Volume 1, Issue 6 , Pages 424-429, November 2005
Finalists Named for Bravewell Leadership Award
Article Outline
- Leadership Award
- ACCF Issues Consensus Report on CAM
- New From NCCAM
- Low Levels of Ionizing Radiation May Cause Harm
- New CAM Center Opens at Ohio State University Medical Center
- FDA Issues Information About Green Tea
- Copyright
Throughout American history, philanthropy has served as a catalyst for social change. In 2002, aware that the healthcare system in our country was in crisis, a small group of dedicated philanthropists joined in conversation with leading physicians in the field of integrative medicine to discuss the potential benefits that might be derived from collaboration. Two key questions were discussed: Could a group of philanthropists working together to fund strategic programs aimed at systems change accomplish more than individual philanthropists working alone? Did the field of integrative medicine hold some of the answers to our healthcare system’s problems? In both cases, the answer to the question was “yes.”
Following that and two subsequent meetings, The Bravewell Collaborative was established as an operating foundation dedicated to transforming the culture and delivery of healthcare. Now composed of 28 members, the Collaborative funds select strategic projects to accelerate change, create synergy and leverage, and translate emerging knowledge into broad practice.
“It is our goal that the future of healthcare will be defined by the creation of a healing partnership between the patient and the physician in which the patient takes a more proactive role in that partnership as they both work with the inner-connectedness of mind, body, spirit, and community and its effects on health and wellness,” says Christy Mack, a member of the Bravewell Collaborative executive council.
Leadership Award
One of the Collaborative’s key projects is the Bravewell Leadership Award. Meant to encourage and sustain leadership in the field of integrative medicine, the award is open to licensed physicians and other doctoral level professionals. Bestowed every other year, the award confers a $100,000 grant to the recipient to help advance his or her work to transform healthcare.
“The Bravewell Award gives this small group of philanthropists the unique opportunity to recognize nationally and honor that person who most represents Bravewell’s vision for the future of healthcare. This award is a testament to the Collaborative’s confidence that the field is closer to that vision because of the recipient’s passion and commitment to integrative medicine,” says Christy, who, in addition to serving on the executive council, is the chair of the Bravewell Leadership Event.
On November 13, 2003, the inaugural Bravewell Leadership Award evening was held in New York City. Before an audience of 450 attendees, Dr. Ralph Snyderman of Duke University accepted the $100,000 award from Walter Cronkite. The second award is being conferred on November 10, 2005, in New York City at Chelsea Piers. The event will be hosted by Christy and John Mack, with Sarah Ferguson, the Duchess of York, presiding as mistress of ceremonies.
Although the winner of the award was not known at press time, he or she will be highlighted in our January issue. The five finalists for the 2005 award are highlighted below. For more information on the Bravewell Collaborative, please visit www.bravewell.org.
Brian M. Berman, MD
One of integrative medicine’s academic leaders, Brian M. Berman, MD, is the director and professor of the Complementary Medicine Program and the founder and director of the Center for Integrative Medicine, the first integrative medicine center at a US academic institution, at the University of Maryland School of Medicine. In addition, he has been a visiting professor at Harvard, Columbia, Johns Hopkins, Stanford, and Shanghai universities.
Brian M. Berman, MD
(Photography by Allegra Studios).
The Center for Integrative Medicine at the University of Maryland, which is one of the largest clinics connected with academia, sees over 5,000 patients a year. “In searching for new ways to relieve suffering caused by chronic disease, I have looked for treatment options that are minimally invasive and stimulate the individuals own healing power. The center also seeks to empower people on their healing journey and in maintaining health,” says Dr. Berman.
Dr. Berman received his medical degree from the Royal College of Surgeons in Dublin, Ireland, and completed his residency in family medicine at the University of Maryland. An accomplished researcher, Dr. Berman has published over 120 peer-reviewed articles and books and has been the principal investigator of five major National Institutes of Health (NIH) grants. His report on the “Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee,” which is one of the largest randomized controlled trials in acupuncture to date, was published as the lead article in the Annals of Internal Medicine in the December 21, 2004, issue.
James S. Gordon, MD
(Photography by Allegra Studios).
Dr. Berman chaired the NIH’s first ad hoc advisory committee on alternative and complementary medicine and edited its first report, Expanding Medical Horizons. He served on the governor of Maryland’s Commission on Complementary Medicine and as the first chair of the Consortium of Academic Health Centers for Integrative Medicine. Additionally, Dr. Berman helped established and is the current chair of the Complementary Medicine Field for the Cochrane Collaboration, which is a highly esteemed network of over 9,000 collaborators from 80 countries, who review and evaluate scientific literature. The Complementary Medicine Field of the Cochrane Library now contains over 8,500 clinical trials and 500 systematic reviews. Most recently, Dr. Berman served on the National Academy of Sciences, Institute of Medicine’s Panel on Complementary Medicine, which is one of the country’s most respected independent medical bodies.
James S. Gordon, MD
One of the early pioneers in this field, James S. Gordon, MD, is the founder and director of the Center for Mind-Body Medicine in Washington, DC. He serves as clinical professor in the departments of Psychiatry and Family Medicine at the Georgetown University School of Medicine in Washington, DC, and clinical professor in the Department of Psychiatry, The Uniformed Services University of Health Sciences in Bethesda, Maryland.
Dr. Gordon received his MD degree from Harvard Medical School in 1967. During the course of his distinguished career, he has served as chair of the White House Commission on Complementary and Alternative Medicine Policy (2000-2002), as a member of the Cancer Advisory Panel of the National Institutes of Health (1998-2001), and as first chair of the Program Advisory Council of the Office of Alternative Medicine at the National Institutes of Health (1994-1996). He is currently a coprincipal investigator for an NIH grant on integrating complementary and alternative medicine into medical education at Georgetown University.
Of his own interest in this field, Dr. Gordon explains that, “In the early 1970s, it became apparent that medicine was in need of profound change—to address a worldwide epidemic of chronic illness; to heal the pain and alienation of patients and health professionals; to explore the therapeutic potential of ancient ways of healing; and to save our healthcare system from economic collapse.” One of his first efforts was to gather leaders in integrative and holistic medicine under the auspices of the National Institute of Mental Health and develop the first major text in the field, Health for Whole Person.
As director of the Center for Mind-Body Medicine, Dr. Gordon founded the professional training program in “MindBodySpirit Medicine”, which has now graduated more than 1,500 health professionals, the “CancerGuides” program. The program teaches health professionals to help people with cancer create comprehensive and integrative approaches to their care. He also founded the “Healing the Wounds of War” program, which has taught mind-body skills to leaders in health and mental health in Kosovo, Bosnia, Macedonia, Israel, and Gaza to help them deal with their own stress and, in turn, to bring effective, integrative care to entire populations traumatized by war. In Kosovo, this approach is now a central element of the countrywide community mental health system. Dr. Gordon is the author of many books, including Manifesto for a New Medicine and Comprehensive Cancer Care.
Erminia M. Guarneri, MD, FACC
(Photography by Gregory Mancuso).
Erminia M. Guarneri, MD, FACC
A champion of integrative medicine, Erminia M. Guarneri, MD, is the founder and medical director of the Scripps Center for Integrative Medicine, Scripps Health in La Jolla, California. As an attending interventional cardiologist who had surgically implanted hundreds of intracoronary stents, Dr. Guarneri came to understand that the treatment of heart disease needed to be more than opening a narrowed artery or surgically repairing the heart. This led her to design a medical center that would blend the best of Western medicine and high technology with alternative medicine, mind-body healing, and prevention strategies. Now known for its “high tech-high touch” approach, the Scripps Center for Integrative Medicine is one of the leading integrative medicine centers in the United States.
Dr. Guarneri received her medical degree from SUNY Medical Center in Brooklyn, New York, and served as assistant clinical professor, Department of Medicine, at the University of California Medical School in San Diego, California, for many years. She is board certified in cardiology, internal medicine, nuclear cardiology, and holistic medicine. She currently serves as the director of the Bravewell Clinical Network, on the board of the American Board of Holistic Medicine, and as a member of the expert consensus panel for integrative complementary medicine at the American College of Cardiology. Her first book, The Heart Speaks, will soon be published by Simon & Schuster.
Early in her career as an interventional cardiologist, Dr. Guarneri conducted intracoronary radiation research for the prevention of restenosis. Later, she constructed the “Healing Hearts” lifestyle change program at Scripps, which allowed her to complete the circle of care for her heart patients. In addition to being the director of the Scripps Center for Integrative Medicine, Dr. Guarneri is also the medical director for the Department of Integrative Medicine within the Scripps Medical Group, a position from which she is teaching physicians about herbal and nutritional supplements, alternative treatment options, and the impact of lifestyle on health.
Most recently, Dr. Guarneri established the Early Detection Center at Scripps, which enables a team of radiologists, cardiologists, nurses, and laboratory technicians to combine state-of-the-art computerized tomography and nuclear medicine technology with nontraditional lifestyle change programs to help prevent illness and create healing prescriptions for their patients. “With the new generation of high-tech diagnostic imaging, we can detect early signs of illness and intervene with treatments and lifestyle changes when they can be most effective. This is integrative medicine at its best,” says Dr. Gaurneri.
Kathi Kemper, MD, MPH
Kathi Kemper, MD, MPH, has dedicated her career to the advancing the rate of integration of complementary medicine into pediatric practice and research. She is the Caryl J. Guth Chair for Holistic and Integrative Medicine and professor of Pediatrics, Public Health Sciences, and Family and Community Medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina. Dr. Kemper also serves as senior research associate at the Mind-Body Medical Institute at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, and instructor of pediatrics at Harvard Medical School.
Kathi Kemper, MD, MPH
(Photography by Tom Sapp).
At Wake Forest University School of Medicine, Dr. Kemper founded the Council on Bioenergetic Healing, the Council on Mind-Body Medicine, the Committee for Holistic and Integrative Medical Education, and the Herb and Dietary Supplement Task Force. In Boston, she founded the Longwood Herbal Task Force and the Center for Holistic Pediatric Education and Research at Boston’s Children’s Hospital. In addition, Dr, Kemper founded the Section for Holistic and Integrative Medicine within the American Academy of Pediatrics.
During her distinguished career, Dr. Kemper has written over 100 articles and chapters in the pediatric literature and served as the chair of research and president of the Ambulatory Pediatric Association (AAP). She created and evaluated the first residency education in holistic pediatrics, the first faculty development program for pediatrics in holistic medicine, and an elective course in therapeutic and healing touch for medical students. Her book, The Holistic Pediatrician, serves as a key reference for families and pediatric educators and clinicians.
Dean Ornish, MD
(Photography by Jason Tinacci).
Dr. Kemper’s work is deeply informed by humanistic principles. “The bedrock underlying all true healing is the clear intent to express and embody compassion,” she says. “Healers need to be deeply mindful of the most peaceful, harmonious aspects of themselves and to bring that awareness to the fore when working with infants, children, adolescents, and their families.”
Dr. Kemper received her MD and MPH from the University of North Carolina at Chapel Hill. In addition to her many accomplishments stated above, Dr. Kemper helped the AAP to revise its guidelines on jaundice, reducing hospitalizations for hundreds of thousands of newborns, and to revise its guidelines on screening for asymptomatic bacteriuria, reducing unnecessary testing for millions of children.
Dean Ornish, MD
Best know for his groundbreaking work with the reversal of cardiovascular disease, Dean Ornish, MD, is the founder, president, and director of the Preventive Medicine Research Institute in Sausalito, California. Also a clinical professor of medicine at the University of California, San Francisco, he received his medical training from Baylor College of Medicine in Houston, Texas, and Harvard Medical School and Massachusetts General Hospital in Boston, Massachusetts.
Over the past 28 years, Dr. Ornish’s clinical research has demonstrated that a comprehensive integrative medicine program can reverse the progression of coronary heart disease without the use of drugs or surgery. By using high-tech, state-of-the-art medical imaging technologies, Dr. Ornish and his colleagues were able to prove that ancient, low-tech and low-cost interventions such as diet, yoga, meditation, and community support were effective. Now used in more than 35 hospitals throughout the United States, his program was recently evaluated and approved by Medicare. “This is a major tipping point,” explains Dr. Ornish. “As Medicare makes this a defined benefit, then most other insurance companies will do the same, thereby making integrative medicine available to those who most need it.”
Dr. Ornish has recently completed the first randomized controlled trial demonstrating that the same integrative medicine program may reverse the progression of prostrate cancer, and he and his colleagues are now conducting the first study to determine whether an integrative medicine program could affect gene expression in men with prostrate cancer. “In short, what we are finding is that comprehensive lifestyle changes may ‘turn on’ the beneficial parts of the genome and ‘turn off’ the more harmful parts,” says Dr. Ornish.
Dr. Ornish was appointed to the White House Commission on Complementary and Alternative Medicine Policy and elected to the California Academy of Medicine. One of the physician advisors to President Bill Clinton, Dr. Ornish trained the White House chefs to cook more healthfully and is currently consulting with the CEOs of McDonalds, PepsiCo, Con Agra, Dole, and Safeway to help them provide healthy food choices. Two of the early outcomes of this work have been removal of trans-fatty acids from some of the fast foods and the offering of premium salads by McDonalds.
ACCF Issues Consensus Report on CAM
The American College of Cardiology Foundation (ACCF) Task Force on Clinical Expert Consensus Documents recently issued its report on the current state of complementary, alternative, and integrative medical therapies as they relate to cardiovascular diseases (CVDs). The report, Integrating Complementary Medicine Into Cardiovascular Medicine,1 informs practitioners and payers of the many evolving areas of clinical practice and/or technologies associated with CVD and offers recommendations about nutrition and supplements, mind-body practices, acupuncture, bioenergetics, and spirituality. “Integrating CAM into medicine must be guided by compassion but enhanced by science and made meaningful by solid doctor-patient relationships,” the report states.
Nutrition
Citing diet as a “major determinant of cardiovascular health,” the report reviews current research and concludes that, “diets containing unsaturated fats, whole grains, fruits, vegetables, fish, and moderate alcohol are optimum for preventing heart disease.” Offering extensive information on what is currently known about the bioactive components of food such as garlic, soy, and tea, the report also includes a comprehensive and well-documented section on dietary supplements. Both benefits and contraindications are noted. Its recommendations concerning vitamins, minerals, and herbs include the ingestion of five to 20 grams per day of soluble fiber and one to two grams per day of omega-3 supplements. The report warns against the use of ephedra and oleander, both of which have “well-defined contraindications to cardiovascular drugs and/or other CVD conditions.”
Mind-Body Therapies
The authors state that, “although stress does not directly cause hypertension, it may lead to hypertension through repeating blood pressure elevations and by increasing the amount of vasoconstricting hormones.” In addition, they agree that postmyocardial infarction depression is a predictor of one-year cardiac mortality. Acknowledging that both of these factors—stress and depression—do have an effect on health, the report reviews the current literature and suggests that stress reduction therapies, meditation, and group support may be helpful for reducing coronary artery disease and that guided imagery for heart surgery patients may result in improved outcomes. Meditation was also cited as having a potential beneficial effect for lowering cholesterol and reducing hypertension.
Acupuncture
Although falling short of a firm recommendation of use, the report does state that, “increasing evidence suggests that acupuncture may be useful in treating patients with neurological disease, including disorders of the autonomic nervous system, hypertension, and other forms of CVD.” Suggested mechanisms for the beneficial effect of acupuncture included placebo; the release of opioids in the hypothalamus, midbrain, and medulla that are concerned with processing information; and the reduction of myocardial oxygen demand.
Bioenergetics
Bioenergetics, as a category, includes such therapies as yoga, qi gong, Reiki, healing touch, and vibrational medicine. Stating that, “no sound scientific evidence demonstrates existence of bioenergy fields” and that “no bioenergy therapy has been shown to alter the natural course of CVD,” the report acknowledges that, “the mind can influence health, life, and death,” and it encourages physicians to be sensitive to their patient’s beliefs about this field. “Potential beneficial effects of these approaches may be in part due to an undefined psychological impact that might ultimately cerate a physiological effect,” the report says.
Spirituality and Intentionality
Noting that, “thousands of observational, instructional, anecdotal, theological, and philosophical treatises suggest the potent impact of the spirit in health” the authors engage in a careful and interesting examination of spiritual support (access to chapels, sensitivity to spiritual preferences) versus spiritual interventions (therapies with a specific healing intent). The lack of satisfactory measurements and mechanistic explanations for how spiritual healing works is also discussed. The report concludes that, “it is reasonable to examine spiritual therapy as an adjunct to modern technology, not as competition or a replacement for standard care.”
How to Obtain the Report
The full report, Integrating Complementary Medicine Into Cardiovascular Medicine, is available on the Web site of the American College of Cardiology (www.acc.org). Reprints of the document may be purchased for $10 each by calling 1-800-253-4636, ext. 694, or by writing to the American College of Cardiology, Educational Services, 9111 Old Georgetown Road, Bethesda, MD 20814-1699.
Reference
1. Vogel JHK, Bolling SF, Costello RB, et al. Integrating complementary medicine into cardiovascular medicine: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (Writing Committee to Develop an Expert Consensus Document on Complementary and Integrative Medicine). J Am Coll Cardiol 2005;46:184–221.
New From NCCAM
The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) recently announced the release of several new informational products. The following new titles are available on the Web or from the NCCAM Clearinghouse:
To access these new products go to nccam.nih.gov/news/newsletter/2005_summer/clearinghouse.htm.
Low Levels of Ionizing Radiation May Cause Harm
A preponderance of scientific evidence shows that even low doses of ionizing radiation, such as gamma rays and x-rays, are likely to pose some risk of adverse health effects, states a new report from the National Research Council at the National Academies of Science and Engineering
The report focused on low-dose, low-linear-energy-transfer ionizing radiation that is energetic enough to break biomolecular bonds. In living organisms, this type of radiation can cause DNA damage that eventually leads to cancers. Although more research is needed, scientists suspect that low doses of radiation can also cause other health problems, such as heart disease and stroke.
The report, which is the seventh in a series on the biological effects of ionizing radiation, offers comprehensive risk estimates for cancer and other health effects from exposure to low-level ionizing radiation and supports a “linear, no-threshold” (linear energy transfer) risk model, which says that the smallest dose of low-level ionizing radiation has the potential to cause an increase in health risks to humans.
“The research shows that there is no threshold of exposure below which low levels of ionizing radiation can be demonstrated to be harmless or beneficial,” said committee chair Richard R. Monson, associate dean for Professional Education and professor of Epidemiology at the Harvard School of Public Health in Boston, MA. “The health risks—particularly the development of solid cancers in organs—rise proportionally with exposure. At low doses of radiation, the risk of inducing solid cancers is very small, but as the overall lifetime exposure increases, so does the risk.”
Sources of Ionizing Radiation
According to the report, people are “exposed to natural background ionizing radiation from the universe and the ground and basic activities such as eating, drinking, and breathing. These sources account for approximately 82% of human exposure. Nationwide, man-made radiation composes 18% of human exposure, 79% of which comes from medical x-rays and nuclear medicine. Elements in consumer products, such as tobacco, tap water, and building materials, account for another 16%, and occupational exposure, fallout, and use of nuclear fuel constitute 5% of the man-made component nationwide.”
Factors that could increase exposure include greater use of radiation for medical purposes, working around radioactive materials, and smoking tobacco. Living at low altitudes, at which there is less cosmic radiation, and living and working on the upper floors of buildings, on which there is less radon gas—a primary source of natural ionizing radiation—are factors that could decrease exposure.
The report was sponsored by the US Departments of Defense, Energy, and Homeland Security; the US Nuclear Regulatory Commission; and the US Environmental Protection Agency. The National Research Council is the principal operating arm of the National Academy of Sciences and the National Academy of Engineering. It is a private, nonprofit institution that provides science and technology advice under a congressional charter.
Copies of Health Risks from Exposure to Low Levels of Ionizing Radiation (BEIR VII-Phase 2) are available from the National Academies Press; telephone: 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu.
New CAM Center Opens at Ohio State University Medical Center
The Ohio State University Medical Center in Columbus, Ohio, recently created the OSU Center for Integrative Medicine (OSUCIM). The center, which opened in February 2005, seeks to combine the best of mainstream medicine with complementary therapies, allowing for evidence-based, patient-centered healthcare that treats a patient’s body, mind, and spirit.
According to Glen Aukerman, MD, the center’s medical director, “The center offers traditional medical services and can help patients select the complementary practices best suited for their condition and personal philosophy.”
The center provides an evidence-based, patient-centered approach to holistic healthcare. Thirty-six practitioners using five areas of therapy from acupuncture to Ayurveda provide patients with creative solutions for a healthier life. Services include the following:
For more information, contact the OSU Center for Integrative Medicine at 2000 Kenny Road, Columbus, OH 43221. Telephone: (614) 293-9777. E-mail: aukerman-1@medctr.osu.edu
Glen Aukerman, MD
FDA Issues Information About Green Tea
Under the Food and Drug Administration’s (FDA) “Consumer Health for Better Nutrition Initiative,” the agency recently announced the results of a review of health claims that green tea may reduce the risk of certain types of cancer. A systematic evaluation of the available scientific data, revealed that, “Two studies did not show that drinking green tea reduced the risk of breast cancer in women, but one weaker, more limited study suggested that drinking green tea may reduce this risk.” In addition, “One weak and limited study did not show that drinking green tea reduces the risk of prostate cancer, but another weak and limited study suggested that drinking green tea may reduce this risk.”
Based on these studies, the FDA has concluded that it is highly unlikely that green tea reduces the risk of either breast or prostate cancer and that existing evidence does not support the health claims for green tea consumption for reducing the risk of any type of cancer.
The FDA stated that it would continue to evaluate new information that becomes available to determine whether changes in these claims, or in the decision, are necessary.
PII: S1550-8307(05)00374-5
doi:10.1016/j.explore.2005.08.005
© 2005 Elsevier Inc. All rights reserved.
Volume 1, Issue 6 , Pages 424-429, November 2005
