Environmentalism as a value pulled me toward the job that drew me into integrative medicine 35 years ago. Part of the magnetism was learning that a primary charge in the field with which I was deciding whether to become involved was to aid and abet the healing power of nature. I surmised that such teaching would make patients of such doctors acolytes of the environment if they weren’t already. For this and other reasons, the environmental movement’s still limited embrace of the broader integrative domain as a core ally has continuously surprised me. If it is science one needs to bind these together, a recent Grand Rounds at Harvard Medical School included intriguing arguments. Peter Wayne, PhD, the interim director of that institution’s Osher Center for Integrative Medicine locked the two movements together through an array of existing, emerging and suggestive evidence.
The number of acupuncturists employed in federally qualified health centers (FQHC) is no longer negligible yet still far from routine. The number who have that experience and have also served their state as members of technology review panels charged to evaluate the science behind non-pharma approaches to pain may be just one. The person doing both in what is essentially a national pilot program in the state of Oregon is Laura Ocker, LAc. I got in touch with Ocker, the past president of the Oregon Association of Acupuncture and Oriental Medicine (OAAOM, for an acupuncture practitioner’s perspective on practicing in the context of the controversial program that led national pain leader Sean Mackey, MD, PhD` to spark a national campaign to limit its expansion. While not fond of the spotlight, Ocker agreed to share some of her experience as part of this ongoing Integrator series.
Seven years ago, David Fogel, MD set the goal of proving what he hoped could be a primary care cornerstone of a transformed system of health care. With a generous philanthropic grant, he and his spouse Ilana Bar-Levav, MD created a team-based integrative health patient-centered medical home (PCMH). To give it power as a national model, the integrative PCMH was fully webbed into the emergent accountable care and value-based system. Early cost and health outcomes at their CHI Health Care significantly outperformed conventional practice metrics. They drew a visit from a US Surgeon General who was in search of innovative, value-based models. Yet now comes news that on July 23, 2019, the Center will shut its doors. An apparent guiding light for health system transformation will be snuffed. What gives?
From the perspective of research contributions from academic institutions in integrative health, the 7 multidisciplinary universities have been key important contributors. These institutions, with one exception, are products of the last 20 years of advance of complementary, integrative and non-pharmacologic approaches in US health care. Each began as a professional school for chiropractic doctors, naturopathic doctors or acupuncturists then chose to expand its offerings for bird-of-a-feather programs, morphing into universities of integrative, natural health sciences. Part 1 of this series, “The Future of Integrative Health – Interviews with Presidents of 7 Multidisciplinary Universities”, examined the cornucopia of their present offerings. Part 2 offers an examination of the current place of research in these integrative health universities as the nation begins to call on their practices and practitioners in developing a new chronic pain strategy.