Spoiler alert. The title of a recent column marking the 10th anniversary of Triple Aim efforts to move medical payment and delivery from volume toward value makes no bones about the effort’s shortcomings. This report card from the Triple Aim’s top cheer-leader is meaningful to the high touch, human-intensive movement for integrative health and medicine for one important reason: the field’s potential uptake is pegged to advance of the values orientation. Success is more broadly meaningful because the values-based war against the forces in the industry that causally associate it with 250,000 medical deaths each year – effectively medicine’s white walkers in Game of Thrones terms – is the bullseye point of reference on what is at stake.
The budding 2020 presidential primary season for Democrats is already focusing on health care. Some advocate for single payer. Others don’t. The prospective force of the issue was underscored on February 27, 2019 when Congresswoman Pramila Jayapal (D-WA) and 106 Democratic co-sponsors introduced Medicare for All legislation. For those involved in the movement to shift US health and medicine toward an integrative model, a question arises: What might be expected, given existing US experience, for coverage and inclusion of integrative health and medicine services if single payer legislation becomes the law of the land?
In July 2018, the Integrator published a series of articles challenging a JAMA Oncology study and stunning headlines that those using complementary therapies in cancer treatment die quicker. The integrative oncology community condemned the paper – though oddly falling short of calling for retraction. (In the Integrator series, I urged retraction.) After 7 months and 193,000 downloads of this story, the JAMA Oncology finally published letters from researchers in 4 nations that led an Medscape article on the reaction to quote a scientist claiming the five letters “completely destroy(ed) the pseudoscience article.” Why is it not retracted? One wonders when the integrative oncology community will demand respect.
Non-naturopathic doctors will have at least these reasons to explore the Special Focus Issue on Naturopathy. One is the review of the necessary scientific work by that whole system profession’s researchers to examine multimodal and whole person treatment. Its the best concerted effort of any integrative health profession. A second is to witness naturopathic medicine’s journey in the last 35 years to raise a scientific mission from scratch. A third is for insight into this still small profession’s outsized contributions to the evolution of integrative health. Their foundational work in linking science to natural health modalities is at its root. The February 2019 volume from JACM-Paradigm, Practice and Policy Advancing Integrative Health (The Journal of Alternative and Complementary Medicine) is available in open access until March 20, 2019.