For the past half decade, the Academy of Integrative Pain Management (AIPM) has carried the policy mantle for integrative pain treatment into ever more influential places. The beacons were the 2017 and 2018 Integrative Pain Care Policy Congress. The most recent convened 70 stakeholder organizations, including key payers and federal agencies. On January 29, 2019, AIPM announced that it has ceased operations. Amidst the present opportunities for transforming pain treatment, the integrative pain field lost its engine. Oddly, the very challenges to the pharma industry in the center of the dominant pain model were part of AIPM’s undoing.
An organization that sees its mission as larger than its present reach hits natural barriers if it uses an association management firm. The management organization is not an “association growing” firm. Nor is the firm devoted solely to the association. In fact, the management firm’s financial incentive structure is akin to that of a fitness center: the best member is one who pays dues and never requires anything. It’s job is to manage and control something that, optimally is passionate, dynamic, and slightly out of control because it is actively flourishing in multiple directions. These disparate tendencies came to mind as good news arrived December 21, 2018 – Solstice Day – that arguably the most powerful engine in the integrative space, the Academic Consortium for Integrative Medicine and Health (“the Consortium”), completed a transition away from an association management firm to its first, 100% time, fully devoted executive director.
On the surface of things, the values of “accountable care” and “patient-centered medical homes (PCMH)” and those of integrative medicine suggest a convergence. A survey found alignment in integrative medicine leaders. Maryland integrative doctors David Fogel, MD, and his spouse Ilana Bar-Levav, MD, presented with a substantial philanthropic gift, jumped into the apparently convergent rivers with both feet, creating the interprofessionally rich environment that is now CHI Health Care. The goal was and remains to prove the value proposition of integrative medicine in the medical industry’s move from volume to value. The center gained recognition as a PCMH and became part of a Medicare Shared Savings accountable care organization (ACO). Now Fogel makes clear that the convergence of the two paradigms have produced rumblings of boulders at the river bottom. While he remains positive about the model, the systemic obstacles are daunting.
A significant trend is appearing in major research organizations on integrative health and medicine. The timing is right: in the United States, major reports, meetings and guidelines now include non-pharmacologic, a.k.a. integrative approaches. But how do we move these into practice? Top acupuncture, integrative oncology and general integrative health conferences are featuring what is called “implementation science.” This study of methods to promote the integration of research findings seeks to propel changes in healthcare policy and practice. The integrative trend arises amidst a renewed push for health services research of all kinds. Action on these lines can straighten out some twisted karma relative to the 1998 US Congressional legislative mandate that established the globe’s most significant scientific investment in alternative, complementary and integrative medicine.