The decision of the Cleveland Clinic to start a Center for Functional Medicine was big news. That the $9-billion system gave the initiative significant visibility suggested arrival for functional medicine. A few hurdles still existed. Cleveland Clinic’s new partners needed to clarify and create a clinical model that could be measured. That was the caveat. This Center was a bet – a pilot based on a largely untested belief that functional medicine could outperform regular medicine, and at lower cost. Most in the field assumed this would prove a slam dunk. Care from a team of functional medicine physician/nutritionist/health coach and then behavioral specialist became the unit for which outcomes would be measured. Now in a publication in JAMA Network, the first results are in. The headlines were positive – but what do the data really say?
Long-timers in the integrative trenches will know the paradoxical feelings of dismay at how messed up health care still is and at the same time satisfaction at just how far “integration” has advanced. Evidence for the latter comes from not one but two recent moves in the career of chiropractor and health services researcher Christine Goertz, DC, PhD. Place yourself in 1988. The chiropractors were just concluding their decade-long, successful Wilk vs. the AMA anti-trust suit. Most of medicine and much of the media – in part because of the AMA’s economically-driven attacks – equated “chiropractor” with “quack”. Now consider where Goertz has arrived via her health services research and policy career that focused on safety, effectiveness and quality issues. She was recently named by the General Accounting Office as Chairperson, Board of Governors, for the Congressionally-funded, quasi-public Patient Centered Outcomes Research Institute (PCORI). And Goertz just began a new role as Professor and the Director of System Development and Coordination for Spine Health at Duke Health in the Department of Orthopaedic Surgery. I reached Goertz to talk with her about her dual ascension.
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.
I sometimes refer to my 1983-1993 years with the re-emergence of the naturopathic profession – amidst the broader social-medical movement that birthed integrative health – as my boot-camp. Given the decade duration of the commitment, it was more of an extended Marine Corp stint. The work was hard, ground won celebrated, compensation scarce, friendships fierce, and mission central. The pole star was the naturopathic profession’s commitment to “treat disease by restoring health.” The constellations that guided the voyage were a set of principles and something educators Jared Zeff, ND and Pamela Snider, ND would articulate as the “naturopathic therapeutic order.” So when the Association of Accredited Naturopathic Medical Colleges (AANMC) recently posted an updated version of the profession’s therapeutic order, I thought it a good time to re-visit the engine room of that field’s transformational work.