Nancy Sudak, MD became known nationally as a leader in the board certification of integrative holistic medical doctors and then as the founding executive director of the Academy of Integrative Health and Medicine (AIHM). In these roles, Sudak knew the challenges of sustainability for integrative medicine models in large delivery organizations. So when she left AIHM, she developed an opportunity in a large upper Midwest system to create and prove an model. Now, two years plus into her experiment that is now a growing enterprise, Sudak has strategies to share in what she continues to view as a way to “normalize” the delivery of integrative medicine as a consultative practice in a large delivery organization.
The January 2019 newsletter from the Integrative Health Policy Consortium (IHPC) led off with a call to action. A 90 day comment period is open on the new HHS Draft Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies and Recommendations. I read the document with an eye to its inclusion of “complementary”, “integrative”, and “non-pharmacologic”approaches (including a 3-page section on “Complementary and Integrative Health”) and any specific reference to related practices and practitioners. The document offers remarkable signs both of how far these have penetrated pain policy strategy and of their absence in key action steps. Changes in these would be optimal for the final report. This article is a guide to inclusion and offers suggestions for how the integrative health community might register comments to advance best practices in pain treatment that will help get the opioid money off our collective backs. Public comments are due March 28, 2019.
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.