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ACAM Annual Meeting CANCELED Due to Hurricanes Irma & Jose

Posted By Administration, Friday, September 8, 2017
Updated: Friday, September 15, 2017

Thank you for your patience with ACAM and AAPMD as we work through this trying time of natural catastrophes Hurricane Irma and the impending Hurricane Jose. At this time we can officially say that the ACAM 2017 Annual Meeting and the AAPMD 2017 Airway Summit have been cancelled.

As our first concern is with the safety of our members, valued partners and esteemed faculty we cannot in good conscious ask any of you to board an airplane as flight interruptions look like they may last for several days.  In addition to flight interruptions, we believe there is reason for concern due to the questionable infrastructure within Puerto Rico, including Government warnings of an increased risk of Zika spread due to flooding, the very public knowledge of their currently overstressed load on energy, as well as the load on their hospitals from neighboring islands who've faced catastrophic loss. All of this warrants the cancellation.

ACAM and AAPMD leaders were on a call early this morning with the claims adjuster assigned to us via our event insurance company.  We have notified them officially that we will be seeking a claim for our meetings and have been advised of the next steps required for documentation. This process will be underway over the next weeks and we'll ask for your patience in seeking refunds on registration or exhibiting monies as we work through the required submission materials.  We will also be legally notifying the headquarter hotel, The Condado Plaza Hilton, of our cancellation and request that our Impossibility Clause be recognized, so they may honor the return of hotel deposits and waive the nonrefundable hotel charges within their normal 30 day cancellation penalty period. There will be no rescheduling of these 2017 meetings, as our organizations are already committed to contracts for the 2018 meetings. 

There is no need to contact ACAM or AAPMD to cancel your registration as our notification to the hotel and our registration company will effectively cancel you, provided you booked your hotel through A Meeting by Design, our authorized Housing and Meeting Management company. If you booked your hotel through other sources, you will need to cancel these yourself, as we have no control over their policies or regulations. You will need to work directly through your airline to facilitate a re schedule or obtain credit for your airline tickets according to their policies.

ACAM leadership sends their hopes and prayers to all those at home and abroad who have been affected by Hurricane Irma and to all those who are still in harms way. Please be safe and take good care of yourself and your loved ones. 

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The Next Big CAM Battle is Here and It's Ugly

Posted By Richard Jaffe, Esq., Thursday, March 16, 2017
Updated: Thursday, March 23, 2017

CAM or integrative medicine doctors have had their problems with the state medical boards. And CAM organizations have had their run-ins with governmental agencies. However, the groups have always survived in large part because they have had a steady income from membership dues and from their annual conferences, where their members learn the latest and greatest from their thought leaders. But the CAM organizations’ income stream is now in jeopardy, and thus so is their existence, based on what looks to be well-planned, systematic effort to put CAM groups out of business, and stop the dissemination information about CAM therapies.


Here is what’s going on

For months, at least two CAM groups have been under review/ investigation by the primary private CME accrediting company, the ACCME (Accreditation Counsel for Continuing Medical Education). Recently, the ACCME has determined that a significant portion of the groups’ prior year’s CME courses does not meet various ACCME standards. ACCME is demanding that everyone involved in these courses be informed that:

“they were presented invalid information….”

and that the groups:

“instruct them [everyone] to avoid making any clinical decisions for testing and/or treatment based on what was presented, and
direct the registrants to accurate and valid sources of information for the problems or systems presented.”

I should point out that this “incorrect” information came from some of the most accomplished, respected and published thought leaders/teachers in the CAM community. These folks have been giving CME courses without incident for decades.

Further, in terms of future CME courses at their conferences, ACCME has informed these groups – and this is the key to understand what this is all about – that:

“recommendations involving clinical medicine must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients and all patient care recommendations must conform to evidence emanating from guidelines and data that meet generally accepted standards of experimental design, data collection, and analysis.”

In short, ACCME is trying to require these groups to only teach mainstream medicine! This is crazy and a huge deal!

Furthermore, the effect on the members of these organizations who attended the conferences last year and who used these courses to satisfy their state CME requirements is unclear.

I am not familiar with ACCME’s inner workings or guidelines, but it doesn’t seem out of the question that ACCME could contact state boards about these groups’ “noncompliance” and the retroactive withdrawal of CME credits. That could cause the state boards to retroactively hold the doctors non-CME compliant. I’m not saying that this will happen, but only that it’s a possibility. But I am saying that if the idea is to delegitimize CAM and cause problems for its practitioners, notifying the state boards would certainly advance that goal.

A specialty interest group also gets the same treatment

Beyond these two professional groups, a disease based group has recently been informed that its CME status for future conferences has been rescinded by its CME intermediary. The intermediary denies that it received any pressure or orders from ACCME.

Three CAM groups which have previously received ACCME course certification without any undue problems who in the last few months have had their prior CME course approval rescinded and/or their future CME approval withdrawn or placed in serious doubt.
Is this all a coincidence? Not a chance in hell.

My guess is that more of the same has or is going to happen to other CAM groups.

What to do?

At this stage, these groups need information about what’s behind this campaign to deny CME credit and delegitimize CAM teachings.

We need to get the word out to the CAM community.

Someone out there has to know something or know someone who knows something about how this came about, and who or what group is behind it. (My guess is that ACCME is the vehicle not the originator.)

I think there is a smoking gun out there, and if we find it, we can probably reverse ACCME’s decision quickly, so my suggestion is that all the CAM groups and interested parties get the word out to search for the smoking gun.

But let’s dig in to this and see if there is anything else that can be done. A logical place to start is:

What exactly is the ACCME and what does it do?

I don’t have any special info on ACCME, but here is what it says about itself:

The ACCME was founded in 1981 in order to create a national accreditation system. It is the successor to the Liaison Committee on Continuing Medical Education and the American Medical Association’s Committee on Accreditation of Continuing Medical Education. The ACCME’s purpose is to oversee a voluntary, self-regulatory process for the accreditation of institutions that provide continuing medical education (CME) and develop rigorous standards to ensure that CME activities across the country are independent, free from commercial bias, based on valid content, and effective in meeting physicians’ learning and practice needs. The ACCME accreditation process is of, by, and for the profession of medicine.
The ACCME’s founding and current member organizations are the American Board of Medical Specialties, the American Hospital Association, the American Medical Association, the Association of American Medical Colleges, the Association for Hospital Medical Education, the Council of Medical Specialty Societies, and the Federation of State Medical Boards of the United States.
Throughout its history, the ACCME has been dedicated to maintaining a relevant and responsive accreditation system that supports CME as a strategic asset to US health care quality and safety initiatives.”

Very noble and reassuring, isn’t it?

Basically, it’s a bunch of health care trade associations, organizations in charge of medical education and specialization credentialing. (Ironically, the medical specialty societies are the reason it’s illegal for practitioners to advertise their CAM board certifications.) And last but not least is CAM’s long-time adversary, the Federation of State Medical Boards. So maybe not so reassuring.

Did you know that the ACCME is accountable to the Public? Yea, just ask them and they will tell you so.

Here is what it says about that:

“Accountability to the Public
The ACCME is accountable to the public for setting and maintaining accreditation requirements that are designed to ensure that CME accredited within the ACCME system is based on valid content, is free from commercial influence or bias, and contributes to the quality and safety of health care. As the US health care system continues to evolve, the ACCME will respond by making changes to its requirements or processes that are necessary to assure that CME serves the best interests of the public.

I’m still not clear exactly how it is accountable to the public, and nothing in its web site gives any further elucidation.

I do have a couple ideas of how it might actually be made accountable to the public.

Some basic facts

It’s obviously a matter of individual state law what type of courses a state medical board will accept as acceptable CME. The ACCME might be the primary CME credentialer, but it is not the only one. For example, here is the Texas law regarding CME accreditation: It’s Board Rule 166.2 and it requires:

(1) At least 24 credits every 24 months are to be from formal courses that are:
(A) designated for AMA/PRA Category 1 credit by a CME sponsor accredited by the Accreditation Council for Continuing Medical Education or a state medical society recognized by the Committee for Review and Recognition of the Accreditation Council for Continuing Medical Education;
(B) approved for prescribed credit by the American Academy of Family Physicians;
(C) designated for AOA Category 1-A credit required for osteopathic physicians by an accredited CME sponsor approved by the American Osteopathic Association;
(D) approved by the Texas Medical Association based on standards established by the AMA for its Physician’s Recognition Award; or
(E) approved by the board for medical ethics and/or professional responsibility courses only.”

Other states have similar types of CME rules. The bottom line is that ACCME is a very important source of state approved CME accreditation, especially for everyone other than the major national and state medical trade groups. But there’s another way of looking at it. Without a state accepting its accreditation, ACCME doesn’t have much of a purpose or job.

What About CAM laws?

Texas, California and some other states recognize the rights of patients to receive CAM therapies. Texas, for example, provides that:

“The purpose of this chapter [Texas Board Rule Chapter 200] is to recognize that physicians should be allowed a reasonable and responsible degree of latitude in the kinds of therapies they offer their patients. The Board also recognizes that patients have a right to seek complementary and alternative therapies.” (Board Rule 200.1)

What are CAM therapies in Texas?

“(1) Complementary and Alternative Medicine–Those health care methods of diagnosis, treatment, or interventions that are not acknowledged to be conventional but that may be offered by some licensed physicians in addition to, or as an alternative to, conventional medicine, and that provide a reasonable potential for therapeutic gain in a patient’s medical condition and that are not reasonably outweighed by the risk of such methods.”

Convention medicine is defined as “Those health care methods of diagnosis, treatment, or interventions that are offered by most licensed physicians as generally accepted methods of routine practice, based upon medical training, experience and review of the peer reviewed scientific literature.”
(California has a similar definition of CAM at B&C code 2234.1)

So, Texas gives practitioners the right to provide non-conventional, not generally accepted therapies to patients, and patients have the right to receive these CAM or non-conventional therapies.

But even though Texas docs can provide CAM or non-standard therapies to Texas patients, ACCME now takes the position that Texas physicians can’t obtain CME credit for learning about these Texas sanctioned treatments. How can the ACCME be acting consistent with Texas law by its insistence that CAM medical groups can only teach:

“recommendations involving clinical medicine must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients and all patient care recommendations must conform to evidence emanating from guidelines and data that meet generally accepted standards of experimental design, data collection, and analysis.”

My view is that ACCME’s position is inconsistent, if not in violation of the Texas CAM Rule (and the California CAM statute) and probably every other state that has a CAM law.

So, what to do?

Complain to ACCME? Won’t hurt, but it won’t help. It’s doing what it’s doing intentionally, and some external pressure has to be brought forth.

Complain to the boards? Maybe, but it would take a lot of complaints.

In all the big CAM states like Texas and California, I know there are legislators who are pro CAM. My suggestion would be to identify who they are (not hard in Texas). I think the boards in a few of these states need to hear from some legislators about how ACCME is undercutting board rules (in Texas) or the CAM statutes (like in California).

These legislators should copy ACCME on their concerns expressed to the boards. If one of them is on a legislative health committee, even better. Better still would be for a couple states to start an investigation on ACCME’s motives. Maybe even an invitation to appear at a specially called hearing. Legislators can hold hearings for all kinds of reasons. So can federal legislators. I think with all the politically connected CAM docs out there, mulitipled by their politically connected patients, well I think there’s a heap of trouble that could be stirred up for ACCME.

It doesn’t have to happen in every state, or even many states, just a couple of the big ones. The story is going to get out, and questions are going to be raised. The widespread dissemination of ACCME’s action might even turn-up that smoking gun I mentioned earlier. And once the nefarious motive and scope of the conspiracy publicly surfaces, I think ACCME will be forced to rescind its actions. So, we need to shine some light on these jokers.

This could all happen pretty quickly if there’s a big enough outreach to the CAM community.

Something to think about anyway.

Rick Jaffe, Esq.


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ACAM Welcomes 19 New Members in February

Posted By Administration, Wednesday, March 1, 2017
Updated: Wednesday, March 29, 2017

Please take a moment to recognize and welcome the new members to our ACAM community!

Ahsan Abdulghani, MD
Turnersville, NJ
  Jeb Andrews, PhD, PA-C
Monroe, LA
  Michael Bartiss, MD
Manahawkin, NJ
Scott Berk, MD
Hampton, NJ
James Biddle, MD
Asheville, NC
Jean Evans, DDS
Groton, MA
Candice Gaitanis, MSN, CFNP
Queen Creek, AZ
Martin Galy, MBBCH
London, United Kingdom
Ahmed Haffejie, MBBCH
Midrand, South Africa
James Halper, MD
New York, NY
Doohi Lee, MD
Plano, TX
Darren Lynch, MD
Northampton, MA
Chaula Patel, MD
Bronx, NY
Norma J Roche, MD
Homestead, FL
Gerardo Rojas, MD, FACP
Orlando, FL
David Sheridan, MD
Katy, TX
Kevin Weiss, MD
New York, NY
Valeska Wells, DO
Houston, TX
Kimberly Williford, MS, NMD
Atlanta, GA


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2017 Annual Meeting Registration Now Open

Posted By Administration, Monday, February 27, 2017
Updated: Wednesday, March 29, 2017  |  Welcome  |  Register  |  Schedule  |  Speakers  |  CME  |  Hotel  |  Activities  |  Supporters

(until June 7)

ACAM Member: $745
Premier: Included
ACAM Scholar: $295
Non Member: $929
Non Professional: $799
(until August 5)

ACAM Member: $815
Premier: Included
ACAM Scholar: $295
Non Member: $1029
Non Professional: $849
(until September 9)

ACAM Member: $885
Premier: Included
ACAM Scholar: $295
Non Member: $1089
Non Professional: $879
(begins September 14)

ACAM Member: $935
Premier: Included
ACAM Scholar: $295
Non Member: $1149
Non Professional: $949
This professional continuing education activity was sponsored by the Institute for the Advancement of Human Behavior (IAHB), PO BOX 5710 Santa Rosa, CA 95402, whose continuing education program has been approved by the organizations listed below, and jointly sponsored by ACAM. Except where otherwise noted, IAHB, as the approved sponsor, maintains responsibility for the program.

PHYSICIANS: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of IAHB and ACAM. IAHB is accredited by the ACCME to provide continuing medical education for physicians. IAHB designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™ per hour attended. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Learn Critical Updates and Application in Functional Medicine this September in San Juan, Puerto Rico at ACAM's annual meeting, held in conjunction once again with AAPMD's annual meeting. The annual meeting will be held at the Condado Plaza Hilton, will teach amateur and veteran integrative medicine practitioners alike an array of new information. Pre-conference optional workshops will be held Wednesday, September 13 and Thursday, September 14; a post-conference optional workshop will be held Sunday, September 17. 

  • promote and share knowledge to reduce human and societal toll from neurodegenerative and inflammatory disorders, cancer and infectious diseases;
  • advance understanding of the stress impact of chronic infectious diseases on metabolic, hormonal, and neurochemical communications networks;
  • advance understanding of the impact of oral pathology and sleep disorders on immune and hormone systems and its impact on chronic degenerative diseases; and
  • enhance care of adults with Alzheimer's Disease, as well as children with Autism, based on sound scientific evidence
Similar to the 2016 annual meeting, ACAM has joined forces with AAPMD to provide an integrative look at both medicine and dentistry. Please join us as we work together to create intelligent healthcare practices and disseminate collaborative information to patients. Even the most cutting edge practitioner will benefit from collaborating with practitioners in other genres of medicine!



Find inspiration in every direction at The Condado Plaza Hilton. As the only hotel in San Juan with views of the Atla  ntic Ocean and Condado Lagoon, The Condado invites you to discover this magical island from a truly unique vantage point. Book your room during registration to ensure conference rate pricing!
Upon arrival, the chic, stylish design greets you with a sense of casual elegance, and panoramic water views and ocean breezes embrace you in tranquility. It is a short, scenic stroll to the beaches and fashionable shopping and nightlife of Condado and five minutes to the colonial charms of Old San Juan, but don't be surprised to find yourself drawn in by the many pleasures of this urban resort. From award-winning fine dining at Pikayo, the flagship restaurant of acclaimed Puerto Rican Chef Wilo Benet to a tucked away beach and exhilarating water sports, capped off with four oasis-style pools, including the only saltwater pool in Puerto Rico.   

TAX (9%)
King or 2 Double
1-2 people
King or 2 Double
3 People
King or 2 Double
4 People
Jr. Suite
1-2 People
Jr. Suite
3 People
Jr. Suite
4 People
SAVE 25% off the 2016 Conference Recordings when you register for ACAM2017 in San Juan, Puerto Rico - registration site opens the end of February!

Since 1973 ACAM has been the leading educator for Integrative Healthcare Professionals. With the purchase of our 2016 conference recordings, you'll learn important updates and gain new techniques while listening to our renowned faculty as they address the escalating problem of chronic conditions facing today's patients. 
The 2016 conference focused on three key areas for advanced integrative approaches including:
  • Cancer Care Prevention
  • Brain Fitness & Dementia Prevention
  • Prevention/Reversal of Heart Disease & Hypertension
Registration site opens February 27, 2017. Once registered you will receive a promo code for the recordings.

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UHN Recognizes ACAM as leader in chelation training

Posted By Administration, Monday, February 20, 2017
Updated: Wednesday, March 29, 2017

Excessive toxic metal exposure from the air, food, water, dental amalgams, and other sources is becoming a recognized and established underlying cause of both acute and chronic disease. With ongoing medical research validating the link between chronic diseases like heart disease and environmental exposure to toxic metals, it is more important than ever for doctors and patients to be well-informed about the detrimental effects of toxic metals and the potential treatments for heavy metal toxicity, including IV chelation therapy.

What is chelation?

The Greek word “chele” means claw. Chelation is the binding of metals (like lead) or minerals (like calcium) to a protein “chelator” in a pincer-like fashion, forming a ring-like structure. Chelation is an important treatment protocol for the removal of toxic metals such as lead and mercury from the body’s bloodstream and tissues. Natural chelation, although weak, regularly occurs from eating certain foods such as onions and garlic. A stronger chelation effect can be induced when certain supplements, such as some amino acids, are taken orally. The strongest chelation effect is achieved with intravenous chelation. 


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ACAM Welcomes 9 New Members in January!

Posted By Administration, Wednesday, February 1, 2017
Updated: Wednesday, March 29, 2017

Please take a moment to recognize and welcome the new members to our ACAM community!

Charles C. Adams, MD
Ringgold, GA
  Jorge Bordenave, MD, FACP
Coral Gables, FL
Michelle Carrillo-Massa, MD
Jupiter, FL
Deborah Dykema, DO
Phoenix, AZ
Kristin Kalmbacher, MD, MPH
Fairhope, AL
Jane Marke, MD
New York, NY
Christa O'Leary, DO
Fredericksburg, TX
James H. Schrenker, MD
Bristol, TN
Nisha Chellam Vedamuthu, MD
Novi, MI


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ACAM Membership Auto-Renew Policy (ARP) Now Instated

Posted By Administration, Sunday, January 1, 2017
Updated: Wednesday, March 29, 2017

Approved at the September Annual meeting by the Board of Directors, ACAM membership auto-renew will begin as of January 1, 2017. This Auto Renew Policy (ARP) has been established to help our members save time and ensure their membership continues automatically. Many of our members believed an ARP was already established - as of January 1st all ACAM members will be enrolled in the ARP, which will allow memberships to automatically renew each year upon renewal notice or joining. ACAM will do the rest!

Have questions about the ARP? Don't want to be enrolled automatically? Please CLICK HERE for a more detailed information on ACAM's ARP and frequently asked questions.  

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ACTION ALERT: Your supplements pulled from shelves

Posted By Alliance for Natural Health, Thursday, December 29, 2016

Senator Claire McCaskill is pressuring the FDA to complete unnecessary and dangerous anti-supplement policies before the new administration takes office in the New Year. Unless you take action now and support our emergency campaign, the FDA could eliminate tens of thousands of supplements from the market [1].

ANH-USA is the largest and most successful grassroots consumer advocacy organization fighting for natural health. We’ve protected lifesaving supplements for over 20 years. But we are dependent on our members to support our work as a non-profit and we need your help­. We must reach our goal to fight the FDA!

$39,227 of $75,000

An anonymous donor has recognized the importance of this threat and has generously offered to match every dollar we can raise before December 31st to double your impact. Make your voices heard on Capital Hill during this pivotal time and please donate today!

We can’t let the FDA complete these anti-supplement policy guides before the inauguration! 
Please make your 100% tax-deductible gift before December 31!


It's because of you, our supporters, that we've successfully stood up to the FDA’s blatant attacks on supplements over the years. We offer our profound thanks for your commitment to the fight for natural health, in the past and in the fights yet to come!

In health and wellness,

Emily Porter dig signature

Emily Porter
Alliance for Natural Health - Membership Director 


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Certify in Chelation Therapy - Save 20% if purchased by 12/31/2016

Posted By Administration, Tuesday, December 13, 2016
Updated: Wednesday, December 28, 2016
STEP 1: Basic Chelation Webinar Series
The BASIC CHELATION WEBINAR SERIES is the pre-requisite required to continue training with the Practicum and Certification. This series is 10 hours of training from experts including Tony Lamas, MD, Dorothy Merritt, MD, David Quig, PhD, Walter Crinnion, ND, and Jeffrey Morrison, MD. 
Offer Expires 12/31/2016. Use code CAPWEB to receive 20% off. Discount taken at check out. 
with ACAM'S Exclusive & Nationally Recognized Chelation Course
APRIL 22 - 23, 2017 | Dallas/Fort Worth Airport Marriott 
Whether you're new to detoxification education or are a seasoned practitioner, the American College for Advancement in Medicine's rigorous training will enhance your practice's treatment options and improve health outcomes. One step cannot be completed without the other - this is a sequential course to provide the most in depth chelation training available to date.
As the recognized leader in heavy metal detoxification/chelation therapy education, ACAM works diligently to ensure our curriculum is robust, relevant and of the highest caliber. Our Chelation  Advanced Providers (CAP) Course & Certification covers a broad spectrum of detoxification topics from biochemistry to billing. Our faculty ensure scientific rigor, complete understanding and safe, practical application of therapy to maximize health worldwide.

MD, DO, ND, NP, and any integrative practitioner allowed by their state to practice chelation will benefit from this comprehensive training led by ACAM's expert faculty.
1. Basic Chelation Webinar Series $485/$585*
2. Workshop/Practicum + 
3. Chelation Exam/Certification
*member pricing varies from nonmember 
Basic Chelation Webinar Series (step 1): Available online now - take at your own pace
Spring Course (steps 2 & 3):
April 22-23, 2017 at the Dallas/Fort Worth Airport Marriott
Fall Course (steps 2 & 3): September 2017 in San Juan, Puerto Rico - More information TBA

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ACAM2016 Conference Recordings Now Available

Posted By Administration, Thursday, December 8, 2016
Updated: Wednesday, December 28, 2016


Since 1973 ACAM has been the leading educator for Integrative Healthcare Professionals. Today, with the purchase of our 2016 conference recordings, we invite you learn important updates and gain new techniques when listening to our renowned faculty as they address the escalating problem of chronic conditions facing today's patients. 

The 2016 conference focused on three key areas for advanced integrative approaches including:
Cancer Care Prevention, Brain Fitness & Dementia Prevention, and Prevention/Reversal of Heart Disease & Hypertension.  

2016 ACAM Annual Meeting's Expert Speakers 


Chemosensitivity and Other 
Tests for Cancer: What's New?

Prevention & Screening
of Prostate Cancer

Integrative Strategies for 
Breast Cancer Prevention

A Master Modulator of Risk


Healing the Heart with Vibrational Medicine

Women and Heart Disease

Vitamin K2 Bone and Heart Health

Ultra-Personalized Nutrition
for Preventing Heart
Disease & Diabetes

Advanced Integrative
Dental Strategies for
Abundant Health

Metabolomics & Biomarkers for Prevention

Ketogenic Diet & Deuterium Depleted Water for Prevention and Treatment

Hydration and Brain Health

Disease, Prevention, & Neuroplasticity: A Mindful Way to Change Your Brain


Cancer Prevention
Ahvie Herskowitz, MD;
Isaac Eliaz, MD, MS;
Lyn Patrick, MD; and
Robert Thompson, MD

Cardiovascular Disease
Dennis Goodman, MD; Stephen Sinatra, MD;
Allen Green, MD; and
Howard Hindin, DDS 

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The American College for Advancement in Medicine (ACAM) is a not-for-profit organization dedicated to educating physicians and other health care professionals on the safe and effective application of integrative medicine.