In academic medical centers promoting transformation toward integrative medicine and health, nurse leadership is rare. So is branding them with “spiritual” and “healing”. The usual chess game of change-making focuses on moving RCTs and systematic reviews like pawns to gain an advantage. Honoring the full professional value of licensed acupuncturists, chiropractors, naturopathic doctors and others is also rare. Most find it easier to gain the support of a dean by reducing such professionals to tools to deploy instead of as interprofessional partners. This year marks the 25th anniversary of an institution that modeled a road less traveled that included these and other distinctive, inclusive traits. The founder-director is nurse and health services researcher Mary Jo Kreitzer, RN, PhD, FAAN. I reached her for a long-overdue profile of a center that a close observer of the field has called “one of the most important centers globally for advancing integrative health.”
Two decades ago, James Gordon, MD was the chair of the top US government effort to examine integrative medicine policy. In an August 20, 2019 blogpost, the integrative psychiatrist shared how 50 years ago he traveled with crisis intervention nurse Sharon Curtin and singer Joan Baez to Woodstock where he treated hundreds of hallucinating attendees through a co-caring model. His August 9, 2019 letter to the New York Times challenged the Trumpian portrayal of mass-shootings motivated only by mental illness. Gordon described himself this way: “Though my professional work is devoted largely to trauma healing for survivors of such mass murders — and of wars, state-sponsored torture and climate-related disasters — I have known and treated a number of violent extremists, including mass murderers.” Trauma is us. On September 10, 2019, trauma hot-spots healer Gordon has a new book coming out on the transformation needed. I reached him for a brief interview.
The idea that “the first is the last and the last the first” was a value in my liberal Protestant upbringing. It likely had some noblesse oblige in it too. The concept can be challenged as an entrapping promise that good will come of waiting. Regardless, in some the call to work with the least-cared-for becomes a guiding mission. Self-preservation of the integrative field may be another motivator of such a mission. A past head of the NIH agency that researches integrative practices has challenged the main body of clinical research as un-generalizable due to the research being on upper income, well-educated, white, female patients. For a multitude of reasons, Integrative Medicine for the Underserved (IM4US) has emerged as the leading edge of the movement for integrative health.
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.