News Feature
Dubai
Healthcare City pioneers integration of CAM and clinical medicine
Worldwide CAM has not
been properly regulated for
several reasons, one of which is
that there is insufficient clinical
research in CAM and any
new research proposals struggle
find funding. In the United
States, in particular, big pharmaceutical
companies tend to
dominate the research funding
landscape and wields considerable
political clout. The US
Government provides considerable
funding for new research
in a wide range of medical
specialties, yet research into
potential CAM medications/
treatments, which could
possibly pose a threat to
certain pharma industry drugs,
seldom see the light of day.
Without regulation and
licensing of CAM practitioners,
conventional medical
physicians are, understandably,
reluctant to refer patients for
CAM therapies as quality and
efficacy of practise cannot be
assured.
Regulation
DHCC has initiated, through
its Center for Healthcare
Planning and Quality (CPQ),
a system of regulated CAM,
which is the practise of CAM,
the licensing of practitioners
and facilities, all overseen by a
governing structure. In 2006
DHCC began working with a
range of consultants around
the world to find out the
status of CAM globally in an
effort to select appropriate
CAM services for Dubai and
the region, from numerous
available worldwide. DHCC
conducted a local public
survey to gauge the use and
perceptions of CAM locally
and to find out what the
public’s needs were and what
more could be done to fulfil
these needs. DHCC also
conducted a survey looking at
physicians’ perspectives on
CAM to find out what they
thought of CAM services,
whether they would be interested
in a referral system and
whether they would be interested
in an integrative system
– as this is one of the goals of
DHCC, to integrate clinical
medicine and CAM.
DHCC then set up a
Steering Committee to initiate
the CAM system at DHCC. It
was tasked with deciding
which services were required
and with developing the rules
and regulations for each
service. After assessing all the
consultants’ reports, the
surveys and looking at available
CAM-related evidencebased
medicine worldwide, the
committee approved 12 CAM
services. These include:
Ayurveda, Chiropractic,
Guided Imagery, Homeopathy,
Massage, Naturopathy,
Osteopathy, Pilates, Tai Chi,
Traditional Chinese Medicine,
Unani, and Yoga.
Rules and regulations were
developed for each of the services
as well as the criteria
required for practitioners
wanting to register and practise
CAM at DHCC. Registration
requirement are stringent and
generally require several years
of education at a recognised
institution, and an interview
with DHCC’s CAM Council,
which was established in 2007
upon the completion of the
Steering Committee’s role.
CAM Council
The CAM Council is responsible
for overseeing CAM practises
within DHCC. The
Council reviewed and
approved all CAM rules and
regulations and the list of
CAM services. Importantly, it
is also tasked with providing
recommendations to DHCC’s
Licensing Board for the
licensing of CAM practitioners
and their facilities in DHCC.
Members of the CAM
Council include internationally
respected CAM practitioners:
Dr Andrew Weil,
Chairman of the CAM
Council, is Director of the
Program in Integrative
Medicine of the College of
Medicine, University of
Arizona. He is regarded as the
father of Integrative Medicine
in the US and is the author of many scientific articles and
several books, including a
number of best sellers. Dr
Weil also writes a monthly
newsletter, Dr Andrew Weil’s
Self Healing – www.drweil.com; Teresa Hale,
the founder of the Hale Clinic,
a world-renown CAM clinic in
London; Dr David Riley, the
Editor-in-Chief of Alternative
Therapies in Health and
Medicine and the Medical
Director for the publishing
company Innovision Health
Media. He is board certified in
Internal Medicine, a specialist
in Homeopathy and a certified
yoga instructor. He has a keen
interest in the evidence-based
integration of conventional
and alternative therapies; Dr
Nishiti Joshi, the founder of
the Joshi Clinic in London, is a
conventional doctor specialised
in Osteopathy; Dr Maria
Alonso, Assistant Director at
Dubai Herbal and Treatment
Centre in Dubai, is a conventional
doctor specialised in
Traditional Chinese Medicine
as well as Preventive Medicine.
CAM codes
In conventional medicine
there are separate codes for
diagnosis and procedure that
have been adopted by
numerous countries around the
world. For diagnosis they are
referred to as ICD-10 codes.
ICD-10 is the latest version of
the World Health Organisation’s “International
Statistical Classification of
Diseases and Related Health
Problems”, which is a coding of
diseases and signs, symptoms,
abnormal findings, complaints,
social circumstances and
external causes of injury or
diseases. The 10th revision
provides a set of more than
155,000 different codes. For
procedures there are CPT-4
codes. The “Current
Procedural Terminology” is a
list maintained by the
American Medical Association
to provide unique billing codes
for services rendered. The
current version is the CPT-4.
The diagnostic codes ICD-
10 can be used within CAM,
but there is no recognised
coding system in place to
capture procedures with the
purpose of providing a billing
code system for services
rendered. These are useful,
most obviously, to standardise
billing for medical procedures
to facilitate the payment and
reimbursement processes of
health insurance companies.
However, ABC Coding
Solutions, a US-based
company, initiated the development
of a procedural
coding system for CAM. DHCC hooked up with the
company and offered to run
their coding system as a threemonth
pilot project at certain
clinics in DHCC and Dubai
Herbal Treatment Centre.
The pilot programme was a
huge success and DHCC, in
partnership with ABC
Coding Solutions has gone on
to develop many more codes
specific to CAM procedures.
These have now been made
mandatory for use by all 20
CAM professionals practising
in DHCC.
A spokesperson for DHCC
says they are now working with
various health insurance
companies to have them cover
all CAM services offered in
DHCC. This will be a major
breakthrough when this is
achieved and will certainly
cement DHCC’s position as a
global pioneer in the integration
of CAM and clinical
medicine.
Date
of upload: 30th Sep 2009
