iccm 4:39: 500 years ago physicians cut, bled & purged.

100 years ago physicians cut, sewed & fretted.

30 years ago nurses did massage.

Interesting, eh? (all dates approximate)


4:09: Would you believe that specific guidelines for writing case reports don't exist?

Neither did David Riley, MD, so he assembled a team to change that (he was involved in establishing guidelines for clinical trials, so no stranger there).

The task was completed and JAMA approved it just this year.

So what is a case report? It's a professional narrative that systematically outlines diagnosis, treatment and outcomes on one or several patients for medical, scientific or educational purposes.

We need case reports. We need them to educate and improve clinical practice. There is a paucity of them in the integrative medicine area. We can change that.

While a case report is a narrative story, it has to include all of the following elements: title; keywords; abstract; introduction; patient information; diagnostic assessment; therapeutic interventions (tell us why and how); follow-up and outcomes; discussion; patient perspective; informed consent.

Of course, there are specific details to each one of those.

Inspired? Intrigued? Do you want more details, a checklist and excellent samples?

Go to  http://Care-statement.org – it's a gold mine.

2:30 : As part of their strategic health initiative for the next 5 years, the Veterans Hospital Administration (VHA) identified adopting a "Whole Health" approach as their number 1 priority.

Tracy defined this approach: "A well-developed national infrastructure for provision of a proactive integrative health approach for Veterans, which is inclusive of a relationship-based approach, self-care strategies, complementary and alternative approaches and integrative health coaching. When implemented, Veterans will have the guidance to address the broad aspects of life that affect their health, will have education and training to build new self-care skills, will have the opportunity to incorporate more holistic and integrative approaches into their health care, and will have ongoing support to help them make the changes they identify as priorities."

May it be so. With someone like Tracy leading the initiative, it's gonna happen.

 2:00: Tracey Gaudet, MD,  founded the first Integrative Medicine Center in the US at Arizona University. She then set up a similar program at Duke University. She is currently utilizing her talents at the VA. They surely need her. She is enthusiastic, excited and quietly passionate (something I think will hold true for all the presenters).

Did you know that we in the US are ranked 33rd in the world for average life expectancy? But hey! We beat Cuba (#34) – yet we spend 2-3x more per capita on healthcare than 32 "healthier" countries that outrank us.

Other take-aways from Tracy's talk:

1) Healthcare consumes 18% of our GNP and is expected to rise to 31% by 2021, which is unsustainable. At that level, we will begin to fail, as a nation, to be competitive in the global marketplace.

2) This is a National Security issue: According to the U.S. Army, 80% of the people who walk into Army recruitment offices cannot enlist to health issues, primarily obesity.

3) Your patient's life aspirations can tell you more about how to treat them and motivate positive change than their problems or diagnoses. Their aspirations will be a better motivator for them to engage/sustain the change(s) they need, rather than "I need to lower my cholesterol" or the equivalent.

"Doing more of the same, even if we do it better, will not fix the problem." Tracy Gaudet

And BTW, those 300+ seats (in the auditorium) are now over 90% full.

1:15: BTW this event is sponsored by many folks, but especially the Consortium of Academic Health Centers for Integrative Medicine. If you don't know who they are, go here now.

1:10: People are filing into main auditorium, which seats over 300, and it is full of people who, as Henri Roca, MD, says "are working at the edge of their profession."  This is definitely a good place to be.

12:30: Hello, Everyone! It's Day One of the International Conference for Clinicians in Complementary and Integrative Medicine and I will be live blogging all about the event.

The big show is about to begin in 1 hour with Tracy W. Gaudet, MD, who will begin with "Cultural Transformation – A Pivotal Transformation for Healthcare in This Country." Afterwards there will be a total of 48 concurrent presentations over the next 2.5 days.

It makes for a literal embarrassment of riches. Do I take the session on fibromyalgia or recent  clinical trials for yoga and ayurvedic trials, paired with "How to Write Case Reports in an Evidence-Based World" ? I think it's going to be the latter, so I'll live blog on everything that I can, based on what I can actually get see.

Wednesday looks  like a big day on gut health issues, in which I have a personal interest, and I cannot wait to hear Leslie Mendoza Temple on "The Gut-Joint Connection." While her focus is on Juvenile Idiopathic Arthritis, I am sure there will be much good general information for the gleaning. There will also be a documentary about our broken healthcare system that evening, followed by dancing! Um, wait... I don't mean that we will be dancing because our system is broken. What I do mean is that it's good to see that someone thought about incorporating movement into this symposium(Robert and Divo, you have spoiled me so!)

As far as fascia goes, that'll be my bailiwick on Thursday morning, with a talk called "The Science of Fascia." While I am 1 of 3 concurrent sessions, and while they are all interesting, they are enough outside my specialty that I won't feel like I missed out, if you know what I mean.

I have to hand it to the organizers for crafting a very robust schedule that manages to avoid having too many things of similar interest scheduled competitively. It makes it easy to choose and I doff my hat in appreciation to you!