That something happens only once every three years can create a good deal of anticipation. This is the time frame between the first two iterations of the North American Research Conference on Complementary and Integrative Medicine (NARCCIM). The first was in Edmonton in 2006. Tentative plans are being made for the next, in 2012. 

Last month, on May 12-15, 810 lucky souls from 24 countries converged on Minneapolis, Minnesota for the 2009 version, an extraordinary 3-day event which was a feast of fascinating information and a celebration of how far a movement has grown. This column is a quick scan of a very few of my favorite things. If you didn't attend, begin planning forward to the Spring of 2012 for the next iteration!

1.  The Sponsors, Leadership and a Salute to Multidisciplinary Diversity

Conference sponsors

The conference is the anchor production of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM, or "The Consortium" as the representatives of the 43 member academic health centers self-refer). Researchers and faculty in integrative medicine from these medical schools were much in evidence. In addition, the organizers, led this year by Aviad (Adi) Haramati, PhD, made a point at every step of the way to include other disciplines and professions.

• The Participating Organizations were a robust list of 26 groups, ranging from the American Association of Medical Colleges to professional, educational and industry organizations representing acupuncture and Oriental medicine (AOM), naturopathic medicine, massage therapy, chiropractic, herbal products, Yoga therapy and others.
• The program team, led by health services researcher Dan Cherkin, PhD, included Christine Goertz, DC, PhD, and Richard Hammerschlag, PhD, the co-chairs of the Research Working Group of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), a separate consortium the includes all the councils of colleges and schools for the licensed complementary healthcare fields.
  
• The conventional Consortium extended a grant to ACCAHC, through which 15 students from these fields were granted scholarships to the conference.
  
• Financial backers included the Massage Therapy Foundation and Northwestern Health Sciences University, a multidisciplinary university with chiropractic, AOM and massage programs.  

was allowed for the assembled multitudes to mix it up.

2.  Conference Materials Readily Available: Innovision Innovates as Conference's "Principal Publisher"

Leading publisher, via Alternative Therapies in Health & Medicine

The conference team did an excellent job partnering with the leading peer-reviewed publications in integrative practice fields to publish abstracts from all of the 250 posters and scores of sessions - plenary, scientific sessions, symposia and featured discussions. (If I had one complaint, it was that there were too many times when I wanted to be more than one place at a time.) The Integrator was a minor media partner and I served on the marketing team.

Innovision Health Media took the lead at the Principal Publisher, publishing all the abstracts. These are available in a searchable database available here. It is a very efficient site which allows one to search by type of research (basic, health services, education, clinical, etc.), see a list of related topics, and then quickly click in to see the abstract desired.

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There are great riches here. Have fun exploring by clicking here - an interesting process even if you attended. Now, for a few of my favorite things.

The other academic consortium

3.  A Meeting Between Two Consortia

NARCCIM including numerous pre-conference events. One which was notable, even historic, was a Monday May 11 meeting of members of the Steering Committee of the conference' sponsoring organization, the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) and the leadership of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), the consortium of CAM academics noted above. ACCAHC, for which I serve as executive director, deliberately co-located its own leadership meeting in Minnesota, May 10-12, to facilitate participation in the conference by it members. ACCAHC also wanted to

Attendees of the May 11, 2009 meeting between members of the Steering Committee of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), and leaders of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC)

Cheryl Ritenbaugh, PhD, MPH

4.  Outcomes from Integrative Health Care: What Patients Say We Should  Measure

Researchers in integrative medicine, stated presenter Angela Greene, "need to make sure that the outcomes chosen are those that matter most to the users." Green was part of a team which presented an oral poster session entitled "Perceived Benefits of Complementary and Alternative Medicine: A Whole Systems Research Perspective." In 5 focus groups involving 36 participants who were self-identified as having benefited from their complementary care interventions, the researchers discovered, for instance, that users believed that the care had helped them in making positive lifestyle changes. They concluded: "In addition, (patients) identified empowerment, increased hope and spiritual growth as results of receiving CAM treatments and identified CAM use as fostering behavioral changes such as increased exercise, smoking cessation, and improving their diets and described how CAM therapists fostered these changes." Search here under Greene AM, McCaffrey A, Sirois F, Walsh E. Notably, an entire Symposium on "Developing Patient-Centered Measures for Outcomes of CAM Therapies" was also offered, led by whole systems researcher Cheryl Ritenbaugh, PhD, MPH. (Search Ritenbaugh C, Coons S, Koithan M, Nichter M, Nichter M, Sims C, Elder C, Sutherland E, Verhoef M, Bell I.)

Comment: This message is an excellent one to get in the hands of President Obama (see his comments on acupuncture and on prevention), US Senator Tom Harkin and others who have, among health reform leaders, at least the beginning of a  grasp of the clinical dimensions to how we can foster prevention and wellness. The case for this value of integrative practices has not yet penetrated most of the policy dialogue. Such a focus in research investment may limit the fallout from the negative outcomes of some CAM research, for which NCCAM is regularly blasted in the media, which typically failed to either look at whole systems input or such patient outcomes as these. 

Christine Goertz, DC, PhD

5.  Efforts to Create Research Which Better Reflects Integrative Practices

Comment: At the meeting, I was asked informally by program chair Cherkin what I noticed as changes in the program from 2006 to 2009. One theme which clearly seems to have matured in this community over recent years is this effort to make research better conform with whole person practice, and patient outcomes. These are healthy directions, which we now must make sure that funders, particularly at NCCAM, also elevate. Happily NCCAM director Josephine Briggs, MD has stated that she would like to move the agenda toward more "effectiveness research" and "real world outcomes." Hopefully this means supporting the nascent exploration of whole practices. (See New "Effectiveness" Direction for NCCAM: An Interview with Director Josephine Briggs, MD, November 26, 2008.)

Wendy Weber, ND, PhD

7.  Educational Research:Transforming the Culture of Research at CAM Schools: Evidenced-Informed Care

Wendy Weber, ND, PhD, formerly at Bastyr University and now a program officer with NIH NCCAM headed up a fascinating panel entitled "Changing the Culture of CAM Institutions Toward an Evidence-Based Approach-One R-25 at a Time." The session consisted of reports from beneficiaries of this exceptional NIH NCCAM initiative which provided funds to CAM schools, partnered with conventional medical schools, to work on ways to shift the culture relative to evidence and research in their schools. One speaker after another offered innovative strategies and tools for shifting culture. At Palmer College of Chiropractic researchers acknowledged that "the old culture of intuitive, patient connection" approaches as the basis of clinical decisions "is still dominant." They created a "Cultural Change Task Force" to head up their initiative. More than one speaker noted that even in institutions with significant investments in research, research tends to "be in a silo" and separate from the rest of the institution, as noted by Roni Evans, DC, MS. at the Wolfe-Harris Center for Clinical Studies at Northwestern Health Sciences University. One interesting shift was away from the "evidence-based medicine" term to "evidence-informed care" or "research-informed clinical practice," as used by Susan Fleishman, a researcher with Oregon College of Oriental Medicine. Heather Zwickey, PhD, a presenter on behalf of the Helfgott Research Institute of National College of Natural Medicine (NCNM) noted that needs were different with distinct disciplines. With the naturopathic medical program, Zwickey noted, the focus was "more on how they do research rather than whether they did it," whereas those in NCNM's Classical Chinese Medicine school tended to base decision processes on "ancient Chinese texts, and there was no real interest" in research. These grants appear to be developing numerous tools that should be useful to many institutions. (Search Weber.)

Evidence of the shifting landscape is some exciting development of joint degree programs through a cluster of CAM schools and Oregon Health Science University, captured in a session entitled: ""Collaborating Across Disciplines to Develop Joint Degree Programs in CAM and Integrative Medicine." (Search Nedrow.)

David Rakel, MD

8.  Integration in Medical Health Homes: A Wild Exploration of the Whole of Care

I had a hand in developing a session led by David Rakel, MD, entitled "Health-Oriented Medical Homes: Defining Cost-Effective Interdisciplinary Integrated healthcare Teams in the Outpatient Environment." The medical home movement figures significantly in Obama health reform efforts. Rakel's panel included Douglas Hiza, from Blue Cross Blue Shield of Minnesota, health economist and researcher Patricia Herman, ND, PhD, consultant Stephen Bolles, DC, and the clinical director for the ambitious Allina program noted above, Lori Knutson, RN. The presentations from the panelists led to a wild discussion by the 60+ participants of the myriad strategies to create health in communities.

Making It happening: The Generous Georges, Plus

Penny & Bill George

As a person who spends half of his professional time as a writer and the other half as a social entrepreneur in building a new organization, ACCAHC, noted above, I am always aware of where it is that the wherewithal to mount a conference like this comes, especially for a not-for-profit like CAHCIM.