Tracking the inclusion of integrative strategies inside the Veteran’s Administration (VA) is an exception to the saying that a watched pot never boils. Integrative health research inside the VA funded in 2016 was the basis by which VA leaders chose 3 years later to more than triple the implementation of the “whole health” model to 55 medical centers. It was cause to exult. Now a special issue of the American Public Health Association journal Medical Care documents a further percolating of the inclusion process. With The Implementation of Complementary and Integrative Health Therapies in the Veterans Health Administration, one witnesses the powerful potential for change when a will is linked to a plan and a budget. The success at the VA casts cold light on the relative failure of reduction-oriented and production-minded public and private agencies to guide optimal implementation of integrative practices and practitioners into the delivery institutions on which the vast majority of U.S. citizens rely for their care.
The push for evidence to assist in formulating more effective clinical response to the COVID-19 pandemic is awakening scores of research projects and multipliers more of recommended directions. In the integrative sphere, a team led by Lise Alschuler, ND from the University of Arizona Andrew Weil Center for Integrative Medicine published a paper on “considerations” for natural practices and agents. The Chinese government claims the use of traditional Chinese medicine is in part responsible for its apparently relatively rapid turn-around there. TCM researcher John Chen, PhD, PharmD, OMD, LAc and others have brought that work to the United States. Ryan Bradley, ND, MPH at Helfgott Research Institute led a global team to create a Traditional, Complementary and Integrative Health and Medicine COVID-19 Support Registry. I helped promote it with this JACM editorial. Yet the US government has been quiet, when not frankly antagonistic to supportive COVID-19 strategies. I connected with the NIH National Center for Complementary and Integrative Health (NCCIH) to see what they are up to related to COVI-19. This column reports the exchange with Helene Langevin, MD, NCCIH’s director.
When members of Congress established what is now the NIH National Center for Complementary and Integrative Health, they cared about whole things. Eight times in two pages, the new Center was charged to examine not just basic research or reductive trials on individual modalities. They pointedly sought to turn the NIH’s attention to the value of complementary and alternative “systems and disciplines … in health care delivery systems in the United States.” This shift of focus was resisted. The first director Stephen Straus, MD famously shouted down his former NCCIH advisory council member Carlo Calabrese, ND, MPH when Calabrese courageously asked for research whole disciplines and whole practices like those of licensed naturopathic and traditional Chinese medicine practitioners. All integrative disciplines urged Straus’ successor Josie Briggs, MD to focus her 2011-2015 strategic plan on “researching the way we practice”. Briggs showed interest but showed no one the money to engage these questions. So when the NCCIH’s current director Helene Langevin, MD opened the NCCIH 2021-2025 strategic planning process with a February 18, 2020 video-cast webinar by focusing on “whole person health,” there was, among many, a great deal of anticipation and pent-up-demand. What might this mean?
The transformation of acupuncturists from things to beings as subjects of research – from modality to whole system professionals – got a big boost at the June 26-29, 2019 Society for Acupuncture Research (SAR) conference. The alchemical stew for which SAR board member Robert Davis, LAc, MS was master chef began with the conference’s real world, policy, and payment focus. A Patient Centered Outcomes Research Institute (PCORI)-funded process for which Davis’ conference co-chair Remy Coeytaux, MD is primary investigator focused attention on implementation and dissemination. Past SAR board president Helene Langevin, MD, who stepped down from the SAR board when she began service as director of the NIH National Center for Complementary and Integrative Health (NCCIH), announced intentions for a precedent-setting initiative on whole systems research. In this mix, the acupuncturist as a whole professional flowered both as research target and as a potentially more valued participant in a reformed system for health care.