The Integrator Blog News & Reports – now published via johnweeks-integrator.com (with content going back to 2006 at the original Integrator site) – annually marks the winter solstice with a Top 10 for Policy and Action in Integrative Health and Medicine. In the selection of each in the Top 10, “the accent” – as the jazzman sings – “is on the affirmative.” Thus the coming of the light from individuals and organizations in the field making positive contributions to shift the medical industry toward a system that focuses on creating health. The Top 10 lists for 2006-2014 are here, for 2015 here, for 2016 here, and for 2017 here. Below are the Top 10 for 2018.

1. Helen Langevin, MD Takes over at the National Center for Complementary and Integrative Health

What a fascinating concept: choose someone to head a research agency who has experience in the field! In September, word emerged that the former board member of the Society for Acupuncture Research and director of the Harvard Osher Center for Integrative Medicine Helen Langevin, MD was named the third director of the NIH National Center for Complementary and Integrative Health. Langevin’s the first with a rich experience in the integrative space (though credit her immediate predecessor, Josie Briggs, MD, for going to school on the integrative fields while on the job). Langevin is an extraordinary choice, given her pioneering work in mechanism – NIH’s coin of the realm – related to acupuncture and connective tissue. I welcomed her with a hope that just as the Republican Richard Nixon opened doors to Maoist China, perhaps Langevin, the basic science researcher, would finally move the agency – it’s been taking some steps – to fully embrace Congress’ implementation research mandate.

2. Social Justice in Integrative Medicine and Its Radical Embrace by the Certified Professional Midwives

A blot on the integrative medicine movement has been its upper class roots and clientele. Blame the lack of insurance coverage and cash models if you want, yet the ability and efforts to reach everyone with these care models has been challenging and under-attended. A February column by two leaders UCSF integrative medicine leaders Shelley Adler, PhD and Maria Chao, DrPH, MHA grabbed the issue by the collar and shook it toward action. Canadian researchers Heather Boon, PhD and Nadine Ijaz, PhD bluntly framed the international dimensions as colonialism. Integrative Medicine for the Underserved (IM4US) featured “health justice” as the theme in their annual conference. But no organization has committed to making the radically inclusive organizational changes as the National Association of Certified Professional Midwives (NACPM). A biracial set of NACPM leaders, Tanya Khemet Taiwo, CPM, MPH and Mary Lawlor, LM, CPM, shared in all transparency the bumpy road of the ongoing restructuring at NACPM to begin to belly-up to the values of equity and justice. Good starts – much work yet to be done here.

3. Harvard Medical School Moves to Re-Brand Its Mission To Health (Then Steps Back)

For better and for worse, it’s hard to overstate the influence of Harvard Medical School (HMS) in US medicine. So the HMS’ bold move to shift the paradigm in its mission statement toward health may be considered a significant step in the right direction for US medicine. The original HMS mission is a devoted dance around the disease Maypole: “To create and nurture a diverse community of the best people committed to leadership in alleviating human suffering caused by disease.” Then, earlier this year, came the truly remarkable and paradigm shifting proposed draft that planted both feel in a full re-orientation toward health: “To create and nurture a diverse community dedicated to teaching and learning, discovery and scholarship, service and leadership to improve health and wellness for everyone.” However, the final pulled back into compromise: “To nurture a diverse, inclusive community dedicated to alleviating suffering and improving health and well-being for all through excellence in teaching and learning, discovery and scholarship, and service and leadership.” Too-bad that the let’s-keep-attention-on-suffering-and-put-it-first contingent won out. Still, an important advance.

4. Taylor Walsh, Larry Rosen, MD and Whole Health in Grade Schools

For a decade, Taylor Walsh of Integrative Health Strategies has been a consultant, activist and writer – including for the Integrator – in the integrative health sphere. For 20 years Larry Rosen, MD has been a leading integrative pediatrician. This year the two connected in an effort to lay a platform for positively shifting the determinants of health in the population. The initiative is Whole Health ED – “whole health education” in grade schools. Recognizing that activists are working in schools in multiple silos – yoga, nutrition, nature, movement, mindfulness, gardening – Walsh and Rosen gathered 30 leaders for a robust June gathering in Washington, D.C. They had backing of the Marino Foundation in their ongoing effort to explore and share strategies, successes, challenges and the potential value of ongoing collaboration and presenting a a combined, larger unit. The work is beginning to power up a consortium of these like interests to up-regulate the skills for health in school age children – who may then be more likely to understand and promote paths to health as they grow and age.

5. Liza Goldblatt, PhD, MPA, HA, the Collaborative and the Integrative Presence at the National Academy of Medicine

The old saw among lobbyists is that if you aren’t at the table, you are dinner. Given that the National Academy of Medicine sets the table for the US – and to an extent globally – in policy in health and medicine, well, it’s a good place for integrative health to be if a broad impact is a desired outcome. Since 2012, integrative health and the complementary medicine professions have had a seat at NAM through the philanthropically-backed (by an anonymous donor) membership and participation of the Academic Collaborative for Integrative Health (“the Collaborative”) in the Global Forum on Innovation in Health Professional Education. This year that relationship building came to fruition in two significant events in which the Collaborative and its leader there, Elizabeth A. “Liza” Goldblatt, PhD, MPA/HA served on the workshop committee and played significant roles. The first related to stimulating well-being and resilience (I was honored to have a role) and the second the robust workshop on non-pharmacologic approaches to pain management.  When the integrative field shows up, change happens.

6. David Eisenberg, MD and the Teaching Kitchens Collaborative

The minimal attention to nutrition in US medical schools and medical industrial practice remain one of the most blatant blights on mainstream medical education and practice.  A Belly Chakra Strategy for Moving Nutrition into Medical Institutions examines efforts of Harvard T.H. Chan School of Public Health’s David Eisenberg, MD and colleagues – including the Culinary Institute of America – to come at the issue through the senses – and now of research. A decade of work in building collaborators like Stanford, Dartmouth, Kaiser, Princeton, nearly a dozen public academic health centers, plus funding members such as Google and additional philanthropic partners, led to TKC’s first “Research Day” and the publication of 51 abstracts. These are key milestones for an initiative that needs evidence to continue to expand. What Eisenberg is ultimately seeking is data that shows doctors, insurers and medical delivery organizations can save and make money keeping people well – knowing food will then be a key strategy. Until then, notes Eisenberg, “the fact that less than 20 percent of medical schools have a single required course in nutrition – it’s a scandal. It’s outrageous. It’s obscene.”

7. Penny George and the George Family Foundation

For a philanthropist whose work for the field has been lower profile since the Bravewell Collaborative sunsetted and the recidivism of Allina Health in not energetically continuing the inpatient and outpatient integrative initiative led by the Penny George Institute there, the work of Penny George and her spouse Bill George with the George Family Foundation has popped up in great spots this year. First, the partnership to move integrative to communities, with YMCAs. Second, funding of what became a terrific organizational newsletter for the Consortium. Third, backing a National Academy of Medicine Global Forum on Innovation in Health Professional Education workshop focused on systemic strategies to advance well-being and resilience. And finally, in early December, word that for 2019 and 2020 the George Family Foundation will sponsor the only ongoing representation of integrative at NAM by the Academic Collaborative for Integrative Health via Global Forum membership. Great strategic investments.

8. The Rise of the Creative Arts Therapies and Social Prescribing

Last spring, the director of extramural research at NCCIH Emmeline Edwards, PhD penned a blog-post that invited anyone interested to attend a breakfast round table at the International Congress on Integrative Medicine and Health: “Many current health challenges such as autism, chronic pain, and Alzheimer’s disease have remained largely intractable. Research suggests that a combination of therapeutic approaches will likely be needed to address these complex conditions. Creative art therapies may have a role to play in these multidisciplinary strategies.” This elevation in the USA of what a national leader in this arena, Ping Ho, MA, MPH of UCLA Arts and Healing has called “low hanging fruit” – in a response to Edwards – appears to be eons behind the United Kingdom where word emerged in a November 8, Smithsonian article that by 2023 doctors there will routinely be sending patients to “art, music, dance and singing lessons” as part of social prescribing.

9. George Washington University’s Misha Kogan, MD: The How Can He Do All That Award

It was a busy year for Mikael “Misha” Kogan, MD. The George Washington University (GWU) integrative medicine leader rolled out his edited Integrative Geriatric Medicine volume. He co-led development of the health justice-oriented conference of Integrative Medicine for the Underserved (IM4US), hosted at GWU. At the International Congress for Integrative Medicine and Health in May he co-convened an overflow breakfast session on medical marijuana . Later news broke that Kogan will co-guest edit a special issue on the topic at Complementary Therapies in Medicine. His small not-for-profit AIM Health Institute, dedicated to providing group integrative care to the underserved (for which I serve on an advisory board) managed to forge relationship with Bread for the City Clinics under a HRSA grant aimed at offering massage and acupuncture in patient care. Meantime, Kogan’s a bee-keeper – a n intense practice of centering. He neatly puts the bees to work for his mission by distributing their honey to donors.

10. Jun Mao, MD: From Integrative Oncology Presidency toward Society for Acupuncture Research Presidency

If one imagines the entire integrative field as a single large administration, then the next step for Jun Mao, MD, MSCE, integrative oncology director at Memorial Sloan Kettering Hospital, is from leading one of the most significant “departments” – integrative oncology – to a horizontal move to guide a second – acupuncture research. In his terms as president and past-president (under Lyunda Balneaves, RN, PhD exceptional presidency) of the Society for Integrative Oncology, SIO’s accomplishments included forging a partnership special issue on the global movement for integrative oncology with the Journal of the National Cancer Institute and the endorsement of an SIO integrative breast cancer guideline by the American Society for Clinical Oncology. One wonders, looking forward, what directions Mao may help set for the also underfunded yet influential Society for Acupuncture Research when he takes over the presidency there.

Finally, impossible to leave off without great gratitude to Ruth Westreich whose investment has fueled the Integrator work since 2016, and to Southern California University of Health Sciences (SCU) via its visionary president John Scaringe, DC, EdD that came on to sponsor this year. Their generosity and commitment to health creation in 2018 provided the financial backing for my time and energy in chronicling, commenting and cajoling that make up the Integrator Blog – and the variety of off-line support and connecting that make up the whole of the work they support. I also thank Today’s Practitioner-Advancing Integrative Health and Academy of Integrative Health and Medicine for publishing partnerships that help significantly to expand the reach of the Integrator content. If you haven’t already, sign up here for the 2-4 times monthly Integrator updates. Here’s to the very best for 2019.