the arrow find its target
and allow us to
society and planet worthy
of our heritage.
IS NOW TIME TO CALL AND EMAIL YOUR CONGRESSMEN, YOUR FRIENDS AND MAKE SURE THAT
THOSE ENGAGED IN THE POLITICAL PROCESS UNDERSTAND THAT THERE IS A NATIONAL CONSENSUS
FOR WHOLE PERSON HEALING; THAT IT IS NOT ENOUGH TO INCREASE OUR FUNDING AND
FOCUS ON ACUTE, CRISIS DISEASE CARE, WHILE IGNORING THE ROOT CAUSE OF ALL
DISEASE. WE MUST MAKE SURE THAT OUR
VOICES ARE HEARD LOUD ENOUGH, THAT THE WELL-HEELED VESTED INTERESTS WITHIN THE
“STAGNANT QUO” WILL NOT BE SUCCESSFUL IN DERAILING TRUE HEALTH CARE
REFORM. GOD BLESS
Right there on the left side of the home page you will see:
Find and contact your federal, state, and local officials.
Enter ZIP Code
Gives you everything you would want to know about your own personal elected
Comment: I have been a fan of Sarnat's work since I first heard of it, via reporting his unique IPA model in Illinois a decade ago. Happily, the feeling has been mutual. Those of you who value the Integrator have Sarnat and his colleagues at Alternative Medicine Integration Group to thank for their steady, 3 years of Integrator sponsorship.
Sarnat and I have always shared a kind of dumb-foundedness that so few of our colleagues have developed business models based on actual clinical and cost outcomes. I cannot count on more than one hand those that have. And thus, here we remain, a decade down the pike, with woefully little effectiveness evidence to go along with our claims that this care we providee is more effective and cost effective that conventional treatment. Yes, contact your federal officials. But, for you who are part of healthcare operations, let's also contact our own experience to ask the right questions and mine the data!
About The Author
Resumes are useful in employment decisions. I provide this background so that you may understand what informs the work which you may employ in your own. I have been involved as an organizer-writer in the emerging fields of complementary, alternative and integrative medicine since 1983. Happily, I have learned some things. I was once called an "expert in alternative medicine" by......more