The American Board of Integrative Medicine

Article Outline

• AHA Survey of CAM Shows Growing Use
  • Survey Results
• Body Insight Scale Now Available
• Call For Research Papers In Energy Psychology and Energy Medicine
• Research Grant Funding Program
• Biography
• Copyright

In collaboration with the American Board of Physician Specialties (ABPS), The Center for Integrative Medicine at the University of Arizona is working toward establishing an American Board of Integrative Medicine. In those states that recognize ABPS, this would establish integrative medicine as an official medical specialty, making greater reimbursement for those certified as a specialist possible.

The following is a letter from Andrew Weil, MD, and Victoria Maizes, MD, that addresses the board's formation and the work ahead.

“We are writing to let you know about an important decision that we recently made—a decision that represents a strategic change in direction for our Center. For many years we have resisted the idea of board certification in integrative medicine (IM). We have always believed that the principles and practices of IM should inform all specialties, rather than be developed into a new field. In other words, that dermatologists, surgeons, and family physicians alike all need to learn the principles of nutrition and mind-body medicine, and to value the innate healing capacity of the body. We still hold that belief.

Earlier this year we approached the American Board of Physician Specialties (ABPS) to discuss creating a board in IM. We did so for many reasons; chief among them was to help patients discern who truly has training and expertise in IM. It is now popular in the marketplace to say you practice IM—yet anyone can say so, whether they studied for an hour, a weekend, or 10 years.

The American Board of Physician Specialties has been providing national board certification since 1953. They have boards in 17 different specialties including emerging ones like urgent care, hospital medicine, and disaster medicine, as well as more conventional ones like family medicine, internal medicine, emergency medicine, and psychiatry.

Unlike the American Board of Medical Specialties (ABMS), which would require approval by every single specialty board, ABPS is interested in creating a single pathway, recognizes fellowship training, and is an innovator. We had hoped the ABMS would consider a Certificate of Added Qualification in IM—such as exists for geriatrics—which can be applied for by different residency specialties; but ABMS is eliminating that concept.

Our goal is to have all graduates of our 1000-hour fellowship become board certified. At the same time we have not relinquished our goal of bringing IM training to all physicians. The success of our Integrative Medicine in Residency makes us comfortable and confident that IM will become a part of all physicians' basic training. This 200-hour program is being used in 22 family medicine and two internal medicine residencies.

In 2012 we will begin a pilot in two pediatrics residencies.

This is an exciting step for the field of IM. Board certification is widely recognized by physicians and the public alike as a critical step in establishing a field. The first meeting of the American Board of Integrative Medicine took place in Tampa, Florida, October 10-11, 2011. Over a two-year period, we will set criteria for sitting for the board exam and develop a validated exam.

Below is the list of the founding members of the American Board of Integrative Medicine.

We so appreciate your support!

—Andrew T. Weil, MD

Executive Director

—Victoria Maizes, MD

Director

Arizona Center for Integrative Medicine

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AHA Survey of CAM Shows Growing Use 

Over the last decade we have been watching the steady increase in the number of hospitals that report they offer complementary and alternative medicine (CAM). As more Americans demand treatments outside of conventional health services, hospitals will continue to respond to that demand. In fact, according to the American Hospital Association's Annual Survey of Hospitals, the number of hospitals offering CAM services has more than doubled, from 7.9% in 1998 to 19.8% in 2006.

To understand this phenomenon better, Samueli Institute in partnership with Health Forum conducted the fourth Complementary and Alternative Medicine Survey of Hospitals to garner in-depth information about the CAM programs and services being offered in U.S. hospitals. The survey was divided into four major areas of inquiry:

Survey Results 

The 2010 Complementary and Alternative Medicine Survey of Hospitals, a 42-question instrument, was mailed to 5838 hospitals in early 2010. A total of 714 responses were received, for a response rate of 12%. Of these, 42% (up from 37% in 2007) stated that they offer CAM services. The following are some highlights of the findings and some commentary on the trends; percentages are based on the 299 respondents that offer CAM services.

General institutional profile: As reported in 2005 and 2007, the hospitals most likely to offer CAM services are urban hospitals (72%). A typical hospital offering CAM is in the Eastern or Midwestern United States and maintains between 50 and 300 beds.

Types of services and location: The most popular services or therapies offered on an outpatient basis are massage therapy (64%), acupuncture (42%), and guided imagery (32%). On an inpatient basis, the top therapies offered are pet therapy (51%), massage therapy (44%), and music/art therapy (37%). Key reasons hospitals gave for offering CAM services were patient demand (85%), clinical effectiveness (70%), and reflecting organizational mission (58%). Although choosing what therapies to offer, hospitals are again relying on patient demand (78%) to select services they will offer. Evidence base (74%) and practitioner availability (58%) ranked next. A total of 82% reported they do not offer herbal supplements in the hospital pharmacy, and less than half (45%) stated they offered nutritional supplements. A total of 67% do report having policies in place regarding patients' use of herbal and nutritional supplements during their hospitalization, and 43% of anesthesia departments have polices regarding patients' use of herbal or nutritional supplements before or after elective surgery.

Finances and reimbursement: Eighty-three percent stated that their startup costs were below $200,000, indicating that these programs can be started with relatively little money. Forty-one percent characterized their programs as breaking even. Interestingly, of the programs not breaking even, 68% stated that they never expected to break even, indicating the programs were likely viewed as part of the organizational mission or as a loss leader. Patient self-pay (69%) continues to be the predominant mode of payment for CAM services; this, unfortunately, forms a barrier to access.

Planning and staffing: Strategic and business planning for CAM efforts are generally lacking in hospitals. Support for the CAM programs came from hospital administrators, who were mostly responsible for both launching (39%) and continuing to champion the organization's CAM efforts (33%). Such support bodes well for the sustainability of these programs. However, only 39% of CAM programs had their own business plan, and less than half of hospitals reported having CAM included in their hospital strategic plan. A total of 78% said they had good to mediocre levels of referrals from their medical staff, a good indicator that physicians are accepting the role of CAM services in caring for patients.

Evaluation and research: Patient satisfaction (85%) seems to be the metric of choice in the evaluation of CAM services, followed by volume (57%). Outcomes research is definitely a weakness of hospital CAM efforts: only 42% are conducting any kind of outcomes assessments. The greatest challenges faced by hospitals in implementing programs are reported to be budgetary constraints (75%) and lack of evidence-based studies (43%). With regard to the future, of those hospitals that are not currently offering any CAM services, 7% stated there were plans to do so. Of those respondents who had previously offered CAM programs but discontinued them, the reasons offered were poor financial performance (42%), general cuts in nonessential programs; lack of medical staff support, and lack of community interest (all 29%).

Clearly, hospitals are paying close attention to the needs and desires of communities and patients while both choosing to offer CAM services and if so, which therapies to offer. Many hospitals include community health and “whole-person” health in their mission statements, making CAM services a natural fit. “The rise of complementary and alternative medicine reflects the continued effort on the part of hospitals and caregivers to broaden the vital services they provide to patients and communities,” says Nancy Foster, vice president for quality and patient safety at the American Hospital Association. “Hospitals have long known that what they do to treat and heal involves more than just medications and procedures. It is about using all of the art and science of medicine to restore the patient as fully as possible.”

To download the complete report, please visit www.siib.org.

—Sita Ananth, MHA

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Body Insight Scale Now Available 

A new transpersonal research tool—the Body Insight Scale (BIS)—is now available through Mind Garden, Inc.

Developed over the past decade by Rosemarie Anderson, PhD, the BIS measures three forms of body awareness that support physical, psychological, and spiritual wellbeing:

Anderson points out that, “Artists, poets, and scientists often engage conscious awareness of bodily processes in their creative endeavors. Yogis, Zen Buddhist Masters, and mystics worldwide are also known to bring conscious awareness of bodily processes to serve awareness and spiritual openings. Some of the world's greatest athletes are highly adept in body awareness and equate athletic success with ‘being in the zone.' The underlying rationale for the development of the BIS assumes that most people can increase awareness of bodily sensations in ways that bring the potential benefits of somatically informed levels of awareness to everyone.”

Dr. Anderson is Professor of Transpersonal Psychology in the Institute of Transpersonal Psychology's Global PhD Program. She teaches courses in qualitative and quantitative research, human development, and the psychology of the body; develops research methods uniquely suited to the study of transpersonal and spiritual topics; conducts research; and supervises doctoral research.

More information about the BIS is available at (mindgarden.com).

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Call For Research Papers In Energy Psychology and Energy Medicine 

The Association for Comprehensive Energy Psychology (ACEP) will be hosting its second annual “Research Day” at their international conference on Thursday, May 31, 2012, in San Diego.

The Association is seeking original empirical research, clinical single-subject case studies, experimental design studies, randomized controlled studies, and theoretical papers. Clinicians, new researchers, and graduate students are especially encouraged to present. The deadline for submissions is February 1, 2012.

For submission guidelines, see: http://energypsych.org/. Send submissions via e-mail to: John Freedom, freejjii@gmail.com.

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Research Grant Funding Program 

The Association for Comprehensive Energy Psychology (ACEP) has announced its Research Grant Funding Program for 2012.

Part of ACEP's Mission is to “move EP into the mainstream” of clinical practice, by collecting and publishing evidence for the efficacy of EP modalities. It is our goal to upgrade EP modalities to the categories of “probably efficacious” and “well-established treatments,” as set forth by the APA Division 12 Task Force on Promotion & Dissemination of Psychological Procedures,” said John Freedom, Chair, ACEP Research Committee.

“Proposals for original empirical research studies are invited in the field of energy psychology. These may include applications of EP to such conditions as anxiety, depression, PTSD, chronic pain, weight loss, etc. We are especially interested in studies documenting changes in physiological correlates such as cortisol, DHEA levels, HRV, EEG, etc.,” he said.

Three grants will be awarded up to $5000. Additionally, those applicants who do not receive an award may be eligible for free technical support/assistance for their project. Submission deadline is March 1, 2012.

For submission details, see: http://energypsych.org/. Send submissions via e-mail to: John Freedom, freejjii@gmail.com.