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2016 Conference presentation slides

Table of contents

Thursday August 18 Preconference

Full Day Workshop

FxnMed4US - Functional Medicine for the Underserved

Introduction to Functional Medicine
Intro to FM Handout

Integrative Gut Health
Integrative Gut Health Handout

Immune Health

Biotransformation and Detoxification




Putting It All Together
Putting it all Together Handout

Morning Presentations

Advanced Group Medical Visit Facilitation and Management

Jeff Geller, MD
Group Medical Visits are growing rapidly as a mechanism to provide medical care. They particularly excel at treatment of chronic illness and conditions, while addressing mental well being. Often group medical visits have more time for participants to freely exchange ideas and best practices. Groups need good facilitation to help participants feel engaged and connected to one another. We will be sharing some facilitation basic and advanced skills to help groups flourish .

Nervines for Body Mind &Spirit: Materia Medica and Clinical Applications and Bitters & Carminatives: The Art& Science of Herbal Digestive Aids

Healing Community Trauma with Acupuncture

Carla Cassler, DAOM

Afternoon Presentations

Mind Your Pain

Jill Frank, FNPC and Robert Laguna, MSOM, L.Ac
This presentation will offer participants the opportunity to experience the Living Well with Pain model as developed by the Seton McCarthy Community Health Center, AOMA Graduate School of Integrative Medicine and other members of the Austin community. This is a shared medical visit format for delivery of pain related education, mindfulness and movement practices by patients willing to utilize self- management strategies. Methods will include the NADA protocol, qigong, mindfulness exercises and shared experience discussion. The aim is to optimize and balance long term opioid management with self-management strategies, improve functional outcomes with decreased ER visits and hospitalizations related to ineffective chronic disease management.

Herbal Medicine and Somatic Practices for Stress, Trauma and Resilience

Larken Bunce, MS, Herbalist

An Integrative Wellness Model within a Federally Qualified Health Center - Virtual Tour and Seminar

Connie Earl, DO, Chris Perkowska, PA, CNM, Mary Szecsey, Natalie Dwyer

Friday August 19 Conference Day 1

8-9 am Plenary

Beyond Collective Impact: Why Collaboration?

David Gibbs

9:15-10:15 am Breakout Sessions 1

Quick and Simple Functional Clinical Pearls for Use in an Underserved Community

Hansie Wong, MD

Integrative Health Coaching: Working Toward Meaningful Behavioral Change in Underserved Communities

Priscilla Abercrombie, RN, NP, PhD

Acupuncture and Trigger Point Dry Needling: Effective, Low-Cost, Low-Risk, Low-Tech Treatment for Myofascial Pain

Jonah Hershowitz, LAc
Acupuncture and trigger point dry needling outline

Latino Herbal Medicine: Traditional Use, Safety and Efficacy

David Kiefer, MD
Latino Herbal Medicine Handout
Matching Exercise

My Experience as an Oncology Nurse

Sangeeta Agarawal
An engaging talk will be given regarding speaker Sangeeta Agarawal’s experience as an Holistic Oncology Nurse. During her time as an Oncology Nurse at The Mayo Clinic, Stanford Hospital, and UCSF Hospital, Sangeeta was able to apply Holistic Medicine principles which allowed her to provide a level of supportive care on top of her oncology care. Her supportive care included patient symptom management, patient education, and in providing emotional support to patients and their families. During her talk, Sangeeta will recount some of her experiences and close with how a Holistic outlook can be applied to other areas of medicine. She will lay out a framework for the instances where various types of Holistic practices such as mindfulness, massage, reflexology, aromatherapy, diet and lifestyle guidance, and music therapy can be applied. She will also discuss the areas to watch out for, the areas to avoid, and the key points to remember when collaborating with a patient’s provider team. During this talk, she will share valuable resources that you can use to understand your patient’s condition so that you can make an informed decision when caring for your patient.

Research Presentations

*Effectiveness of a Mind-Body and Peer Support Program for Teens Living with Chronic Illness and their Parents: A Pilot Study
Brittany Blockman MD

  • Acceptability of a Mindfulness Based Intervention for Depression Among African-American Women in a Federally Qualified Health Center
Inger Burnett-Zeigler, PhD
  • Improving Cardiovascular Outcomes among Overweight/obese Latino Cancer Survivors using a Culturally Tailored Yoga Program: Preliminary Findings from a Non-Randomized Pilot Study
Bruriah Gutierrez, MeD
Improving Cardiovascular Outcomes Outline

10:30-11:30 am Breakout Sessions 2

Your Gut Microbiome: Why and How

Arti Chandra, MD, MPH
Why give a kraut? Handout

Health Coaching for the Underserved: Case Reports from San Francisco

Meg Jordan PhD, RN, CWP

How to improve chronic pain care

Sandra Gordon, B.Sc., CEC
Use of prescription painkillers has soared by nearly 400 percent in the past 15 years, yet there has not been an overall change in the amount of chronic pain reported from over 100 million Americans. Stigma for both patients experiencing chronic pain and providers treating pain hinders care in this critical area. We need a new chronic pain care model that places the patient at the center of a personalized, tailored, integrated multi-disciplinary model of self-care and directed care drawing upon all available evidence-based modalities to relieve pain and improve function.
In 2015, Samueli Institute conducted a Chronic Pain Breakthrough Collaborative, a learning and action community designed to accelerate education and widespread implementation of best practices in interdisciplinary care for chronic pain. Leading providers in civilian, military and veteran healthcare to addressed four components of chronic pain care: 1) integrative care delivery, 2) patient self-efficacy, 3) reliable systems and processes, and 4) a sustainable business model.
Participants reported a decrease in the number of patients relying on opioids for chronic pain, an increase in the number of patients using non-pharma and self-care therapies for pain, and an increase in quality of life and patient function. Additionally, improvements in staff communication, multi-disciplinary teamwork and collaboration were reported.
Participating health care leaders illustrated positive change tangibly, with a shared belief that we cannot wait for reimbursement and regulation to catch up to the reality of the over 100 million people who are suffering with chronic pain.

The use of medical cannabis in the treatment of chronic pain

Harry McIlroy, MD

The Art of Medicine - Developing Therapeutic Presence

Onna Lo, MD, ABIHM

Beyond Food Access: Advancing a Food Systems and Equity Agenda

Jamie Harvie

11:30-12:30 pm Lunch/Plenary  Single Payer Health Care: An Integrated Delivery System

Bill Skeen, MD, MPH

12:45 - 1:45 pm Breakout Sessions 3

Functional Approaches to Chronic Pain Management

Connie Basch, MD
Integrative Pain Treatment Handout

Increasing Access to Integrative Cancer Care in a Cancer Center

Ana Maria Lopez

Building Communities of Support for Extreme States of Consciousness: Involving Integrative Medicine in Spiritual Dimensions of Psychosis

Dina Tyler
Can mental health crises called psychosis be transformational? How can Integrative Medicine illuminate the trauma and spiritual aspects of what so often gets labeled as schizophrenia or bipolar during a mental health crisis? The presenters combine years of clinical work with individuals diagnosed with psychosis and their families, as well as having their own personal journeys of recovery, which inform how they work with clients. They will share how they have created supportive communities for people who experience voices, visions and different realities and how these communities reduce distress associated with symptoms, decrease reliance on hospitals and medication, and improve outcomes such as returning to school and work. They will share a community-building model for how Integrative Medicine Practitioners can become involved in supporting the mind, body and spirit of individuals given a psychiatric diagnosis.

Principal Plants in Herbal First Aid

There are a number of therapeutic categories commonly seen in first aid situations, including, inflammation, pain, infection, and trauma. This class will cover some common and useful plants from these categories such as antispasmodics, anodynes and antimicrobials to give the participants practical tools for these circumstances.  Some of the plants included are Willow, Valerian, Skullcap, Eyebright, Propolis, Licorice, Lobelia and others.

Telemedicine Mind-Body Group Therapy in a Public Mental Health Setting: Efficacy, Acceptability, and Best Practices

Chanel Heermann, MD
Telemedicine is becoming an increasingly common solution to issues of mental health service access in many areas.  This lecture will discuss a small-scale demonstration project, which was designed to investigate telemedicine as feasible and acceptable means of delivering group therapy services to underserved communities.  Our presentation will highlight our experience delivering the 7 Foundations of Health and Happiness (7FHH), a mind-body medicine skills group, via telemedicine. Outcomes discussed will include the Arizona Integrative Outcomes Scale (AIOS), and the overall mental, physical, and spiritual health measures, using the Mental, Physical and Spiritual Well-being Scale (MPS), as well as qualitative feedback from the participants and the facilitator.  An overview of “lessons learned” from our project will be presented. In it, we will offer suggestions for best practices pertaining to technology, logistics, and group process, and possible accommodations for the needs of a public mental health population, especially those patients with chronic mental illnesses.  Discussion and contribution from participants is welcome. Our hope is to contribute to the ongoing development of best practices in this emerging field.

Hepatitis-Cure: Efficient, Patient-Centered, Holistic Group Visits to Optimize Health Beyond the Liver and Cure Hepatitis C

Fasih Hameed, MD

2 - 3 pm Breakout Sessions 4

Functional Medicine based Group Visits for the Underserved

Kara Parker, MD

Ayurveda in a Community Clinic setting

Chris Perkowska, PA
Hydration Ideas Handout

Harm Reduction Approaches to Psychiatric Medication: Using Integrative Medicine as an Alternative Way to Support Mental Health

Benjamin Zappin, LAc and others
This panel of consists of experts who work with people who choose alternatives to the use of psychiatric medications for dealing with mental health issues. Ben Zappin is an acupuncturist and herbalist in Oakland, CA who uses integrative medicine to assist people struggling with emotional and spiritual distress. Dr. Judith Pentz is a Integrative Psychiatrist in New Mexico, who incorporates various modalities including orthomolecular, nutritional options, homeopathy, targeted amino-acid therapy, breathing techniques and meditation, in her work with individuals given a psychiatric diagnosis. Will Hall, DiplPW is an internationally recognized therapist, trainer, advocate and author who wrote the “Harm Reduction Guide to Coming Off Psychiatric Drugs,” and has presented about coming off medications around the world. Dina Tyler is a peer specialist who shares her personal lived experience of the mental health system and alternative approaches with underserved populations in Alameda County, California.

Preconception Care in Underserved Populations: Blueprint to a Healthy Start…and Future

Abigail Aiyepola, ND
Infant and maternal mortality are disproportionately higher in certain populations across the globe. Research has established certain critical periods of development as important considerations related to improved birth outcomes.   This course will explore some of the trends related to these statistics, and consider ways in which specific targeting of preconception and fertility awareness programs towards these vulnerable populations may perhaps serve to mitigate or even solve some of the disparities we find within our global healthcare systems.

Breema, The Art of Being Present

Karen Burt-Imira, MD
Breema uses touch and movement based on the body's natural mechanics and rhythms to create a comfortable and balanced experience which is relaxing, nurturing and energizing for both giver and receiver.
Breema uses bodywork, self-care exercises, body-centered meditation, and the Nine Principles of Harmony to foster a tangible connection between mind and body—enabling us to experience being present in our body. This experience supports our ability to become present in any activity of daily life, and becomes the foundation for living in greater connection and harmony within ourselves and with others.
Self-Breema exercises are short and easy to learn. Requiring no special attire or equipment, they can be done at any time to calm and refresh mind, body, and emotions. Simple Breema bodywork can be offered in a clinical setting to patients/clients and co-workers to relax and rejuvenate them and ourselves, or to friends and family members as a mutually supportive and nurturing activity. The Nine Principles of Harmony can be applied in any situation to support tension and stress release, to let go of reactive emotions and see a bigger picture, to help open our hearts to others with well-wishing and compassion, and to move from a scattered to a more focused and clear mind. In short, we become more present in life, and this offers us the possibility of discovering new dimensions of relationship, health and well-being.

It’s About Resilience: Building Personal, Community, Organizational and Societal Resilience

Michael Bennett, NP
Resilience Assessment and Planning Program

3:15 - 4:15 pm Poster Session

4:15 - 4:30 pm Quick IM Activity Self-Massage

Hansie Wong, MD

4:30 - 5:30 pm Plenary Integrative Treatment of Infectious Disease in Underserved Populations: Insights from Three Decades of Researching and Treating A.I.D.s. H.I.V., and Hepatitis C

Misha Cohen, OMD, LAc

Saturday August 20 Conference Day 2

6-7 am Morning Activity: Introduction to Taichi

Hansie Wong, MD
Taichi is an ancient Chinese martial art that exercises the mind and body through slow movements. Practicing taichi regularly can improve balance and coordination, increase energy and stamina, reduce stress, and calm the mind. This workshop will go over the fundamental taichi principles. Participants will have the opportunity to put these principles into practice and learn two basic taichi movements.

7:30 - 7:45 am Opening Remarks Jeff Geller MD

7:45 - 8 am Quick IM Activity: How to Get Unstuck

Chanel Heermann, MD
The Center for Mind-Body Medicine has been teaching a “Shaking and Dancing” active meditation to their practitioners for years, and now we are bringing this simple, effective technique to IM4US.  It’s a great way to get “unstuck” – either “shaking loose” mental blocks and worries, or releasing tension held in the body.

8 - 9 am Plenary Addressing Community Health Through the Development of Community Leaders

America Bracho,MD, MPH

9:15 - 10:15 am Breakout Sessions 5

Somatic Complaints in the Primary Care Setting

Elena Rosenbaum, MD

Transforming your 15-minute visit with Mind-Body Medicine

Anuj Khattar, MD

Assimilating Integrative Medicine within the Education System

Sanaz Demehry, PA-C, MS

An Osteopathic Approach to Headaches and Integrating Essential Oils in the Clinic Setting

Josephine Conte, DO
An Osteopathic Approach to Headaches Integrating Essential Oils in the Clinic Setting Handout

Direct Care, Education, Research and Partnerships: Anatomy of a Comprehensive Integrative Medicine Program at a Community Clinic

Myles Spar, MD, MPH
In 2006, the Venice Family Clinic, then the largest free clinic in the United States, established a multidisciplinary health, wellness and Integrative Medicine program.  Housed at the renamed Simms/Mann Health and Wellness Center, this program has continued to grow to include direct patient care from practitioners of multiple modalities, IRB approved research studies, education of students from various health science programs and self-care programming for providers.  This workshop will break down the program explaining the structure, partnerships and finances to enable participants to take all or part of this model back to their home clinics. Assessment tools and MOU’s will be shared with participants.

Research Presentations

"A Fruit and Vegetable Prescription Program at a Federally Qualified Health Center Decreases Hemoglobin A1c among Low-income Diabetics" (Richard Bryce, DO)
"Composition of Integrative Medical Group Visits (IMGV) Randomized Controlled Trial in an Urban Population" (Paula Gardiner, MD)

“Racial Disparities in Use of Chiropractic Services under Medicare in Los Angeles County, California" (James Whedon, DC, MS)

10:30 am - 12 pm Breakout Sessions 6

Incorporating an integrative approach to interprofessional primary healthcare education to meet the needs of the underserved

Mindfulness for Daily Living: Adapting Ancient Practices for a Modern World

Diana Shakarian, PhD
Mindfulness for Daily Living Outline

Pediatric obesity group visits on the Navajo Nation: Collaboration with national and local partners

Maryclaire O'Neill, DO
Overview on using pediatric obesity group visits at a Navajo Nation clinic as the format for implementing the CDC REACH (Racial & Ethnic Approaches to Community Health) grant and Wholesome Wave fruit & veggie prescription program (FVRx), through coordination with dietitians, community health workers, local trading post owner, and the elementary school on the Navajo Nation. 
The narrative of implementing this program will be the basis for discussion on: 1) The value of group visits for both patient and practitioner; and 2) considerations in establishing group visits, including venue, partnerships, and billing.

Osteopathic Manipulative Medicine 101- a practical experiential workshop

Connie Earl, DO, ABIHM
This session is a hands-on intro into Osteopathic Manipulative Medicine (OMM), and is intended to leave participants with practical skills that they can start using right away. In this half-day workshop, we will discuss the philosophy and principles of Osteopathic Medicine, review supporting evidence for OMM, practice palpation skills and discuss the principles of several forms of OMM. We will apply osteopathic technique and principles in the review of case studies, and practice these techniques on each other in the workshop.  I have selected some of the highest yield and most-used techniques to allow participants to apply them to a wide base of patients on return to their practice.

Making it Easy, Combining Modalities for Effective Treatment

Bonney Lynch, LAc, CMT

Returning to Normal

Andrea Lee, MD, FACOG

1 - 2 pm Breakout Sessions 7

Back to wellness basics- for ourselves, our patients, our learners

Andrea Gordon, MD

Mindfulness Training: Preventing Burn-out and Increasing Resiliency for Providers and Staff

Lisa Hardmeyer Gray
Recent studies are concluding that healthcare professionals are at higher risk for professional burn-out.  Burn-out is  characterized by a loss of mental, physical and emotional energy from continued job-related stress and has been linked to poorer quality of care,  patient dissatisfaction, medical errors, lawsuits and increased costs to medical organizations in staff-turnover.  Burn-out also seems to have adverse personal consequences including contributions to broken relationships, problematic substance abuse, and suicidal ideation. To reduce professional burn-out,  improve retention and promote employee morale, administrators must implement strategies to reduce burn-out while also promoting productivity.  There is a need to offer innovative resiliency skills for all health care workers to adapt to a dynamically changing practice environment.  There is mounting evidence that Mindfulness skills are an effective means of preventing burn-out and developing resiliency skills.
 Supported by evidence-based research reported in in JAMA and the Annals of Family Medicine, this 2-part workshop the presenter will offer discuss her professional experience and expertise in Mindfulness training for health care providers, staff and patients and draw from recent evidence-based research reportedhese studies have concluded that Mindfulness programs are a low-cost practical tool in decreasing burn-out and increasing short-term and sustained patient-centered care.  Providers and staff report they are more present, attentive and empathic with their patients resulting in better care, greater job satisfaction and well-being. In addition, as health care moves from fee-for-services to value-based outcomes, there is also mounting evidence that Mindfulness programs have beneficial, low-cost outcomes for health and well-being for patients.

Adverse Childhood Experiences (ACEs) and Risk for Chronic Disease. Creating A Trauma Informed Community Network to build Resilience

Anu French, MD, FAAP ABOIM

Clinical Pearls and Walking Alongside: Lessons from Naturopathic Community and Global Health

Sean Hesler, ND

A Tale of Two Cities: Bringing Loma Linda's Lifestyle Medicine to a Free Clinic in San Bernardino

Christina Miller, MD, MPH
Organization Plan for Developing a Free Clinic

Re-Organizational Healing vs Restorative Healing Restructuring the way we assess our patients

Laura Polak, DC
Health Wellness and Quality of Life Questionnaire

2:15 - 3:15 pm Breakout Sessions 8

Health Disparities and the Social Determinants of Health

Donna Odierna, DrpH, MS, CH(AHG)

Mindfulness For the Clinician: Dismantling Systemic Bias in Health Care Delivery

Elizabeth Adler
Mindfulness for the Clinician: Dismantling Systemic Bias Outline

Medicinal Mushrooms: Clinical Insights and Practice

Renee Davis, MA RH(AHG)
Medicinal Mushroom Handout

Naturopathic Primary Care at an FQHC - Politics, Policy and Practice

Bill Walter, ND

Integrative Nutrition: A Collaborative Community-based Approach

Michelle Steinberg, MS

Listening to Ourselves and Each Other; Healing the Negative Health Impacts of Racism, Sexism and Poverty

Elizabeth Rocco, MD

3:30 - 4:30 pm Plenary  The Global Integrative Health and Medicine Movement: What Every Clinician Should Know

Tabatha Parker, ND

Leading the Charge: Making the case for integrative care for the underserved