Spiritual care lowers depression, study finds

A study spearheaded by a colleague of mine, Sara Warber MD at University of Michigan medical school, finds that drumming, guided imagery and other techniques helps heart patients.

According to the study:

Attending a non-denominational spiritual retreat can help patients with severe heart trouble feel less depressed and more hopeful about the future, a University of Michigan Health System study has found.

Heart patients who participated in a four-day retreat that included techniques such as meditation, guided imagery, drumming, journal writing and outdoor activities saw immediate improvement in tests measuring depression and hopefulness. Those improvements persisted at three- and six-month follow-up measurements.

The study was the first randomized clinical trial to demonstrate an intervention that raises hope in patients with acute coronary syndrome, a condition that includes chest pain and heart attack. Previous research has shown that hope and its opposite, hopelessness, have an impact on how patients face uncertain futures.

"The study shows that a spiritual retreat like the Medicine for the Earth program can jumpstart and help to maintain a return to psycho-spiritual well-being," says study lead author Sara Warber, M.D., associate professor of family medicine at the U-M Medical School and director of U-M's Integrative Medicine program. "These types of interventions may be of particular interest to patients who do not want to take antidepressants for the depression symptoms that often accompany coronary heart disease and heart attack."

The findings were published in the July issue of Explore: the Journal of Science and Healing.

It's no surprise that non-denominational spiritual methods are effective, as is prayer, in changing mood and offering hope to patients.  Dr. Warber is quoted as saying: "Our work adds an important spiritual voice to the current discussion of the importance of psychological well-being for patients facing serious medical issues, such as acute coronary artery disease."

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One company is building an integrative medicine brand through integrative pharmacy, by adding staff versed in naturopathic medicine and homeopathy.

Questions of legal scope of practice boundaries, standard of care, and pharmacy laws will be prominent in developing the model.

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Colon cleansing gets questioned in this new study:

Researchers from Georgetown University Medical School looked at 20 studies published in the last decade and found little evidence of benefit to colon cleansing. But they did find dozens of cases of problems: cramping, bloating, vomiting, electrolyte imbalance,  renal failure, and the biggest problem of all, death.

“This is not a manifesto against complementary and alternative medicine, since I’m a big proponent,” says Georgetown family medicine physician and lead author Dr. Ranit Mishori. “But there is absolutely no evidence that it [colon cleansing] helps. Instead, we found that it can be harmful.” 

The theory behind the need to cleanse your colon is called “autointoxication.” Food gets trapped in the colon, rots, and causes the release of toxins. The theory was largely discounted in the early 20th century.....

You can get your colon clean a few ways. Herbal concoctions, some of which are mixed with coffee or laxatives, can be taken orally or in the form of a suppository. Although they promise rejuvenation and well being, herbal preparations, none of which are FDA regulated, can cause serious side effects like dehydration and liver toxicity. Other DIY cleanses, such as the lemon-juice based Master Cleanse, are reportedly used by celebrities such as Gwyneth Paltrow.

Some people prefer a more up-close-and-personal approach with a colonic, also called colon hydrotherapy. A “colon hydrotherapist,” or “colon hygienist” inserts a rubber tube into the rectum, and fluid (often as much as 60 liters) is pumped in and out through the tube. The procedure is like an "enema on steroids," says Mishori, citing rectal perforations, acute water intoxication and even an outbreak of amebibiasis, a parasitic infection caused by contaminated equipment, among study findings.

People who perform colon cleansing need to be sure they are not engaged in unlicensed practice of medicine or otherwise running afoul of the relevant laws.  In many states there is a debate as to whether chiropractors and other licensed practitioners have colonic irrigation within their scope of practice. 

Practitioners also need to be careful about the claims they make, and beware of state laws governing advertising, health care advertisements, and unfair and deceptive business practices.

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Michael H. Cohen

www.michaelhcohen.com

 


Michael H. Cohen is a thought leader in health care law, pioneering legal strategies and solutions for business law clients in traditional and emerging healthcare. wellness, and lifestyle markets.  Mr. Cohen represents a broad range of healthcare providers and entities, including: medical and osteopathic doctors; physician groups and clinical facilities; integrative medicine centers; psychologists, licensed clinical social workers, registered and advanced practice nurses, physician assistants, dentists and other allied health professionals; complementary and alternative medicine practitioners such as chiropractors, acupuncturists, massage therapists, somatic bodyworkers, energy healers, hypnotherapists and medical intuitives, naturopathic physicians and practitioners of homeopathy; life coaches; dietary supplement manufacturers and distributors; cosmetics manufacturers; HCG and weight loss centers; medical device manufacturers; telemedicine and telehealth business; healthcare educational institutions, health insurance organizations, and medical spas;  and many other enterprises.

As a corporate and regulatory attorney who has also handled litigation matters, Mr. Cohen represents conscious business leaders in a transformational era. Clients seek Mr. Cohen’s specialized expertise on business structure and entity formation (corporations, partnerships, LLCs); credentialing, licensing, and scope of practice concerns; professional disciplinary matters before state medical, psychology, chiropractic, and other boards); employment contracts and independent contractor agreements; dispute resolution; e-commerce; intellectual property issues; informed consent and malpractice liability issues; HIPAA and confidentiality and privacy issues; Stark, self-referral, anti-kickback, patient brokering, and fee-splitting questions; dietary supplement labeling; medical device approval and other FDA matters; insurance reimbursement and Medicare issues; website disclaimers and review of marketing materials; advice on concierge medicine and retail boutique medicine; telemedicine, telepsychiatry and telehealth; and other legal and regulatory advice in the business law and health law arenas.  Mr. Cohen is also highly sought after for special legal counsel by other attorneys and law firms in the areas of complementary/integrative medicine, aesthetic and cosmetic medicine, medical board discipline, medical spa liability, and medical malpractice liability malpractice  (negligence) involving CAM practices or telemedicine, tele-health and online health services.

Mr. Cohen graduated from Columbia University (BA), Boalt Hall School of Law at the University of California, Berkeley (JD); the Haas School of Management at the University of California, Berkeley (MBA); and the Iowa Writers' Workshop at the University of Iowa (MFA).  In law school, he served as an editor of the California Law Review.  He also attended the Medical Institute for Law Faculty at the Cleveland Clinic. Following law school, he served as judicial clerk for the Honorable Thomas P. Griesa, United States District Judge in the federal Southern District of New York. Mr. Cohen was an associate in the Corporate Department at the Wall Street law firm Davis Polk & Wardwell, focusing on banking, securities law, and mergers & acquisitions. He was on the faculty of several law schools, teaching civil procedure, conflicts of laws, constitutional law, criminal law, health law, and insurance law.  He served as Director of Legal Programs at the Center for Alternative Medicine Research and Education (Beth Israel Deaconess Medical Center), and then the Harvard Medical School Division for Research and Education in Complementary and Integrative Medical Therapies and Harvard Medical School Osher Institute. He was also Assistant Professor of Medicine at Harvard Medical School, with a joint appointment as Assistant Adjunct Professor in the Department of Health Policy and Management at the Harvard School of Public Health. While at Harvard, Mr. Cohen was Principal Investigator on two grants, Legal and Social Barriers to Alternative Therapies (National Library of Medicine at the National Institutes of Health) and Pediatric Use of Complementary Therapies by Parents: Ethical and Policy Choices (Greenwall Foundation), and Co-Investigator on several other funded projects, including Models of Integrative Care in an Academic Health Center. Among his activities, Mr. Cohen pioneered the course, “Complementary and Alternative Medicine: Health Law and Policy” at the Harvard School of Public Health. He also was awarded a Fortieth Anniversary Senior Fellowship at the Center for the Study of World Religions, Harvard Divinity School.

Mr. Cohen has published over 100 articles, and books, including: Creative Writing for Lawyers (Citadel Press, 1990); Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives (Johns Hopkins University Press, 1998); Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Human Evolution (University of Michigan Press, 2000); Future Medicine: Ethical Dilemmas, Regulatory Challenges, and Therapeutic Pathways to Health and Healing in Human Transformation (University of Michigan Press, 2003); Legal Issues in Integrative Medicine (NAF Press, 2005); and Healing at the Borderland of Medicine and Religion (University of North Carolina Press, 2005).

Following a successful academic career, Mr. Cohen returned to the practice of law. In addition to his professional activities, Mr. Cohen received certification as a Registered Yoga Teacher. Whether advising start-ups or established companies, he brings his entrepreneurial spirit and caring insight to cutting-edge legal and regulatory challenges.

Mr. Cohen is admitted to practice in California, Massachusetts New York, and Washington, D.C.  To speak with an experienced business and health care law attorney about your legal concerns, contact our attorneys today.