Tracking the inclusion of integrative strategies inside the Veteran’s Administration (VA) is an exception to the saying that a watched pot never boils. Integrative health research inside the VA funded in 2016 was the basis by which VA leaders chose 3 years later to more than triple the implementation of the “whole health” model to 55 medical centers. It was cause to exult. Now a special issue of the American Public Health Association journal Medical Care documents a further percolating of the inclusion process. With The Implementation of Complementary and Integrative Health Therapies in the Veterans Health Administration, one witnesses the powerful potential for change when a will is linked to a plan and a budget. The success at the VA casts cold light on the relative failure of reduction-oriented and production-minded public and private agencies to guide optimal implementation of integrative practices and practitioners into the delivery institutions on which the vast majority of U.S. citizens rely for their care.
The surprising news last August that Tracy Gaudet, MD was leaving the Veterans Administration where she birthed the transformational Whole Health program was leavened on learning that Gaudet would partner with the world’s wealthiest woman, Alice Walton. Together they would form the Whole Health Institute with a goal of nothing less than to translate and build off the VA model in civilian health and medicine and spread it globally. Other than a brief announcement at kick-off, plans have not been public. Last week word arrived that the professional with the most significant experience in developing integrative strategies in civilian medical institutions, Lori Knutson, RN, BSN, HNB-BC, is joining Gaudet. Knutson will serve as the Institute’s senior director for health system redesign. I communicated with Gaudet and Knutson on this development. Gaudet shared additional insight into evolving plans that, like the rest of life, have been shifted by COVID-19.
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.
That there should be a huge transformational drama underway in the US medical industry is a desire and dream that powers the integrative health movement and the work of many others. Those who might enjoy a sort of reality TV examination of not the fantasy but the multi-dimensional actuality of what such change looks like have a treat coming. The scene of action is 18 huge medical centers distributed across the entire United States. The script writers are 25 scientists on an evaluation team. The drama cuts across 4 deeply inter-related story lines: the impact of the transformational change on patients, on employees, on utilization, and on the extent of implementation and cost. We the people literally own this story. The investment and outcomes – from which any delivery organization can learn – are revealed in plain English in the public domain. If the launch of the transformational journey was Episode 1 of the series, then this 39-page report after two years is Episode 2. It’s deep insight into a dream coming true in the Whole Health System of Care at the US Veterans Administration (VA). It’s long awaited. And it is exciting.