Fall­ing Bar­ri­ers and In­creas­ing Team­work

Progress in In­te­gra­tive Health and Medicine

Alternative Medicine - - The Big Picture - BY JOHN WEEKS

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-

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