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.
A significant trend is appearing in major research organizations on integrative health and medicine. The timing is right: in the United States, major reports, meetings and guidelines now include non-pharmacologic, a.k.a. integrative approaches. But how do we move these into practice? Top acupuncture, integrative oncology and general integrative health conferences are featuring what is called “implementation science.” This study of methods to promote the integration of research findings seeks to propel changes in healthcare policy and practice. The integrative trend arises amidst a renewed push for health services research of all kinds. Action on these lines can straighten out some twisted karma relative to the 1998 US Congressional legislative mandate that established the globe’s most significant scientific investment in alternative, complementary and integrative medicine.
From 30,000 feet – where I sit – it’s easy to proclaim all the reasons why group visits are a terrific fit for the values and practice of integrative health and medicine. Docere. What better format than groups? Adults learn better interactively. Groups are mediums for taking power in oneself and changing lifestyle. Now a presentation through the Academic Consortium for Integrative Medicine and Health (“the Consortium”) offers data on how group visits both expanded access and increased revenues in integrative health services. Meantime, peer-reviewed journal JACM has announced that it is developing an entire Special Focused Issue on Innovation in Group-Delivered Services.
At one point over the past three years of robust expansion of dialogue related to chronic pain care I received a somewhat panicky email from an integrative care advocate. He was concerned that by me speaking of the “opportunity” for integrative health produced by the US’ enthrallment with opioids that his field would be tainted as “opportunists.” Fact is, the dialogue over right use of “non-pharmacologic” practices and practitioners in chronic pain treatment has provoked a quantum opening in many quarters. This article shares an invitation to a December 4-5 workshop at from the National Academy Medicine (NAM) – the most robust inclusion of integrative health there since the 2009 Summit. Also included: another positive development at NAM, and first notes of advances at AIPM’s recent Integrative Pain Care Policy Congress. The bad news of the opioid crisis is proving very good for opening needed dialogue.