Should accredited continuing medical education providers for integrative medicine be prohibited from training medical doctors to practice integrative modalities that aren’t “generally accepted within the profession of medicine as appropriate for the care of patients”? What impact might this have on efforts – for instance – to shift chronic pain treatment toward non-pharmacologic approaches that most of medicine doesn’t “generally” include? Might giving arbiters of science in a disease model this power put the brakes on efforts to shift clinical care from managing disease to creating health? These other significant questions are on the table for the integrative health field as the Accreditation Council for Continuing Medical Education (ACCME) posts its draft revision of accreditation standards. The changes, targeting issues throughout CME, have particular challenges for the integrative medicine field. The comment period closes February 21, 2020.
Prior to publication of my article on the proposed new standards on “content validity” from the Accreditation Commission for Continuing Medical Education (ACCME), I circulated it to a few leaders in the field for comments. In the process, I learned that a team from the Academic Consortium for Integrative Medicine and Health (“the Consortium”) recently had a conference call with Graham McMahon, MD, MMSc, ACCME president and chief executive officer. Saturday morning, January 25, 2020 I spoke with Rick Hecht, MD, the Consortium chair, who was part of the conference cal. He has had other recent discussions with key colleagues in the CME office of his home institution. Hecht’s comments offer some perspective on ACCME’s current areas of focus in CME. I have assembled his comments in the following interview format and secured his approval prior to publication.
The beginning of the RAND project proposal captures dimensions of an awful tend: “The future of research in the Complementary and Integrative Health (CIH) institutions is in jeopardy. A number of CIH colleges and universities are losing their research departments due to lack of consistent funding and the understandable inability to subsidize them with tuition costs. The CIH Colleges are in danger of becoming technical teaching institutions and not institutions of learning. Those teaching the students will not be scholars and researchers who are producing new knowledge for their profession. NIH offers several training grants for researchers and these have been very effective in training CIH practitioners to be researchers. Unfortunately, these CIH practitioners generally leave their institutions for research training and degrees, and without robust research centers at the CIH institutions, they are rarely able to go back.” In December 2019, RAND received a $1-million gift to kick-start a strategy – led by Patricia Herman, ND, PhD and Ian Coulter, PhD – to overcome these structural flaws. Here is a look at the project.
In July 2019 I published a piece entitled Harvard Medical School Grand Rounds Powerfully Interlocks Integrative Medicine and Climate Agendas. It was based on an event led by Peter Wayne, PhD. Now Wayne and two colleagues with the Osher Collaborative for Integrative Medicine have published a related commentary that makes a direct claim in its title: Integrative Medicine Is a Good Prescription for Patients and Planet (in open access throughout January). The authors initiate an intriguing and expansive case for myriad ways that this assertion may be so. For instance: how might an increase in mindfulness diminish shopping addiction, and thus resource consumption? This column is a call for your perspectives of up to 250 words on angles and arguments that support – or oppose – that bold claim. I will select from and publish responses along with photos and brief bio data of contributors in a future Integrator piece. The findings are meant to deepen an evidence-informed dialogue on this topic. Might the integrative health-climate change connection re-frame much more broadly the transformative meaning of this movement?