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.
Shortly after my recent post, “How the Backlash to Oregon’s Plan to Taper Opioids with Integrative Approaches Missed the Mark”, I received an e-note from national pain leader Sean Mackey, MD, PhD. The letterhead of the chief of the division of pain medicine at Stanford University and co-chair of the US HHS National Pain Strategy was the vehicle through which Mackey and 100 co-signers successfully campaigned for the Oregon Health Authority to prevent forced tapering “of certain patient populations.” Mackey wrote that he presumed we had shared interests in bettering care, yet he thought there was a harmful “negativity” in my article: “May I suggest rather than a ‘missed opportunity’ message, you could easily frame it as ‘forced opioid tapering defeated – here is what we need to do next …'”
On May 7-10, 2019, I attended the top international integrative health research conference that comes around each year. The 14th International Congress on Complementary Medicine Research drew roughly 400 “delegates” as the Brisbane, Australia hosts welcomed us. We hailed from 34 nations. The turnout to the distant location was about half that when the meeting is hosted in North America or Europe and roughly on par with a 2015 South Korean event. Yet despite or perhaps because of the size and distance new themes emerged and old ones that needed prodding re-emerged. Together these offer an impactful direction for the global integrative research community and for ISCMR, the organization of traditional, complementary and integrative medicine researchers that co-sponsors each of these event.