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.
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?
After publishing on challenges the Accreditation Council for Continuing Medical Education (ACCME) is presenting to the integrative and functional medicine continuing medical education (CME) providers, I sent links to Graham McMahon, MD, MMSc, the organization’s president and CEO to request an interview. Multiple integrative CME providers with decades delivering integrative CME have lost or are facing potential loss of recognition. They have shared serious questions of transparency and intent on ACCME’s part. Some efforts to connect with ACCME have been rebuffed. Is integrative medicine being targeted? In my request for an interview, I provided McMahon some background on concerns. McMahon responded immediately, and affirmatively. We spoke for over 30 minutes via zoom on February 5, 2020. His responses included a surprising assertion that he believes the present ACCME is aligned with integrative medicine principles and practices. He committed to open dialogue in ACCME’s move “from cop to coach.” He underscored that the new proposed language is yet open for comment. I assembled our exchange in the following interview format and sought his edits and written replies to additional questions, then secured his approval prior to publication.
Word began to break mid-summer of two developments at the Veteran’s Administration related to the giant agency’s integrative whole health effort. One was that Tracy Gaudet, MD, the charismatic founding director of the VA’s Office of Patient-Centered Care and Cultural Transformation that birthed the initiative was moving on. The immediate response of many is concern. Yet the news came concurrently with word that the VA’s initiative is expanding from the initial 18 to 37 new sites. Even with leadership change at the top of the VA, the initiative is secure and strongly supported. I connected with Ben Kligler, MD, MPH, Gaudet’s colleague who is presently acting director for an update.