Falling Barriers and Increasing Teamwork
Progress in Integrative Health and Medicine
Amajor dream in integrative health and medicine is of a world in which practitioners from disparate health professions readily and knowledgably help patients find the optimal aides to their health at the optimal moment. This is the team care ideal.
One measure of the depth of the chasm between medicine as currently practiced and this ideal is evident in the evolution of the movement that describes itself as “integrative health and medicine.” Even with the intention expressed in this name, the barriers between professions like medical doctors and chiropractors have not readily fallen.
Many people are surprised and even shocked to learn of the barriers that exist, for instance, between chiropractors and acupuncturists, or acupuncturists and naturopathic doctors. Over the last eight years, I have been involved in an organization that unites leaders of academic groups from these different medical professions. Despite a shared values set—to do less invasive things first, for example, and to lessen the reliance on pharmaceuticals—getting these people in the same room was often like herding cats. We came to say that we practice collaboration internally to foster it externally.
The very good news is that walls are cracking and tumbling in integrative health and medicine. New partnerships are being forged and embraced. The potential of the integrative health field to model a collaborative path for health is opening. This column celebrates recent openings to this necessary element in transforming our care system.
The most conservative entity in this field is a powerful group of now 64 institutions called the Academic Consortium for Integrative Medicine and Health. Its members are exclusively medical schools, such as Harvard, Michigan, Stanford, New York University, and Duke. In 2014 the organization set a new strategic priority: partnership.
This priority is manifest in the planning of the Consortium’s signature event, an international research conference. For 2016, these medical schools have a new direction and new partners. One is education; the partner is the group of educators in naturopathic medicine, acupuncture, massage, chiropractic, and direct-entry midwifery with which I have worked—the Academic Consortium for Complementary and Alternative Medicine. Interprofessional education is a necessary foundation for team-based practice. The rule in interprofessionalism is that practitioners must learn “from, about, and with” each other.
Another thematic focus of the conference is on policy. Here the partner is the Integrative Health Policy Consortium, another broad multidisciplinary group that has typically had a missing piece in integrative medical doctors. For 2016, the two organizations will collaborate on a policy track. To move the integrative agenda into expanded practice in the United States, policy will need to be shifted. Such broad consortia are needed to drive change.
An exceptional development in the policy arena is the decision of the Academy of Integrative Health and Medicine, a new organization of mainly holistic medical doctors, to directly form an alliance with the Integrative Health Policy Consortium. This is a major declaration that the values and the missions of these distinct disciplines are thoroughly intertwined and that a rich, working alliance is critical to success. Notably, the bylaws of the Academy require that a significant percentage of the members of its governing body are from non-MD disciplines.
Another remarkable area of interprofessional respect was evident in the requirements set by a new agency to grant board certification for medical doctors in integrative health and medicine. While exclusively for MDs, one avenue to distinguish oneself as Board Certified in Integrative Medicine (ABOIM) is to be a medical doctor who has completed aca-