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October, 2010 - VOL. 9, NO. 5  October, 2010
The Path Ahead: Do We Believe in Wellness?
Joseph Pizzorno, ND
I enjoy writing these editorials as they provide an opportunity and a deadline to deeply explore a topic I think will be of interest to clinicians. Usually, I come up with a topic, research it, and then write. This editorial might, perhaps, be my most controversial—it has no research and only 1 reference. Instead, I want to ask you a question: “What do you truly believe about wellness and disease?” I readily admit the following discussion is more about naturopathic medicine than integrative medicine. However, I think those interested in healing may find my thoughts of interest, if nothing else than to better understand their naturopathic colleagues. I am part of a team that is writing the first new textbook in more than a half century on the philosophy of naturopathic medicine. It is being created through the Foundations of Naturopathic Medicine Project (www.foundationsproject.com) under the leadership of Pamela Snider, ND, executive editor, and will be published by Elsevier. I think this textbook will be the most important work on health and disease in the English language. In many ways, the textbook is about naturopathic medicine reaffirming its roots. As one of the senior editors (the others include Dr Snider; Jared Zeff, ND; James Sensenig, ND; Stephen Myers, ND, MD, PhD; Don Warren, ND; and Roger Newman-Turner, ND) we have engaged almost 200 authors from around the world to comprehensively and rigorously address the concepts underlying the formulations we call health and disease and how these concepts guide clinical diagnostic and treatment decisions.
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October, 2010 - VOL. 9, NO. 5  October, 2010
Industry Insights: Ornish, Benson Programs to be Covered by Medicare . . . plus more
John Weeks
Dean Ornish, MD, tells about contacting what is now the Centers for Medicaid & Medicare Services (CMS) in 1994 to promote Medicare coverage of his integrative health program for reversing cardiovascular disease. The agency’s then director, a chain-smoker who weighed in at 280 pounds, reportedly responded, “If we do this, anyone with a crystal and a pyramid will want us to pay for what they do.”1 After 16 years of perseverance, including a national pilot project, the program first researched by Ornish in the 1980s was recently approved for coverage by CMS.2 A similar integrative program developed by Herbert Benson, MD, and Eileen Stuart, RN, PhD, that was also subject to a CMS pilot project was also approved. Under the approval, Medicare will guarantee coverage in either program for 36 sessions within an 18-week period, with a possible extension to 72 sessions for 36 weeks. As of the end of July 2010, the final details of how much will be covered were still under negotiation. The CMS decision indicates an acknowledgment that comprehensive lifestyle changes can lower cholesterol and blood pressure and reverse coronary artery disease without medication or surgery. The multidisciplinary programs include such modalities as support groups, nutrition counseling, cognitive restructuring, and exercise and stress management techniques like yoga, meditation, or breathing exercises.
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October, 2010 - VOL. 9, NO. 5  October, 2010
Marketplace Dynamics: Implications For Integrative Providers
Stephen Bolles, DC
While recent headlines trumpet health care reform for focusing on revising elements of the delivery and compensation systems, in fact, the transactional part of our health system already had been undergoing substantial evolution. New health care products have dramatically altered insurance coverage models, and health plan subscribers are being thrust into a new role—one resembling that of retail consumers. Providers, however, have not been adequately prepared for this shift, and, although some nonmedical professions have grown and become established outside of health-plan coverage, there still is a need for an ongoing conversation about how the retail health care marketplace will affect integrative practitioners.
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October, 2010 - VOL. 9, NO. 5  October, 2010
Business Strategies Applied to an Integrative Medicine Practice: A Case Study Research on Sustainability
Peter P. Amato, MS;  Steven J. Szydlowski, DHA, MBA, MHA
This case study demonstrates the application of practical business principles to an integrative medicine clinic in Northeastern Pennsylvania and measures the effectiveness of those applications in terms of profitability and operational indicators. This article provides strategies and recommendations for clinicians, practice managers, and researchers to advance the integration of integrative medicine into the US health care system. Methods for sustaining financially viable, quality-driven integrative medicine clinics are suggested.
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October, 2010 - VOL. 9, NO. 5  October, 2010
The Challenge of Providing Integrative Cancer Care: An Interview With Keith Block, MD, and Penny Block, PhD
Nancy Nachman-Hunt
Keith Block, MD, serves as medical director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois, and is a graduate of the University of Miami School of Medicine. He completed a Flex-Medicine residency at Illinois Masonic Medical Center in Chicago and went on to do post-graduate training in nutritional oncology. He later trained in enteral and parenteral nutrition. Among his many academic appointments are clinical assistant professor, College of Medicine, University of Illinois, Chicago; adjunct assistant professor of pharmacognosy, Department of Medicinal Chemistry and Pharmacognosy, University of Illinois, Chicago. Dr Block is director of integrative medical education and also director of Integrative Oncology Fellowship at the University of Illinois College of Medicine, Chicago. He also serves as editor in chief of the peer-reviewed medical journal Integrative Cancer Therapies (a Sage publication). Dr Block is author of Life Over Cancer (Bantam, 2009). Penny B. Block, PhD, serves as executive director of the Block Center. She is a graduate of Cornell University and received her doctorate from the University of Chicago with an academic focus in psychosocial oncology and clinical emphasis on behavioral medicine. She has advanced training in clinical hypnosis and mind-body medicine and serves as assistant editor of the peer-reviewed medical journal Integrative Cancer Therapies. IMCJ: Keith, why did you decide to become a physician? Keith Block: I think what drove me, certainly through my younger years and college, was a deep search for personal meaning. It was a historic time. We were at the tail end of the Vietnam War, there was social turmoil, and I wanted a career and life direction that could make a genuine difference, if not on a global basis at least for individuals. This focus led me to work at a suicide prevention center during my undergraduate years. And that experience led me toward medicine. I found it very personally meaningful to be able to help someone in crisis and at least metaphorically talk someone down from the edge.
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October, 2010 - VOL. 9, NO. 5  October, 2010
The Effect of a Brief Emotional Freedom Techniques Self-Intervention on Anxiety, Depression, Pain, and Cravings in Health Care Workers
Audrey J. Brooks, PhD;  Dawson Church, PhD
This study examined whether self-intervention with Emotional Freedom Techniques (EFT), a brief exposure therapy that combines a cognitive and a somatic element, had an effect on health care workers’ psychological distress symptoms. The participants were 216 attendees at 5 professional conferences over a span of 1 year. Psychological distress, as measured by the Symptom Assessment 45 (SA-45), and self-rated pain, emotional distress, and craving were assessed before and after 2 hours of self-applied EFT by using a within-subjects design. A 90-day follow-up was completed by 53% of the sample, with 61% reporting using EFT subsequent to the workshop. Significant improvements were found on all distress subscales and ratings of pain, emotional distress, and cravings at posttest (P<.001). Gains were maintained at follow-up for most SA-45 scales. The severity of psychological symptoms was reduced (-45%, P<.001) as well as the breadth (-40%, P<.001), with significant gains maintained at follow-up. Greater subsequent EFT use correlated with a greater decrease in symptom severity at follow-up (P<.034, r=.199), but not in breadth of symptoms (P<.0117, r=.148). EFT provided an immediate effect on psychological distress, pain, and cravings, which was replicated across multiple conferences and health care provider samples.
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October, 2010 - VOL. 9, NO. 5  October, 2010
The Transmission of Affect: Compassionate Love in Clinical and Educational Settings
Paul Posadzki, PhD
This article presents a conceptual model of compassionate love and its transmission within clinical settings that is based in spirituality, humanism, and ethics. This model proposes that compassionate love can be transmitted to patients by therapists as overt energy in therapeutic relations. It also assumes that loving compassion and its transmission can be measured objectively via functional magnetic resonance imaging or changes in hormone levels. This article advances the premise that compassionate love is a resource that, when transferred, may improve patients’ quality of life and health. The article concludes by demonstrating how compassionate love can be taught at the university level.
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October, 2010 - VOL. 9, NO. 5  October, 2010
Quality Assurance: Toxic Solvent Found in Curcumin Extract
Rick Liva, RPh, ND
In this article I wish to illustrate 4 major points: 1) the absolute need for clinicians to ascertain that their supplement manufacturers/suppliers are vigilant in contamination screening and actually go beyond the US Food and Drug Administration (FDA) Dietary Supplement current Good Manufacturing Practices (cGMPs)—you will see the reason why I say they need to go beyond cGMPs as you read this article; 2) the importance of the concept that “You only find what you look (test) for”; 3) that some amount (maybe a large amount) of the worldwide curcumin (Curcumin longa) extract supply may be tainted with a Class 1 (the highest level) toxic solvent, and clinicians—as well as some manufacturers—have no awareness of this possibility; 4) the importance of total daily dose and duration of treatment when evaluating patient toxicity load and exposure. In this article, I decided to say as little as possible and let the information and data I have collected speak for itself.
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October, 2010 - VOL. 9, NO. 5  October, 2010
Green Medicine Tips: Energy and the Costs of Health Care
Joel Kreisberg, DC
Energy costs may not be top of mind for multitasking clinicians. However, reducing energy consumption is one of the simplest ways to save money in a busy practice. Considering the national dialogue about global climate change and reducing the CO2 footprint, independent health care professionals can play their part in supporting this cause while saving themselves money as they go along. Do you know your current energy costs? Have you considered energy conservation measures?
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October, 2010 - VOL. 9, NO. 5  October, 2010
BackTalk: Big Dog, Little Dog
Bill Benda, MD
Clayton is dead. Clayton College of Natural Health, that is, formerly of Birmingham, Alabama. If you haven’t heard of this online university, you are not a naturopathic physician—as every brick-and-mortar medical-school-trained naturopath has been regaled with stories of Clayton College and its evil minions. First, a little contextual history. Clayton College began life as the American College of Holistic Nutrition, sired by Lloyd Clayton, Jr some 30 years ago. Renamed Clayton College of Natural Health in 1997, at 1 point it boasted more than 25 000 students and graduates participating in 5 degree and 7 certificate programs. Notable (and controversial) alumni include Gilliam McKeith, well-known author and television personality in the United Kingdom; Hulda Regehr Clark, whose many books include The Cure for All Diseases (New Century Press, 1995)—she died of multiple myeloma in 2009; and Kim Barnouin, former model and coauthor of Skinny Bitch (Running Press, 2005) and Skinny Bitch in the Kitch: Kick-Ass Recipes for Hungry Girls Who Want to Stop Cooking Crap (and Start Looking Hot!) (Running Press, 2007).
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