On the surface of things, the values of “accountable care” and “patient-centered medical homes (PCMH)” and those of integrative medicine suggest a convergence. A survey found alignment in integrative medicine leaders. Maryland integrative doctors David Fogel, MD, and his spouse Ilana Bar-Levav, MD, presented with a substantial philanthropic gift, jumped into the apparently convergent rivers with both feet, creating the interprofessionally rich environment that is now CHI Health Care. The goal was and remains to prove the value proposition of integrative medicine in the medical industry’s move from volume to value. The center gained recognition as a PCMH and became part of a Medicare Shared Savings accountable care organization (ACO). Now Fogel makes clear that the convergence of the two paradigms have produced rumblings of boulders at the river bottom. While he remains positive about the model, the systemic obstacles are daunting.
An alert went out two weeks ago to a set of policy-oriented integrative health and medicine types. The Trump administration had published a report – “Reforming America’s Healthcare System Through Choice and Competition.” The email suggested that there was support here for the non-discrimination in healthcare provision of the Affordable Healthcare Act (a.k.a. “Obamacare”). Was this actually a dovetailing support of the Trump administration with the healthcare policy of his predecessor? I took a look and then connected a lobbyist who was on the ground when the Obama administration’s Section 2706: Non-Discrimination in Health Care was being drafted. The findings on the Trump study were mixed.
The principle of using the least invasive methods first – a corollary of “first do no harm” – is central to integrative health and medicine. Also core is the idea of patient-centered, functionally-oriented outcomes. Each of these principles is being chucked out the window as the FDA is systematically removing multiple natural agents from an approved list for compounding pharmacists.
Married to the mob is a term of endearment here – capturing a part of the motivation behind the remarkable contributions of David Schleich, PhD to the naturopathic medical profession’s “mother ship” and to powering growth for the naturopathic profession in North America.