It was astonishing two decades ago when word emerged that medical device industry giant Medtronic – famed for its pacemakers – had made $1-million grants for cardiologists at heart centers across the country to explore complementary therapies. One seeded the creation of a center at Scripps led by interventional cardiologist Mimi Guarneri, MD. Guarneri would go on to be awarded the Bravewell Award, become the founding president of the Academy of Integrative Health and Medicine (AIHM) and most recently be presenting her Live Better Now program for PBS. I checked in with her early this “heart month” of February to get a sense of the state of integrative cardiology.
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.
An alert went out two weeks ago to a set of policy-oriented integrative health and medicine types. The Trump administration had published a report – “Reforming America’s Healthcare System Through Choice and Competition.” The email suggested that there was support here for the non-discrimination in healthcare provision of the Affordable Healthcare Act (a.k.a. “Obamacare”). Was this actually a dovetailing support of the Trump administration with the healthcare policy of his predecessor? I took a look and then connected a lobbyist who was on the ground when the Obama administration’s Section 2706: Non-Discrimination in Health Care was being drafted. The findings on the Trump study were mixed.