Beruflich Dokumente
Kultur Dokumente
Anne Nedrow, M.D. Medical Director, Womens Primary Care/Integrative Medicine Center for Womens Health Oregon Health & Sciences University 12/2/04
Components of Healthcare
Surgical and Emergency Medicine
Ingestive Therapies
Noningestive Therapies
Why?
National Initiatives in Complementary and Alternative Medicine Education in Allopathic Health Professional Learners
The National Center for Complementary and Alternative Medicine (NCCAM) R25 Education Grants http://nccam.nih.gov/ The Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) www.imconsortium.org
History of NCCAM
October 1991 - $2 million dollars to establish Office of Alternative Medicine (OAM) within the NIH to study unconventional medicine practices October 1995 -A Research Centers Program is established to provide a nationwide focus for interdisciplinary CAM research in academic institutions October 1998 OAM is elevated to NIH Center status and NCCAM is established. May 1999 NCCAM independently awards its first research project grant. 2002 budget exceeded $100 million with nearly $80 million in grant awards
Mind-Body Interventions
Mind-body medicine uses a variety of techniques designed to enhance the minds capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy). Other mind-body techniques are still considered CAM, including meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.
Energy Therapies
Energy therapies involve the use of energy fields. They are of two types:
Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include qi gong, Reiki, and Therapeutic Touch. Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating current or direct current fields.
R25 grantees
Georgetown University University of Michigan Maine Medical Center University of North Carolina Rush University College of Nursing Harvard - Childrens Hospital Boston Oregon Health & Sciences University University of Washington School of Nursing University of Washington School of Medicine University of Minnesota American Medical Student Association University of California, San Francisco Tufts University School of Medicine University Texas Medical Branch Kentucky Clinic
CAHCIM Members
Albert Einstein/Beth Israel Columbia University Duke University George Washington Georgetown Harvard OHSU University of CA/Irvine Thomas Jefferson University of Arizona University of Calgary University of Hawaii University of Washington University of California/LA University of California/SF University of Connecticut University of Maryland University of Massachusetts University of New Jersey University of New Mexico University of Michigan University of Minnesota University of Pennsylvania University of Pittsburgh University of Texas-Galveston
Identify potential legal and ethical implications related to the inclusion or the exclusion of CAM modalities in a patient's treatment plan. Identify reputable information resources for CAM and IM in order to support life-long learning. Explain the current status of government regulation of herbal medicines and dietary supplements. Describe the evidence for mindbodyspirit relationships in illness and health. Describe the prevalence and patterns of CAM use in the patient's community.
Demonstrate an ability to utilize the principles of evidence-based medicine in analyzing integrative medicine approaches, including: a. developing focused question regarding the application of IM principles or practices for an individual patient; b. utilizing databases, peer-reviewed publications, authoritative textbooks, Web-based resources, experiential knowledge of CAM practitioners, and participatory observation to gather relevant information; c. evaluating the information for scientific quality and clinical relevance; d. formulating a plan to implement findings in care of an individual patient; and e. evaluating the outcome of applying IM principles or practices in patient care.
The Continuum
CAM Skills
CAM Literacy
CAM Consciousness
Licensure
CAM MODALITY
Chiropractors
LICENSURE
All states
Massage ther.
Naturopaths
27 states
13 states
Homeopaths
Acupuncturists
3 states
32 states
Recently Updated
Definition of Integrative Medicine (2003)
A healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyles. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.
Program in Integrative Medicine, University of Arizona Consensus of Fellows (Current and Graduated), 2003.
Patient Evidence Centered Care Based Cultural MedicinePower Sensitivity Of the Mind
Basic Science
CAM literacy
Changing Paradigms
Drugs and Surgery Mind Body Techniques Self Care
Ethical Issues
Network marketing schemes Separation of church and medicine Legal implications of implicit knowledge Fraud and quackery Drug-herb interactions Quality control of OTC preparations Delay of Evidence-Based Medical treatments
Quick References
www.naturaldatabase.com ($92/yr) www.consumerlab.com ($15) www.intelihealth.com (free)
Mrs. E.R.
Multinutrient 6/day Taurine 500mg tid Tincture which includes coleus extract, Hawthorne, Hoxsey, licorice bid Magnesium glycinate 120mg tid Co-Q10 q d Fish oil concentrate tid Melatonin q d 5HTT (3 q hs) Betaine tid Vit E qod Black cohosh tid Thiamilate qd -two if having heart palpitations Homeopathic nerve tonic 6 tablets bid Calcium carbonate 2 qhs Tamoxifen 10mg bid Pre-op:
Phosphorus 9C qAM Staphysagria 30C qPM Arnika 9C (day of)
Mrs. P.G.
Chromium 100mg tid Garcinia cambogia 500mg tid Hydroxycitric 250mg tid Garlic powder 350mg tid Alph lipoic acid 100mg tid Evening primrose oil 500mg tid Quercetin 100mg tid Ginger root extract 50mg tid Dandelion root 130mg tid Alpha lipoic acid 70mg tid Gymnema Sylvestre 133 tid Banana leaf extract 5mg tid Colon Care fiber tid Multiple pancreatic enzymes Siberian Ginseng 67mg tid Holy Basil extract 67mg tid Vanadyl sulfate 33mg tid Cinnamon bark 100mg tid L-carnitine 200 mg bid Olive leaf extract 250mg bid Lemon balm 85mg bid B-complex q d Aspirin 81mg q d CoQ10 30mg q d Vit E 20 units tid 5-HTTP 50mg q d MSM 750mg bid-tid Glucosamine sulfate 657mg bid
The U.S. health care system is in need of fundamental changeHealth care today harms too frequently, and fails to deliver its potential benefits routinely. As medical science and technology have advanced at a rapid pace, the health care delivery system has foundered. Between the care we have and the care we could have lies not just a gap, but a wide chasm1
1 Institutes
of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C. National Academy of Sciences Press, 2001.