Sometimes synergies call for a solid moment of appreciation. In early 2019, Delia Chiaramonte, MD, an educator and integrative doctor who works in palliative medicine pinged me under my journal editor hat. How about a special issue of JACM-Paradigm Practice and Policy Advancing Integrative Health to highlight “integrative palliative care”? I liked the idea. I also knew that Chiaramonte, principally a clinician-educator, would be served to have a partner with more research experience. Two days later, Shelley Adler, PhD emailed me. The UCSF educator with fine research chops informed me she would be co-author on the next in a series of quarterly JACM commentaries from the Osher Collaborative for Integrative Medicine. The subject: the integrative-palliative intersection. Last week the JACM special issue was published with the Chiaramonte-Adler dyad offering the introductory editorial as curators and guest editors. The entire issue is in open access for a month.
In recent weeks, two influential integrative health organizations each chose to feature presentations on the expansive, multidisciplinary, and remarkably patient-choice integrative pain pilot associated with the University of Vermont Medical Center (UVMC). The presentations for the Academic Consortium for Integrative Medicine and Health and the Alliance to Advance Comprehensive Integrative Pain Management (AACIPM) featured the project’s remarkable, multi-stakeholder partners: the state’s dominant payer, Blue Cross Blue Shield, the Vermont Department of Health, and the academic medical center. Included in the latter was the project’s research leader, longtime integrative health policy activist and prior NIH National Center for Complementary and Integrative Health adviser Janet Kahn, PhD, LMT. The parties shared early outcomes from the unique bundled payment model. Many consider the strategy a potential pilot for the nation. What is being discovered? Can it be implemented elsewhere?
In the minds of many in the dominant school of medicine, all of integrative medicine is frontier science. That bias often holds that the integrative frontier toward which one may sail is a chimera. Yet new continents have been found. Witness findings supporting acupuncture effectiveness and telomere lengthening through meditation. For integrative health, the frontier of that frontier is subtle energy and biofield healing. Spearheading efforts to quantify and advance science and action in this $2.8-billion industry is a self-styled “collaboration accelerator,” the Consciousness and Healing Initiative (CHI). CHI posits that the world they are mapping in their just published resources positions energy medicine as “the new mindfulness.” The multi-year CHI mapping project offers fascinating interactive journeys to 6,200 studies, 74,000 US practitioners, 250 energy devices, and a literal map that takes one to the location of 400 researchers globally who are examining these subtle therapies. Their goal is nothing less that systems change. They believe their work can be a model for all in the integrative health field who favor dramatic shifts in the health and medicine landscape.
The easy access by medical doctors to accredited continuing medical education in integrative medicine is an engine of the field’s growth. So as stories emerged of what was believed to be an Accreditation Council on Continuing Medical Education (ACCME) clamp down, I engaged a series of interviews and reports. I reported direct and indirect assurances from ACCME’s CEO Graham McMahon, MD, MMSc that integrative medicine is not being targeted. Yet a recent commentary from leaders of the Osher Collaborative for Integrative Medicine raised the question again. I decided to review evidence to this date. I cannot but conclude that integrative medicine is, in fact, at the center of the bullseye in ACCME’s recent push for new standards of “content validity” regarding “controversial areas”. Here is the evidence.