Virtually every corner of the medical industry houses an entangling drama between mission and money. There is the service, the need to make a living, and then the way making a living can transform into a production orientation dominated by the impulse to make more money. For integrative health and medicine, the drama is intense, whether in integrative centers owned by large institutions or solo practices in the community. The mission-money challenges get “curiouser and curiouser” for the licensed integrative practice fields that are not fully swept up into the thundering $3.3 trillion river of cash that annually rips through the dominant medical industry. An edginess sets in when, as the sick joke has it, you have just enough recognition to get into debt, but not enough to get out of it yet. So it is always interesting to explore new data on income and practice methods such as were recently published by the Association of Accredited Naturopathic Medical Colleges in it’s 2020 Graduate Success and Compensation Study.
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?
A week after the murder of George Floyd, I published brief accounts of some of the integrative health community’s response. I quickly learned that I’d missed statements from some key players. Subsequently, many others were called to make statements. These are evidence that some of white people – and most in the integrative fields are white – in present day parlance, that some are “woke” or waking. The next question, as interviewer Brian Carter put it during a June 21 Seattle Arts & Lectures dialogue with Emory University professor Carol Anderson, author of White Rage and One Person: No Vote, is: “They may be woke – but are they getting out of bed?” There are signs below among some of new actions to make sure there is ongoing, systemic engagement to address the chronic, systemic abuses, micro and macro. Here is a second overview, with links where available. The good news is that many show signs of getting out of bed . Many were called to make public commitments. (In addition, for reference, a include links to two statements from organizations in the dominant school of medicine.)
In a recent conference organized out of Prague and moved online, a presenter from the United Kingdom shared a list of concerns that seemed to go on forever of all that is frightening people these days. Foremost on his list were Covid19, what seem to many like authoritarian governmental measures to control its spread, uncertainty about the economy, and the questionable competence of world leaders in the face of a mounting global crisis. In the United States, these are compounded by unrest over police brutality against Black people forcing many to re-examine the legacy of 400 years of what historians call our “peculiar institution” of slavery. Author and clinician James Lake MD is an integrative psychiatrist who has witnessed the effects of this “perfect storm” close up. For Psychiatry Times, Lake authored a column on what he calls A Mental Health Pandemic: The Second Wave of COVID-19. He urged a re-think of typical mental health responses to include integrative solutions in his “Call for a National Strategy.” I reached Lake to explore what has steered his vision to make such dire predictions, and to explore how integrative methods might best figure into solutions.