This week we have in the studio, Dr. Brian Paris, the owner of Pain Arthritis Relief Center. His focus has been to build an integrative healthcare delivery facility and company that creates a wow experience, gets really good results, and creates a better pathway for our fellow brothers and sisters to feel better and then get well.
This week we do a deep dive into the different treatment methods offered within Eastern Medicine in this interview with Yaron Cohen, the Director of Clinical Education at the Clinic, at Virginia University of Integrative Medicine.
This week we are joined by Erin Sonn from Eat Yoga Drink to discuss the unique experience of Yogapuncture. The Virginia University of Integrative Medicine partners with Eat Yoga Drink to blend the healing modalities of yoga and acupuncture.
This week, we have a lecture by the President of VUIM, Dr. Lixing Lao, Ph.D. Dr. Lao discusses the history and emergence of Integrative Medicine in the West and the need to treat the whole person, mind and body.
Lixing Lao, Ph.D.
President of VUIM
Dr. Lao currently serves as a member of the Board of Trustees for the Virginia University of Integrative Medicine. He will serve the student and patient communities of Virginia University of Integrative Medicine as the institution’s new President starting in October 2019.
Dr. Lixing Lao is currently the Vivian Taam Wong Endowed Professorship in Integrative Medicine, Director of the School of Chinese Medicine, The University of Hong Kong. He is currently an elected vice president of the World Federation of Acupuncture and Moxibustion Societies (WFAS), and an appointed Secretary General of the Consortium for Globalization of Chinese Medicine (CGCM) which is based in the University of Hong Kong. He is also an Adjunct Professor of Family Medicine and the Director of Traditional Chinese Medicine Research Program in the Center for Integrative Medicine of the School of Medicine, University of Maryland, Baltimore (UMB), USA.
Dr. Lao was the principal investigator and co-investigator of over 20 clinical trials and pre-clinical studies in acupuncture and Chinese herbal medicines funded by the National Institutes of Health (NIH) and Department of Defense (DoD), USA. He is particularly interested in conducting translational research that bridges basic science, clinical trials, and real world acupuncture and Chinese medicine clinical practice.
Speaker 1 (00:04):
Integrative medicine has been around for thousands of years and is now a widely used form of healthcare across the modern world. In this podcast we discuss holistic wellness and share how integrative medicine has evolved to become a part of our culture today. This is All Things Integrative brought to you by Virginia University of Integrative Medicine.
Speaker: Dr. Lao (00:33):
Integrative medicine by name is considered to integrate different systems of the medicine into one system, but in different delusions in different countries? There’s a definition that might be slightly different for them. In China, integrated medicine means the integrative, a Western mass and Chinese medicine. But in the United States, the definition I’m integrating with a much more broad, the indication of the, the, the means integrated Western medicine or alternative medicine, which are the including erratic medicine Indian medicine which means they integrate Western medicine and Chinese medicine, echo, Fallon chair outerwear, team medicine homeopathic medicine, many other modalities. But most of the agreeable concept of integrative medicine is a holistic medicine means to, it’s a holistic medicine incorporated into the conventional Western medicine. So making something new is more appropriate for the patient’s care. Okay. In the 1990s about 10 to 30 years ago, you didn’t ask this.
Speaker: Dr. Lao (01:53):
We already had a wave of so called alternative medicine and complementary medicine. So at that time, we only call alternative or complementary. Actually there’s a new office in the national Institute of health NIH established the call in the name called office of alternative medicine and complementary medicine. So this office particularly they to study, to do research on, so called the alternative medicine and comprehensive medicine. Then along the many years, more and more people started [inaudible] that the, the integrative medicine is a better concept, which is a very integrated, different medicine in tool when system to help better patient care. But in this country so-called alternative medicine is very broad. As I mentioned early, could it be Indian medicine? Ayurvedic medicine, homeopathic medicine, all considered all turtle medicine, which is any medicines not in a mainstream Western commission medicine all considered alternative medicine. But Chinese medicine and acupuncture, the wind of the, our total medicine but nows in different alluding different schools and the, our school particularly, we mainly emphasize not acupuncture and Chinese medicine is a part of the integrative medicine.
Speaker: Dr. Lao (03:19):
The future of integrative medicine is very important as a promising in recent years. If you look at the history back in the most recent years, the integration person became more and more popular. And we already know in the United States there’s a consortium of the academic of integrative medicine which contains about over seventies universities in the United States and Canada and in Mexico. They work together. These are consortiums with many universities. They all have the programs of an integrative medicine program. Integrative medicine in the country it has been widely used and why the little usage is started and the patients feel lots of benefit and even hospitals realize the integrated math and reality can help the improve the health of their patients. Integrative medicine has become more and more popular in the United States and worldwide. There are several reasons for that.
Speaker: Dr. Lao (04:26):
The wind, the other reason is the patient to get benefits and they all improved their health. You are using integrative medicine instead of only Western medicine and a Western America. Tata also feels that to the day for the upright integrative medicine to the patient, the patient helped better outcomes and also patient feel better. This also wasn’t a loss for acceptance. The major reason for acceptance is lots of research has been conducted and the impoverished did indicate that integrative medicine particular echo poucher a some as alternative medicine that they’re, they’re already efficacies and a safe to be used. A clinically do you just start to have been conducted by using the master call randomized. The canoe trial is a trial demonstrated egg puncture, DRD superior to the control to help patient care such as paying paying headaches, low back pain or internal medical disorder, constipation while they range all the symptoms that had been treated by ex puncture.
Speaker: Dr. Lao (05:41):
Then demonstrate in these RCTs that the X [inaudible] superior to the control for helping these you know, illness. Integrative medicine is the emphasized on holistic medicine. They not only emphasize their body but also their mind. So they addressed the issues there too. Is it a physical condition in a patient? Also my mental illness or mental disorder is like a stress anxiety, they will address both this call the holistic medicine. So patient views not only fit the critic feel better, but also mentally the off feel happier and relieved. He has integral medicine that is changing the way of practice. And before usually the daughter mainly focused on the one particular condition in the body. From your hand. Pain with folk pays attention to her hand for the pain. We pay attention to the foot, but integrative medicine looks at a holistic condition, particularly for chronic illness.
Speaker: Dr. Lao (06:44):
So we look at the losing why you have the Uranus and any dye tissue to consider and exercise should use. And as a, as a centerpiece like acupuncture, herbal medicine can be used to show how this condition not only focused on one aspect of disease. Yes, integrative medicine, the more proactive and also incorporated. [inaudible]. One aspect of integrated medicine, very important, is we encourage patients to participate in the healing process. Not a passive read, receive the treatment, but also we encourage the patient to work together with the Tata and to help better the to help their healing process faster. Integrative medicine such as acupuncture and Chinese medicine, they very much emphasize holistic medicine. It’s your whole body condition. So we do not look at only one part of the body. We also look at your mental status, your whole systems that treat them.
Speaker: Dr. Lao (07:47):
Also, we are not only to the wind part of volleyball, but also barons our own whole bodies. We call Inga yam parents to make a D out smoothly parents, which is you’re not only physically your body getting better or some mentally you feel better so of college free that people would be more priest except the diseases that have and the face the disease faced does seem, tends to with them. So they know how to overcome these symptoms the mentally prepared. And also we, for example, we also instruct a patient that can practice a Tai Chi or yoga do their own part and also watch their diet. So by activity, by the patient together with the treatment provided by the provider, the patient is the house so much better. And the heating process is also faster. Now, integrative medicine on a large scale is that mainly practiced by universities, a medical school?
Speaker: Dr. Lao (08:56):
What it means in Western medical doctors, they are trained in certain parts of the integrative medicine law. We call a Chinese medicine meditation, yoga or the medication incorporated into their Western conventional practice. So these are thoughts when a graduate student, when the graduates graduate from the medical school, they can not only use a Western pharmacological approach surgery, they also can use the approach provided by a so called integrative medicine approach so they can help the patient the better. Why is our school different in that we train our students to become qualified, licensed acupuncturist or Chinese medicine practitioners. So mainly our training is for the different aspects of the integral integrative medicine. But the way we need is to incorporate the Western conventional medical knowledge into our students’ skew. So that means our students are not only good in acupuncture and, and Chinese medicine diagnosis skill and a prescription skill.
Speaker: Dr. Lao (10:09):
But they also understand the human body anatomy, physiology, any disease, the the course of disease like ADR, edge and also the past knowledge of disease and able to understand the diagnosis by Western medical thought took. So they understand to interpret the lab test and image a test every abs studies and lab tests they understand and interpret. So they very clearly understand the, what’s going on on the patient in a patient. Then they can perform better treatment using Chinese medicine. Acupuncture. So this a, we understand the importance of a student in our school to be trained in a knowledge was a Chinese [inaudible] end Western conventional knowledge. So when they treat a patient, they have better sense that what’s going on with the patient in there has maker proper etiquette, the referral to the physician if necessary. Also, can they collaborate with commission?
Speaker: Dr. Lao (11:22):
Daughter walking together was a commission, but in the winter graduate they can work in hospitals in a walkie. The other medical setting was other medical providers like a Western medicine physical therapists cow practice, pro cow practice, cow practice Western physician so that they can work together because they understand the common language or the Western medicine and modern science. If we’re list a aspects of the integration that disease or Uranus can be treated by integrative medicine. I can give you some examples for them. For most of the common illness from patients coming to the clinic, often lack of low back pain and to have a chronic osteoarthritis there’s good core osteo, we call these kind of condition, we would call a musculoskeletal disorders then they’re often used if we understand the anatomy and physiology, you know, the muscle and the origin of the muscle, the beginning of the end of muscle, you know, the bone structure, you know all the conditioning.
Speaker: Dr. Lao (12:37):
And also, you know, what past ology what’s happened if something heaven to the muscles spring or the bone fracture even all join the dislocation. If we understand, then you have better sense to help patient care, your treat them with the more accurate, there’s the wings, the inputs, and also very common way a, a patient who was a cancer, they’re loosened the years and also cancer patient looking for alternative mez or integrative medicine for their health care. So in addition, they seek the treatment from the fish, a Western medical Tata by using chemotherapy, radiation therapy or surgeries. But they also are suffering lots from the Saudi fair towels, seminars. These setups. So alternative medicines such as egg puncture, they’re often used for relief. These symptoms like financial chemotherapy could cause nausea. Vomiting. Acupuncture demonstrates in Los Aloosa to show their kinder can help decrease the nausea, vomiting so patients can tolerate chemotherapy without much side effects.
Speaker: Dr. Lao (13:50):
And also some medication. Chemotherapy costs. The profile in Europe sees numbness and tingling in the hands and feet after taking the chemo sedative medication. But now [inaudible] can be used for treated conditions where a dead patient continues to receive the chemotherapy but without too much discomfort in the hand. The fit, just two examples. There’s many of the inputs for them, for the patient with the after surgery or recovery. Now URI, after surgery, the patient was still in bed. Very painful. And also you, you are still in the hospital for some time. But now some research showed if you use acupuncture in a surgical loom, you can shorten the cost of the stay. They can recover faster. So we understand the healing process. When you cut, I have surgical procedure, then we changed some as in call stacks to see the Pratt or she stay in Asia and then we can open them meridians and that she so helped patients recover faster.
Speaker: Dr. Lao (14:58):
But in the Western point of view, the maximums are the action of [inaudible] also can help to stimulate the brain to release some neurotransmitters then which can decrease the pain and also release loss of hormones to help the healing process. Now, integrative medicine, nausea mostly often be used for certain disorders, particularly chronic disease like a disease with a chronic degenerative ritual change it, I could osteoarthritis visit lots of pain and for chronic headaches also for long time Yunus okay for the people have the after cancer then they even did a covered from the after the commission treatment but is still very weak. So these areas that Western mass and not have, that did not have that good solution for their chronic condition for them, for chronic pain. Also one of the examples, but when you have a chronic pain patient, how to take pain medicine for a long time because the chronic but the payment is only can relieve the pain temporarily and sometimes the not work always works for the patient but it costs loss of side effect.
Speaker: Dr. Lao (16:15):
If we take a long time but [inaudible] have uniqueness, there’s no medication in the body, no side effects, then we can relieve the pain very effectively effectively. So patients can take it, these medicines take it autism medicine X pound chair or some over medicine then have help with knowing the little side effects can achieve the maximum recovery for the patients. So these examples that particularly in the, in the area to commission medicine and not help much solution integrative medicine really can pre bigger role integrative medicine, particularly like our school trains student to learn acupuncture is a very ancient healing art and also is very [inaudible] invasive live, very little invasive procedure, which is little side effects. They just make a very thin needle in to insert into certain points and stay for about 27 minutes.
Speaker: Dr. Lao (17:22):
Then patient after treating them, the patient, usually the cover very soon, their pain relieved after treatment. So these are the treatment very safe and particularly with the good training, the student can understand anatomy physiology. So they are performing. They’re very safe and under the supervision of a trainee. So now you can ask for a mission and I go for tenure as a student is that very unique. We not only train our students to be good acupuncturists and Chassen medicine practitioner, they should be able to understand commission to a knowledge and able to communicate efficiently, effectively with the commission medical doctor so they can provide better care to work together with the conventional medical doctor and work with the patient to achieve the best ago, best often optimal goal of the patient or healthcare. So this requires us, our students to be more put in more knowledge and more time and emphasis on, in our not only the tech training and the costs, but also in the clinical training.
Speaker: Dr. Lao (18:38):
So we teach them not only the Chinese medicine part, but we also teach them how to understand disease in conventional medicine. Integrative medicine means to use a lot of areas for integration law many years have been. So first of all, my background training in Chinese medicine and [inaudible] when I came to the United States was about 20. So years ago I trained in Western medicine as physiology. I have attained the PhD degree in physiology, so I understand both aspects or the medicine then have him practice Chinese medicine by using my knowledge obtained in the modern science and modern medicine. So we are a help lot to enhance the treatment effectiveness. So as I nearly enjoyed a practice was all the good results with my patient, I realize that this important pass, so we had to take to help better patient care by seeing that.
Speaker: Dr. Lao (19:47):
Also, I obtained the endowed professor of integrative medicine in Hong Kong received in the university, university of Hong Kong where I worked for six years. Then I came here, this school having to be Virginia university of integrative medicine. Also, I serve as a chief editor, editor in chief of the journal culture, not of integrative medicine. So I been practice and the work on integrates the field for many years and I believe that in to train the next generation, we also should be prepare them to be better PR practitioners to who understand the boasts knowledge in Chinese investment [inaudible] and well as the modern science and Western medicine. So I think that this, the future for integrative medicine. So the better you know, the disease for the patient, the better patient care you can achieve. I’m Dr. Lao. I’m the president of the Virginia University of Integrative Medicine.
Speaker 1 (20:54):
Thanks for listening to All Things Integrative. Be sure to tune into our next episode where we’ll share more information on how integrative medicine can help you lead a happier, healthier life.
This week we were joined by 3 current students, Renee Lee, Colleen Rossier, and Jacob Rosenbaum to discuss their experiences at VUIM, how to handle the course load and their prospects looking forward.
The state of acupuncture and oriental medicine has grown tremendously over the last few decades in America. Today it has truly become an integrative practice combining traditional western medicine with ancient eastern systems to treat the whole person. Jeff Millison, the Dean of Academic Enrollment at VUIM discusses how the time has never been better to consider a career in Integrative Medicine.
Today the Centers for Medicare & Medicaid Services (CMS) finalized a decision to cover acupuncture for Medicare patients with chronic low back pain. Before this final National Coverage Determination (NCD) reconsideration, acupuncture was nationally non-covered by Medicare. CMS conducted evidence reviews and examined the coverage policies of private payers to inform today’s decision.
“Expanding options for pain treatment is a key piece of the Trump Administrations’ strategy for defeating our country’s opioid crisis,” said HHS Secretary Alex Azar. “President Trump has promised to protect and improve Medicare for our seniors, and deciding to cover this new treatment option is another sign of that commitment. Medicare beneficiaries will now have a new option at their disposal to help them deal with chronic low back pain, which is a common and sometimes debilitating condition.”
The decision regarding coverage takes into account an assessment of benefits and harms and the opioid public health crisis. While a small number of adults 65 years of age or older have been enrolled in published acupuncture studies, patients with chronic low back pain in these studies showed improvements in function and pain. The evidence reviewed for this decision supports clinical strategies that include nonpharmacologic therapies for chronic low back pain. CMS notes too that while there is variation in covered indications and frequency of services, a number of large private payers provide some coverage of acupuncture for certain indications.
“We are dedicated to increasing access to alternatives to prescription opioids and believe that covering acupuncture for chronic low back pain is in the best interest of Medicare patients,” said CMS Principal Deputy Administrator of Operations and Policy Kimberly Brandt. “We are building on important lessons learned from the private sector in this critical aspect of patient care. Over-reliance on opioids for people with chronic pain is one of the factors that led to the crisis, so it is vital that we offer a range of treatment options for our beneficiaries.”
In 2017, opioids were involved in 47,600 deaths related to overdose. CMS is keenly focused on fighting the opioids epidemic including by supporting access to pain management using a safe and effective range of treatment options that rely less on prescription opioids, including non-pharmacological approaches. In addition to today’s announcement, CMS has made significant strides in preventing opioid use disorder, such as issuing safety alerts to pharmacists when a beneficiary’s opioids prescription exceeds certain levels. Given these and other efforts from federal partners, total opioids dispensed by pharmacies nationwide declined 31 percent since 2017.
Acupuncture is a treatment in which practitioners stimulate specific points on the body, most often by inserting thin needles through the skin. As with other complex diseases, CMS recognizes the importance of having treatment options which allow for an integrated approach that is tailored to the needs and preferences of Medicare patients. Today’s decision will cover up to 12 sessions in 90 days with an additional 8 sessions for those patients with chronic low back pain who demonstrate improvement.
To read the final decision, visit the CMS website at: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=295
Source: CMS finalizes decision to cover Acupuncture for Chronic Low Back Pain for Medicare beneficiaries