AMERICAN NATUROPATHIC RESEARCH INSTITUTE
NATUROPATHIC ONCOLOGY RESEARCH INSTITUTE
1250 E. Baseline Rd., Suite 205
Tempe, AZ 85283
JOINT MEETING OF THE
AMERICAN NATUROPATHIC RESEARCH INSTITUTE (ANRI)
NATUROPATHIC ONCOLOGY RESEARCH INSTITUTE (NORI)
INVESTIGATIONAL REVIEW BOARD (IRB)
August 3, 2012
MINUTES AND MEETING NOTES
In accordance with the requirements of the United States Code of Federal Regulations, Title 45, Part 46, the eleventh regular quarterly meeting, of the American Naturopathic Research Institute (ANRI) and the Naturopathic Oncology Research Institute (NORI) and the Institutional Review Board(IRB) was called to order at 12:45 p.m., August 3, 2012 at 1250 E. Baseline Rd., Suite 205, meeting in Suite 203, Tempe, AZ 85283.
The following members and visitors were in attendance (alphabetically by last name):
Turshá Hamilton NMD
Colleen Huber, NMD
Thomas Jemison, NMD
Kenneth Lashutka, NMD
Eric López, NMD
Kenneth Proefrock, NMD
Nanao Takaki, NMD
Two children also attended.
Phranq Tamburri, NMD* attended 2nd smaller meeting, same day
Others who have attended previous meetings or wish to attend future ones are cordially invited to join us for future meetings.
It has generally been the policy of ANRI / NORI to stay uninvolved in insurance matters. However, Dr. Huber has been noticing increasing insurance reimbursement to her clinic’s patients, and shared the following information:
Some insurance companies have been reimbursing much more than others. Plans that turned out to be much more likely to reimburse were discussed, as well as ways to have insurance claims processed smoothly, using a 3rd party insurance biller, as well as a 3rd party provider network, and some considerations regarding coding. Dr. Huber noted that this arrangement is feasible with an all-cash practice and complete physician autonomy regarding medical practice, including scope of practice, time spent with patients, and all sorts of clinical considerations, while making subsequent reimbursement possible for patients. Total time spent on insurance matters is approximately 1 hour per day of one medical assistant’s time. Dr. Huber spends another average of ½ hour per day, processing insurance reimbursement checks, and doing the bookkeeping and writing reimbursement checks to patients out of a trust account established for that purpose. There is about a 4 to 6 week delay after date of service in reimbursement checks arriving from the insurance companies. The difference between secondary and supplemental insurance with Medicare was also discussed, as well as a plan that has reimbursed Medicare patients at about 60% of their naturopathic medical expenses. The cost as a percentage of revenue was also discussed.
In the previous ANRI / NORI meeting in May 2012, we discussed qualification for the awarding of an ANRI fellowship or a NORI fellowship to ANRI / NORI members. At that meeting Dr. Proefrock said that each doctor should present 5 case studies in order to qualify for this designation, and the membership agreed. We look at those 5 cases, and we ask questions, such as what is happening with the patient now, and questions based on seeking further clarification of what happened during treatment. Dr. Lashutka had said that during each meeting a certain number of cases could be presented, perhaps one from each doctor each time, until each doctor arrives at 5 cases presented. The membership agreed. Dr. Huber noted that continuing education of a particular kind would not be a feasible requirement, because relevant conferences are too seldom and generally too distant to expect the membership to all be able to attend. Perhaps the continuing education requirement would be able to consist of individual study of the medical literature as well as formal continuing education.
It was generally agreed that case studies would be the requirement of a Fellowship for ANRI or NORI, depending on the nature of the cases presented, ANRI for general cases, NORI for cancer cases, as each physician prefers for himself or herself.
We had agreed back in May that next time we would begin to all bring case studies and begin with these, and that as time goes on more and more of our meetings would be about this. So that is how we spent almost all of today’s meeting.
Dr. Huber started with a case of breast cancer, the second case that she has presented to ANRI / NORI, following the one described in the previous minutes. The membership then asked questions, clarified possible patterns of cause and effect in disease progression, and expressed ideas regarding treatment strategies.
Dr. López then presented a case of a chronic cough, looking at some differential diagnoses that had been considered. This was the first he has presented to ANRI / NORI, after which the membership asked questions and Dr. López discussed the case in more depth.
Dr. Lashutka then presented a Hodgkins lymphoma case, the first he has presented to ANRI / NORI, in which he described a successful trajectory of a case that at first seemed to have a poor prognosis. Clarifying questions were asked by the membership, and Dr. Lashutka answered these questions.
Dr. Proefrock commented that as layers of perception of success in a case build onto initial success, there is psychological reaffirmation of healing, making physical healing more certain and more lasting.
Dr. Proefrock then presented follow-up information on a pancreatic cancer case that he had presented at the last ANRI / NORI meeting, another case that had had a poor prognosis, now on a successful path. This was Dr. Proefrock’s 3rd case that he presented to us.
DR. TAMBURRI’S SURPRISE APPEARANCE
At the end of the ANRI / NORI meeting, just as most people had left, Dr. Tamburri arrived, hurrying over after a busy day at his clinic.
We discussed naturopathic urology, and the usefulness and limitation of PSA. We talked about how a man’s PSA number is not nearly so useful or helpful as PSA velocity, or the trajectory of where PSA goes over time, such as how fast it rises, as well as other valuable tests, such as PCA3, etc.
Dr. Tamburri discussed the history of the use of PSA, pointing out that prior to 1980 the number of men who were diagnosed with prostate cancer was only slightly higher than the number of men who died of prostate cancer, because there were no good diagnostic markers, and we did not know a man had prostate cancer until it had advanced to a late stage, and until he had unrelenting back pain or anuria or hematuria, etc. By then the cancer was usually Stage IV and very hard to treat. Then, in 1980, with the advent of the PSA test, there was an enormous difference in the number of men diagnosed with prostate cancer and the number of men who die from prostate cancer, because it is now diagnosed much earlier, even to the point of overdiagnosis, highly sensitive testing, not highly specific.
Dr. Tamburri then presented a case illustrating that concept, discussing that case with Dr. Huber regarding how the patient may have been treated prior to 1980 and after, with questions and answers. Dr. Tamburri requested that this be his 1st case presented to the Board, which will have to wait for a vote by the Board on the next meeting, because by the time the case was discussed, a quorum was no longer present that day.
Marilyn Brewer, L.Ac., who had been a member of this Board passed away on May 30, 2012, from complications of breast cancer. Marilyn is missed by those who knew her warm, cordial personality and her steadfast research into natural approaches to cancer treatment.
NEXT BOARD MEETING: Friday, November 2, 2012 at noon, at the usual place, the clinic of Drs. Huber, Lashutka and Jemison, in Tempe. Food from Herbs and Flavors will be served, unless objections surface before then.
Please mark your calendars now, to keep this afternoon open for ANRI / NORI.
Please remember to bring your case studies in to present, at least one. We may have time for two each, for those of you feeling ambitious.
Dr. Huber continues to offer for her clinic to provide lunch for the meetings at no cost to the membership, in order to save up the usual $10 dues per quarter per person to pay the $400 fee for the eventual incorporation of the non-profit.
POSSIBLE AGENDA ITEMS FOR MAY 18, 2012 BOARD MEETING
These meetings are the opportunity to present anything that you think important or interesting. Of course, agenda items may even be added at the last minute.
Colleen Huber, NMD
Secretary, ANRI / NORI
August 3, 2012