ICIM Blog

The culture of the International College of Integrative Medicine (ICIM) is still developing as it comes into its own as a distinct, independent group. In this paper I will explore the emerging culture of ICIM , using Gareth Morgan’s metaphor of Organization as Culture from his book Images of Organization (2006).
ICIM uses the following methods to embed organizational culture: published formal statements, printed and promotional materials, our slogan, the “Pearls and Nuggets” ritual, careful word choices, and stories about the founders of the group.
The ICIM mission statement was carefully worded years ago to be a broad description of the organizational goals of the group. As we re-evaluate our mission statement, I hope to edit the wording to reflect the fact that ICIM is a close community of colleagues and that ICIM insists on scientific excellence.
Our policies and procedures document is a new project which has been co-written over the last year using contributions from numerous board members. The process has been organic, with lots of group revisions. The fact that our P&P document is a constant “work in progress” rather than a static, published set of rules says a lot about our organizational culture! It is also placed prominently on our website, showing that we value complete honesty, democracy and transparency in our office dealings.
Slowly, we are standardizing the design of all of the forms, letterhead and newsletters that we create, using a simple graphic of an “i” surrounded by a circle, and a wave, or as some call it, a “woosh” of blue sweeping across the top of the page. The simplicity of the small letter i surrounded by the symbolic wholeness of the circle expresses that we are a vulnerable group of doctors who are made strong by our commitment to holistic thinking and world class medicine. The curve of blue illustrates our belief that we are riding a wave of the future of healthcare and that we are on the cusp of a movement that will change everything. Even the color blue symbolizes truth and expression, something our organization strives to offer to wider society on behalf of our members. Within the circle around the “i,” our graphic sometimes fades to green, a color which symbolizes healing and healers.
The ICIM slogan is currently “dedicated to advancement in medicine.” I read this slogan as something with sad overtones. It is a reference to the past that we definitely need to replace and update. Culturally, our slogan betrays defensiveness from the rejection experienced by many in our leadership from the larger “mother” group American College for Advancement in Medicine (ACAM). When some of our founders were forced to leave ACAM it was as if they needed to express that their new group was still “dedicated to advancement in medicine,” and maybe the insinuation was even that we were the group that had the true “dedication” after all. Whatever meaning it had for the committee that first chose it, we must now find a new slogan that is proactive and sets a unique, positive tone to define ICIM to the public and its members.
Each medical meeting ICIM organizes includes a ritual that has become important to the culture of the group. We have a sharing time listed in the program as “Pearls and Nuggets,” During this period, participants are encouraged to describe things they are doing in their practice that are working well, sometimes even simple or surprising treatments. Doctors can also feel comfortable here to mention problems or failures that they have encountered and ask colleagues for ideas and support in how to face these challenges. This portion of the program displays an organizational culture that is supportive and non-competitive, and portrays ICIM, not as a group with insiders and outsiders, but as a community of people dedicated to exploring treatments that work and evaluating what doesn’t work openly with each other
In an emerging field that is struggling for an acceptable definition, linguistic subtlety takes precedent. Our board has spent many hours discussing the proper terms to describe our collective practice of medicine. Some of the words that have been rejected are “holistic” (too wide and vague), “complementary” (something harmless that is an additive to mainstream medicine; we try to offer a whole separate paradigm), “alternative” (sounds like something that rejects all modern treatment, which we do not do), “new age” (non-medical, spiritual, flakey association), or “natural” (insinuates herbs and teas instead of lasers and IVs). We try to avoid these terms to avoid confusion about who we are. ICIM doctors do not want to be seen as backwards quacks or out-of-touch spiritual fanatics. Words that have been deemed appropriate are “integrative” (integrating the wisdom of modern medicine with the acceptance of innovative, multi-cultural, and ancient understandings of healing) and “functional” (helping the body to function properly; doing what “works”) medicine. A standing joke is that, by this description, we are set apart from conventional doctors who practice “dysfunctional” medicine. ICIM doctors want to be viewed as high tech, cutting edge, and scientifically legitimate.
Stories about the founders of the group are fondly told in informal ICIM contexts, and recently we have begun to formalize this at each meeting by starting a tradition of honoring several long time members who have recently passed away. We give a plaque to the current owner of the practice as well as more personal certificate to the widow, signed by multiple friends and associates of the person being honored. Each time we do this, stories are told from the podium about the doctor which remind everyone to appreciate the sacrifices and bravery of these early pioneers in the field. A popular book among ICIM members is Medical Mavericks, by Hugh Desaix Riordan, MD (1988) which describes doctors throughout history who were persecuted or ridiculed for theories and treatments that later became mainstream. ICIM doctors see both themselves and the founders of their group as following in this tradition of medical mavericks.
Based on these specific examples of embedding organizational culture within ICIM, I identify the corporate values of democracy, innovation, community, participation, scientific validity and courage. Our process in creating policies and procedures identifies democracy and transparency. Our passion for innovation is illustrated by our graphic images. Our desire to be a close community will soon come out of our mission statement. Participation is shown to be an essential value through the ritual of “Pearls and Nuggets.” The careful word choice we use in all descriptions of what we do shows the value we put in scientific validity. And the stories and legacy of medical mavericks present examples of the value of courage in our organization.
My impression of the organizational culture of ICIM is that this is a group that is truly holistic in nature, with values that extend beyond medicine and celebrate the individual spirit of each member who identifies with it.

References

Morgan, Gareth (2006). Images of Organization. Thousand Oaks, California: Sage Publications, Inc.

Riordan, Hugh Desaix (1988). Medical Mavericks, Wichita, Kansas: Bio-Communications Press.

To Bot or Not To Bot
The Appropriateness and Effectiveness of ICIM’s Electronic Networks
By Wendy Chappell, Executive Director

A doctor sits down to his email early in the morning. Fifteen messages are there, as usual from the International College of Integrative Medicine, “Someone has viewed your listing on www.icimed.com.”
“Great,” he thinks, “when will the phone start ringing with all these new patients this damn website is promising me?” He idley clicks on one of the announcements and browses his listing, tossing off a quick email to Wendy changing a few details about his office. Sometimes he just clicks return and tells her the weather. At least he knows she’s always there behind those obnoxious emails, ready to answer any questions he has at the moment about what ICIM is up to.
This scenario happens in over one hundred locations across the country almost daily. Our bots tell our doctors when they’ve got a hit. To some of them this is a sign of life and hope that they will be found in the gobbly-gook of cyberspace. To some it is a meaningless waste of email space. After all, it’s just a bot, not a patient. “Give us names and addresses so we can do something about the inquiry,” they plea. But we have nothing but an anonymous click to give. The bots don’t discuss things with the potential patients, and they certainly don’t give in to the doctor’s questions. They quietly do what they were built to do; they follow the rules and nothing more. As John Seely Brown and Paul Duguid write in The Social Life of Information (2002, p. 54)), “bots, in contrast to humans, live a wretchedly impoverished social existence.”
Those bots didn’t come from nowhere. They were built by their godfather Antonio, who is also our webmaster at ICM. In The Social Life of Information the authors argue that technology will not make organizations flatter, as once was thought (p. 28). I would agree with that, however, in ICIM, the hierarchy takes an interesting turn, because on a practical level it is arranged according to technological power. Though I am Antonio’s boss and the ICIM Board of Directors employs me, Antonio is at the top of most of our daily interactions. It is Antonio, our IT department that links me into most of ICIM’s communications, and he also has the power to change major and minor details of how we interact with the world. If he were to quit, ICIM would not be able to carry on until a replacement “Antonio” who had similar intellectual abilities and experience could be hired. I have some abilities to adapt the website and enter data, and members rely on me to update their listings and membership status, etc., so I am next in line on the power scale. Members of our group have only limited abilities to control their profile, so they are the lowest in the hierarchy, relying on me, and ultimately Antonio, to “present” them and represent them in an attractive way to society at large. Hierarchy is alive and well, and based on IT.
What does our electronic office provide? It is a library where members can download forms, power points, schedules, papers, and links to other friendly organizations (http://www.icimed.com/links.php). We post drafts of documents, which are meant to foster discussion and elicit comments and corrections from member doctors. Faxed documents all come by email and can be posted directly to our website. In some ways it would seem quite useful and efficient, but it is static for the most part, with few interactive possibilities. Our one attempt at interacting is a members-only section, and we find most of our members incapable of remembering the password. On page 70 of Wikinomics; How Mass Collaboration Changes Everything (2006), authors Don Tapscott and Anthony Williams explain why people participate in voluntary production and building of collective websites such as Wikipedia. They claim that the people who are peer producers love participating and feel a sense of pleasure at doing it. Most are also involved professionally in some aspect of their voluntary participation. ICIM has failed to make electronic participation a pleasurable, easy experience for our members.
One exception to this was a project where I wanted to define our specialties as a group. I tried sending out a blanket email and got no response. I tried giving individuals a paper with lines and one word on it, encouraging them to write a definition with no response. Finally, when I was processing membership information and I noticed that a member had a specific specialty, I sent that member a personal email asking for a bite sized definition of his/her specific specialty. I got almost 100% response. Here is a link to view this special page, the only place on our website that has a participatory flavor:http://www.icimed.com/specialty_list.php
Some of the most effective aspects of our website are the bots that find a practitioner based on a person’s zip code, searching in a complete circle around the target area (http://www.icimed.com/member_search.php). The public are looking for alternatives in medicine, and our website is recommended in several popular health newsletters as a place to do just that. This service seems very personalized; the public can even search according to specializations, however, just as described in The Social Life of Information on p. 46 (2002, Brown and Duguid), that is somewhat misleading. There is nothing personal about our bots and they are only as good as the information we feed them, which is not always updated. Though we are a small group and I put a lot of effort into data entry, the public still has higher hopes than web that is a “vast, disorderly and very fast-changing information repository with enormous quantities of overlapping and duplicate information…all its catalogues are incomplete and out of date” (p.44).
In conclusion, I would say that ICIM is in its infancy in using electronic networks effectively. Next week I will enjoy giving some vision for what our networks could be like, but for now, I will end with one small point. When the doctor I described at the beginning of this paper clicks “return” and chats with me in a friendly email, we may be engaging in one of the most powerful potential forces of IT; the old fashioned social aspect of organizations that has held us together from the beginning of time (2002, The Social Life of Information, Brown and Duguid, p. 103)
References:
The Social Life of Information:
http://www.amazon.com/gp/reader/1578517087/ref=sib_dp_pt/002-7900473-2055206#reader-link
Wikinomics: How Mass Collaboration Changes Everything:
http://www.amazon.com/gp/product/images/1591841380/sr=1-1/qid=1173621335/ref=dp_image_0/002-7900473-2055206?ie=UTF8&n=283155&s=books&qid=1173621335&sr=1-1

Fully Engaging Technology; A Web Networking Proposal for ICIM

As I answer the phone for the International College of Integrative Medicine, I am often asked if we are a college where people come to study. We do not have a physical campus, a consistent student body, or a degree-granting academic program. However, I reply that we are indeed a kind of “college;” we are an association of medical practitioners who come together to learn, teach, and share knowledge in a supportive community. Without bricks and mortar to contain and locate this college, our main portal and hub is our website. This is where the public finds us; this is where our members come to participate. Though we meet in person twice yearly, our email and telecommunications provide the bulk of our interactions. Already we rely on technology to help us associate closely with each other. How can we develop by fully engaged the smorgasbord of technological potential available to us?

To guide my answer, I will use the model of a college campus, echoing Adam Greenfield’s assertion that in the next few years, computers’ “processing power [will be] so distributed throughout the environment that computers per se effectively disappear (p.1). As we envision ICIM’s website home, we need to assume that it will be able to exude the atmosphere and emotional resonance of a college campus, with the logistics of technological information secondary to the natural thought process of a college community.

We have made great strides in building an engaging website over the last two years. To continue that growth, I would like to think about web networking using four themes: Finding, Staying, Participating, and Reaching Out.

Finding

Currently, a Google search for “integrative” medicine does not even bring up our website http://www.icimed.com/. We have been offered the use of a portal to help us register on search engines by Empowered Doctor, an essential first step if we are to take the resource of the web network seriously. As a smaller, but also important step, we are beginning a campaign of asking likeminded groups, our members, and our corporate sponsors and friends to link to our site, consciously building the web of links that will draw search engines our way.

Staying
Once the public finds our site, we can see by our web stats that many spend very little time on it. Currently, the sidebar choices we offer are: Home, Find a Practitioner, Doctor of the Month, Conferences, Corporate Sponsors, Marketplace, Classified Ads, ICIM Forum, ICIM E-Journal, Specialty List, Library, Links, Board, Members Only, and Member Application. Some of these can be developed to be more engaging, interactive, or useful, and more can be added to make our site a memorable destination. In the next year, we intend to add or re-design the homepage, a multi-media page, Politician of the Month,, Library, and Marketplace.

Our campus commons, or homepage could be made beautiful and intriguing, rather than utilitarian in style. Friendly images of doctors taking care of patients could fade from one to another with original music that we sell our our Marketplace page. This kind of welcome is necessary to prepare the way and open the heart for the learning and interaction that is to follow.

We have a wealth of video lectures and radio shows recorded by our members that we must display prominently on our website, making us multi-media. This provides our “campus” with those winding pathways that help us encounter people we might have otherwise missed. Internally, our links to each other will be enhanced, but we can also use this raw material as YouTube data and Empowered Doctor’s medical news story releases, for the benefit of raising the profile of integrative medicine.

A new page of the site is in the works; “Politician of the Month,” where we will encourage and post comments on these profiles of professional politicians who make integrative medicine part of their platform.

Of course, every college needs a library at its center, and our “library” page needs to be expanded to include the full texts of donated books written by members. We need to develop a FAQ page with an automatic range of answers, reflecting the fact that we have diverse opinions on some issues, and giving the basic information about ICIM. As part of our library, we must make our collection of articles, power points and newsletters available to the public in a searchable way.

Some of our members have written books that are for sale on our Marketplace page, and we can quickly expand this section by making automatic links to Amazon.com for these resources rather than typing and scanning all the information ourselves. By becoming an affiliate for Amazon, our organization can get a cut from every book sold that we recommended. We can also include links to movie trailers like Lorenzo’s Oil and The Tomato Effect that portray issues struggle for integrative medicine on an emotional level (don’t forget the fine tradition of a college campus bonding over an art or international film series).

Participating

Making our website a place where people want to linger and stay is an important goal. Allowing the people to participate in the creation of the site can save hours of administrative time as well as add even more valuable data with a prosumer flavor.

Our professor’s “offices” will exist in the form of email and website links to board members and guest speakers we hire for conferences, making them thoroughly accessible for questions from member-students before and after their lectures with us. The word college implies knowledge, that we are an organization that exists to share knowledge about the latest scientific findings in integrative medicine. If our website is a static data base, it will hold much information, but The Social Life of Information reminds us on p. 119 that “first, knowledge (as opposed to information) usually entails a knower.” There are people, teachers behind all that information on the website, and we need to make the human connection tangible to our member/students. It is this engagement that causes learning and breeds knowledge. On a very practical level, it is also this kind of engagement that will keep our members and public coming back to our site and in the long run, keep our group alive.

There are interesting features our webmaster has already built in our campus landscape that are special and hard to find elsewhere. “Find a practitioner” search by zip code is one. Another is a list where members have each defined one of the integrative medical specialties they do. To fully make use of modern technology, members should be able to add or change these definitions at will.

Every campus needs a stadium full of students, and our membership could be more engaged and more easily sustained with an automatic PayPal payment for all yearly fees and conference registrations. I’d like to see an email go out yearly to the physicians, letting them review their membership listing, email me revisions, and pay with the click of a button. We need to find a way to take credit cards or PayPal over the web to make these processes realistic. We need to create templates for online registration for conferences, as well as exhibitor registrations online that are self-serve. Once someone registers, they should be sent a packet of information automatically. This feature could save hours of individual calls and emails asking for clarification of conference information.

Reaching Out

One of the main reasons we have a website is to do outreach. It is time for us to think of outreach as something beyond just our site. It is time for ICIM to become a member of the worldwide web community and begin to participate in the wider forums of web discussion and discovery. College campuses have the same challenge.

Now that we have the ICIM Forum for discussion on our website, we need to make sure we use it! Our board president is the moderator and will be first in line to answer questions that arise. As the Executive Director, I will be monitoring the forum to insure only legitimate sounding students and doctors are posting. Most importantly, we need to recruit medical students to make sure discussions get started and so that others know that the venue is available. One of the best ways to do this is to make sure our forum is linked from the American Medical Student Association, one of the organizations with which we have a good working relationship.

Our webmaster has built the forum so that when someone signs in to leave a comment, they are automatically added to an email list. We use the mass email feature of our website to send out a monthly E-Journal with reminders and links to articles that have commentaries from some of the medical students involved with ICIM. We can now add the extra emails from our forum visitors and have a way to keep in touch with them. Our E-Journals will be listed on the public side of the website, so that they can be browsed by anyone who visits our “campus.” These E-Journals are also meant to be messages to the outside world from ICIM. We need to find ways to widen our audience.

Another important and easy way ICIM could reach out is by putting any videos of our members out on YouTube. We have already started participating in Wikipeadia, with a definition of ourselves. The next step is to appoint several Web Network Research Ambassadors from our website committee to continue expanding our Wikipeadia submissions, purposeful blog sites about our organization, and searching for ideagoras where our research could be put to use and more widely seen.

Conclusion

This vision for the ICIM website may take a while to come to fruition. Most certainly, it is a vision that will constantly change and be adapted as new technology and resources quickly become available. Our current budget for website maintenance is not adequate to include website development, and we need to look at a major expansion of that budget item in later years if the board agrees that our web presence is indeed the essence of where ICIM lives in society. We are expecting approximately $10,000 in corporate sponsor revenue in the next few months, and I propose that we use some of these monies to invest in website development before the year’s end. Our priority is learning, and we can take our cues from institutions of learning, and become a college in more than name only. Beyond bricks and mortar, we have the building blocks of knowledge, dedicated “knoweres” to communicate it, and our website is the best way to make these available to the world.