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.
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.
Prior to publication of my article on the proposed new standards on “content validity” from the Accreditation Commission for Continuing Medical Education (ACCME), I circulated it to a few leaders in the field for comments. In the process, I learned that a team from the Academic Consortium for Integrative Medicine and Health (“the Consortium”) recently had a conference call with Graham McMahon, MD, MMSc, ACCME president and chief executive officer. Saturday morning, January 25, 2020 I spoke with Rick Hecht, MD, the Consortium chair, who was part of the conference cal. He has had other recent discussions with key colleagues in the CME office of his home institution. Hecht’s comments offer some perspective on ACCME’s current areas of focus in CME. I have assembled his comments in the following interview format and secured his approval prior to publication.