Paradoxes and Policy Decisions Involving CAM and Integrative Medical Therapies
Is third party reimbursement for CAM/Integrative services a beneficial objective? What is the “dark side” of third party reimbursement for the CAM professions?
Is CAM/Integrative Medicine:
a valuable refinement of mainstream, conventional medical care?;
a “disruptive technology”?;
a (potentially) disruptive reconfiguration of health care delivery models?; or
none of the above?
Should academic medical centers launch model integrative care centers in the absence of scientific consensus on the efficacy, safety, and mechanism of action of each modality used? Conversely, are these model integrative care centers necessary engines of research to discern CAM efficacy and safety?
Can/should/will increased governmental regulation (and/or legal incentives for pharmaceutical companies) be required to address quality assurance issues regarding dietary supplements? How can the issue of intellectual property (i.e., patents) be addressed in light of existing DSHEA legislation? Should DSHEA be revisited? Amended? What would prompt Congress to do so?
Can reproducible models of credentialing, billing, and data tracking be devised and can existing electronic medical records systems be refined to build a national data warehouse/registry of integrative care outcomes?
How best to distinguish quackery/fraud/deception
Responsible delivery of CAM (by an individual or institution)
The responsible co-management of patients with a (licensed) CAM provider?
Each creates unique liability exposure and relates to specific professional sanctions.
How best to incorporate relevant information regarding CAM into required core curricula and training of MDs/RNs/PharmDs/dieticians, and other allied health professional at the undergraduate and postgraduate levels? Can appropriate, web-based, interactive CME programs be jointly developed across professional disciplines? Isn’t the same “core” information needed by each medical discipline?