Integrative Health Competencies for Primary Care Professionals

by John Weeks, Publisher/Editor of The Integrator Blog News and Reports

The dynamism with which new organizations and initiatives pop up to educate or certify in integrative health and medicine can be overwhelming. One seemingly significant initiative may just have been cooked up by a single individual sitting in his or her kitchen. That individual may dream up some new competencies for your practice and then advertise them to you as though they were handed down from on high. Another initiative might have the force of a dozen or more significant organizations behind it and either still seem indistinguishable or be less visible due to less attention to marketing and promotion. One more recent initiative has been developing a measurement of integrative health competencies for primary care physicians – and it is worth paying attention to.

This initiative is the National Center for Integrative Primary Healthcare (NCIPH) , a project backed by a $1.7-million grant from the U.S. Health Resources and Services Administrating (HRSA). The mission is nothing less than to establish the Center as “the first of its kind in a movement toward integrative interprofessional patient care.” The NCIPH is leveraged to spread the integrative model nationally. While the focus is on medical doctors, the model includes chiropractors, advanced practice nurses, naturopathic doctors, licensed acupuncturists and others as part the target audience.

Since late 2014, the NCIPH has been located at the Arizona Center for Integrative Medicine (AzCIM), founded by author and educator Andy Weil, MD. The initiative’s clout is boosted through a partnership with the Academic Consortium for Integrative Medicine and Health (The Consortium). The Consortium boasts over 60 medical schools as members.

The first step is to create a “set of competencies and educational materials relevant to and appropriate for use across the entire interprofessional spectrum of primary care practitioners.” The process was led through their 16 member Interprofessional Leadership Team chaired by Ben Kligler, MD, MPH (pictured right). Subgroups of chiropractors, naturopathic doctors, acupuncturists and others were convened to support the development. The NCIPH has now published and declared the following as “Integrative Health Competencies for Primary Care Professionals”:

1. Practice patient-centered and relationship-based care.
2. Obtain an integrative health history which includes mind-body-spirit, nutrition, and the use of both conventional and integrative therapies.
3. Collaborate with individuals and families to develop a personalized plan of care to promote health and well-being, which incorporates integrative approaches including lifestyle counseling and the use of mind-body strategies.
4. Demonstrate skills in understanding and utilizing the evidence as it pertains specifically to integrative healthcare.
5. Demonstrate basic knowledge on the major health professions both integrative and conventional.
6. Facilitate behavior change in individuals, families and communities.
7. Work effectively as a member of an interprofessional team.
8. Practice self-care.
9. Demonstrate skills to incorporate integrative healthcare into community settings and into the healthcare system at large.
10. Incorporate ethical standards of practice into all interactions with individuals, organizations and communities

The NCIPH has since established pilot sites for its 45-hour Foundations in Integrative Health course. One at Oregon College of Oriental Medicine began in January. Topics include an introduction to integrative health, motivational interviewing, behavior change, various integrative health interventions, backgrounds on various fields, and content on the well-being of health care professionals.

Comment: This is good work, foundational for the movement, as the 45-hour course will be for individuals. The interprofessionalism, the extension into families, and into communities is terrific, expanding the conceptual boundaries of many solo integrative practices.

The value in a program like this is that it is opening minds to new ways of approach, philosophy, and practice. For many, the self-care focus – still virtually absent in much health professional education - will be worth the entire investment. The concern is that, instead of experiencing this as a beginning, participants will become front line warriors who know just enough to be dangerous. The principal investigator, Patricia Lebensohn, MD (pictured left), Ben Kligler, and the team that they brought together are a good insurance policy against that. This is another sign of a continuous infiltration of integrative ways. Credit the University of Arizona Center for conceiving the idea and promoting it.