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 Integrative Medicine and Integrated Health Care Round-up: June 19-July 17, 2009 
 
The following is one in an ongoing series of columns entitled Integrator Blog by . View all columns in series
Summary: Integrative services double at Providence Integrative Cancer Care ... CAM gains mention in IOM and Obama Council's report on directions for comparative effectiveness research (CER), plus Calabrese comments ... Licensed CAM, integrative practice and wellness in the US Senate reform bills ... NCCAM clarifies position on homeopathic research following furor over Zicam and National Center for Homeopathy request ... States move to regulate yoga schools ... Israelson on FDA, dietary supplement firms and adverse event reporting ... IAYT convenes effort to clarify definition, scope of practice, guidelines for Yoga therapy ... ACA announces formation of specialty Chiropractic Board of Clinical Nutrition ... Huffington Post runs 2 articles relative to functional medicine as health reform model ... NCCAM announces portion of Obama stimulus funds ... International Journal of Naturopathic Medicine re-launched ... New York Times article underscores how the NIH review process may keep the best research unfunded ... New positions for Michael Wiles, DC, MEd and Patricia Wolfe, ND ... New York Chiropractic College acknowledged in Chronicle of Higher Education ... Eric Goldman offers review of first Physician Heal Thy Practice conference.

Integrative Medicine and Integrated Health Care Round-up: June 19-July 17, 2009

Summary: Integrative services double at Providence Integrative Cancer Care ... CAM gains mention in IOM and Obama Council's report on directions for comparative effectiveness research (CER), plus Calabrese comments ... Licensed CAM, integrative practice and wellness in the US Senate reform bills ... NCCAM clarifies position on homeopathic research following furor over Zicam and National Center for Homeopathy request ...  States move to regulate yoga schools ... Israelson on FDA, dietary supplement firms and adverse event reporting ... IAYT convenes effort to clarify definition, scope of practice, guidelines for Yoga therapy ... ACA announces formation of specialty Chiropractic Board of Clinical Nutrition ... Huffington Post runs 2 articles relative to functional medicine as health reform model ... NCCAM announces portion of Obama stimulus funds ... International Journal of Naturopathic Medicine re-launched ... New York Times article underscores how the NIH review process may keep the best research unfunded ...  New positions for Michael Wiles, DC, MEd and Patricia Wolfe, ND ... New York Chiropractic College acknowledged in Chronicle of Higher Education ... Eric Goldman offers review of first Physician Heal Thy Practice conference.

Hospitals & Health Systems

Image
Program coordinator Rosemary Spyhalsky, RN, HN-BC
Services doubling in one year in Providence Integrative Cancer Care program


Rosemary Spyhalsky, RN, OCN, HN-BC, the nurse coordinator for the Providence Integrative Care Cancer Program in Lacey Washington, has graciously offered data on the growth and changes in that program in its first 18 months. Total patients served, and services offered, are tracking toward more than doubling. Spyhalsky shared that the program offers yoga therapy and acupuncture twice a week. Interest in naturopathic services and oncology massage is growing: "We are about to add additional days as there is a several week waiting list to see these providers." The integrative services are also gaining a broader hold in the Providence system: "We are also gearing up to start services at a new location in Lewis County at the brand new Lewis County Cancer Center in Centralia (Washington)." The new center has a room dedicated to offering integrative care with commencement of services anticipated for September.

Practitioners types since start-up
  Acupuncturist,
oncology massage therapist,
nutritionist, Yoga therapy
Service recently added
  Naturopathic physician
2008 total patients served
  120
2008 total patient encounters
  520
2009 annualized total patients
  264
2009 annualized total encounters
  1224


Spyhalsky notes that most patients bill their insurance but a foundation associated with Providence also provides some support. The program's tag-line is straightforward:
“Providing Resources to Complement Conventional Medical Care.”


Policy

Image
Report on CER notes CAM
CAM listed in reports from Obama team and IOM as possible areas for Comparative Effectiveness Research (CER)


The Federal Coordinating Council charged with directing the Obama administration's $1.1-billion comparative effectiveness research (CER) initiative has issued a June 29, 2009 report in which complementary and alternative medicine (CAM) figures among the areas listed for potential research. The mention is in page 53 of an appendix on the Council's listening sessions: "A few people talked about studying the role of alternative treatments, including homeopathic treatments for chronic and acute disease states." (For more on these sessions, see Daphne White, CHTP's insightful Integrator piece
The Kabuki Play of Monied Interests Around Comparative Effectiveness Research, April 28, 2009.) A perspective on a companion report on CER by the Institute of Medicine (IOM) in the July 23, 2009 New England Journal of Medicine, Prioritizing Comparative-Effectiveness Research-IOM Recommendations, gives CAM more prominence. In a bar chart from the IOM paper entitled "Distribution of the IOM's Recommended CER Priorities," CAM is in 19th position, just below "Nutrition" and "Skin Disorders" and above "ENT Disorders," "Genetics and Disease" and 8 other areas.

Image
Researcher Carlo Calabrese, ND, MPH
Helfgott Institute researcher Carlo Calabrese, ND, MPH, a former NIH National Center for Complementary and Alternative Medicine adviser, notes that, while the Council's report barely mentions CAM, at least it "
doesn’t exclude non-randomized studies." Calabrese also notes that an article planned for publication in the August 4, 2009 Annals of Internal Medicine, Rethinking Randomized Clinical Trials for Comparative Effectiveness Research: The Need for Transformational Change includes a recommendation which might create more openness to the kinds of whole practice trials which interest him. The recommendation is to target more funding toward what is called "pragmatic clinical trials," an approach which may better fit with research on integrative practices.

Licensed CAM providers, integrative practitioners and wellness make headway in US Senate reform bills 

Two articles in this issue of the Integrator detail points of inclusion of "licensed complementary and alternative medicine practitioners," "integrative practitioners" and whole systems wellness strategies in the evolving US Senate versions of health reform language. See
Update: IHPC, Others, Place CAM, Integrative Practices/Care in US Health Reform Legislation and, for information on wellness advances, Samueli Institute's Thiel on Wellness Provisions in US Senate Health Reform Legislation both published in the Integrator July 10, 2009.

Image
Raises concern to NCCAM
NCCAM clarifies position on homeopathy research at request of National Center for Homeopathy following Zicam story

Furor over a June 17, 2009 Associated Press (AP) account of adverse effects of a nominally homeopathic remedy Zicam led to successful efforts by the National Center for Homeopathy (NCH) and its president, Nancy Gahles, DC, CCH, RSHom (NA) to gain clarity on the position of the NIH National Center for Complementary and Alternative Medicine on funding homeopathic research. The AP account regarding a product from a firm called Matrixx Initiatives which includes homeopathic agents but is administered as a non-classical nasal spray and has caused loss of sense of smell in some consumers of these OTC products. The article includes this paragraph:
"The National Institutes of Health's alternative medicine center spent $3.8 million on homeopathic research from 2002 to 2007 but is now abandoning studies on homeopathic drugs. 'The evidence is not there at this point,' says the center's director, Dr. Josephine Briggs." 
Image
Clarifies position on homeopathic research
The NCH sought clarity on NCCAM's views. The NCCAM office sent a June 23, 2009 letter from Catherine Law, MTSC, press team leader in the NCCAM office of communications, which stated, in part:
"NCCAM will continue to accept investigator-initiated research grant applications for homeopathy and will continue to consider for funding those that receive outstanding scores in peer review.

"In regard to the AP article about the regulation of homeopathic remedies, the quote attributed to Dr. Briggs is one very short sentence, 'The evidence is not there at this point.'  This was a comment on the general state of the scientific evidence base for homeopathic treatments and their use in clinical practice. The statement that NCCAM is '...now abandoning studies on homeopathic drugs' was the reporter’s.  Dr. Briggs did comment that homeopathy drug research has posed major scientific challenges and has generally not done well in NIH peer review.


"Receiving a grant from NCCAM is an intensely competitive process; the Center has one of the lowest success rates at the NIH. As with all NIH grant applications, applications for research on homeopathy must undergo a rigorous two-stage process of peer review, which helps ensure the most promising and meritorious research is funded.
"
The damaging AP article also includes a statement that according to Food and Drug Administration records, perhaps up to 800 homeopathic ingredients were implicated in adverse effects in 2008. The Matrixx Initiatives' products targeted were not only delivered non-traditionally as a nasal spray, but used the agent zinc gluconate in more of a whole dose form of 2 parts per 100 rather than a typical homeopathic dose. The publicly-traded Matrixx has seen its share price drop from $22 to $6 since the AP article.
Comment: I was invited by Gahles to be in the loop of this exchange between the NCH and NCCAM and credit NCH for its advocacy and NCCAM for its responsiveness. My guess is, considering the not insignificant pressure that NCCAM is feeling to justify its existence, that exploring the conceptually challenging homeopathic remedies will be somewhere higher up the tree than the relatively low-hanging fruit of applying natural health practices to pain conditions. Briggs has publicly indicated these as potentially fruiutful NCCAM pursuits. Of course, there is that truism that one needn't believe in homeopathy to believe in Arnica for pain conditions.
Pressure rises as states move to regulate yoga schools

Yoga was the subject of a major story, July 10, 2009 in the New York Times entitled Yoga Faces Regulation, Firmly Pushes Back which documents efforts of state regulators to begin to treat yoga schools like vocational schools and require them to be regulated and taxed accordingly. For instance in April, "New York State sent letters to about 80 schools warning them to suspend teacher training programs immediately or risk fines of up to $50,000. But yogis around the state joined in opposition, and the state has, for now, backed down." Other state actions in Michigan and Virginia were also noted. The Yoga Alliance, which certifies over 20,000 teachers, maintains a list of over 1,000 schools nationwide. One yoga leader shared that "overall we found it a very balanced piece."  

Image
Israelson - forecastiung tough times supplement firms
Dietary supplement firms facing combined heat as FDA offers adverse events reporting (AER) guidance document


Natural products maven Loren Israelson, of the LDI Group, sent his list of dietary supplement industry participants a note that the
Food and Drug Administration (FDA) has announced the availability of a guidance document entitled ‘‘Questions and Answers Regarding Adverse Event Reporting and Recordkeeping for Dietary Supplements as Required by the Dietary Supplement and Nonprescription Drug Consumer Protection Act.’’ Israelson, founder and CEO of the Utah Natural Products Alliance and long-time lobbyist for the industry, uses the occasion to offer this cautionary note:
"Today FDA issued a guidance with respect to the reporting of serious adverse events for dietary supplements. This is a helpful overview for all (dietary supplement) companies subject to adverse event reporting. It is worth noting that the failure to understand or properly report AERs has dearly cost several well known companies in recent months.  It is my view that the combination of increased GMP inspections, growing problems with allergen label declarations, increased AER reporting responsibility and the increased use of recalls all clearly suggest the importance of fully and rigorously understanding the rules concerning AER reporting."

Professions


Image
Convenes Yoga therapy programs
IAYT convenes 41 Yoga therapy schools, creates definition of Yoga therapy, moves toward scope of practice document


An article in Yoga Therapy Today (Vol. 5, Issue 2) from the
International Association of Yoga Therapists (IAYT) reports a meeting of representatives of 41 schools from 5 nations which IAYT convened this spring. All present were members of the IAYT Council of Schools Initiative. Their interests in gathering focused on creation of a draft statement of a scope of practice for Yoga therapy. Facilitating was accreditation expert Dan Seitz, JD, former chair of the Accreditation Commission for Acupuncture and Oriental Medicine and current executive director of the Council on Naturopathic Medical Education. The group came up with an 'IAYT definiton of Yoga therapy: Yoga therapy is the process of empowering individuals to progress toward improved health and well-being through application of the philosophy and practice of Yoga. Among the issues examined was what would be in the core body of biomedical knowledge "in what a Yoga therapist should know." A committee was formed to develop a draft scope of practice document. The list of schools, and more about the initiative are available by clicking here.
Comment: This work to find agreement and set standard is hard, fascinating, powerful and pioneering work, such as the educators in acupuncture and Oriental medicine, naturopathic medicine, direct entry midwifery and massage therapy have grappled with over the last 30 years. Work in those fields led to developments of educational standards and eventually, federal recognition of an accreditation agency, which in turn helped create the present integration dialogue. Credit the IAYT for moving this important work for Yoga therapy. It furthers one to cross the great water!
ImageACA announces formation of Chiropractic Board of Clinical Nutrition

In a June 22 release, the American Chiropractic Association (ACA) announced the formation of the Chiropractic Board of Clinical Nutrition (CBCN), which it has authorized to grant diplomate status in the field of clinical nutrition. The
professional specialty board for doctors of chiropractic will serve as a credentialing and certifying agency. CBCN President Jeffrey E. Weber, MA, DC, DCBCN states that "our goal is to advance clinical nutrition while at the same time enhancing the health of chiropractic patients." The board has a grandfathering program for those who can show they've taken "nutrition classes at an accredited institution." New diplomates will need to either complete at least 300 hours in a "nutrition diplomate course," show evidence of 400 nutrition hours from various sources coupled with 5 years in practice, or have earned a master's degree in nutrition from an accredited institution.  More information can be found here.


Media

ImageHuffington Post runs two pieces on functional medicine's role in healthcare reform

Two recent columns in the widely read liberal news-source Huffington Post have given some prominence to the role of functional medicine as a way of reforming actual medical practice. On June 18, 2009 Mark Hyman, MD posted a story entitled How to Fix Obama's Health Plan Before It's Too Late. Hyman references the February 2009 IOM Summit, the hearings on integrative medicine before US Senator Kennedy's reform panel and a recent
"think tank sponsored by the National Institutes of Health on 'whole systems research.'" He then offers a 9-point plan for "Real Healthcare Reform." Then on July 16, 2009, a column by self-described functional medicine practitioner, John Neustadt, ND, medical director of Montana Integrative Medicine published a piece entitled A Vital Part of Health Reform: How We Educate Our Doctors. Neustadt, who is also a principal in a supplement firm, focuses on providing primary care doctors information about nutritional biochemistry and dietary supplements. As of July 16, 2009, the Hyman piece generated 44 comments and Neustadt's 18. The visibility of functional medicine follows the forward-thinking push of the Institute for Functional Medicine to publish its white paper on 21st Century Medicine: A Model for Medical Education and Practice. Thanks to Susan Luck, RN for the heads-up on the Hyman piece and Michael Cronin, ND for sharing the Neustadt.


Research


NCCAM's portion of the Obama stimulus: $31-million

Those wondering what the Obama stimulus package has done for complementary and alternative medicine lately will want to read a notice from the NIH NCCAM entitled Moving the Economy - And Biomedical Discovery - Ahead."  Of $10.4-billion of additional funds the NIH will receive in 2009 and 2010 via the package, $31-million will trickle down to NCCAM. NCCAM maintains a web page with developments on the directions with these stimulus funds.
Comment:  If you wonder why you haven't heard from your NIH-funded, or would-be NIH-funded researcher friends this summer, now you know why. They're all responding to the dangling of this $32-million. Given the activity level, one can only conclude that the Obama initiative has increased employment. But given the very low success rates of most proposals to NCCAM, as noted by director Briggs, above, and the even lower rates anticipated for the stimulus grants, one can guess that few of these so industriously employed this summer will be able to say that they are gainfully employment via success in their grant-writing.
ImageNew York Times on the challenges of getting research funding out of its stuck places

The New York Times
included a story by Gina Kolata (carried June 28, 2009 in the Seattle Times as Cancer Research Funded Cautiously) which underscores the challenges in getting reviewers to think out of their boxes. Top researchers are quoted about how many of funded studies "are only likely to produce incremental progress." The reason: "Reviewers are too timid about taking chances on (proposals) that might not succeed." Focus is on the $105 billion spent by the NIH on cancer research since 1971 in the war on cancer. The criticism: "Projects that could make a major difference in cancer prevention and treatment are all too often crowded out because they are too uncertain." Such criticism is typically muted because scientists "worry that their remarks will be viewed as lashing out at the health institutes which support them." Many researchers find ways to manipulate funds, "siphoning money from their grants," to be able to explore "chancy experiments." Kolata concludes with an observation from a leading researcher that while "great discoveries have been made with NIH financing ... by and large it is despite, rather than because of, the review system."
Comment:  This article reeked of the challenges I have heard repeatedly from researchers who want to undertake out-of-the-box research that looks at the whole practices of integrative care that attract consumers to integrative professionals. Under past NCCAM director Stephen Straus, MD, the pressures on NCCAM to behave like the other institutes brought out the worst of the conservative reviewer behavior criticized here. I have been told that Straus frankly stifled discussion of the need to explore what is actually going on in the field. Happily, under the current director, Josephine Briggs, MD, there are some signs of change. However, we still need to see a significant whole practices program, with funds dedicated toward whole practice research. This would help break the stranglehold of the reviewers and get us moving toward an agenda which, while riskier, is more likely to lead to "great discoveries" that will develop more leadership from, and respect for, the NIH's bastard step-child.

Publications

ImageInternational Journal of Naturopathic Medicine re-booted as hard-copy publication

The International Journal of Naturopathic Medicine, formerly an online-only publication, has been kicked off as a print journal. Dugald Seely, ND, MSc, a whole practice-focused researcher who is the director for Research and Clinical Epidemiology at the Canadian College of Naturopathic Medicine is editor. The publisher is David Tallman, DC, ND, who also publishes Naturopathic Doctors News & Review, a respected print resource on clinical developments in naturopathic medicine presently. Seely has assembled an editorial board which includes most of the top researchers in or related to the profession (Calabrese, Zwickey, Bradley, Weber, Herman, Myers, etc.)

The first issue includes three contributions from researchers associated with the Helfgott Research Institute, directed by Heather Zwickey, PhD. Seely offers a training document for members of the profession on writing up single case articles. The founding issue notes sponsorship from a handful of dietary supplement companies, together with the Northwest Naturopathic Physicians Convention, a Canadian-US offering which is the longest-running annual conference in that profession, dating back to the mid 1950s.

Notably absent from the sponsorship at this time are either the Canadian Association of Naturopathic Doctors or the American Association of Naturopathic Physicians. Neither professional association presently sponsors a professional peer-reviewed journal although the AANP has announced a plan to initiate a Journal of Natural Medicine. Publisher Tallman shares that
"our original hopes were that it be a subscriber-funded entity whose sole purpose is to enhance communication amongst naturopathic physicians and serve as a benchmark to the rest of the medical community." They may be pursuing other financing models. A release on the launch is available here.
Comment: A challenge in the naturopathic medical profession, which derives its research base from diverse communities of practice (clinical nutrition, botanical medicine, homeopathy, mind-body medicine, conventional medicine, etc.) is laying claim to its distinct body of research on naturopathic practice. The challenge is compounded in that, if the profession is true to its whole-person approach, its associated researchers immediately confront all the cultural, reviewer and funding biases against multi-variable and individualized therapeutic regimes which were ably described by New York Times reporter Gina Kolata in the article noted above. There are signs in this first issue that editor Seely and his team are seeking to highlight research on actual naturopathic practice, even if that means focusing on quality single case reports. Good for them!

People


Image
Michael Wiles, DC, MEd
Michael Wiles, DC, MEd named provost at Northwestern Health Sciences University


Michael Wiles, DC, MEd was named provost at Northwestern Health Sciences University where he previously served as dean of the college of chiropractic at the multidisciplinary academic institution of natural medicine. In his post, Wiles will oversee the academic programs at Northwestern, including Northwestern College of Chiropractic, Minnesota College of Acupuncture and Oriental Medicine, The School of Massage Therapy, and College of Graduate and Undergraduate Studies. In addition, the Wolfe-Harris Center for Clinical Studies and Northwestern’s clinic system will also be under his leadership. The position also includes significant relationships with regional partnerships in clinical services with conventional healthcare delivery organizations in Minnesota which the University has established. Wiles, an experienced advocate of collaboration and integration, is a co-chair of the Education Working Group of the Academic Consortium for Complementary and Alternative Health Care. For the University's notice of the appointment, click here.

Image
Patricia Wolfe, ND, emeritus president at Boucher Institute
Key naturopathic educator Pat Wolfe, ND, becomes emeritus at Boucher Institute; Cortina takes helm


The Boucher Institute of Naturopathic Medicine, in British Columbia, has had a change at the helm, with Alexander Cortina, BA, BEd, MEd, EdD-cand, taking over for Patricia Wolfe, ND. Wolfe guided Boucher for 7.5 years, through the consuming processes of its founding and ultimate success in earning accreditation through the Council on Naturopathic Medical Education. Boucher is just the second naturopathic medical school in Canada and the 6th in North America to achieve that status. She will remain on part-time in a president emeritus status. Cortina took over on July 1, 2009.


Miscellaneous

Image
NYCC president Frank Nicchi, DC, MS
New York Chiropractic College awarded


The Chronicle of Higher Education has honored New York Chiropractic College as one of 2009's "Great Colleges to Work for." The Chronicle's award is modeled after a Fortune magazine award for businesses. The school, led by president Frank Nicchi, DC, MS, was awarded in five categories, outstripping most other colleges which were noted.
According to a July 15, 2009 release from NYCC, which has both chiropractic and acupuncture and Oriental medicine programs, no other chiropractic college or school of acupuncture and Oriental medicine were named.” Results are based on responses from nearly 41,000 administrators, faculty and staff members who rate the institutions they work for by taking an online survey

ImageHecht Memorial Foundation once again offers $250,000 CAM/IM Dr. Rogers prize

The Hecht Memorial Foundation is once again offering a $250,000 Dr. Rogers Prize
"to highlight the important contributions of complementary and alternative medicine to health care." This $250,000 award celebrates the leaders and trailblazers who have dared to pursue the unfamiliar and new approaches that come under the expansive umbrella of Complementary & Alternative Medicine." The award is given to a person making a significant contribution to CAM/IM in Canada. 

Conference Report

ImageReport from Holistic Primary Care's Goldman on "Physician Heal Thy Practice" conference


Few conferences in integrative medicine specifically focus on business models and practice success. These were the lead theme in the recent "Physician Heal Thy Practice" conference sponsored by Holistic Primary Care (HPC). I asked HPC editor and sometimes Integrator contributor Eric Goldman for a few facts about HPC's first venture into conferencing. (See Goldman's comments on the IOM Summit here.) Goldman filed this report:
It took a lot of doing, but we managed to pull off our first conference.  Heal Thy Practice: Transforming Primary Care it was pretty dern great, if we may be permitted to toot our own horn!

We had a total of about 120 people from 26 states attending (~80 paid physicians, plus spouse-guests, students, non-physicians, etc). Given how bad the economy has been and how difficult it is to get people to travel, we were pretty happy with that turnout, especially for a first-time meeting. The vast majority were MDs, though we had a fair number of DOs, a handful of naturos, a few nurses, and a couple of physician assistants. All were very open-minded and highly motivated, which pleased our exhibitors.

  • 47% of the physician attendees described their practices as "primarily conventional" primary care medicine
  • 37% said they had "mixed/integrative" practices"
  • 6% said they had completely "holistic/alternative" practices
  • 64% routinely recommend supplements, and
  • 39% said they dispense supps/natural products from their offices.  

The energy  was fantastic. Attendees were eager to learn, share & connect. Nearly all of them stayed through all the lectures---and we had VERY full days w/ almost no "pool time"---from start to finish. The Q&A was lively and the meals were buzzing. There was a wealth of creativity, solution-seeking and goodwill among this crowd. As one attendee told us, "I have learned as much from the other attendees as I have from the speakers."

We were surprised---and pleased---by the number of mainstream clinicians who attended. Many of them are at wits end as far as how to stay in practice. Some are literally living hand to mouth, barely able to keep their clinics open. If anyone out there still thinks that MDs have it made, and its only "alternative" doctors who are struggling, they really need to come talk to our attendees!

Interest in direct-pay models

They showed strong interest in "direct-pay" models, ie, Fee for Service & Concierge type plans, like the straight fee-for-service model advocated by Dr. Brian Forrest, a family physician in North Carolina. Dr. Forrest  was the undisputed "star" of "Heal Thy Practice," and he makes a great case for FFS as a way of stripping out the burdensome overhead that makes it almost impossible for primary care docs to survive. He also dispels the notion that direct-pay is only for the rich. He practices in a working class NC hill town, and says he's got more Medicaid patients who choose to pay him directly than many area physicians who allegedly take Medicaid but rarely see these patients.


Primary care docs, especially those with a holistic bent, are yearning to shake off the shackles of insurance. They feel badly battered by the plans, and there's very little love here for insurance based fixes to the health care crisis. One attendee put it very succinctly: "Low reimbursement plus high overhead equals burnout."

Forrest fielded questions for about 2 hours, and practically had to fight his way out of the hall. We spoke w/ him last week, and he's already had several Heal Thy Practice attendees fly to Apex, NC, to visit his practice & see his model in action.

CAM-IM veteran attorney Alan Dumoff on medico-legal issues

What stops many of these docs from jumping to cash based or direct-pay practice is a fear that they don't have the financial cushion to make it through the transition. As one doctor told us: ""I have no savings, 3 kids, and a mortgage to pay." They feel trapped and enslaved by insurance companies & managed care.


The other area of very strong interest was in medico-legal issues, ably handled by Alan Dumoff, JD. The regulations related to holistic/integrative medicine vary widely by state, and practitioners really need to know what's happening in their regions. Dumoff, one of the nation's leading attorneys on these issues, is a firm advocate of detailed informed consent & he shared many practical tips to help practitioners avoid legal hassles.

Our two luncheon keynote lectures were very well received. Victoria Maizes, MD, Executive Director of the Arizona Center for Integrative Medicine at the University of Arizona, Tucson, took attendees on a tour of various integrative practices established by physicians who've completed University's acclaimed Fellowship in Integrative Medicine. The diversity of these practice settings & models speaks well for the creativity, energy & inventiveness inherent in the holistic/integrative movement.

Sherri Tenpenny, DO, offered a humorous, insightful and challenging lecture called "If I Can Do It Here, You Can Do It Anywhere: Lessons Learned from an Integrative Clinic in the Midwest." She detailed the challenges of establishing a practice that stays true to the ideals and principles of healing in a region with an extremely conservative mainstream medical establishment, which she described as akin to a street gang in its pressure tactics.

Testimonies and a plan for 2010

In a testament to the public's fondness for holistic/integrative folk, we got several very positive comments from hotel staffers praising the good vibes of our attendees. One of the banquet servers said that in 25 years of working at Westin's La Paloma, and servicing countless conferences, she's never served a nicer group of people. Now, that felt good!!!


Attendee reviews of the conference have been very positive and encouraging. Here are a few of the comments we received:

"As someone planning to leave organized medicine and create my own practice, this information did so much toward helping me design a workable future."

"We need more conferences like this, which really help us realize we are doing the right stuff."

"I wish there had been a conference like this 20 years ago, when I was starting out in practice."

Attendees and exhibitors alike have been asking us if we're going to do it again. The short answer is, "Yes!" We're in the early stages of planning Heal Thy Practice 2010. We'll be announcing the time and place this fall. In the mean time, there will be highlights of the '09 conference in the upcoming Fall edition of Holistic Primary Care, as well as on our website. Audio recordings and slide sets from the meeting are available for purchase. Just visit www.holisticprimarycare.net and click on the "Conference Recordings" banner at the top of the home page.
HPC plans to annualize the meeting, the entire proceedings of which are available for $249, or for $18 per program. A date has not been set for 2010.



      
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 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......moreJohn Weeks
 
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