Most involved in integrative and functional medicine have by now heard of how traffic on scores of integrative health and natural products websites dropped 50%-95% via the cutting stroke of changes quietly made by Google leaders. I summarized and commented on the reporting of others in Self-Interested Whims of the Oligarchs: Google and Facebook Kill Access to Alternative and Integrative Medicine. The bias in the title was my judgement based. More questions than answers remain. I chose to explore further via a colleague of 30 years, medical writer, Erik Goldman. The traffic at his relatively conservative website, Holistic Primary Care (HPC), the hard-copy broadsheet for which he serves as founding editor, was one of those whacked. Goldman, who will host a panel on the Google issues at HPC‘s “Practitioner Channel Forum” (April 23-24 at the TWA Hotel at JFK Airport) offers a look under the covers at Google’s actions that seem to have motivations somewhere between unintended consequences and an external pernicious influences of the first order.
The decision of the Cleveland Clinic to start a Center for Functional Medicine was big news. That the $9-billion system gave the initiative significant visibility suggested arrival for functional medicine. A few hurdles still existed. Cleveland Clinic’s new partners needed to clarify and create a clinical model that could be measured. That was the caveat. This Center was a bet – a pilot based on a largely untested belief that functional medicine could outperform regular medicine, and at lower cost. Most in the field assumed this would prove a slam dunk. Care from a team of functional medicine physician/nutritionist/health coach and then behavioral specialist became the unit for which outcomes would be measured. Now in a publication in JAMA Network, the first results are in. The headlines were positive – but what do the data really say?
Two decades ago, James Gordon, MD was the chair of the top US government effort to examine integrative medicine policy. In an August 20, 2019 blogpost, the integrative psychiatrist shared how 50 years ago he traveled with crisis intervention nurse Sharon Curtin and singer Joan Baez to Woodstock where he treated hundreds of hallucinating attendees through a co-caring model. His August 9, 2019 letter to the New York Times challenged the Trumpian portrayal of mass-shootings motivated only by mental illness. Gordon described himself this way: “Though my professional work is devoted largely to trauma healing for survivors of such mass murders — and of wars, state-sponsored torture and climate-related disasters — I have known and treated a number of violent extremists, including mass murderers.” Trauma is us. On September 10, 2019, trauma hot-spots healer Gordon has a new book coming out on the transformation needed. I reached him for a brief interview.
The idea that “the first is the last and the last the first” was a value in my liberal Protestant upbringing. It likely had some noblesse oblige in it too. The concept can be challenged as an entrapping promise that good will come of waiting. Regardless, in some the call to work with the least-cared-for becomes a guiding mission. Self-preservation of the integrative field may be another motivator of such a mission. A past head of the NIH agency that researches integrative practices has challenged the main body of clinical research as un-generalizable due to the research being on upper income, well-educated, white, female patients. For a multitude of reasons, Integrative Medicine for the Underserved (IM4US) has emerged as the leading edge of the movement for integrative health.