Former U.S. Army Surgeon General Eric Schoomaker, MD, PhD, has characterized the military’s advanced engagement of complementary and integrative approaches and practitioners as “the imperative for integrative medicine in the military.” This urgency came even as integrative practices are already embedded in military medicine. By 2012, 120 military facilities offered 275 complementary and alternative medicine programs producing 213,515 visits for active duty military members.

Shortly thereafter, the director of the National Institutes of Health’s National Center for Complementary and Alternative Medicine, Josephine Briggs, MD, announced an NIH working group involving Schoomaker on integrative pain strategies for the military, declaring that “opioids alone cannot be the answer.”

The perception of an “imperative” for using non-pharmacological strategies in the military begs a major policy question. Is there an imperative for integrative health and medicine for treatment of pain in the civilian population?

In 2010 with the passage of the Patient Protection and Affordable Care Act (ACA), Congress recognized the impact of complementary and alternative medicine (CAM) — a term that includes meditation, acupuncture, chiropractic care and naturopathic treatment, among other things. While CAM is mentioned in various parts of the ACA, two sections specifically call attention to this integrative, bio-psychosocial approach. Section 2706 requires that insurance companies “shall not discriminate” against any health provider with a state-recognized license. Section 5101 includes licensed complementary and alternative medicine providers and integrative health practitioners in its definition of health professionals in the “health care workforce.”

“This is a unique, historic moment to capitalize on what we know works to effectively treat pain. It marks the beginning of a cultural shift in how health care is practiced in the military.” — Former Army Surgeon General Lt. Gen. Eric B. Schoomaker, MD, PhD, 2009

d
c