Seven years ago, David Fogel, MD set the goal of proving what he hoped could be a primary care cornerstone of a transformed system of health care. With a generous philanthropic grant, he and his spouse Ilana Bar-Levav, MD created a team-based integrative health patient-centered medical home (PCMH). To give it power as a national model, the integrative PCMH was fully webbed into the emergent accountable care and value-based system. Early cost and health outcomes at their CHI Health Care significantly outperformed conventional practice metrics. They drew a visit from a US Surgeon General who was in search of innovative, value-based models. Yet now comes news that on July 23, 2019, the Center will shut its doors. An apparent guiding light for health system transformation will be snuffed. What gives?
I recently gave a commencement talk at Northwestern Health Sciences University, the day before Episode One of the last season of Game of Thrones. I chose to inject the sacredness of that day by referencing that other world by presenting the landscape of health and medicine that the graduates were entering as a jockeying between three Houses. In power on the Iron Throne: the House of Volume/Industry. The other two Houses are each insurgencies: the House of Integrative Health and the House of Value-Based Medicine. Can this life-and-death game play out favorably with an alliance between the two insurgencies in a field of health creation?
From the perspective of research contributions from academic institutions in integrative health, the 7 multidisciplinary universities have been key important contributors. These institutions, with one exception, are products of the last 20 years of advance of complementary, integrative and non-pharmacologic approaches in US health care. Each began as a professional school for chiropractic doctors, naturopathic doctors or acupuncturists then chose to expand its offerings for bird-of-a-feather programs, morphing into universities of integrative, natural health sciences. Part 1 of this series, “The Future of Integrative Health – Interviews with Presidents of 7 Multidisciplinary Universities”, examined the cornucopia of their present offerings. Part 2 offers an examination of the current place of research in these integrative health universities as the nation begins to call on their practices and practitioners in developing a new chronic pain strategy.
The recent global activity featured in the Integrator Blog News and Reports and re-posted by ISCMR, an international society of researchers in traditional, complementary, alternative and integrative medicine and health, has shown an unmistakable pattern: multiple governments are acting to remove recognition of homeopathy and certain of other complementary and integrative practice deemed “psuedo-scientific.” It’s not the only pattern. There hjave been recent positive governmental steps in Switzerland, India, the US and elsewhere. Still, the regulatory integrative ectomies in Spain, France, the UK, Australia, Canada – and here in the USA – are worth a collective heads up.