On May 7-10, 2019, I attended the top international integrative health research conference that comes around each year. The 14th International Congress on Complementary Medicine Research drew roughly 400 “delegates” as the Brisbane, Australia hosts welcomed us. We hailed from 34 nations. The turnout to the distant location was about half that when the meeting is hosted in North America or Europe and roughly on par with a 2015 South Korean event. Yet despite or perhaps because of the size and distance new themes emerged and old ones that needed prodding re-emerged. Together these offer an impactful direction for the global integrative research community and for ISCMR, the organization of traditional, complementary and integrative medicine researchers that co-sponsors each of these event.
In the United States, the complementary and integrative medicine dialogue about “traditional medicine” typically looks to Asia. The West-meets-East orientation respects the power and influence of Chinese and Indian traditions. Yet in doing so, both local indigenous practices and the roles of traditional, complementary and integrative medicine (TCIM) in Mexico, Central America, South America and the Caribbean are mostly overlooked. The Pan American Health Organization (PAHO) recently created a partial remedy for this hemispheric forgetfulness. A two-year collaborative process with representatives of over 20 nations has created a powerful network and opened access to a nation-by-nation bounty of practices, papers, research, and regulations.
When Oregon announced in 2016 that it would shift its back and neck care for Medicaid clients from opioids toward acupuncture, spinal manipulation, massage, yoga therapy and mind-body methods, it was heralded as a breakthrough for pain treatment nationally. Inside that policy was a mandate many now consider even bigger news. Doctors were required to totally taper patients off opioids. A backlash propelled by a letter signed by over 100 conventional pain academics nationwide – plus with one notable signer from the integrative pain community – stopped Oregon’s planned expansion of the model in its tracks. While there are good reasons for caution on mandatory tapering, the one-sided reactivity missed a chance for practitioners and patients alike to gain more experience with non pharmacologic tools to rein in the known abuses associated with opioids.
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?