Family Doctor | Summer 2016
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Volume five • Number one Summer 2016 A JOURNAL OF THE NEW YORK STATE ACADEMY OF FAMILY PHYSICIANS FEATURE ARTICLES: • Two Views • Incorporating Acupuncture into Primary Care • Chronic Pain: From Public Crisis to Integrative Relief • Integrative Nutrition Focus: Integrative Medicine CLINICAL INQUIRY FOR: HIV • HCV • STD • PEP • PrEP CEI LINE 1-866-637-2342 ASK AN EXPERT Call for a clinical inquiry regarding your patient with an STD, HIV, HCV, or those in need of PEP or PrEP 866-637-2342 www.ceitraining.org WHY MLMIC? For over 40 years, Medical Liability Mutual Insurance Company (MLMIC) has put the interests of our policyholders first in everything we do. Our mission has always been to provide the highest quality liability insurance at the lowest possible cost consistent with long term viability. We charge premiums that are speciality and territory specific, without a profit motive or high operating expenses. 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YEARS STRONG Endorsed by MSSNY Family Doctor, A Journal of the New York Articles State Academy of Family Physicians, is published quarterly. It is free to members Incorporating Acupuncture into Primary Care of the New York State Academy and is By Lisa Morrow, DNP, FNP, L.Ac .................................................................20 distributed by mail and email. Non-member subscriptions are available for $40 per year; Chronic Pain: From Public Crisis to Integrative Relief single issues for $20 each. By Michael Spertus, MD and Pooja Amy Shah, MD ...................................23 New York State Academy of Integrative Nutrition Family Physicians By Kaushal B. Nanavati MD, FAAFP, ABIHM and Benjamin Kim, BS. ..........26 260 Osborne Road Albany, New York 12211 The Paleo Diet as a Therapeutic Tool www.nysafp.org By Ann Carey Tobin, MD, FAAFP ...............................................................29 Phone: 518-489-8945 Fax: 518-489-8961 Can Eating High Fat Improve Health? By Shree Mulay, MD and Joon Lee, MD .....................................................32 Letters to the Editor, comments or articles can be submitted by mail, fax or email to Decreasing Wait Times in a Family Medicine Clinic – [email protected] A Creative Approach By Shilpa Darivemula; John Huppertz, PhD; Editor: Penny Ruhm, MS and Elena Rosenbaum, MD, ABOIM ..........................................................35 Editorial Board Integrating MBSR in Primary Care Robert Bobrow, MD By Carla Podgurecki, MD ...........................................................................39 Richard Bonanno, MD, Chair Rachelle Brilliant, DO Integrative Pain Management with an Underserved Population William Klepack, MD By Maureen Healy, LCSW, MPH, LMT; Lisa Morrow, DNP, FNP, L.Ac; Louis Verardo, MD Robert Simon, MD; and Patrick Masseo, MA ............................................41 New York State Academy Officers Moving Medicine into the Third Era: Creating Optimal President: Robert Ostrander, MD Health and Well-Being President-elect: Sarah Nosal, MD By Mark Nelson, MD, FACC, MPH ............................................................. Vice President: Marc Price, DO 44 Secretary: Barbara Keber, MD Treasurer: James Mumford, MD Departments Staff Executive Vice President: From the Executive Vice President: Vito Grasso ....................................... 6 Vito Grasso, MPA, CAE [email protected] President’s Post: Robert Ostrander, MD, FAAFP ......................................... 8 Director of Education: Kelly Madden, MS [email protected] Advocacy: Marcy Savage ...................................................................... 10 Director of Finance: Two Views: Integrative Medicine ...............................................................14 Donna Denley, CAE [email protected] View One: The Appeal of the CAM Rhetoric & Lessons for Biomedicine – Project Coordinator and Journal Editor: Utsav Hanspal, MD, MPH Penny Ruhm, MS [email protected] View Two: Integrative Medicine – Family Medicine at its Best Kaushal Nanavati, MD, FAAFP, ABIHM For Advertising Information Upcoming Events ......................................................................................21 Contact Don McCormick at 518-542-3341, or In the Spotlight..........................................................................................47 fax: 321-600-4227 or [email protected] Index of Advertisers American Dairy Association ........................................................IFC American Academy of Child & Adolescent Psychiatry .................BC Atlantic Health Partners .............................................................19 Core Content Review .................................................................13 Fidelis Care ................................................................................9 Marley Drug ...............................................................................7 MLMIC ......................................................................................4 Mount Sinai Roosevelt Hospital ..................................................3 Saratoga Hospital .......................................................................Summer 2016 • Volume five • Number11 one • 5 From the Executive Vice President By Vito Grasso, MPA, CAE Integrative Care Integrate means to combine In reviewing articles submitted for this value and potential of non-medical services one thing with another. The implication of issue I found interesting and informative to enhance patient health. I do not recall course, is that the things being integrated contributions on the value of nutrition seeing many references in those articles to are, otherwise, different. Indeed, the tone in health, non-drug approaches to pain the issue of payment for those services. In of much of the discussion about integrated management, stress reduction strategies and this regard, it is significant to note that the medical practices is that traditional practices how incorporating non-medical services into focus of clinicians on doing what is best have not included things like nutrition a practice can enhance the practice’s ability for patients is an element in the business counseling, non-drug therapies for pain, to help patients maintain good health. In relationship between patients and health smoking cessation or other services to this regard, much of the discussion around insurance plans that is beyond the calculus keep patients healthy. To the extent that integrative care is, indeed, about interjecting of determining value. this is true, I think it is a consequence health awareness and prevention into Read with interest the many good articles in of how insurance has affected medicine. practices as an alternative to the traditional this issue about non-medical services that Health insurance has essentially evolved as focus on treating disease and injury. can truly help patients. But to understand a mechanism for dealing with catastrophic Inevitably, such discussions quickly include what it means to be a caring, compassionate, costs associated with serious illness or some reference to how practices get paid for patient-centered professional whose work injury. Premiums are contributed to a pool keeping patients healthy. and purpose has value well beyond what of funds for use in paying for care when As payers grapple with the challenges of insurance plans have a rate schedule for, that time ultimately arrives. The assumption valuing investment in non-medical services read Dr. Ostrander’s president’s column and has been that people are responsible for to keep patients healthy and, thereby, reduce aspire to replicate the standard of decency maintaining their own health. their costs of health care, I am compelled to reflected in the impressions he chose to Interest in integrated care seems to be point out how different the standard of value focus on in his inaugural president’s column growing among insurance plans as they appears to be for clinicians. The articles in for this journal. recognize that keeping patients healthy can this issue by clinicians uniformly explore the reduce costs. Not quite altruism, but still a development that could help enhance healthy lifestyles among people who may benefit from the additional incentive of having someone else pay, at least in part, for Health insurance has essentially their health club, diet, smoking cessation class or other form of behavior modification. evolved as a mechanism for dealing with catastrophic costs associated with serious illness or injury. 6 • Family Doctor • A Journal of the New York State Academy of Family Physicians Summer 2016 • Volume five • Number one • 7 President’s Post By Robert Ostrander, MD, FAAFP