Now That Yoga Therapy's Papers Are Pretty Well in Order - What's Next? International Association of Yoga Therapists

Transcription

1 Now That Yoga Therapy's Papers Are Pretty Well in Order - What's Next? International Association of Yoga Therapists John Weeks Publisher-Editor, Integrator Blog News & Reports Editor-in-Chief, Journal of Alternative and Complementary Medicine johnweeks-integrator.com

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3 The Flow The Middle Way the present professional status of yoga therapy Understanding the other Next steps in the Middle Way - IAYT and yoga therapy strategies

4 IAYT and The Middle Way

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6 Accountability and Soul Pamela Snider, ND, SYTAR 2007 Boarding Chaos onto Catastrophe John Weeks, SYTAR 2007

7 Emergence of the CAM Professions Profession Accrediting Agency Established US Department of Education Recognition Recognized Schools or Programs Standardized National Exam Created State Regulation* Licensed Practitioners Acupuncture & Oriental Medicine ,000 Chiropractic ,000 Massage Therapy Direct-Entry Midwifery Naturopathic Medicine * , s *Only schools accredited via the Commission on Massage Therapy Accreditation. There are over 1300 schools. Source: Clinicians and Educators Desk Reference on the Licensed Complementary and Alternative Healthcare Professions. ACCAHC. Goldblatt, Weeks, Rosenthal et al. 2 nd Edition, 2013.

8 Academic Collaborative for Integrative Health Core Organizational Members Councils of Colleges Accrediting Agencies Certification and Testing Traditional World Medicine/ Emerging Professions

9 IAYT s Middle Way Responsible Self-Regulation Council of Schools Standards Accreditation Certification No licensing

10 Understanding the Other Who Are Those (Still Mostly) Guys?

11 The Bi-Polar Narrative of US Medicine

12 The (Sad) State of the USA Medical Industry $3.3 trillion/year of revenue Nearly 20% of GNP One-third is waste and much of it harmful (IOM) 251,000 deaths/year from medical error (2016)

13 Misalignment and Perverse Incentives: Insurance - The 80/20 Rule 20% of premium can be kept by insurers for marketing, administration, and profit Year Family Premium Insurer s 20% 1983 $3500 $ $5700 $ $16,000 $3200 If you are running the insurance corporation, what does your self-interest favor?

14 Perverse Incentives in Volume-Based Fee-for-Service Model Tendencies of the (Still) Dominant Delivery System If a CFO targets X angioplasties, what is a successful year? What is the attraction of an Ornish program when you have a huge heart center?

15 The Human Toll in Health Professions Slowly and surely, we ve been burning out a generation of doctors and nurses. The numbers are startling: Over 50 percent of physicians report one or more symptoms of burnout. Over 50 percent of nurses are emotionally exhausted, and 25 percent are clinically depressed to numerous observers, the problem is getting worse. American Hospital Association May 15, 2017

16 Response: Value-Based Medicine

17 Value-Based Medicine Are You/IAYT Aligned with These Values? Patient-centered Interprofessional Team-focused From sick-care to health-focused From individuals to communities Outcomes orientation Effectiveness/real world in research Cost-reduction

18 Voices: From Sick Care to Health Care How? We have been honed to focus on sick care It is a tough transition, but we have to learn how to move from sick care to health care. I'm not sure that any of us fully understands or knows the recipe." Jonathan Perlin, MD, PhD Chair-Elect, AHA CEO, HCA

19 Voices: No More Tinkering We are preparing people literally for a system that does not exist. We can t just reform and tinker around the edges. We need to break some boxes. We need to break the box of the curriculum. Susan Scrimshaw, PhD Co-Chair, IOM Global Forum on Innovation in Health Professional Education, President, Sage College

20 Voices: Health Creation the new way, the way to health, may be vastly further from the current design of care than we may at first wish it to be, or believe it to be The pursuit of health, the creation of health, may require something even bolder [than the Triple Aim]. The redesign we need may be even more radical than we have imagined." Donald Berwick, MD Former CMS Administrator, Co-Founder, Institute for Healthcare Improvement

21 And Who Were Berwick s Mentors in Creating Health? In his 2013 keynote to the Institute for Healthcare Improvement, he credited: Mind-body expert Richie Davidson, PhD, the Dalai Lama s collaborator Dean Ornish, MD Above all Wayne Jonas Fact: Integrative health leaders are mentoring the most significant influencer of reform in US medicine

22 Voices: Shifting Incentives in Payment When I first heard of integrative medicine in 2006, I thought of it as an expense but as the Affordable Care Act's payment structure kicks in that supports keeping people healthy, integrative medicine will be an asset. Ken Paulus, then CEO Allina Health System Ken Paulus, CEO, Allina Health System Presentation at the Bravewell Collaborative Lecture and Luncheon, November 2011

23 Voices: 2018 NAM Workshop A Systems Approach to Alleviating Workinduced Stress and Improving Health, Wellbeing, and Resilience of Health Professionals Within and Beyond Education A Prime Mover: Academic Collaborative for Integrative Health with IAYT s Membership! National Academy of Medicine: April 26-27, 2018

24 Where Does the IAYT Go from Here?

25 The beginning of wisdom is to call things by their proper name. Confucius

26 Language Shapes (Economic) Value Volume Sick care or disease management Production of services Hospitals/ medical delivery organizations US medical industry Value Health care Creation of health Healthcare systems US healthcare system The beginning of wisdom is to call things by their proper name. Confucius Love is not hate and war is not peace. Production of services (volume) is not a health care.

27 IAYT s Middle Way Strategic Questions on Accreditation and Certification Seek US Department of Education Recognition of Accreditation? Seek Institute for Credentialing Excellent recognition? Make current initiatives independent organizations?

28 Licensing: A Whole Systems View All health care is local

29 IAYT s Middle Way If not licensing, what is the strategy for community engagement? Create state/local IAYT chapters Local Action Kits Resources to support IAYT members on the ground Collaboration on national/local campaigns Focused resources and support

30 IAYT s Middle Way IAYT Action Kit for Individual Activists in Community Engagement Research briefs on key topics YT and pain YT and stress Brief profiles of best practices YT in hospitals YT as adjunctive outpatient care YT in the workplace YT payment models Linking and teaching Conference calls and webinars

31 Collaborating on National/Chapter Campaigns All health care is local

32 Seek values-based alignment

33 IAYT and Integrative Community: Good Steps! Seek values-based alignment Research community/academic medicine National Education Dialogue (2005) ACIH Membership Academy of Integrative Health and Medicine presence 2017

34 What We Chose with ACIH Seek values-based alignment Raised profile in IHM community Interprofessionalism Integrative Pain Management Value-based medicine Health, wellness, resiliency

35 IAYT Campaign: Integrative Pain Care? The Emergent Edge of Respecting Non-Pharmacological Approaches Pain treatment/opioids issue

36 National Pain Strategy: 4 Invitations to Collaborate Service Delivery & Payment Objective #1 Define and evaluate integrated, multimodal and interdisciplinary care... urged inclusion of licensed integrative health practitioners. Same section, Objective #3 Tailor payment to promote and incentivize high-quality, coordinated pain care... reaches out to licensed integrative health care providers. Disparities, Objective #1 Reduce bias (implicit, conscious, and unconscious) and its impact on pain treatment by improving understanding... calls out to include social service providers (including licensed practitioners who provide integrative and complementary health approaches). Prevention and Care, Objective #2 Develop nationwide pain selfmanagement programs... invites collaboration with licensed complementary and integrative health fields.

37 IAYT s Middle Way IAYT s Role in Yoga/Yoga Therapy and Integrative Pain Care Engage at the National Level Infiltrate the network of pain leaders with YT information Inform Chapters of key activity Feed local efforts with connections Provide Action Resources for Local Chapters Research brief(s) on YT/pain Experience sharing Celebrating successes

38 Campaign: IAYT and the Payment/Insurance/Inclusion: Define and Promote Your Own Model Policy Recommendation from Benson-Henry Mind-Body Intervention (2015) The data suggests that the intervention should be applied to all at risk populations, since the intervention has minimal risk, minimal cost and yields substantial benefits for patients with a wide variety of illnesses. The long-term effect of these interventions on healthy populations is unclear, but the data suggests that mind-body interventions should perhaps be instituted as a form of preventative care similar to vaccinations or driver education. Such interventions are likely to be useful in population management and supported self-care, have negligible risk and cost and may help reduce the demand curve in healthcare. While the risk benefit ratio of this intervention is very favorable to further elucidate the effect size a prospective evaluation is called for.

39 Campaign: IAYT and the Payment/Insurance/Inclusion: Define and Promote Your Own Model Social Prescribing Social prescribing aims to expand the options available in a primary care consultation. This expansion is in the direction of strong choices options that make available new life opportunities that can add meaning, form new relationships, or give the patient a chance to take responsibility or be creative. Stay tuned for more from Sat Bir Khalsa, tomorrow

40 Members: You Are One Degree of Separation from IAYT s Philanthropic Partners

41 Last Word: Health Professionals in the 21 st Century Need to Be Change Agents Type of Learning Flexner/1910 Informative Post WWII-1950 Formative Today/2010 Transformative Objectives Information, skills Socialization, values Leadership attributes Outcome Experts Professionals Change agents The Source: Health Professionals for a New Century: Transforming education to strengthen health systems in an interdependent world. The Lancet (2010)

42 Thank You! John Weeks Publisher-Editor Integrator Blog News & Reports Editor-in-Chief, Journal of Alternative and Complementary Medicine johnweeks-integrator.com