The early “integrative medicine” period clearly was one of “non-integrated integration.” The hospital or insurer wanted to throw the consumer an integrative bone in the competitive marketplace. They produced stand-alone integrative clinics or a carve-out insurance products. Offerings, in these forms, serve dual purposes. The medical delivery organization or insurer pleases patients by offering a little yoga, or acupuncture, or manipulative therapy or massage. At the same time, the non-integrated nature of what is offered pleases medical leadership: they are not asked to take the integrative methods seriously. They needn’t cross the medical-cultural divide to weigh whether the integrative approaches may be better than usual care. For most of the past decade, the Society for Integrative Oncology (SIO) has been building bridges across the chasm. Twice they’ve developed integrative oncology guidelines with mainstream oncology organizations. Now, through an unrestricted grant from the Samueli Foundation, SIO and the influential American Society for Clinical Oncology (ASCO) are commencing a project to raise three additional girders to bridge treatments.
Sometimes synergies call for a solid moment of appreciation. In early 2019, Delia Chiaramonte, MD, an educator and integrative doctor who works in palliative medicine pinged me under my journal editor hat. How about a special issue of JACM-Paradigm Practice and Policy Advancing Integrative Health to highlight “integrative palliative care”? I liked the idea. I also knew that Chiaramonte, principally a clinician-educator, would be served to have a partner with more research experience. Two days later, Shelley Adler, PhD emailed me. The UCSF educator with fine research chops informed me she would be co-author on the next in a series of quarterly JACM commentaries from the Osher Collaborative for Integrative Medicine. The subject: the integrative-palliative intersection. Last week the JACM special issue was published with the Chiaramonte-Adler dyad offering the introductory editorial as curators and guest editors. The entire issue is in open access for a month.
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.)
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.