The Integrative Medicine Puzzle: Putting the Pieces Together

The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options. They want forms of care that include mainstream medicine, acupuncture, massage therapy, spiritual counseling, nutrition counseling, and more. Patients don't necessarily want to just manage symptoms, they want to live healtheir lives and are looking for the experts that can help them achieve their health goals. Last year, I had the pleasure of attending the Academy of Integrative Health & Medicine (AIHM) Annual Conference and was quite impressed by the quality of lectures on topics ranging from the value of meditation, to detoxification and the microbiome. Every healthcare practitioner, including my AOM colleagues, would benefit from the AIHM's inter-professional curriculum, and I recently reached out the AIHM Executive Director, Nancy Sudak, MD, ABIHM, to gain a clearer picture of the Academy's history and vision and to share some information regarding this year's conference: People, Planet, Purpose: Global Practitioners United in Health & Healing in San Diego, Oct. 25-29, 2015.

AT: Can you tell me a bit about the history, mission and vision/ philosophy of your organization?

Nancy: The mission of the AIHM is to transform health and medicine on a global scale. The goal of the Academy is to offer a unified voice for all health professionals interested in integrative health and medicine. We are an inter-professional organization working to prevent illness and restore health, rather than just treat disease. The Academy provides critical resources (training, fellowship program, education, advocacy, membership) to support collaboration between practitioners working to transform our disease-care model into one that serves the whole person — body, mind, spirit — and beyond to include community and planet. We also provide resources to the public. The AIHM Find-A-Provider Directory is becoming a central resource for consumers looking for holistic providers. Collaboration is at the heart of the AIHM's mission. We evolved from an MD/DO centric entity because we believe in a team-based, heart-centered approach to health and medicine. Healthcare transformation will require unprecedented changes in our thinking about prevention and treatment strategies. Together we can do it. Beyond promoting integrative tools and the art of an holistic style of practice, we also offer a systems-oriented, broad-minded worldview and even an ecological perspective that brings meaning to clinicians as we step away from the "ill to the pill" mentality. To be in service of the integrative health agenda, we have to actually think integratively, which is much different than simply replacing drugs with a green pharmacy. The Academy is also committed to supporting clinicians who are working with underserved populations.

AT: You recently launched a fellowship with Tieraona Low Dog, MD. Can you share some background? Is it relevant to AOM practitioners?

Nancy: The AIHM Fellowship program offers an unprecedented opportunity and unites advanced professional clinicians in service of learning together. Dr. Low Dog is the internationally renowned educator, physician, herbalist, midwife and thought leader in integrative medicine who directed the Arizona Center for Integrative Medicine Fellowship for nine years. She brings unparalleled international expertise, vision and heart to the development and delivery of our program. The AIHM Fellowship in Integrative Health and Medicine is relevant to acupuncturists, conventional physicians, nurse practitioners, physician assistants, doctors of chiropractic, naturopathic physicians, doctors of oriental medicine, dieticians, nutritionists, selected psychotherapists and others. The two-year program includes online, in-person and clinical components. The best of health and medicine is moving toward values-based health care that rests on leadership, care of all communities and the broad determinants of health (socioeconomic, environmental, behavioral, cultural), with mutual respect across all healthcare disciplines in truly patient centered environments. The AIHM Fellowship will be the pace-setter in engaging these inclusionary and health creating values and strategies. Applications for the first class are being accepted now at www.aihm.org for the February 2016 cohort. There will be a special informational session with Dr. Low Dog at our San Diego Conference in October.

AT: Are your conference PDAs cleared through NCCAOM?

Nancy: We currently offer continuing education through the State of California Acupuncture Board and are in the process of applying to the NCCAOM. Our understanding is the PDAs through the NCCAOM are valued nationally. AMA PRA Category 1TM Credits will be available.

AT: What part would you like to play in implementing an integrative medicine model in U.S. healthcare?

Nancy: The Academy hopes to support the implementation of integrative medicine in the U.S. and globally by providing community and empowering unification of multiple disciplines within a single organization. The AIHM will provide a home to a broad international community of healthcare practitioners and health seekers connected by a shared holistic philosophy of person-centered care, and recognizing the link between our health and the health of the planet.

We want to transcend the silos and put patients first. We know this is a unique endeavor. It has been a dream of the board of directors to create harmonious conversations among diverse professions of health care professionals — that were not happening previously — in a single organization. We also want to build bridges between the clinical and nonclinical worlds. Integrative medicine is blossoming primarily due to public demand. People understand that the system is broken. They are ready for change. With our collaborative partner, the Integrative Health Policy Consortium (IHPC), the AIHM's advocacy activities aim to empower practitioners and consumers. For example, we are rallying around Section 2706 of the Affordable Care Act and are ready to challenge current reimbursement models.

AT: Where do prevention and health promotion stand in relation to primary care?

Nancy: To transform the medical system, we have to transform the role of prevention in primary care. As providers of care, of course, we want to prevent suffering. We understand the cost of not focusing on prevention. What may shift the conversation at the level of insurance reimbursement policies and legislation is the conversation around cost. The cost of not focusing on prevention is staggering. Of the more than $2.8 trillion spent annually on health care within the United States, the majority is spent on chronic diseases, most of which have a significant lifestyle component. According to a recent Interheart Study from IHPC, changing lifestyle could prevent 90% of heart disease. So, if 10% of angioplasties and CABG's are avoided pursuant to lifestyle changes, $10 billion will be saved per year.

AT: Integrative medicine is gaining momentum among physicians as well as the American public – how can you help tip the scales?

Nancy: Three things come to mind – advocacy, collaboration across organizations, and inter-professional community. The growing patient demand around the world for integrative and holistic services is bolstered by mounting evidence of its effectiveness. Consumers want access to integrative health, but there are still barriers such as insurance coverage. What we all can do is support critical legislation that is in the House and Senate to create change. We long recognized that legislation directly impacts patients' health and access to care. Among the most important ongoing initiatives of the IHPC is the support of Section 2706 of the Affordable Care Act, which basically states that all state-licensed providers can be reimbursed by insurance and not discriminated against as long as they operate within their scope of practice. That would include acupuncturists, chiropractors, nurse practitioners, naturopathic physicians, midwives, massage therapists, and others. We are proud to be joining hands with the IHPC as we show up to ensure that Section 2706 is properly enforced. There is an initiative called "Cover My Care," another IHPC initiative, which reflects the consumer-action side of the 2706 equation.

We are also helping tip the scales by creating an environment of collaboration across disciplines and like-minded organizations. Early in our formation, we entered into dialogue with a number of organizations sharing similar goals. Last year we opened our conference with a day-long workshop inviting inter-professional collaboration from a field of invited guests representing many professional associations. We are learning more about how to effectively collaborate by asking and listening to the leaders in the health arena.

The Academy membership community is generating a wave of change. It's critical that we connect with one another, learn together, and take action together. We are deeply invested in empowering members in their practices with resources like a trusted Find-A-Provider directory and the AIHM Journal Club, which helps clinicians keep pace with global advances in health care with a focus on integrative medicine. Events such as our annual conference in San Diego and local chapter meetings are critical for building and sustaining our inter-professional community. It's important for professionals to network and strategically plan at the local level as well as nationally. Imagine an inter-professional group – maybe an LAc, ND, MD, and NP - gathering around a table writing a proposal to a local healthcare system's CEO about why integrative health and medicine reduces costs. The Academy will be a platform to spark those connections. To start an AIHM chapter you need a minimum of six AIHM members. Please contact us to learn more.

AT: Communication and cooperation are key to successful outcomes in any endeavor. What steps are you taking to interact with the CAM community?

Nancy: We reached out to the Academic Consortium of Complementary and Alternative Healthcare, ACCAHC, to learn more about education. We are delighted to be connected ACCAHC because they are the academic experts of the CAM disciplines, and offer considerable value to our work. The certificate — and all other educational initiatives of the Academy — will aim to weave together themes of personal transformation, social justice, and planetary well-being, and will be broadly appealing to licensed health care providers.

We are also joining hands with the Academic Consortium for Integrative Medicine & Health, ACIMH, as a partner for the clinical track of their International Research Congress in Integrative Medicine and Health in Las Vegas in May 2016 and are discussing an international event with other organizations into 2016, as well. Another important connection is our partnership with Commons Health to support place-based integrative, health creation models that will function as our incubator for our community and ecological health efforts. This year, we will be cohosting our second Commons Health Conference in Duluth, Minn., integrating the clinician voice and sharing insights with the local community on issues such as social determinants, climate change, food systems, and more.

At the Annual Conference last year, we hosted an Association Leadership Summit with more than 60 individuals representing diverse disciplines and organizations. The group overwhelmingly voiced its support and intention to create the new Association Alliance, and two-thirds of those in attendance volunteered to serve on an Association Advisory Task Force. The AATF is comprised of Executive Directors, Board Presidents or Chairs or other highly respected individuals appointed to speak on their organizations' behalf. They provide wisdom, insight and counsel to create the Association Alliance in 2015.

The biggest question facing the AATF is, "How do we grow our collective voice?" If the AMA has 220,000 members or about 20% of all MDs, how isn't it in our own interest to bring together the hundreds of thousands of inter-professional practitioners dedicated to integrative health? This isn't about CAM. It's about all of the MDs and non-MDs pulling together for a better way of care - cutting edge stuff.

Last year, we launched the AIHM Ambassador Program to ensure our transition is successful and our vision of pluralism and inclusion is achieved at our annual conference and within the AIHM at all levels. Representing the non-MD/DO communities, ambassadors embody excellence at the top of their respective fields. They help guide the AIHM programs and educational offerings, participate in AIHM initiatives and share insights and feedback for further development. Ambassadors help the Academy connect with new communities and develop functioning networks among integrative clinicians. We are honored to work with these leaders. Bill, you are an AIHM Ambassador, and it has been great privilege to work with you. This year, we are working with four additional TCM Ambassadors, Jason Jishun Hao, DOM, Jeannie Kang, L.Ac., Fujio McPherson, DAOM, ARNP, L.Ac. Dipl Ac., and C. Daerr Reid, L.Ac.

AT: Who are some of the people you have lined up to speak at your conference?

Nancy: Those slotted at the podium are at the absolute forefront of their respective fields in medicine, ecological health, and social justice. Inter-professional leaders include, Deepak Chopra, MD; Efrem Korngold, OMD; Tieraona Low Dog, MD; Mimi Guarneri, MD; Lise Alschuler, ND; Jeff Bland, PhD; Jean Watson, RN; and, Harriet Beinfield, LAc.

AT: How would an AOM practitioner benefit from attending the upcoming AIHM conference?

Nancy: The Academy Conference is not designed to replace an attendee's respective profession's training. Our focus is on inter-professional training, education, and collaboration. An AOM practitioner will appreciate the excellent interdisciplinary curriculum that is directly applicable to their practice. The conference committee reached out to the experts in their respective fields to present at the conference.

There are ample opportunities for inter-professional networking and advocacy. We have created a sacred space where everyone's knowledge, experience, and perspective is honored. We meet on equal ground and share a vision of transforming health care – nationally and globally.

We live in a time of great change. While each of us is called to deepen our skills within our own discipline, we must also extend ourselves if we want to truly transform our system of care. I don't think we can presume to offer the depth of training in Chinese medicine you would find at one of your own professional conferences, but perhaps we are laying the groundwork for a deeper level of partnership and an opportunity to carve out the future together? The sense of renewal and celebration of People, Planet, Purpose makes the experience unique. Self-care is part of empowerment. We rejuvenate by connecting with one another on deep level over five full days of education and celebration in a beautiful space.

AT: What feedback have you received from your 2014 conference?

Nancy: Participants quite typically comment that the experience at the AIHM Annual Conference was "transformational" relative to their personal and professional lives. The event has long been recognized for its evidence based, academically rigorous content, presented in a thoughtful and holistic manner. Feedback is quite positive. Amidst all the science and rigor and exchange of ideas, the atmosphere of connection is what people often remember most clearly.

We also heard a desire for even more integrative content and for more advanced content. Some people who attended before asked us to reinvigorate the curricula. You'll see that feedback reflected in our program development. This year's program is something entirely new. We've doubled the number of speakers. There are nine break-out sessions. You'll notice clear themes and a new focus on planetary health. The research component is much stronger. The Academy membership is taking a much more central role with special events woven throughout the week. The 2015 AIHM Ambassadors will be more visible.

AT: How can practitioners learn more about your People, Planet, Purpose Conference in late October in sunny San Diego?

Nancy: To learn more, go to www.aihm.org, call 858-652-5400 or email med.edu@scrippshealth.org. The conference is October 25 – 29, 2015. There are three excellent pre-conference workshops on the 24th. On the final night, following an afternoon with our three final speakers, Jean Watson, PhD, RN, Deepak Chopra, MD, and Mimi Guarneri, MD, we are having a gala and awards ceremony. I encourage you to become an Academy member. Members receive a 10% discount on the conference. But there are more important reasons to join. If we are going to play a role in shifting the global medical paradigm to whole person, health-focused, socially and globally conscious, inclusive team-based care, the Academy needs to be in a central position and that requires the emotional and financial support of its members.