The polarization between reductive biomedical science and a whole person integrative model obscures deeper differences relative to human nature. The top-down, fix-it mode of the former is grounded in a fundamental belief that people (a.k.a. “patients”) either do not want to change or simply can’t. Meantime, the time-consuming, get-in-there-and-partner focus of lifestyle-oriented integrative practitioners assumes that the presenting human being arrives with seeds of change seeking ground for germination and growth. A recent Harris poll on perceptions of self-care among conventional medical doctors and their patients that was funded by the Samueli Foundation and led by its integrative health director Wayne Jonas, MD describes the chasm that has opened between the two parties. The patient is seeking an integrative model for self care amidst the present predication of medical delivery on the skeptical view of human nature.
Cast a net for papers on “innovations in group-delivered services” and what do you get? Guest editor Maria Chao, DrPh, MPA summed up the nearly 40 submissions this way: “Our editorial team was struck by the heterogeneity of integrative group visits for a range of health conditions, serving diverse patients across the life course and implemented in varied healthcare settings. A unifying theme is the potential for integrative group visits to address unmet needs of underserved and vulnerable patients. In many ways, group visits serve as a critical model towards integrative health equity.” The commentaries and research articles in the JACM Special Focus Issue on Innovation in Group Delivered Services make a potent case for an expanded role for groups not just for those who can pay cash but for all populations in a transformed healthcare system. All the articles are in open access until August 25, 2019.
Environmentalism as a value pulled me toward the job that drew me into integrative medicine 35 years ago. Part of the magnetism was learning that a primary charge in the field with which I was deciding whether to become involved was to aid and abet the healing power of nature. I surmised that such teaching would make patients of such doctors acolytes of the environment if they weren’t already. For this and other reasons, the environmental movement’s still limited embrace of the broader integrative domain as a core ally has continuously surprised me. If it is science one needs to bind these together, a recent Grand Rounds at Harvard Medical School included intriguing arguments. Peter Wayne, PhD, the interim director of that institution’s Osher Center for Integrative Medicine locked the two movements together through an array of existing, emerging and suggestive evidence.
The transformation of acupuncturists from things to beings as subjects of research – from modality to whole system professionals – got a big boost at the June 26-29, 2019 Society for Acupuncture Research (SAR) conference. The alchemical stew for which SAR board member Robert Davis, LAc, MS was master chef began with the conference’s real world, policy, and payment focus. A Patient Centered Outcomes Research Institute (PCORI)-funded process for which Davis’ conference co-chair Remy Coeytaux, MD is primary investigator focused attention on implementation and dissemination. Past SAR board president Helene Langevin, MD, who stepped down from the SAR board when she began service as director of the NIH National Center for Complementary and Integrative Health (NCCIH), announced intentions for a precedent-setting initiative on whole systems research. In this mix, the acupuncturist as a whole professional flowered both as research target and as a potentially more valued participant in a reformed system for health care.