“Modeling interprofessional education and care has been the mantra for both organizations for years.”  These words from Bill Meeker, DC, MPH capture the core sentiment on the remarkable news of a merger in the making of the Academic Collaborative for Integrative Health (ACIH aka “The Collaborative) and the Academy of Integrative Health and Medicine (AIHM aka “The Academy”). Meeker, whose term as president of AIHM begins January 1, 2021, until recently served on both boards. The core of the former consists of academic, accreditation, and certification leaders of the 5 licensed integrative health professions: chiropractic, East Asian medicine, naturopathic medicine, massage therapy and direct entry/certified professional midwifery. Participation in AIHM is about 65% medical doctors transitioning their practices toward integrative models, with the others from a range of disciplines. The combined ACIH-AIHM organization is anticipated to become a robust environment for these newer parts of the healthcare workforce to engage with integrative doctors and power up the abilities of their combined force in change agency.

Two preliminary points, one personal. Meeker, whose day job is as president of Palmer College of Chiropractic West, brought the story to me because he knew I was working on my last Integrator. He also knew I’d helped co-found the ACIH – then the Academic Consortium for Complementary and Alternative Health Care –  with Pamela Snider, ND and others in 2004-2006. I’d served, following Snider, as its executive director, from 2007-2015. I’d heard rumors of the merger. I was an interested party. One is interested in decisions of one’s offspring!

The other preliminary is the intriguing and useful context for this action in this moment in the United States. Despite the over 400,000 licensed members of ACIH’s 5 core professions, and despite the millions of people who routinely turn to them with health concerns – and the millions more who would if their services were covered – these professions are still essentially not included as part of the U.S. health professions work force by the nation’s workforce planners.

Section 5101 of the 2010 Affordable Care Act could have changed that, but it was never funded. Chiropractors are included in law here and there. Acupuncturists, massage therapists, and some of ACIH’s “Traditional World Medicine” and “Emerging Professions” members, like yoga therapists, are making gains in the Veteran’s Administration. The nation’s crisis in chronic pain management has stimulated un-coordinated, adhoc inclusions. Things are percolating. The time for all these professions to regularly be acting together, in mutual strength and in a single professional organization would seem to be ripe.

I contacted JoAnn Yanez, ND, MPH, CAE, the board chair for ACIH and one of the members of the ACIH-AIHM Joint Task Force that has been working on the idea, kicked around for years, then actively pursued for the past two, during the period of Alyssa Wostrel’s time as ACIH executive director. Asked why ACIH chose this course, Yanez, whose own day job is as executive director of the Association of Accredited Naturopathic Medical Colleges, referenced the Collaborative’s historic priority:

Key to our mission is collaboration. We feel this will bring exceptional value to [us in the Collaborative]. AIHM is an established leader in the integrative space. They model interprofessionalism. It’s how they’ve defined themselves from the start. This is an opportunity for them to really expand on what they already do. It’s exciting. We bring a high functioning educational unit into the Academy and expand what they can offer.”

I asked her to drill down a bit. Where might these benefits play out?

This is a unique opportunity for synergies that we both could not accomplish alone. The synergy begins with shared mission. In our discussions on the Task Force and in our separate boards, we have been focusing a lot on our ACIH Working Groups.  [See ACIH’s Working Groups Charter.] As you know we have these in the areas of education, clinical care, and research. These are already multidisciplinary. We anticipate expanding the roles and the reach of the Working Groups. We believe that in the Working Groups and elsewhere we will be able to execute larger projects that will be easier to do as a partnership.”

Meeker, whose own involvement on AIHM’s board grew out of discussions between leaders of the two organizations dating back to 2014, laid out some of the mechanics. The Joint Task Force created a non-binding letter of intent signed by the two boards. Discussions went on hold with COVID then picked up again. The two organizations now have a Memorandum of Agreement. They are working out an “operation manual” to define the relationship, and other details. Some key directions:

• Some new ACIH positions on the AIHM board.
• Guarantees of “the right interprofessional mix” on that board.
• The consideration of the Collaborative as a “Council” of the Academy.
• Importing of the ACIH’s leadership structure into this Council.
• Continuance of ACIH’s membership categories (organizational members, individual colleges members, associate/individual members, founding members).

No one expects any significant issues. Yanez noted that the Collaborative voted unanimously to sign the Memorandum. Meeker likewise referenced no significant opposition:

There are few negatives I can think of, unless for some reason there is more value in keeping a plurality of small, like-minded organizations in the integrative space. With this merger we have come to the opposite conclusion – that there is more value in having a larger and truly diverse multidisciplinary organization under shared management. Perhaps some feel there may be some dilution of one or the other’s power, but the voices on that concern are not strong. Modeling interprofessional education and care has been the mantra for both organizations for years.

I was curious if ACIH had explored the potential of a merger with the Academic Consortium for Integrative Medicine and Health (aka the Consortium). The medical school organization with its some 75 academic medical center members might seem the more likely partner. In fact, the ACIH was formally born in dialogue with Consortium members via the 11-profession National Education Dialogue to Advance Integrated Care: Creating Common Ground.

Yanez notes that there were some initial conversations. Yet these, she recalls, began at a time of internal transition at the Consortium, before that organization moved to an executive director model and hired its widely-respected CEO, Dale West, CAE. Yanez shares enthusiastically that she and her Collaborative colleagues look forward to ongoing collaborations with the Consortium and its members.

A record of historic engagement

The ACIH has a record of taking the “licensed integrative health professions” and bringing them into environments that did not historically include them. A glance at the Collaborative’s History on their website reveal some of this, as do multiple publications, including the influential Clinicians and Educators Desk Reference on the Licensed Integrative Health and Medicine Professions.

• Multiple influential engagements at the National Academy of Medicine (NAM), including representing and highlighting integrative models and the important of wellbeing for 8 years at NAM’s most significant interprofessional gathering, the Global Forum on Innovation in Health Professional Education.
• Co-sponsorship of an International Conference on Education in Integrative Medicine and Health with Georgetown University and the Consortium.
• Direct dialogue and influence with the NIH National Center for Complementary and Integrative Health. (Notably Meeker was part of an ACIH Research Working Group team that met with NCCIH leadership in 2011 to present the group’s collaboratively established priorites.)
• Working with AIHM on the development of the Academy’s interprofessional Fellowship. (Notably, the curriculum in the AIHM fellowship is mapped to ACIH’s prior Competencies for Integrated Practice.)
• Participation with the Health Resources and Services Administration project on integrative primary with colleagues at the University of Arizona Andrew Weil Center for Integrative Medicine, the Consortium, and others.
• Multiple engagements with the National Center for Interprofessional Practice and Education.
• Plenary presentation at the annual workforce meeting of the Association of American Medical Colleges.
• Leadership in the publication of a key integrative pain white paper, early in the opioid dialogue, under the auspices of the mainstream national PAINS organization.

Access to capital and philanthropic partnerships?

For the Academy, rolling the present ACIH annual revenues, mainly via membership, will increase by $100,000 annual AIHM revenues that hover around $2-million. Notably, the Collaborative’s bump in AIHM’s total revenues is roughly the same amount as the American Holistic Medical Association’s founding contribution to the Academy when AHMA rolled its operation into the founding mix.

In the past, the Collaborative’s work has been fueled by revenues of over 3.6 times as much, in its most successful year, thanks to a then dedicated but since declining set of philanthropic partners. This challenged philanthropic base is in contradistinction to the kind of philanthropic support that the Consortium, for instance, has been able to attract to fuel its ideas. The fact that policy makers don’t yet fully consider ACIH’s licensed disciplines a part of the nation’s workforce seems to be reflected in the donor class not descending to substantially fund the yet under-included licensed integrative health professions.

Viewed in this way, the merger decision for ACIH was a means of hooking up to the engine that is most respected in US medicine: a strong body of medical doctors. At AIHM, this includes the likes of founding and current president Mimi Guarneri, MD, past presidents Danny Friedland, MD and Bradly Jacobs, MD, MPH. Rachel Abrams, MD, Erika Capelluti, MD, PhD, and most recently, Scarlet Soriano, MD. Sometimes one needs to play to prejudice to bring the attention and respect that will in turn draw resources for those “larger projects” to which Yanez alluded.

The time and space feels rights. Check out how AIHM, directed by naturopathic doctor Tabatha Parker, ND, has already evolved its staff and its board, currently chaired by nurse Lucia Thornton, RN, MSN, AHN-BC, ThD. I count 4 MDs, 2 RNs, 2 DCs, 1 PT, and a certified healing touch practitioner on the board. In addition, AIHM has 2 NDs, 2 MEds, 1 MD, 1 MS, and assorted others on the staff.  Fascinating interprofessional home in which this imported AIHM “Council” will take shape and have the opportunity to thrive. Here’s wishing the best!

AIHM’s Present Interprofessional Board and Staff

https://aihm.org/leadership/