COMMENTARY
The US Medical Industry Turns Toward “Health Creation” … plus more John Weeks
This column is offered in collaboration with The Integrator Blog News & Reports (http://theintegratorblog.com), a leadership-oriented news, networking, and organizing journal for the integrative medicine community. For more information on these and other stories, enter keywords from the articles in the site’s search function.
The US Medical Industry Turns Toward “Health Creation” In April 2013, Douglas Wood, MD, the head of innovation for the Mayo Clinic, told an American Hospital Association (AHA) audience that their mission in this current era is “to change the focus of the health care industry to creating health, not just producing health care.”1 In December 2013, former Center for Medicare and Medicaid Services administrator Donald Berwick, MD, MPH, focused a 45-munute plenary session to an Institute for Health Improvement (IHI) audience of delivery-system executives on the same theme. After first noting positively how “commonplace” references in medical dialogue that describe the need to shift toward “health creation” have become, Dr Berwick identified present reform efforts such as accountable care organizations, interprofessionalism, and patient-centered medical homes. Then he added: “The pursuit of health—the creation of health—may require something even bolder. The redesign we need may be even more radical than we have imagined.” At roughly the same moment, readers of the December 2013 issue of the flagship periodical of the AHA, Hospitals and Health Networks, were introduced to new chair-elect, Jonathan Perlin, MD, PhD. He urged delivery system leaders to learn how to “move from sick care to health care,” acknowledging that it will be a “tough transition.”2 Dr Perlin, the chief medical officer for the Hospital Corporation of America (HCA), echoed a theme that runs through Dr Berwick’s talk: “I am not sure that any of us fully understands or knows the recipe.” Comment: Appreciate, first, that this is not a call to shift deck chairs on the Titanic. These are calls for the very paradigm shift that is engrained in the character and practice of all integrative practitioners worth their title. Note also the spoken humility: We don’t know how to do it. This admission would appear to be the entrance cue for the integrative health and medicine community. If you are not sure, listen to the Berwick talk.3 Virtually all of his mentors in thinking about his “more radical than we have imagined” shift are close to this movement: Jon KabatZinn, PhD; Herbert Benson, MD; Dean Ornish, MD; and 16
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Wayne Jonas, MD, among them. A door of acknowledged ignorance—and pursuit of answers—has swung wide open. New Reports Underscore Penetration and Success of Integrative Approaches in the Military Two recent reports point to present and future leadership of the military in turning US medicine toward an integrative model. The first was required testimony to Congress from the US Department of Defense to US Senator Carl Levin (D-MI) on January 8, 2014.4 The number of facilities where the following therapies or providers were found include chiropractic (59), acupuncture (83), massage (9), yoga (11), clinical nutritional therapy (68), naturopathic medicine (1), biofeedback (13), and meditation (14). This care was delivered, the report summarized, “in 120 Military Treatment Facilities, 99 in the continental United States, and 21 outside the continental United States, offer[ing] a total of 275 complementary and alternative medicine (CAM) programs.” A total of 213 515 of these patient visits were offered in 2012. The most visits were for chiropractic (73%) and acupuncture (11%). The second report spoke to effectiveness, this time via a February 25, 2014, media release from the US Department of Veterans Affairs (VA): “VA Initiative Shows Early Promise in Reducing Use of Opioids for Chronic Pain.”5 Launched in October 2013, the initiative “is already demonstrating success in lowering dependency on this class of drugs.” For instance, at 8 Minnesota locations, VA integrative practices “have decreased high-dose opioid use by more than 50 percent.” The initiative includes “an emphasis on patient education, close patient monitoring with frequent feedback and Complementary and Alternative Medicine [sic] practices like acupuncture.” Robert Petzel, the VA undersecretary for health is quoted: “The Opioid Safety Initiative is an example of VHA’s [Veterans Health Administration’s] personalized, proactive and patient-centered approach to health care. We are also using a full-range of support treatments for veterans, including complementary and alternative medicine. We are delivering health care with the patient’s long-term personal health goals at the forefront.” The program includes a pain monitoring app. Comment: Integrative health policy leader Janet Kahn, has suggested that the military may be the agent of change for patient-centered policy on integrative health PhD,
Weeks—Industry Insights
5/6/14 12:13 PM
ShortTakes u The event to honor retiring US Senator Tom Harkin (D-IA) for his multiple contributions to advancing integrative health and medicine was moved from May 5 to September 29, in Washington, DC. The Samueli Institute is a lead organizer with support from leaders of 3 large policy and academic consortia. u The American Holistic Medical Association (AHMA) is exploring a merger with the American Board of Integrative Holistic Medicine to form the new Academy of Integrative Health and Medicine (ABIHM).6 The latter is designed as a multidisciplinary and global initiative.7 u A report card from the Washington Health Alliance once again found that, from the perspective of “patient experience,” the Bastyr Natural Health Center ranks among the top primary care facilities in the Seattle area.8 u In February, the Cleveland Clinic honored integrative medicine leader Tanya Edwards, MD, by naming their integrative center the Tanya I. Edwards Center for Integrative Medicine. Edwards, perhaps the most prominent person of color in the academic integrative medicine arena, died in March from breast cancer just short of 54 years of age. u The American Academy of Pain Medicine (AAPM) has issued a position paper entitled “Minimum Insurance Benefits for Patients with Chronic Pain”9 followed by a media release—“Pain Physicians Say Insurance Coverage Falls Short”— in which they call on insurers to cover integrative protocols.10 u James Gordon, MD, and Tieraona Low Dog, MD, received the 2014 “visionary” and “leadership” awards, respectively, from the Integrative Healthcare Symposium.
and medicine, even as AIDS activists in the 1980s changed FDA approval timelines toward interests of the individuals the agency is to serve. The movement for integrative care has always been powered by those who, in search of more functionality and productivity—whether individual patients, athletes, actors, employers, or the military—take a commonsense approach to open exploration. Individual integrative health practitioners would be served to consider the extent to which they, with other colleagues in their community, can provide the whole system of support Weeks—Industry Insights
IMCJ_13_3.indd 17
u Edwards’s leadership was behind news reported in a Cleveland Plain Dealer article on the new Chinese Herbal Therapy Clinic at the Cleveland Clinic. In addition, Chinese herbal medicine consultations began at the University Hospitals (UH) Ahuja Medical Center via the UH Connor Integrative Medicine Network.11 u An April 9, 2014, release has announced that Vanderbilt Univeristy’s Center for Integrative Health is now the Osher Center for Integrative Medicine at Vanderbilt University. The integrative center at Northwestern University in Chicago is reportedly soon to follow. They join programs at Harvard; the University of California, San Francisco; and Karolinska University with Osher support for their integrative programs.12 u In a wild example of the industry-regulator revolving door, FDA official Daniel Fabricant, PhD, who was earlier an acting director of the Natural Products Association (NPA), is back with the NPA as its CEO. u Idaho yoga therapist Jennifer Knight, ERYT 200, RYT 500, and Naomi Jones of Idaho Health and Yoga Awareness were the catalysts for the decision of Saint Alphonsus Medical Center to endorse prenatal yoga therapy. The decision was assisted by a personal experience of Mary Janowiak, MD, an OB/GYN at the medical center.13 u The widely heralded interprofessional text from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), titled the Clinicians’ and Educators’ Desk Reference on the Licensed Complementary and Alternative Healthcare Professions, is in its second edition and available in e-versions, book format, and as a free PDF.14 u Amidst pressure from a 2-part investigative article by Donald Peterson, publisher of Acupuncture Today, titled “AAAOM-Making Promises It Can’t Keep,” the controversial president of the dysfunctional American Association of Acupuncture and Oriental Medicine (AAAOM), Michael Jabbour, LAc, has stepped down.15
of this VA model that led to these profound—if yet early— outcomes. Should Integrative MDs in the United States Worry About Guidelines From Nova Scotia’s College of Physicians? Chris Foley, MD, is an integrative medicine veteran, with both hospital-based and private centers in his curriculum vitae. Foley sent an alert about a new “Policy and Guidelines on Complementary and Alternative Integrative Medicine • Vol. 13, No. 3 • June 2014
17
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Therapies”16 directive issued by the Council of the College of Physicians and Surgeons of Nova Scotia. The 3-page document requires “ethical physicians” to follow 6 precepts. Some are simple restatements of basic ethics regarding thoroughness, safety, and nonexploitation of patients for personal gain. These appear to be based in a condescending assumption that those using these therapies need reminders of their medical oath. The most onerous and subject to punitive interpretation is the requirement to “prescribe or recommend an effective and proven therapy not delayed or supplanted by the choice of a complementary or alternative treatment.” The guidelines allow a physician to “discharge” a patient who does not consent to these guidelines. The Nova Scotia group worked off a similar document prepared by their colleagues in British Columbia. Comment: Such guideline writers need to ask the following: What is a clinician to do if he or she has first rate, definitive evidence on how to suppress the symptoms of a disease but only impressionistic evidence on how to work with root causes to help the individual create health? In this context, how then does one respond as an “ethical physician” to the second bullet on delay of suppression? And how ethical is it to decisively suppress symptoms if we have some evidence that the problematic causes may be altered if one only takes another approach? Dr Foley wonders what will become of integrative medicine if the guidelines embraced in Nova Scotia are widely embraced across Canada and sweep through the United States. Perhaps the strategy is to accept the premise but turn them against the regulators. What, indeed, is the best evidence in this era of “health creation?”
8. Washington Health Alliance. Your voice matters: patient experience with primary care providers in the Puget Sound region. WHA Web site. http:// wahealthalliance.org/wp-content/uploads/2014/02/WHA-PatientExperience-2014.pdf. Published February 2014. Accessed April 14, 2014. 9. The American Academy of Pain Medicine. Minimum insurance benefits for patients with chronic pain: a position statement from the American Academy of Pain Medicine. AAPM Web site. http://www.painmed.org/files/minimuminsurance-benefits-for-patients-with-chronic-pain.pdf. Accessed April 14, 2014. 10. Anson P. Pain physicians say insurance coverage often falls short. American News Report Web site. http://americannewsreport.com/nationalpainreport/ pain-physicians-say-insurance-coverage-often-falls-short-8823180.html. Published March 7, 2014. Accessed April 14, 2014. 11. Townsend A. Chinese herbal therapy debuts at Cleveland Clinic, University Hospitals. Cleveland.com Web site. http://www.cleveland.com/healthfit/ index.ssf/2014/03/chinese_herbal_therapy_available_at_cleveland_clinic_ university_hospitals.html. Published March 5, 2014. Accessed April 14, 2014. 12. Philanthropy News Digest. Osher Foundation awards $5.5 million to Vanderbilt University Medical Center. PND Web site. http://www.philanthropynewsdigest.org/news/osher-foundation-awards-5.5-million-to-vanderbiltuniversity-medical-center. Published April 12, 2014. Accessed April 14, 2014. 13. Murri J. Prana mamas: Saint Al’s prenatal yoga referrals bring together Western and Eastern medicines. Boise Weekly Web site. http://www.boiseweekly.com/boise/prana-mamas/Content?oid=3059889. Published February 19, 2014. Accessed April 14, 2014. 14. Academic Consortium for Complementary and Alternative Health Care. Clinicians’ and Educators’ Desk Reference on the Licensed Complementary and Alternative Healthcare Professions. 2nd ed. Seattle, WA: ACCAHC; 2014. 15. Petersen DM. AAAOM—Making promises they can’t keep: profession seeks answers as dwindling support leads to financial ruin. Acupuncture Today. http://www.acupuncturetoday.com/mpacms/at/article.php?id=32868. Updated March 14, 2014. Accessed April 14, 2014. 16. College of Physicians and Surgeons of Nova Scotia. Policy guideines on complementary and alternative therapies. CPSNS Web site. http://www.cpsns. ns.ca/PhysicianGuidelinesandPolicies.aspx?EntryId=136. Accessed April 14, 2014.
References
1. Stempniak M. The patient experience: taking it to the next level. Hospital and Health Networks Web site. http://www.hhnmag.com/display/HHNnews-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/ HHN/Magazine/2013/Apr/0413HHN_FEA_PatientexperienceGate. Published April 1, 2013. Accessed April 14, 2014. 2. Weinstock M. Toward a healthier tomorrow. Hospital and Health Networks Web site. http://www.hhnmag.com/display/HHN-news-article. dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/ Magazine/2013/Dec/1213HHN_Coverstory. Published December 2, 2013. Accessed April 14, 2014. 3. Weeks J. Hooking up: Don Berwick, integrative medicine and his call for a radical shift to ‘health creation.’ Huffington Post. February 18, 2014. http://www. huffingtonpost.com/john-weeks/don-berwick-integrative-m_b_4781105.html. Accessed April 14, 2014. 4. Department of Defense. Letter to the honorable Carl Levin. TRICARE Web site. http://tricare.mil/tma/congressionalinformation/downloads/ Military%20Integrative%20Medicine.pdf. Accessed April 14, 2014. 5. US Department of Veterans Affairs. VA initiative shows early promise in reducing use of opioids for chronic pain. VA Web site. http://www.va.gov/ opa/pressrel/pressrelease.cfm?id=2529. Published February 25, 2014. Accessed April 14, 2014. 6. Roberts M. Holistic news and views: moving right along. AHMA Web site. http://www.holisticmedicine.org/blog_home.asp?Display=192&utm_ source=Molly+%26+Steve+Blog+-+Transition&utm_campaign=Molly+and +Steve+Blog+transition+eblast&utm_medium=email. Published April 1, 2014. Accessed April 14, 2014. 7. Guarneri M, Sudak N. ABIHM announces its expansion to larger international academy. ABIHM Web site. http://www.abihm.org/about-us/aihmannouncement. Published January 24, 2014. Accessed April 14, 2014.
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Weeks—Industry Insights
5/6/14 12:13 PM
The US Medical Industry Turns Toward “Health Creation” … plus more John Weeks
This column is offered in collaboration with The Integrator Blog News & Reports (http://theintegratorblog.com), a leadership-oriented news, networking, and organizing journal for the integrative medicine community. For more information on these and other stories, enter keywords from the articles in the site’s search function.
The US Medical Industry Turns Toward “Health Creation” In April 2013, Douglas Wood, MD, the head of innovation for the Mayo Clinic, told an American Hospital Association (AHA) audience that their mission in this current era is “to change the focus of the health care industry to creating health, not just producing health care.”1 In December 2013, former Center for Medicare and Medicaid Services administrator Donald Berwick, MD, MPH, focused a 45-munute plenary session to an Institute for Health Improvement (IHI) audience of delivery-system executives on the same theme. After first noting positively how “commonplace” references in medical dialogue that describe the need to shift toward “health creation” have become, Dr Berwick identified present reform efforts such as accountable care organizations, interprofessionalism, and patient-centered medical homes. Then he added: “The pursuit of health—the creation of health—may require something even bolder. The redesign we need may be even more radical than we have imagined.” At roughly the same moment, readers of the December 2013 issue of the flagship periodical of the AHA, Hospitals and Health Networks, were introduced to new chair-elect, Jonathan Perlin, MD, PhD. He urged delivery system leaders to learn how to “move from sick care to health care,” acknowledging that it will be a “tough transition.”2 Dr Perlin, the chief medical officer for the Hospital Corporation of America (HCA), echoed a theme that runs through Dr Berwick’s talk: “I am not sure that any of us fully understands or knows the recipe.” Comment: Appreciate, first, that this is not a call to shift deck chairs on the Titanic. These are calls for the very paradigm shift that is engrained in the character and practice of all integrative practitioners worth their title. Note also the spoken humility: We don’t know how to do it. This admission would appear to be the entrance cue for the integrative health and medicine community. If you are not sure, listen to the Berwick talk.3 Virtually all of his mentors in thinking about his “more radical than we have imagined” shift are close to this movement: Jon KabatZinn, PhD; Herbert Benson, MD; Dean Ornish, MD; and 16
Integrative Medicine • Vol. 13, No. 3 • June 2014
IMCJ_13_3.indd 16
Wayne Jonas, MD, among them. A door of acknowledged ignorance—and pursuit of answers—has swung wide open. New Reports Underscore Penetration and Success of Integrative Approaches in the Military Two recent reports point to present and future leadership of the military in turning US medicine toward an integrative model. The first was required testimony to Congress from the US Department of Defense to US Senator Carl Levin (D-MI) on January 8, 2014.4 The number of facilities where the following therapies or providers were found include chiropractic (59), acupuncture (83), massage (9), yoga (11), clinical nutritional therapy (68), naturopathic medicine (1), biofeedback (13), and meditation (14). This care was delivered, the report summarized, “in 120 Military Treatment Facilities, 99 in the continental United States, and 21 outside the continental United States, offer[ing] a total of 275 complementary and alternative medicine (CAM) programs.” A total of 213 515 of these patient visits were offered in 2012. The most visits were for chiropractic (73%) and acupuncture (11%). The second report spoke to effectiveness, this time via a February 25, 2014, media release from the US Department of Veterans Affairs (VA): “VA Initiative Shows Early Promise in Reducing Use of Opioids for Chronic Pain.”5 Launched in October 2013, the initiative “is already demonstrating success in lowering dependency on this class of drugs.” For instance, at 8 Minnesota locations, VA integrative practices “have decreased high-dose opioid use by more than 50 percent.” The initiative includes “an emphasis on patient education, close patient monitoring with frequent feedback and Complementary and Alternative Medicine [sic] practices like acupuncture.” Robert Petzel, the VA undersecretary for health is quoted: “The Opioid Safety Initiative is an example of VHA’s [Veterans Health Administration’s] personalized, proactive and patient-centered approach to health care. We are also using a full-range of support treatments for veterans, including complementary and alternative medicine. We are delivering health care with the patient’s long-term personal health goals at the forefront.” The program includes a pain monitoring app. Comment: Integrative health policy leader Janet Kahn, has suggested that the military may be the agent of change for patient-centered policy on integrative health PhD,
Weeks—Industry Insights
5/6/14 12:13 PM
ShortTakes u The event to honor retiring US Senator Tom Harkin (D-IA) for his multiple contributions to advancing integrative health and medicine was moved from May 5 to September 29, in Washington, DC. The Samueli Institute is a lead organizer with support from leaders of 3 large policy and academic consortia. u The American Holistic Medical Association (AHMA) is exploring a merger with the American Board of Integrative Holistic Medicine to form the new Academy of Integrative Health and Medicine (ABIHM).6 The latter is designed as a multidisciplinary and global initiative.7 u A report card from the Washington Health Alliance once again found that, from the perspective of “patient experience,” the Bastyr Natural Health Center ranks among the top primary care facilities in the Seattle area.8 u In February, the Cleveland Clinic honored integrative medicine leader Tanya Edwards, MD, by naming their integrative center the Tanya I. Edwards Center for Integrative Medicine. Edwards, perhaps the most prominent person of color in the academic integrative medicine arena, died in March from breast cancer just short of 54 years of age. u The American Academy of Pain Medicine (AAPM) has issued a position paper entitled “Minimum Insurance Benefits for Patients with Chronic Pain”9 followed by a media release—“Pain Physicians Say Insurance Coverage Falls Short”— in which they call on insurers to cover integrative protocols.10 u James Gordon, MD, and Tieraona Low Dog, MD, received the 2014 “visionary” and “leadership” awards, respectively, from the Integrative Healthcare Symposium.
and medicine, even as AIDS activists in the 1980s changed FDA approval timelines toward interests of the individuals the agency is to serve. The movement for integrative care has always been powered by those who, in search of more functionality and productivity—whether individual patients, athletes, actors, employers, or the military—take a commonsense approach to open exploration. Individual integrative health practitioners would be served to consider the extent to which they, with other colleagues in their community, can provide the whole system of support Weeks—Industry Insights
IMCJ_13_3.indd 17
u Edwards’s leadership was behind news reported in a Cleveland Plain Dealer article on the new Chinese Herbal Therapy Clinic at the Cleveland Clinic. In addition, Chinese herbal medicine consultations began at the University Hospitals (UH) Ahuja Medical Center via the UH Connor Integrative Medicine Network.11 u An April 9, 2014, release has announced that Vanderbilt Univeristy’s Center for Integrative Health is now the Osher Center for Integrative Medicine at Vanderbilt University. The integrative center at Northwestern University in Chicago is reportedly soon to follow. They join programs at Harvard; the University of California, San Francisco; and Karolinska University with Osher support for their integrative programs.12 u In a wild example of the industry-regulator revolving door, FDA official Daniel Fabricant, PhD, who was earlier an acting director of the Natural Products Association (NPA), is back with the NPA as its CEO. u Idaho yoga therapist Jennifer Knight, ERYT 200, RYT 500, and Naomi Jones of Idaho Health and Yoga Awareness were the catalysts for the decision of Saint Alphonsus Medical Center to endorse prenatal yoga therapy. The decision was assisted by a personal experience of Mary Janowiak, MD, an OB/GYN at the medical center.13 u The widely heralded interprofessional text from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), titled the Clinicians’ and Educators’ Desk Reference on the Licensed Complementary and Alternative Healthcare Professions, is in its second edition and available in e-versions, book format, and as a free PDF.14 u Amidst pressure from a 2-part investigative article by Donald Peterson, publisher of Acupuncture Today, titled “AAAOM-Making Promises It Can’t Keep,” the controversial president of the dysfunctional American Association of Acupuncture and Oriental Medicine (AAAOM), Michael Jabbour, LAc, has stepped down.15
of this VA model that led to these profound—if yet early— outcomes. Should Integrative MDs in the United States Worry About Guidelines From Nova Scotia’s College of Physicians? Chris Foley, MD, is an integrative medicine veteran, with both hospital-based and private centers in his curriculum vitae. Foley sent an alert about a new “Policy and Guidelines on Complementary and Alternative Integrative Medicine • Vol. 13, No. 3 • June 2014
17
5/6/14 12:13 PM
Therapies”16 directive issued by the Council of the College of Physicians and Surgeons of Nova Scotia. The 3-page document requires “ethical physicians” to follow 6 precepts. Some are simple restatements of basic ethics regarding thoroughness, safety, and nonexploitation of patients for personal gain. These appear to be based in a condescending assumption that those using these therapies need reminders of their medical oath. The most onerous and subject to punitive interpretation is the requirement to “prescribe or recommend an effective and proven therapy not delayed or supplanted by the choice of a complementary or alternative treatment.” The guidelines allow a physician to “discharge” a patient who does not consent to these guidelines. The Nova Scotia group worked off a similar document prepared by their colleagues in British Columbia. Comment: Such guideline writers need to ask the following: What is a clinician to do if he or she has first rate, definitive evidence on how to suppress the symptoms of a disease but only impressionistic evidence on how to work with root causes to help the individual create health? In this context, how then does one respond as an “ethical physician” to the second bullet on delay of suppression? And how ethical is it to decisively suppress symptoms if we have some evidence that the problematic causes may be altered if one only takes another approach? Dr Foley wonders what will become of integrative medicine if the guidelines embraced in Nova Scotia are widely embraced across Canada and sweep through the United States. Perhaps the strategy is to accept the premise but turn them against the regulators. What, indeed, is the best evidence in this era of “health creation?”
8. Washington Health Alliance. Your voice matters: patient experience with primary care providers in the Puget Sound region. WHA Web site. http:// wahealthalliance.org/wp-content/uploads/2014/02/WHA-PatientExperience-2014.pdf. Published February 2014. Accessed April 14, 2014. 9. The American Academy of Pain Medicine. Minimum insurance benefits for patients with chronic pain: a position statement from the American Academy of Pain Medicine. AAPM Web site. http://www.painmed.org/files/minimuminsurance-benefits-for-patients-with-chronic-pain.pdf. Accessed April 14, 2014. 10. Anson P. Pain physicians say insurance coverage often falls short. American News Report Web site. http://americannewsreport.com/nationalpainreport/ pain-physicians-say-insurance-coverage-often-falls-short-8823180.html. Published March 7, 2014. Accessed April 14, 2014. 11. Townsend A. Chinese herbal therapy debuts at Cleveland Clinic, University Hospitals. Cleveland.com Web site. http://www.cleveland.com/healthfit/ index.ssf/2014/03/chinese_herbal_therapy_available_at_cleveland_clinic_ university_hospitals.html. Published March 5, 2014. Accessed April 14, 2014. 12. Philanthropy News Digest. Osher Foundation awards $5.5 million to Vanderbilt University Medical Center. PND Web site. http://www.philanthropynewsdigest.org/news/osher-foundation-awards-5.5-million-to-vanderbiltuniversity-medical-center. Published April 12, 2014. Accessed April 14, 2014. 13. Murri J. Prana mamas: Saint Al’s prenatal yoga referrals bring together Western and Eastern medicines. Boise Weekly Web site. http://www.boiseweekly.com/boise/prana-mamas/Content?oid=3059889. Published February 19, 2014. Accessed April 14, 2014. 14. Academic Consortium for Complementary and Alternative Health Care. Clinicians’ and Educators’ Desk Reference on the Licensed Complementary and Alternative Healthcare Professions. 2nd ed. Seattle, WA: ACCAHC; 2014. 15. Petersen DM. AAAOM—Making promises they can’t keep: profession seeks answers as dwindling support leads to financial ruin. Acupuncture Today. http://www.acupuncturetoday.com/mpacms/at/article.php?id=32868. Updated March 14, 2014. Accessed April 14, 2014. 16. College of Physicians and Surgeons of Nova Scotia. Policy guideines on complementary and alternative therapies. CPSNS Web site. http://www.cpsns. ns.ca/PhysicianGuidelinesandPolicies.aspx?EntryId=136. Accessed April 14, 2014.
References
1. Stempniak M. The patient experience: taking it to the next level. Hospital and Health Networks Web site. http://www.hhnmag.com/display/HHNnews-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/ HHN/Magazine/2013/Apr/0413HHN_FEA_PatientexperienceGate. Published April 1, 2013. Accessed April 14, 2014. 2. Weinstock M. Toward a healthier tomorrow. Hospital and Health Networks Web site. http://www.hhnmag.com/display/HHN-news-article. dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HHN/ Magazine/2013/Dec/1213HHN_Coverstory. Published December 2, 2013. Accessed April 14, 2014. 3. Weeks J. Hooking up: Don Berwick, integrative medicine and his call for a radical shift to ‘health creation.’ Huffington Post. February 18, 2014. http://www. huffingtonpost.com/john-weeks/don-berwick-integrative-m_b_4781105.html. Accessed April 14, 2014. 4. Department of Defense. Letter to the honorable Carl Levin. TRICARE Web site. http://tricare.mil/tma/congressionalinformation/downloads/ Military%20Integrative%20Medicine.pdf. Accessed April 14, 2014. 5. US Department of Veterans Affairs. VA initiative shows early promise in reducing use of opioids for chronic pain. VA Web site. http://www.va.gov/ opa/pressrel/pressrelease.cfm?id=2529. Published February 25, 2014. Accessed April 14, 2014. 6. Roberts M. Holistic news and views: moving right along. AHMA Web site. http://www.holisticmedicine.org/blog_home.asp?Display=192&utm_ source=Molly+%26+Steve+Blog+-+Transition&utm_campaign=Molly+and +Steve+Blog+transition+eblast&utm_medium=email. Published April 1, 2014. Accessed April 14, 2014. 7. Guarneri M, Sudak N. ABIHM announces its expansion to larger international academy. ABIHM Web site. http://www.abihm.org/about-us/aihmannouncement. Published January 24, 2014. Accessed April 14, 2014.
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Weeks—Industry Insights
5/6/14 12:13 PM
