Many years ago, an integrative colleague and adviser – my spouse! – explained something to me about an important part of her lengthy integrative intake process. The time is needed to build trust to have the patient divulge what is going on at the time a chronic condition set its hooks so that the freeing might commence. The past half-century was witnessed a slow, cultural recognition of the power of trauma in micro and macro ways. The “shell-shocked” of WWI became, post Vietnam, a potentially actionable PTSD. The women’s movement opened the lid on pervasive sexual abuse, emotional abuse, and rape. Adverse Childhood Experiences (ACES) emerged as powerful determinants of life chances and choices. George Floyd’s murder ripped open reckoning on police battery, slavery, Jim Crow, red-lining, and mass incarceration.
News feeds for the natural products and integrative health practitioner fields have in recent weeks included a drumbeat of alerts on actions of the Food and Trade Commission (FTC) on what the agency considers inappropriate claims relative to COVID-19. A major natural health organization blasted the FTC’s efforts as practitioner gagging and censorship and is mounting a campaign to stop the activity. Others in these fields point to bullseyes some practitioners and companies have painted on their foreheads via gross over claims (“this mushroom will cure your COVID”) that laser-guide FTC’s actions. At a sober center amidst a tangle of issues – state/federal jurisdiction, free speech, provider-patient relationship, and the peculiar institution of in-office sales of natural products – sit Laura Farr and Rob Kachko, ND. They are the executive director and president, respectively, of the American Association of Naturopathic Physicians (AANP). Among the multiple questions is whether naturopathic doctors and others in integrative medicine are “canaries in the coal mine” of a new, potentially widening push by the FTC and other federal and state agencies into the regulation of integrative and functional medicine practitioner offices.
The polarization in US medicine has never been so front and center as it is with COVID-19. Natural agents are off the table. Despite early clarity that the state of the host matters big time in susceptibility to the virus, natural strategies focusing on host susceptibility are routinely denigrated and dismissed. So it was remarkable that within the course of 24 hours in late April, two colleagues independently sent news of a formal medical center protocol associated with a medical school that includes multiple natural agents. These are inlaid with conventional measures into a series of stages that the institution’s medical staff is following. Who are these people and how did this come to be? I was able to reach the primary author of the institution’s Critical Care COVID-19 Protocol, a South Africa educated internist, Paul Marik, MD, FCCP, FCCM. Marik is a professor of medicine and chief of pulmonary and critical care medicine at Eastern Virginia Medical School (EVMS) who has previously stirred controversy for unorthodox approaches. The non-conventional reasoning that drove the COVID-19 protocol Marik calls “uncommon common sense.”
The easy access by medical doctors to accredited continuing medical education in integrative medicine is an engine of the field’s growth. So as stories emerged of what was believed to be an Accreditation Council on Continuing Medical Education (ACCME) clamp down, I engaged a series of interviews and reports. I reported direct and indirect assurances from ACCME’s CEO Graham McMahon, MD, MMSc that integrative medicine is not being targeted. Yet a recent commentary from leaders of the Osher Collaborative for Integrative Medicine raised the question again. I decided to review evidence to this date. I cannot but conclude that integrative medicine is, in fact, at the center of the bullseye in ACCME’s recent push for new standards of “content validity” regarding “controversial areas”. Here is the evidence.