That there should be a huge transformational drama underway in the US medical industry is a desire and dream that powers the integrative health movement and the work of many others. Those who might enjoy a sort of reality TV examination of not the fantasy but the multi-dimensional actuality of what such change looks like have a treat coming. The scene of action is 18 huge medical centers distributed across the entire United States. The script writers are 25 scientists on an evaluation team. The drama cuts across 4 deeply inter-related story lines: the impact of the transformational change on patients, on employees, on utilization, and on the extent of implementation and cost. We the people literally own this story. The investment and outcomes – from which any delivery organization can learn – are revealed in plain English in the public domain. If the launch of the transformational journey was Episode 1 of the series, then this 39-page report after two years is Episode 2. It’s deep insight into a dream coming true in the Whole Health System of Care at the US Veterans Administration (VA). It’s long awaited. And it is exciting.
When members of Congress established what is now the NIH National Center for Complementary and Integrative Health, they cared about whole things. Eight times in two pages, the new Center was charged to examine not just basic research or reductive trials on individual modalities. They pointedly sought to turn the NIH’s attention to the value of complementary and alternative “systems and disciplines … in health care delivery systems in the United States.” This shift of focus was resisted. The first director Stephen Straus, MD famously shouted down his former NCCIH advisory council member Carlo Calabrese, ND, MPH when Calabrese courageously asked for research whole disciplines and whole practices like those of licensed naturopathic and traditional Chinese medicine practitioners. All integrative disciplines urged Straus’ successor Josie Briggs, MD to focus her 2011-2015 strategic plan on “researching the way we practice”. Briggs showed interest but showed no one the money to engage these questions. So when the NCCIH’s current director Helene Langevin, MD opened the NCCIH 2021-2025 strategic planning process with a February 18, 2020 video-cast webinar by focusing on “whole person health,” there was, among many, a great deal of anticipation and pent-up-demand. What might this mean?
In the mid-1980s, editor of Holistic Primary Care Erik Goldman began a career as a medical reporter. It was a boom-time for pharma-sponsored print publications. Each month mounds of media arrived at each medical doctor’s doorstep. Goldman’s first reporter job was with Dermatology News. It was what he calls “the height of unfettered spending” by big pharma. Goldman”s personal interests in natural medicine made him feel “an imposter – like they’d find out about me somehow.” By the early 1990s he was encouraging his editors to dip into the emerging “CAM” world. He unsuccessfully shopped the idea of focused holistic medicine publication to publishers before realizing that the “someone” just might be him. In 2000, he teamed up with with publisher Meg Sinclair and co-founded Holistic Primary Care which now goes out to 60,000 mainly conventional practitioners. I caught up with this fellow who is the integrative field’s most legit and enduring medical reporter – and presently sponsor of the Practitioner Channel Forum – to reflect on the two decades and look forward.
First, some self-declarations. Since 1992 I have benefited financially from in-office sales of dietary supplements via the integrative medical practice of my spouse. On multiple occasions over 30 years, I have helped mount or been associated with medical conferences in which the business model relied on exhibits from dietary supplements companies. I have in multiple instances secured grants from natural products companies to support initiatives of various professional organizations, research projects, and for The Integrator Blog. Such relationship are often the rule across the functional, naturopathic, integrative, chiropractic and traditional Chinese medicine communities. What’s new now is that those involved in integrative and functional medicine continuing medical education are increasingly in the spotlight of the Accreditation Council for Continuing Medical Education (ACCME) via new application of old rules, and new ACCME rules under consideration. These may – for better and for worse – shake-up the way integrative CME is offered, and potentially not only for medical doctors.