To promote an environment conducive to integration of conventional
medicine with CAM therapies.
For the purposes of this project, CAM care includes acupuncture,
manipulative therapies, herbal remedies, homeopathy, and mind-body
interventions. The project also has an evaluation component
that will measure the project’s impact.
After the first 10 months, project staff have been challenged
to maintain faculty members’ involvement, particularly with
competing demands on time. But the project has been sustained
by success factors including faculty support, dedicated personnel,
and enthusiasm by faculty, residents and patients. Project staff
are also encouraged by the overwhelming support they have received
from the CAM community, as well as resident and faculty receptiveness
to new ways of thinking about health care. The project looks
forward to fully integrating with the family practice residency,
evaluating and refining the student curriculum, and sharing
their experiences with the integrative medicine community.
Eric Leskowitz, MD and Joseph Audette, MD,
Spaulding Rehabilitation Hospital
Title: Rehabilitation as a Natural Focus for Integrative
Medicine
Report by Jennifer Lewy
The core values of rehabilitation - restoration of function,
patient empowerment, and teamwork - are all core values of complementary
and alternative medicine (CAM). And the clinical implementation
of CAM can thus fits seamlessly into the rehab setting. Drs.
Leskowitz and Audette gave an information-packed talk on integrative
medicine at Spaulding Rehabilitation Hospital (SRH). The Pain
Management Program at SRH has been practicing integrative medicine
(ranging from biofeedback and meditation to energy healing,
craniosacral and acupuncture) in a hospital and clinic setting
for over 25 years. The Program currently has an inpatient and
outpatient program offering a full range of CAM modalities.
Dr. Audette explained that many of the patients at the program
have “tried everything” in conventional medicine without relief.
They want to feel better, be empowered in the medical interaction,
have the time to share views about health and healing, and want
real time with a clinician. The Program, using a truly integrative
approach, can address these needs. Patients receive tailored
healing plans that involve treatments ranging from Tai Chi to
psychotherapy.
The practitioners’ experience in the Pain Program demonstrates
that successful integrative medicine incorporates ongoing science,
has links with conventional medicine, guidelines for credentialing
providers, funding from the public and private sectors, and
practices careful selection of practitioners. Challenges to
integration include the general financial instability of health
care, time pressures of standard care, unrealistic expectations
of healing, poorly designed research studies, and inappropriate
referrals to CAM by conventional practitioners. A major strength
of the program - and a fact that has helped the program deal
with criticism - is that many of its conventional practitioners
are also CAM providers (such as nurses who provide therapeutic
touch, MDs who provide acupuncture). Another strength is their
use of skilled CAM providers in the community. By utilizing
conventional clinicians who have complementary skills and the
community’s CAM resources, the Pain Program will continue to
provide truly patient-centered integrative care.
Judith Petry, MD, FACS, Holistic healing consultant
Title: Integrative Healing in Vermont: Shifting the
Paradigm
Report by Seth Goodwin
Dr. Petry’s presentation provided an overview of the future
of medicine. It was a provocative and well informed discussion
of the current state of medical affairs, problems, and possible
solutions. Dr. Petry began by stating that the mechanistic and
Newtonian system of medicine is no longer working well. It is
her belief that we need to seek a new model and that complementary
and alternative medical (CAM) therapies and Integrative Medicine
are the guideposts for this new paradigm. She believes that
we are now moving into an intermediate area between our current
state of healthcare and the desired state of healthcare. She
feels that CAM therapies and Integrative Medicine are filling
this intermediate area and providing guidance as to what the
future of medicine will look like in the years to come.
Dr. Petry suggested that the dominant belief about our current
healthcare system is that it allows people to live the life
they want, including the pursuit of habits that may be antithetical
to good health. She suggested, that in this way, the current
healthcare system acts as an enabler. She went on to suggest
that the burgeoning interest in CAM therapies marks a beginning
of a new consciousness. She warned, however, that if current
trends persist, CAM therapies would continue to be “allopathized”
by conventional medicine.
Dr. Petry suggested that we do not know why people choose CAM
therapies over other therapies. But she believes it may be the
beginning of a social change that charts a shift in the medical
paradigm. She hypothesized that people may choose CAM therapies
because of their own spiritual evolution. In her opinion, there
is little doubt that the mind/body effect has made its way into
the conventional healthcare system. This is witnessed by the
fact that many therapies like massage and acupuncture have gained
credibility. She believes these two modalities, in particular,
will be the next CAM therapies to receive insurance reimbursement.
Dr. Petry views CAM therapies as the catalysts for change that
may spark the full movement to another medical paradigm. She
suggested that new degrees of freedom are created when we pump
new energy into a system. She believes we must resist treating
CAM like allopathic medicine. If we do not, we will turn people
away who are choosing CAM for the very reason that it is different.
Dr. Petry referenced the four-quadrant work of Ken Wilber that
appears in his book The Marriage of Sense and Soul. This
complex approach creates four hierarchies, each of which represents
a different aspect of phenomena and experience. In Dr. Petry’s
interpretation of Wilber’s work, she said that two of these
quadrants represent areas exterior to human mind/body, and two
represent the interior aspects of human mind/body. Dr. Petry’s
argument, like Ken Wilber’s, is complex and requires significantly
more space than this summary to do justice. Suffice to say,
that Dr. Petry’s assertion is that conventional medicine has
spent a great deal of time focusing on those quadrants of the
human experience that can be apprehended with the scientific
method, while ignoring aspects of the four quadrant model that
are interior and not well suited to exploration by the scientific
method. The result, of course, is that certain aspects of the
human mind/body have been ignored by conventional medicine.
Dr. Petry suggests that part of CAM’s rising popularity is that
it speaks directly to those interior aspects of the human experience
that that have largely been ignored.
Dr. Petry closed her presentation by saying that the body is
the mouthpiece of the soul, and that we need to understand all
the messages coming forth from Wilber’s four-quadrant model.
She suggested that we also need to decide what the purpose of
healthcare is. Perhaps, she suggested, the role of healthcare
is to expand and explore the soul’s voice. She also suggested
that illness and injury are tools of evolution and spiritual
journey. With that, she concluded her presentation to a warm
applause and fielded questions. For further information about
her work in Vermont, she provided email addresses for two people:
Carole Heaney, Southern Vermont Healing Center:
HEAC@phin.org
Fritha Bowditch, President, Vermont Healing Tools Project:
fritha@together.net
Robb Scholten, MLIS, Division for Research
and Education in Complementary and Alternative Medical Therapies,
Harvard Medical School
Title: Reimbursement Options for Complementary Medical Providers:
A Scan of the Horizon
Report by Linda Kenney
Robb’s informative discussion focused on issues and organizations
impacting reimbursement options and insurance coverage for complementary
and alternative medical (CAM) services. His PowerPoint presentation
entitled, “Reimbursement and Integrative Medicine: a 10,000
foot view” provided a look at some of the strides that have
been made by managed care and employers to provide constituents
access and reimbursement for basic complementary treatments
such as acupuncture, chiropractic, herbal medicine and relaxation
techniques. Although the trends toward CAM reimbursement have
been encouraging, there are still misconceptions and misrepresentation
of the actual scope of CAM coverage from these organizations.
There was agreement among this session’s attendees and the presenter
that sometimes what is currently offered by managed care organizations
in terms of CAM reimbursement, is often done more for public
relations purposes than for actual health-benefit reasons or
to fulfill the true needs of their clients.
Concerning the general public, Robb listed some ‘known’ health
plans that provide varied reimbursement for CAM services. Full
or partial coverage for these therapies are available via some
3rd party payers through standard plans, discount
programs or rider clauses and through some employers who have
‘defined contribution plans’ as part of their employee health
package. A number of insurance companies nationally that are
participating to some extent in CAM coverage, including Aetna
US Healthcare, United Health Group, CIGNA Healthplan, Kaiser
Permanente (Northern California Kaiser is very innovative re
CAM coverage), Humana Health Care and Blue Cross of California.
Some businesses with CAM coverage in their defined contribution
health plans include Textron of Rhode Island, Medtronics of
Minnesota, and Raytheon of Massachusetts.
Robb examined some of the strategies being pursued by New
England-based insurers pointing out that many New England health
plans are at least beginning to offer some options for CAM therapies,
although they are far down on the national list in this regard.
For the practitioner, clearly billing and coding issues continue
to be a drawback to reimbursement for services/treatment. Robb
indicated that the integration of new codes into current billing
systems is ongoing and tedious. There is still much work to
be done defining ‘standards of care’, CPT codes and Medicare
re CAM, evaluation, management and benchmarks for these types
of treatments. However, Robb discussed trends that are enhancing
the effort to secure coverage for CAM including newly released
guidelines from the Federation of State Medical Boards (www.fsmb.org)
and the fact that chiropractic is now available throughout the
armed services as a standard medical benefit. Robb’s final slide
“Why Reimbursement” summed up the value and value-add
from CAM coverage including building effectiveness data, profiling
cost/benefit date, benchmarks for Medicare and medical school
curriculum.
For further useful clinical and reimbursement information
on a national level, Robb directed the audience to the website
of ‘The Collaboration for Healthcare Renewal”
www.thecollaboration.org. ‘The Collaboration’ has ongoing
working committees that publish white papers to its website
and is a source of information on CAM coverage.
Robb’s presentation handouts were available during his talk
and at the Resource Table in the lobby of MCP. They included
a copy of his PowerPoint presentation and a 6-page ‘Resources
in Complementary Medicine’ list. We hope to have his excellent
and thorough resource list on the IMA website within a few weeks.
Robb Scholten can be reached at:
Robert_scholten@hms.harvard.edu
617-384-8550
Harvard Medical School Osher Institute
Landmark Center 22-A
410 Park Drive
Boston, MA 02215
Beth Sommers, MPH, AIDS Care Project/Pathways
to Complementary Medicine
Title: Integrating Complementary and Alternative Medicine
into Public Health
Report by Linda Kenney
Beth’s thoughtful presentation focused on innovative partnerships
of complementary, alternative, integrative medicine and public
health. As a practicing acupuncturist for 23 years, a public
health activist, editor of the complementary and alternative
medicine (CAM) section of the American Public Health Association
newsletter and a working member of the Health Resources Network
(AIDS Care Project (ACP) and Pathways to Complementary Medicine),
Beth is an experienced contributor and authority on the CAM/Public
Health ‘partnership’.
She stated during her presentation
that, “we are the ‘public’ in public health” and that, as CAM
stakeholders, we should develop, support and strive to integrate
CAM into mainstream care to enhance public health. The hallmarks
of public health: access, affordability, and appropriate care
are truly augmented by the integrative model.
As a striking example of the success
of such a partnership, Beth used the Pathways to Complementary
Medicine/ACP to illustrate the paradigm of integration.
This program, which has been in existence since 1990, provides
acupuncture and herbal medicines as an adjunct to Western medicine
and offers a powerful healing force geared specifically to the
healthcare needs of people living with HIV/AIDS. It is a national
model in the field of public health and showcases the positive
outcomes that can result from collaboration, case review and
evaluation, funding (federal, state and private) and ‘standards
of care’ with regards to the partnership of CAM and Public Health.
Beth emphasized that we must work
together, and harder, to improve these models of integration.
Collaboration should involve clinics sited in hospitals, health
facilities, and community centers. We, as health professionals,
need to do a better job at designing meaningful studies that
measure outcomes and assess quality of care. And, we need to
develop ‘standards of care’ and ethics that become a foundation
for CAM/PH partnerships in the future. (Beth cited chemical
dependency treatment, asthma clinics and post-9/11 stress reduction
as further examples of where CAM/Public Health partnerships
find success.)
Encouragingly, the American Journal
of Public Health, according to Beth, will be dedicating an entire
issue to CAM in the future. That’s progress!
In a few weeks Beth will be off
to Uganda to help deliver acupuncture and teach moxabustion
treatments to healthcare givers there. We thank her for sharing
her dedication, work and wisdom with the world! The CAM/PH partnership
is not just a U.S. initiative. It is international.
Beth presented us with this wonderful
quote:
“To survive in
the world we have transformed, we must learn to think in a new
way. As never before, the future of each depends on the good
of all.”
- signed by 100 Nobel Laureates
Beth
Sommers may be reached at 617-859-3036 ext. 24 or via email
at:
bsommers@pathwaystcm.org
For more information on the AIDS Care Project and Pathways:
Visit:
www.aidscare.org
Call: 617-859-303
Email:
acpstaff@aidscare.org
The AIDS Care Project office is
located at 140 Clarendon St., Boston, MA 02116-5169
PANEL
DISCUSSION: Integrative Health and Wellness Care in
the 21st Century: Challenges, Visions and Our Collective
Response
Featuring:
Linda Barnes, Ph.D., Director, Boston Healing
Landscape Project
Jeanne Colbath, RN, C, MSN, HNC, Director,
Cardiac Rehabilitation,
St. Elizabeth’s Medical Center, Boston
Lynne Hadley, M.Ed., Spirit of Health
Center for Wellbeing, Royalton, VT
Sonith Peou, Program Director, Metta
Health Center, Lowell Community Health Center.
These four panelists – each representing a unique and fascinating
perspective on integrative medicine – addressed three questions.
While they spoke, Public Forum attendees remained glued to their
seats. The room became quiet. Taking advantage of an unprecedented
opportunity, attendees and participants learned from each other’s
challenges and vision for integrative health care in New England.
The first question: “From your perspective, what is preventing
New England from heading towards a more integrative and equitable
health care system?”
Challenges
Linda Barnes: In addition
to economic barriers to access, the complementary and alternative
medicine (CAM) community must address the myth that because
CAM is “marginal,” it therefore does not discriminate. Additionally,
as CAM practitioners try to look more ‘legitimate’ or scientize
themselves they can exclude modalities that are more extreme
or don’t fit into easy descriptions. The community continues
to deal with the perception that CAM is “fluff”.
Jeanne Colbath: Integrating
CAM therapies into a hospital setting faces many challenges.
Finding funding is problematic, as is proving the “worthiness”
of CAM approaches from the perspective of the reductionist medical
model.
Lynne Hadley: There is
a confusion of terms, and we are missing an opportunity with
using the phrase “complementary and alternative medicine.” Complementary
to what? Alternative to what? We can’t be reactive. To start,
we can use the word “integrative” to describe the kind of health
care we envision, but we need to learn to speak truthfully and
proactively.
Sonith Peou: We are challenged to keep traditional
medicine in the Southeast Asian community a viable and respected
form of health care. We need to educate patients and providers
who work with certain populations about the whole picture of
health – this includes trauma that certain groups may have experienced
in the counties they emigrated from. Being financially viable
as a low-income clinic continues to be a major challenge. It
is important to advocate for insurance coverage.
The second question: “What is your vision of a New England
where all health and wellness traditions are respected, are
accessible to all who need care, and work in harmony?
What would you like to see?”
The third question: “What can we do now to work towards
your vision?”
Vision and Action
Linda Barnes: It is essential to remember that the roots
of CAM are in social injustices, not personal transformation.
As individuals in the integrative medicine community, we need
to do examine and transform our own racism and classism, including
institutional racism, that affects our participation in “whole”
health. Integrative Medicine should be as diverse as our country.
We must promote and engage in pro bono work to enhance public
health. Make health care “transpersonal care” – and let this
grow out of our school system, encouraging a caring consciousness
and respect for all.
Jeanne Colbath: Our institutions
of health care are not healing places – we need to pull in simple
modalities like music therapy into our hospitals. Let’s be creative
in what our hospitals physically look like. Let’s find ways
support each other as practitioners. We need to engage in outreach
to graduate school community, and involve the media in publicizing
our work. We need to continue to invite patients to write about
their health care experiences from personal perspective.
Lynne Hadley: As part of
integrative medicine in New England, we care and act in the
spirit of collaboration. Needs get met at appropriate level.
We need to move away from proprietary model and towards a free
exchange of resources that are recycled. We cannot continue
to be beholden to corporate interests who do not have a stake
in our communities. Farmers in Vermont say that “money is like
manure: it is only valuable when spread in a field.” We need
to shift towards an economics of abundance – what does that
look like in our work with clients? It may include the use of
local currencies, barter, and cooperatives. We need to move
from a culture of health insurance to health assurance.
Sonith Peou: Now that our country is more of a
“salad bowl” instead of a “melting pot,” it is essential to
provide culturally appropriate and competent care. We must involve
the community in planning and implementing health care services
AFTERNOON
NETWORKING GROUPS
In the afternoon, the Public Forum’s three
Networking Groups (Clinics, Healthcare Businesses and Organizations;
Hospitals and Researchers; and Solo Practitioners) each considered
the three fundamental questions posed to our panelists.
This
generated wealth of responses, which are listed in full in the
Appendix. These responses are summarized below.
OUR
CHALLENGES
(See Appendix 1 for the complete list)
Clearly, heading towards a more collaborative,
people-centered, sustainable and equitable healthcare system
in New England is rife with challenges. How do we “retrieve
the soul of healthcare?” Can we find a common language?
Can we find the courage needed to do what’s right?
Panelists
and participants identified a number of major barriers to a
more integrative and equitable healthcare system: economic,
political, cultural, institutional, and educational. Many
difficulties exist, such as: prejudice and fear of the unknown;
political marginalization, acceptance in the allopathic community;
“turf” issues; corporate power; the unjust appropriation
of traditional healing ways by others; the notion of complementary
and alternative medicine (CAM) therapies being “guilty until
proven…”; the issue of legislation, credentialing and regulation;
the issue of the scientization of alternative therapies; and
the difficulty of quantifying the heart/head aspect of healing.
Broad
challenges include the need for better communication; for affordable,
relationship-centered care; for a better economics; for a clearer
understanding of what CAM therapies can deliver; for greater
cohesiveness among integrative practitioners; and for respecting
patient preferences.
More
specific challenges include the need for more research, for
working out billing and reimbursement issues, for educating
conventional practitioners and the public, for dialogue, for
networking, for funding, for marketing and outreach assistance,
for honest communication with allopathic doctors, and for putting
informal healers on the map.
In other
words, we’ve got our work cut out for us!
OUR
VISION
(See Appendix 2 for the complete list)
Can we envision a New England where all health
and wellness traditions are respected, are accessible to all
who need care, and work in harmony? It looks like we can:
Panelists
and participants wanted to see a healthcare culture characterized
by collaboration, justice, respect, spirit, openness, learning,
humbleness, accessibility, affordable and equitable care, multi-cultural
awareness, and cultural inclusiveness and pluralism. We
would “honor the light”.
This
better healthcare system would embrace a holistic view of health:
physical, emotional, spiritual, cultural, social and relational.
It would work beyond either/or, beyond a depersonalized, overly
clinical, symptom-focused, disease management, and “sick care”
approach. Instead, healthcare would focus on wellness
optimization, personal empowerment, prevention, and health maintenance.
Healthcare would be more personal and would recognize the uniqueness
of everyone. Mind and body would be recognized as whole--for
example, there would be no such thing as “mental health care”
as separate from the whole person. The importance of compassion
and better human relationships would be recognized. This
would be a team/partnership model of healing, with the caregiver
and care receiver as equals. And there would be more communication
and seamless coordination among all healthcare practitioners,
with more openness and easier referrals.
What
was the conventional medical education system of 2002 would
now include complementary and alternative healing traditions,
with integrated clinical training (which could help provide
low cost care). Healthcare facilities would emphasize
creating a healing environment. There would a central institutional
location for education materials on healthcare modalities.
Healthcare would recognize the importance of the environment,
and there would be a sense of wider circles of community.
There would be more fiscal and social resources committed to
CAM research, with real outcome measurements. There
would be alternative income sources for this integrative healthcare
evolution.
Healthcare
in our vision would be part of a larger social transformation,
and be connected with anti-racism and social justice work. People
would have healthier work schedules, and healthy food would
be inexpensive and everywhere (with a tax on junk food).
Integrative healthcare centers would be in our neighborhoods,
with bodyworkers even giving treatments in public parks.
Holistic health education would start at childhood. As
a result of these changes, there would be less “medical” visits.
Sounds
good? Let’s make it happen! Namaste!
TAKING
ACTION
(See Appendix 3 for the complete list)
What
can we do now to work towards our vision? By the end of
the Public Forum, participants had come up with 83 ideas for
action, and affixed stars by the ones that they thought were
most worth implementing (#s of stars indicated in parentheses).
We found
the “most-starred” ideas were in three areas: education, financing,
and outreach. We then formed three action groups around
them, which over the next year will work toward implementing
at least one of these great ideas for action.
The
IMA encourages you to get involved with one of the groups below
by reaching the contact people listed. We will report
on progress at the IMA’s 2003 Public Forum next year.
Education
action group
Of the
ideas that were generated, many of the most “starred” ones related
to education. Participants supported taking steps now
to introduce CAM and integrative healthcare into the public
education system. They also supported educating
allopathic medical professionals and institutions.
Contact
person: Yuliya Cohen at 617 731 9529 or e-mail her at
Yuliya@rcn.com.
This group will meet on Tuesday June 4th at 7:00
p.m. at Yuliya Cohen’s house on 57 University Road, Brookline,
MA (T accessible).
Call or e-mail Yuliya for directions.
Members:
Cynthia Cartwright, Jeanne Colbath, Yuliya Cohen, Jane Goodwin,
Mary Nykoruk, June Riedlinger, Phyllis Tan, Kate Ulbricht, Bev
Wedda
Pilot
integrative healthcare program in a public school (e.g. Holliston)
(12 stars)
Educate
traditional/conventional healthcare practitioners (11)
Work
closely with healthcare provider education (11)
Conduct
educational/clinical research (10)
Start
with children in school system (7)
Create central institutionalized location for education materials
(6)
Educate future conventional medical practitioners (9)
Educate in modalities where you don’t need practitioners (e.g.
“focusing”) (3)
Teach people to grown own food/herbs/plants (3)
Culinary
school and landscapes hooked up with hospitals (3)
Yoga, etc. in public school gym or health classes
Guide for healthcare professionals on how to partner with CAM
practitioners
Community
gardens offering herbal medicine training/expertise
Financing Integrative Healthcare Transformation action group
Participants supported applying “alternative” economic approaches
to the challenge of financing integrative healthcare transformation,
ranging from alternative funding sources to taxation to local
currencies.
To get involved, contact IMA Board member Seth Goodwin at
Seth.Goodwin@valley.net or call him at (603) 252-8799.
Members: Jane Goodwin, Seth Goodwin, Lynne Hadley, Paul Serafini.
Create economics that generates abundance (10 stars)
Petition for junk food tax (9)
Explore alternative funding: foundations, businesses, private
wealth (8)
Create
team to partner with private financing (4)
educational trade
experiential
Access public funding (3)
Local currencies (3)
Cooperative models (1)
Fundraising with gardening kits (1)
Pro bono caregiving to those who can’t pay as an interim step
Barter
Outreach/Media action group
Participants supported many ways of promoting complementary,
alternative and integrative healthcare, both in the news media
and directly to communities. There was interest
in finding speakers and spokespersons for talks and presentations.
To get involved, contact IMA Board member Jennifer Lewy at
JenniferLewy@hotmail.com or call her at (617) 484-6115.
Members: Jane Goodwin, Lynne Hadley, Jennifer Lewy, and many
others.
Community forums for education individuals re: options (12
stars)
Write
about it / talk / publicize – radio shows (11)
Integrative medicine awareness month (9)
Find
the ambassadors and natural bridge people to be spokespeople
(8)
Get
spokespersons (6)
Create speakers’ bureau (6)
Media (6)
Target every cable access station (4)
Offer presentations at assisted care centers (4)
Workshops/seminars/publications on a range of healthcare modalities
(2)
Publishing
more info re: wellness process (1)
Booths at town/neighborhood fairs (1)
Catalyze media! (1)
Strategic communications – ongoing (1)
Pull simple remedies into hospitals and educators (1)
Having
educational materials available
Healthy garden contest
APPENDICES
APPENDIX 1: CHALLENGES
From your perspective, what challenges
must be overcome for New England to head towards a more integrative
and equitable healthcare system?
Panel Discussion Participants
Economic barriers to access
Political issue of marginality of complementary/alternative
medicine and perpetuating problems
Appropriation
Scientize and professionalize CAM and thus exclude others
Economic
Cost
Getting funds
“Worthiness” stemming from reductionist medical model
Who is out there?
Establishing credibility
Language
Definitions and titles
Reactive language
Dialogue about values needed
Economics: need to create a different form
Education
Cultural Keeping tradition
Being able to talk to provider
Providers not knowing history of group
Education
Communication
Cost/Reimbursement
Clinics, Healthcare Businesses and Organizations Networking
Group
Educating the public: increased awareness/understanding
Billing and reimbursement
Power? “Turf”
Proprietary ownership vs. sharing mentality
Lack of acceptance in medical community
Lack of honest communication with allopathic doctors
Need for courage re: what works for us
DoBeDoBeDo – Values?
Identify heart/spirit values
Need for cohesiveness amongst integrative practitioners
Research to support integrative therapies
Quality, “hard” research
Integrative therapies “guilty until proven…”
Institutional barriers
No credentialing process
Needs
Better network: communication
Information: connection
Funding: resource: non-profit, for-profit
Marketing and outreach assistance
Hospitals and Researchers Networking Group
No clear methodologies
No common language
No clear understanding of what can be delivered via complementary/alternative
modalities
How do you quantify the heart/head aspect of healing?
Cultural context is underrepresented
Educating conventional practitioners in the field
Respect for patient preferences
Relationship-centered care
“Retrieving the soul of healthcare”
Cost (insurance, etc.)
olo Practitioners Networking Group
Reset
Prejudice
Fear of unknown
Corporate interest
Requirement of research
Informal healers not on map
Legislation/regulation
Target population unidentified
Attitude/Priorities of spending
Education
Insurance reimbursement
Cost
APPENDIX 2: VISION
hat is your vision of a New England where all health and
wellness traditions are respected, are accessible to all who
need care, and work in harmony? What would you like to
see?
Panel Discussion participants
Collaborate
Social transformation
Justice
Anti-racism work
Cultural pluralism
Central institutional location for educational materials on
healthcare modalities
Alternative income sources for integrative healthcare evolution
Clinics, Healthcare Businesses and Organizations Networking
Group
Beyond “sick care”
Personal empowerment
Being in charge of our own care
Multi-cultural awareness
Cultivating multicultural involvement
Teams
Integrating Mind/Body: No more “mental health care” as separate
More communication between practitioners
Children * Education
Beyond either/or
Care not Cure
Beyond symptom focus
Spirit
Building relationships with more compassion
Individual/personal vs. clinical/standard
More acceptance of the positive
Namaste: Honoring the Light: Respect
Holistic view of health
Physical, emotional, spiritual, cultural, social, relational
Life is Health
Wellness v. dis-ease management
Health – prevent/maintain
Practice of learning and humbleness
Recognize importance of our environment
Hospitals and Researchers Networking Group
Accessible
Culturally inclusive
Multiple cognitive styles of communication
Equitable
Affordable
Collaborative (including patients)
Medical education system includes complementary/alternative
medicine
Intention of healthcare is optimizing wellness
Healing environment emphasis
Sense of wider circles of community
Seamless coordination of healthcare
Resources ($ and social) committed to complementary/alternative
medicine research
Integrated clinical training (can help provide low cost care)
Solo Practitioners Networking Group
Partnership model of healing
Bodywork in the parks
Openness – easy referrals
Health work schedules
Healthy food inexpensive and everywhere
Empowerment
Schools
Junk food tax
Integrative centers all over
Self-empowerment for own health
Less “medical” visits
Start holistic health education at young age
Real outcome measurements
APPENDIX 3: ACTION STEPS
hat can we do now to work towards our vision? Participants
generated 83 ideas for action, and placed stars by the possible
actions that they thought were most worth implementing (#s of
stars indicated in parentheses). Panel Discussion
participants and audienceBilingual healthcare provision (2)Healthcare
clinic staff works with community (1)Healthcare clinic staff
knows and respect culture of patientsEducation for healthcare
providers about the community they serve (4)Work closely with
healthcare provider education (11)CAM treatments for healthcare
providersEducation for healthcare providers about CAM treatmentsOutreachCreate
central institutionalized location for education materials (6)Explore
alternative funding: foundations, businesses, private wealth
(8)Start with children in school system (7)Change site of healthcare
(1)Pull simple remedies into hospitals and educators (1)Culinary
school and landscapes hooked up with hospitals (3)
pay attention to environmentCAM treatments for hospital staff
(2)Care for providersMeditation spaces in hospitals (2)Grad
student involvement (3)Media (6)Hospital patient responses recorded
(6)Local currencies (3)BarterCooperative models (1)Insurance
– assurance
Create economics that generates abundance (10)Reproduce Metta
Health Center experience elsewhere (1)
Move from inner transformation to social transformation (5)
Work with other modalities, don’t appropriateBring in all
groups
Pro bono caregiving to those who can’t pay as an interim step
Clinics, Healthcare Businesses and Organizations Networking
Group
Create residency/rotations for integrative medicine (3)
Community forums for education individuals re: options (12)Target
every cable access station (4)
Catalyze media! (1)
Publishing more info re: wellness process (1)
Offer presentations at assisted care centers (4)
Build bridges between disciplines (5)
Create political lobbying organization (11)
Form cross-disciplinary focus groups: bone health
children hospital-based programs any topic Create structures for
communication (2)Create forum for communication (1)
web-based
on protocols
to share infoCreate Earth Charter equivalent to define our vision/values
for integrative care (2) (Lynne Hadley is interested in working
on this with others)Access public funding (3)Lobby for researchCreate
team to partner with private financing (4) educational trade
experientialLive it Embody it Model it (1)Find the ambassadors
and natural bridge people to be spokespeople (8)Create speakers’
bureau (6) Hospitals and Researchers Networking GroupKeep
inspiring/encourage each other (1)Build bridgesCreate models (e.g.
Maine Medical Center integrative residency program) (2)National
link page/clearinghouse (3)Placed to record evidence-based results
(3)Take care of ourselves (4)Be informed (public arena) and take
actionConduct educational/clinical research (10)Write about it
/ talk / publicize – radio shows (11)Having educational materials
availableStrategic communications – ongoing (1)Be employed – hold
the spaceContact elected officialsIntegrate arts into healthcare
(4)Get spokespersons (6) Solo Practitioners Networking GroupPetition
for junk food tax (9)Networking clubs for CAM practitionersModel
healthy lifestyles (4)Make contact with more healthcare professionals
(1)Referral service (4)Credential service for uncredentialed professionals
(1)Pilot integrative healthcare program in a public school (e.g.
Holliston) (12)Yoga, etc. in public school gym or health classesWorkshops/seminars/publications
on a range of healthcare modalities (2)Guide for healthcare professionals
on how to partner with CAM practitionersEducate traditional/conventional
healthcare practitioners (11)Go to International Society for Subtle
Energy Medicine conference, Colorado, June 14th through
19th Free body/energy work day in a public space once
a month (3)Booths at town/neighborhood fairs (1)Educate in modalities
where you don’t need practitioners (e.g. “focusing”) (3)Community
gardens offering herbal medicine training/expertiseTeach people
to grown own food/herbs/plants (3)Fundraising with gardening kits
(1)Integrative medicine awareness month (9)Healthy garden contest
APPENDIX 4: POTENTIAL ALLIES
Clinics, Healthcare Businesses and Organizations Networking
Group
Dr. Andrew Littman @ Mass. General Hospital
Socially conscious media:
Public
radio and TV
Oxygen
Noggin
Scholastic
Yes!
Magazine
Disney
Assisted care centers
Spencer Shaeffer, D.O.
Other health science and medical schools
New England School of Osteopathy, Biddeford, Maine
PRESENTER AND PANELIST BIOGRAPHIES
Wande Abimbola, Ph.D., Official
spokesperson for the Ifá religion, Professor of African Religions,
Boston University
Dr. Abimbola is the officially appointed delegate to Boston
from Nigeria to represent and transmit the tradition of Ifá.
As Babalawo and Àwise Ni Àgbáeé ("spokesperson for Ifá
in the World"), he is a renowned scholar of Ifá thought,
Yoruba theology and traditional culture. He is president of
the International Congress of Orisa Tradition and Culture. He
is also Professor of African Religions at Boston University.
Dr. Abimbola has written extensively on the Yoruba tradition,
authoring such works as Seminar on Yoruba Oral Tradition, Poetry
in Music, Dance and Drama, Sixteen Great Poems of Ifa, Ifa:
An Exposition of Ifa Literary Corpus, and Ifa Divination Poetry,
and is a contributor to Secrecy: African Art that Conceals and
Reveals (Mary H. Nooter, ed.). One of his most recent books
is Ifá Will Mend Our Broken World: Thoughts on Yoruba Religion
and Culture in Africa and the Diaspora.
Joseph Audette, MD, Medical Director, Medford
Clinic, Spaulding Rehabilitation Hospital
Dr. Audette earned his medical degree at Harvard Medical School
in 1991 and completed a residency in Physical Medicine &
Rehabilitation at Columbia Presbyterian Hospital in New York
in 1995 and is board certified in PM&R and Pain. While in
New York, he was trained in acupuncture at the Tristate School
of Traditional Chinese Acupuncture. He is currently the Director
of Spaulding Rehabilitation Hospital’s Outpatient Pain Services
and also leads a multidisciplinary team in Comprehensive Pain
Evaluations at the Beth Israel Deaconess Medical Center in the
Department of Anesthesiology. He has lectured extensively
on topics including Myofascial Pain , Pain Rehabilitation, and
Acupuncture. His clinical and research interests include
myofascial pain, chronic pain, and acupuncture. He has
recently developed the Harvard CME course on Clinical Acupuncture
for Physicians with Kiiko Matsumoto and her husband David Euler.
The course is an intensive 9 month course to train doctors in
clinical acupuncture using modern Japanese methods that have
evolved based on interpretations of the ancient Chinese
texts of Acupuncture.
Linda Barnes, Ph.D., Director,
Boston Healing Landscape Project
Dr. Barnes
is Director of the Spirituality and Child Health Initiative
at Boston University School of Medicine. She is also Director
of the Healing Landscape Project: Complementary Healing in African
Diaspora Communities in Boston, a multi-year project based at
Boston University, in collaboration with Harvard Medical School.
The project is investigating traditional healing approaches
in African immigrant, African-American, Afro-Caribbean, Brazilian,
and related communities within Boston.
Cynthia Cartwright, M.Ed., Maine Medical Center, Integrative
Medicine Residency Program, Portland, ME
Cynthia is currently involved with integrating complementary
and alternative medicine into the Family Medicine Residency
Program at Maine Medical Center. She serves as the Faculty
Coordinator in this effort. Previously, she was an Educational
Consultant working with medical educators and residencies to
develop comprehensive curricula, sound teaching strategies,
and evaluation techniques. She has worked for a variety
of programs at Maine Medical Center, as well as the Maine-Dartmouth
Family Practice Residency Program in Augusta, Maine; the New
England College of Osteopathic Medicine in Biddeford, Maine;
Central Maine Medical Center Family Practice Residency Program
in Lewiston, Maine; and the University of New England Physical
Therapy Department in Biddeford, Maine.
Jeanne Colbath, RN, C, MSN, HNC, Director, Cardiac
Rehabilitation, St. Elizabeth’s Medical Center, Boston
Jeanne has worked at St. Elizabeth's Medical
Center for the past 30 years in various aspects of cardiovascular
nursing. In 1983, she developed and has since directed
the Cardiac Rehab Program. She is a past board member
of the American Holistic Nurses Association where she was the
Northeast Regional Director and Secretary. Presently,
Jeanne is the networker for the Allston Brighton Chapter of
the American Holistic Nurses Association. In June, she will
speak at their annual conference on how she has integrated holistic
nursing into her cardiac rehab practice.
Lynne Hadley, M.Ed., Spirit of
Health Center for Wellbeing, Royalton, VT
Lynne is an entrepreneur. In 1987, she
co-founded the Catalyst Financial Group, a visionary financial
services firm which brings people, projects and money together.
Catalyst has arranged over 1 billion in specialized financing
and consults internationally. In 1998, she co-founded Spirit
of Health Center for Wellbeing, a cooperative community-based
wellness center. Lynne serves on the finance and marketing
team for the cooperative, and serves as acting director in the
development of a tax-exempt non-profit to coordinate the center’s
education and outreach. She teaches ecstatic, therapeutic
and meditative movement and maintains a private practice working
as a coach with individual clients and as a consultant to groups.
Eric Leskowitz, MD, Staff Psychiatrist, Spaulding Rehabilitation
Hospital, Boston
Dr. Leskowitz is a psychiatrist for the Pain Management Program
at Spaulding Rehabilitation Hospital. He is also an Instructor
in the Department of Psychiatry at Harvard Medical School.
He has edited Transpersonal Hypnosis (CRC Press, 2000)
and Complementary and Alternative Medicine in Rehabilitation
(Harcourt Press, 2002). He likes to write and lecture
about energy medicine.
Sonith Peou, Program Director, Metta Health Center,
Lowell Community Health Center
Before taking his current position at
the Lowell Community Health Center, Sonith worked at the Revere
Counseling Center for three years, providing counseling services
to the Cambodian community of East Boston, Chelsea, Revere and
Lynn. Along with other staff member at Revere Counseling,
Sonith worked as a team to design culturally appropriate approaches
to caring for the health and well being of Cambodian community
members. Sonith worked as a co-therapist for Project Sangkhim
(Project Hope in Khmer), a project directed by Boston University
School of Social Work, that focused on treating substance abuse
among Cambodians. The initiative targeted dually-diagnosed
clients with depression and PTSD. Sonith has lived in
the United States since 1981 after fleeing Cambodia. He
spent time in Khoa I Dang Refugee Camp as a 'barefoot doctor'.
He moved to Boston in 1985 where he studied at the Refugee and
Immigrant Training program at Boston University School of Social
Work. He also served as a Site Coordinator for the Center
for Immigrant and Refugee Community Leadership and Empowerment
(CIRCLE) project of University of Massachusetts, Lowell.
Judith Petry, MD, FACS, Holistic healing consultant,
Brattleboro, VT
Dr. Petry retired from the clinical practice of Plastic and
Reconstructive
Surgery after 16 years, in order to focus her teaching
and research on holism in healthcare, alternative systems of
healing and the integration of complementary therapies into
allopathic medical systems. She functions as a liaison between
mainstream health care and complementary therapies for the purpose
of optimizing the potential for each individuals healing. She
writes and lectures for the public and the medical profession
on the scientific basis for herbs, supplements, and other
complementary therapies, and the concepts of holism in surgery
and in Health care. She is currently a Private Consultant in
Integrative Medicine in Westminster, VT and Medical Director
of Vermont Healing Tools Project in Brattleboro, VT.
Robb Scholten, MLIS, Executive Information Officer,
Division for Research and Education in Complementary and Alternative
Medical Therapies, Harvard Medical School.
Robb is an authority on the research, development and practice
of integrative medicine in and outside New England. Robb is
also the executive secretary for the Division's three major
continuing education courses, which focus on integrative medical
therapies. Prior to his work at Harvard, he was Information
Resources Manager at the Center for Alternative
Medicine Research and Education at Beth Israel Deaconess Medical
Center in Boston, MA.
Beth Sommers, MPH, Research Director, AIDS Care Project
/ Pathways
to Complementary Medicine
Beth has been practicing acupuncture for 23 years and is a
public health
activist. Currently, she is editor of the CAM section of the
American Public
Health Association newsletter and writes a column called
"Public
HealthWorks!" for the alumni newsletter of the New England
School of
Acupuncture. Her primary research interests are HIV related
studies and
cost-of-care. Beth has presented on acupuncture research
nationally and internationally.
SPONSOR INFORMATION
HOSTING
INSTITUTION AND GOLD LEVEL SPONSOR
www.mcp.edu/rc/citpc/rc_citpc.shtml
E-mail Dr. June Riedlinger at JRiedlinger@mcp.edu
(617) 732-2182
The mission of the Center for Integrative Therapies in Pharmaceutical
Care is to conduct research that establishes the safety and
efficacy of substance-based alternative therapy, such as herbals,
homeopathic remedies, and nutraceuticals. The Center develops
educational programs and databases providing pharmacists with
information needed to assess complementary therapies and counsel
patients, health consumers, and conventional practitioners regarding
appropriate and safe use. The Center also coordinates research
and educational programs on non-substance based therapy that
affect disease and medication management, such as acupuncture,
chiropractic, meditation, and massage.
CITPC’s primary mission is to develop educational programs
and materials for pharmacists and other healthcare providers
about Complementary Alternative medicine. The Center also maintains
a webpage containing CAM journals, databases and links to CAM
Websites at www.mcp.edu/rc/altmed/index.shtml
SILVER LEVEL SPONSORS
Chris Brenne
www.ChrisBrenne.com
info@ChrisBrenne.com
Chris Brenne’s guitar playing reminds you that there are
unearthly sounds that can be created to inspire you to hear
human emotions. Chris is a local Cambridge artist, originally
from Sweden, whose music has grounded listeners with beautiful,
lyrical melodies that are naturally relaxing and spiritually
uplifting.
“I have used his music for my yoga classes and what comes to
mind is that it is heart-opening. It is one of the few pure
solo, acoustic guitar arrangements that I have found... Something
to nourish the mind, body and spirit.” -- Brenda Fingold,
Kripalu Certified Yoga Instructor
As a composer, Chris developed a style of acoustic compositions
that includes many of the familiar “folk” idioms, but veers
towards enlisting jazz and contemporary qualities. Currently,
Chris is working on incorporating some new ideas, partly inspired
by Hawaiian slack key guitar (“very peaceful and expressive
sounding”), as well as an open tuning that will accommodate
“sitar timbres”.
Chris has released one solo acoustic CD to date, “Lady of
the Spice Lands,” which he has been prompted to re-release
to the health and healing market. That means replacing
some “wild bits” with more introspective music. You can
purchase his cd from him directly or from HMV in Harvard Square.
The East/West Institute of Alternative Medicine,
presenting a yearlong postgraduate course: Integrative Ayurveda.
www.BostonShiatsuSchool.com
eastwestinst@mindspring.com
(617) 876-4048
Ayurveda, the oldest system of natural health care still in
contemporary practice, is a medical science which emphasizes
Prevention and Self-care, Creative Intelligence and Individually
Oriented Medicine. Ayurvedic principles are based on discovering
and maintaining a natural balance of elements in the body, and
recognizing how that balance contributes to the health and natural
function of our body and mind. This first of its kind program
is designed to demonstrate how Ayurvedic principles can be employed
in conjunction with breakthrough western medical practices to
enhance any contemporary health care modality.
The program consists of a year long study which will include
active clinical workshops evaluating student’s own health profiles
including: Regulation Thermography profiles, Chem Screen and
Biological Terrain Assessment from an Ayurvedic perspective.
Biological Medicine /Dentistry, Nutritional Pharmacology, Essential
Fatty Acid Metabolism, Eastern & Western Herbology, Pancha
Karma & Vibrational Medicine (STO) will also be addressed
in this course. Classes meet one weekend a month between May
2002 and May 2003 and are available as part of the year long
program or on an individual basis. Instructors include: Dr.
Vasant Lad, founder of the Ayurvedic Institute and international
educator on Ayurveda, staff from the Ayurvedic Institute, Dr.
Rudolph Ballentine, author of Radical Healing, Dr. Patricia
Kane, groundbreaking researcher and educator in Essential Fatty
Acid and other pioneers in the fields of Ayurveda and Integrative
Medicine.
Reliv International
Anita Jedwabski, R.Ph.
Izabella Jedwabski MD
Independent Consultants
www.relivonline.com/LorettaJ
ajedwabski@msn.com
(978) 774-5836
Reliv International, of St. Louis, MO, is a Food Science company
with a mission to "Nourish Our World". Founded in
1988, Relìv is a key player in advancing and simplifying nutrition
for people around the world. Reliv has operations in: Australia,
Canada, Ireland, Mexico, New Zealand, Philippines, United Kingdom,
United States.
Consumers appreciate the vital role nutrition plays in health
and well being, they're looking for nutritional solutions that
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seeking safe and effective products to recommend to their patients.
Providing these solutions is our mission. We focus on the development
of essential nutritional supplements and functional foods which
enhance performance, protect against disease and relieve discomfort.
As a sponsoring member of the distinguished Functional Foods
for Health Institute at the University of Illinois, Reliv is
committed to creating quality products that bring the life-enhancing
benefits of soy, herbs, antioxidants and other botanicals to
the daily diet — without sacrificing taste or convenience.
The value of our scientifically advanced, bioavailable, patented
products is seen in the faces of the thousands who've discovered
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