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From the Townsend Letter,
the Examiner of Alternative Medicine
February/March 2006


Pathways to Healing
by Elaine Zablocki

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National Education Dialogue Prepares for Integrated Healthcare Training

In June 2005, more than 70 healthcare educators gathered at Georgetown University for a meeting that could change the course of U.S. healthcare. Participants came from conventional medicine and a wide range of Complementary and Alternative Medicine (CAM) disciplines such as chiropractic medicine, acupuncture, and naturopathic medicine. Their goal: to create common ground in shaping healthcare education and the next generation of healthcare practitioners.

At present, most education for healthcare practitioners takes place in independent silos. Each profession is trained in its own methods and philosophy, with perhaps a brief overview course to survey other disciplines. While students are in school, they don't have any opportunity to study or work alongside other disciplines. Is it any surprise that they finish training without the skills needed to function as part of an integrated team?

At "The National Education Dialogue to Advance Integrated Health Care: Creating Common Ground," representatives of the licensed CAM disciplines and educators from a broad cross-section of conventional medical institutions met together for the first time to discuss issues in integrated healthcare education. Their goal was to find ways of educating students who will be trained to work collegially with other disciplines, each discipline contributing its unique viewpoint and expertise.

IOM Committee Chair Praises NED Work
In January 2005, the Institute of Medicine (IOM) of the National Academies released its landmark report on CAM usage, "Complementary and Alternative Medicine in the United States." Citing widespread use of CAM, the report calls for "comprehensive care that is safe and effective, care that is collaborative and interdisciplinary, and care that respects and joins effective interventions from all sources." Care should be based on continuous healing relationships, the report said, customized to meet patient needs and values, and marked by cooperation among clinicians, evidence-based decision making, shared knowledge, and the free flow of information.

Stuart Bondurant, MD, chair of the committee that wrote the IOM report on CAM, and executive dean of Georgetown University Medical Center, keynoted the meeting, calling education the major factor that will shape integrative medicine over the next decade. "CAM use is widespread, and here to stay," he said. "Our ultimate goal should be to create a healthcare delivery system that is comprehensive, patient-centered, evidence-based and cost-effective. What you are doing here, this great collaborative work, is one of the most important things anyone can do to implement our report."

Face-to-Face Communication is Key
The National Education Dialogue (NED) is a project of the Education Task Force of the Integrated Healthcare Policy Consortium. Work began in March 2004, with a series of task forces addressing aspects of the project.

Participants in the June meeting included representatives of conventional academic medical centers as well as licensed CAM disciplines such as chiropractic, acupuncture, naturopathic medicine, massage therapy, and direct-entry midwifery. In addition, diverse fields including nutrition, holistic nursing, social work, occupational therapy, yoga. and homeopathy were represented.

Perhaps the most valuable aspect of the meeting was the continuous, informal sharing of information and experience among people who have had few opportunities to meet face-to-face. The chairman of the Association of Chiropractic Colleges, Frank Zolli, DC, EdD, said, "This is the first time in thirty years I've been in a room with so many medical doctors while the decibel level remained relatively normal. I've realized that we're all in this together, despite our differences. We all have to deal with the same issues as we provide care for our patients."

NED participants heard detailed reports about current collaborations between CAM and conventional schools, with supportive materials to aid in applying these examples in their own communities. For example, at the University of Minnesota, all first-year medical students experience a half-day immersion in traditional Chinese medicine. At the Southwest College of Naturopathic Medicine, students work in community clinics alongside physicians, residents, and medical students from the University of Arizona.
Most NED participants are committed to inter-institutional and multidisciplinary work. "We realized that many of the participants are a few steps ahead of their disciplines," comments NED director John Weeks. "In addition to fostering new relationships and providing educators with tools for change, NED must also engage in the more fundamental work of raising consciousness. One of our planned 'next steps' will be a campaign to increase awareness throughout the disciplines about the importance of all healthcare professions learning to work better within integrated teams."

NED Report Summarizes Priorities and Looks to the Future
Now a 64-page NED Progress Report (March 2004 – September 2005) has been published, allowing those who did not attend the meeting to share in its cutting-edge thinking about current healthcare education and ways to improve that education. Meeting participants developed several recommendations for the future education of health professionals. They include the following:

  • Facilitate development of inter-institutional relationships and geographically based- groupings of conventional and CAM institutions and disciplines in diverse regions. Promote student and faculty exchanges, create new clinical opportunities, facilitate integrated post-graduate and residency programs, and provide opportunities for students to audit classes and share library privileges.
  • Create resource modules on teaching about distinct CAM, conventional and emerging disciplines (approved by the disciplines), which can be used in a variety of formats – from supporting materials in such areas as definitions and glossaries, to full curricular models.
  • Share educational and faculty resources and information on inter-institutional relationships, including samples of existing agreements and existing educational resources, through development of a web site.
  • Continue multi-disciplinary work to create a concise statement of core values, which have resonance across the disciplines and can guide efforts to create quality integrated healthcare education.
  • Collaboratively develop and sponsor continuing education initiatives designed to draw participants from diverse disciplines.
  • Create collaboratively developed educational resources to prepare students and practitioners to practice in integrated clinical settings.
  • Assist individuals with making institutional changes by offering support for leadership in change creation. Explore strategies for overcoming the challenges of prejudice, ignorance, and cultural diversity.
  • Develop an outline of skills and attitudes appropriate for those involved in collaborative integrated health care.
  • Explore third-party clinical sites that serve the underserved, such as community health centers, as locations for developing clinical education in integrated healthcare practices.

During the coming year, NED plans to continue work towards these goals. Its planning team has developed a two-year timeline, which will carry the work through September 2007, and they are seeking project support. While the planning team anticipates smaller meetings of ten to 20 educators to work on specific projects during 2006, the earliest date for a larger, second national NED meeting would be spring, 2007.

To contact NED director John Weeks:

To download a copy of the recently released NED progress report, go to
The Integrated Healthcare Policy Consortium, NED's parent organization, works to identify important policy directions in healthcare, build broad alliances, and provide a forum in which key stakeholders in integrated care can communicate effectively. Currently IHPC has four task forces, working on issues such as access and delivery, education and training, a federal office, and research. For more information, contact IHPC Executive Director Janet Kahn, PhD, at

The recently released progress report, "The National Education Dialogue to Advance Integrated Health Care: Creating Common Ground," offers a wealth of useful information that will interest anyone who cares about the CAM disciplines, including the following:

  • Data from Internet-based survey of 158 institutions and programs on current inter-institutional relationships between CAM disciplines and conventional integrative medicine programs (Appendix 2)
  • Summary of inter-institutional and interdisciplinary relationships explored at the NED meeting (Appendix 3)
  • Outline for educational resources to be developed to enhance collaborative care (Appendix 5)
  • Draft working document on core shared values (Appendix 7)
  • Descriptions of eight CAM disciplines (Appendix 10)

Elaine Zablocki is the former editor of CHRF News Files and Alternative Medicine Business News.


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