Health creation. Transformation. From reactivity to well-being. Empowerment. From system-centered to person-centered. Using the least force. Changing the therapeutic order of the nation. These aspirations warm and power the integrative health movement, dreams on the long march for radical re-direction of a $3.5-trillion industry. Yet how often do change prescriptions meet the radical requirements of the dreams? Acupuncture in Medicare doesn’t do it. Nor non-pharma into chronic pain guidelines. In The Community Cure: Transforming Health Outcomes Together, Evolution of Medicine impresario James Maskell offers a re-framework that seeks to rise to the task. Maskell grounds his “cure” in group services models through which the medium is the message for a population crippled by loneliness.
What kind of response would come in from the call for perspectives (up to 250 words): “How might rapid uptake of the integrative model influence climate change?” My call was stimulated by a commentary from Harvard’s Peter Wayne, PhD and others in the Osher Collaborative for Integrative Medicine in which they boldly assert that Integrative Medicine Is a Good Prescription for Patients and Planet. I opined that I don’t believe that the environmental movement necessarily views the movement for integrative medicine as a core ally yet that the field would serve itself to up its environmental profile. The call brought a fine array of responses from a diverse, interprofessional group: American Public health Association integrative health leader Elizabeth Sommers, PhD, MPH, LAc, True Health Initiative founder and long-time Yale-based preventive-integrative-lifestyle medicine leader David Katz, MD, MPH, IM4US president Udaya Thomas, MSN, MPH, ARNP, commons activist and Institute for a Sustainable Future founder Jamie Harvie, Bastyr University faculty and past president of the Dieticians in Integrative and Functional Medicine Mary Purdy, MS, RDN, author author and Vermont Chinese medicine practitioner Brendan Kelly, LAc, and Alaska clinician Emily Kane, ND, LAc.
After publishing on challenges the Accreditation Council for Continuing Medical Education (ACCME) is presenting to the integrative and functional medicine continuing medical education (CME) providers, I sent links to Graham McMahon, MD, MMSc, the organization’s president and CEO to request an interview. Multiple integrative CME providers with decades delivering integrative CME have lost or are facing potential loss of recognition. They have shared serious questions of transparency and intent on ACCME’s part. Some efforts to connect with ACCME have been rebuffed. Is integrative medicine being targeted? In my request for an interview, I provided McMahon some background on concerns. McMahon responded immediately, and affirmatively. We spoke for over 30 minutes via zoom on February 5, 2020. His responses included a surprising assertion that he believes the present ACCME is aligned with integrative medicine principles and practices. He committed to open dialogue in ACCME’s move “from cop to coach.” He underscored that the new proposed language is yet open for comment. I assembled our exchange in the following interview format and sought his edits and written replies to additional questions, then secured his approval prior to publication.
Should accredited continuing medical education providers for integrative medicine be prohibited from training medical doctors to practice integrative modalities that aren’t “generally accepted within the profession of medicine as appropriate for the care of patients”? What impact might this have on efforts – for instance – to shift chronic pain treatment toward non-pharmacologic approaches that most of medicine doesn’t “generally” include? Might giving arbiters of science in a disease model this power put the brakes on efforts to shift clinical care from managing disease to creating health? These other significant questions are on the table for the integrative health field as the Accreditation Council for Continuing Medical Education (ACCME) posts its draft revision of accreditation standards. The changes, targeting issues throughout CME, have particular challenges for the integrative medicine field. The comment period closes February 21, 2020.