The Cream Rises to the Top

By Carl Hangee-Bauer, ND, LAc
AANP President

Photo courtesy of psdGraphics.

In my daily practice life as well as my "political" life as AANP President, I am always on the lookout for trends and conditions in my communities, both local and national, that have effects on my practice and my profession. I came across some news recently that caught my eye and has had me thinking about its ramifications.

Along with being licensed as a naturopathic doctor here in California, I have also carried an acupuncture license since 1989 and have been a long time member of the American Association of Acupuncture and Oriental Medicine (AAAOM) as well as my state acupuncture association. Recently, the AAAOM published a study of the acupuncture profession that found, among other things, that despite the prevalent use of acupuncture in the United States, the demonstrated cost-savings and effectiveness of acupuncture treatment, and the wide reimbursement by third party payers, many licensed acupuncturists are finding it hard to make ends meet.

In John Week's Integrator Blog, he quotes Lisa Rohleder, LAc and co-founder of the Community Acupuncture Network, who concludes that "Acupuncture education, and the conventional acupuncture business model, ought to come with a warning label, the way cigarettes do: NOT SUSTAINABLE. May take years of your life and leave you with nothing, except huge student loans."

In short, licensed acupuncturists graduate and get licensed, but then struggle for years to pay off student loans and get paid appropriately for their education and skills.  Many encounter barriers in third party reimbursement.  Many fail.

Sound familiar?

As naturopathic physicians, many of us feel that one of the reasons it is hard to make a decent living is that many people out there just don't know what an ND is. But is that truly the case? It seems to me that most if not all people know something about acupuncture -- what it looks like, what it's good for (at least pain, anyway). And yet acupuncturists are dealing with some of the same frustrations and challenges that affect the naturopathic profession.

As I said before, this has given me much to think about, and I've come to some conclusions.

First, the good news: we are not alone. If LAcs are struggling with these issues, you can bet that it's affecting other "CAM" providers. We tend to think we are unique, but maybe not so much.

Next, knowing that these challenges exist, we can and must do better on all levels. Our colleges have to do a better job at preparing our graduates to enter the healthcare marketplace. The AANP has to be more active at developing programs and resources for our member physicians in order to help them excel in the business of naturopathic medicine. Our state organizations must help build awareness of our profession and, together with the AANP, "brand" naturopathic medicine as a desired choice for patients. The AANP and the states must work together better to strengthen laws and policies that allow access to naturopathic care via state and federal programs and remove the unfair barriers to naturopathic physicians in federal and state health programs. For example, did you know that while the Department of Education recognizes ND educational programs as on par with MD and DO training, we are still effectively shut out of loan repayment programs for our ND graduates? If this is not unfair, I don't know what is.

Our graduates (you) have to take the individual initiative to learn the elements of successful practice and focus on the business of our medicine as well as its practice. There are pages devoted to practice growth and success on the AANP website.  Log-in and then visit select "Practice Resource Library" after clicking on "Practice Tools."  There are several courses taught by successful NDs that will help new graduates learn the tools to be successful.  The resources are out there and we must take the responsibility to use them.

When I graduated from Bastyr in 1984, there were few choices for people entering the profession. One could go into a solo practice, perhaps join a small group practice, teach at one of the schools, or maybe work for a supplement company. Now I'm amazed at the choices graduates have, and I am particularly excited to see the increasing opportunities in integrative medical settings for us to take our place alongside our "mainstream" colleagues. I, for one, think our profession could do much more to prepare our graduates to enter these new medical settings.

I can tell you that, both individually and collectively, we are up for these challenges. "The cream rises to the top," it's said, and naturopathic medicine is the gold standard for people seeking new choices and new directions for their healthcare.

Why I Hate AANP Conferences

By Jacob Schor, ND, FABNO
2013 AANP Conference Speaker Selection Committee Chair

It’s such a relief that the AANP conference is over. I can finally stop pretending that I was looking forward to it. Or enjoying it!

Nothing personal. I enjoyed seeing many of you there in person, but honestly who among us would choose to spend a week hermetically sealed in an air conditioned hotel sitting in windowless lecture rooms? Are our schools graduating a new kind of naturopathic physician? Ones that like fancy hotels and that don’t need nature? If you take nature out of naturopathy, you don’t have much left.

I return home from AANP conferences dreading the arrival of our credit card bill; we spend more on a conference than we would ever consider for a vacation.

Why do we do these conferences? Because the MDs do, isn’t a good enough excuse. Because the AANP makes money off them? Well I’m not yet sure that the AANP breaks even. Because we need continuing education? That’s a joke these days as we can find all the CE we need online.

Most of the year my weekdays are spent sitting indoors at a desk with a changing array of patients sitting with me. The last thing I want to do when I take off time from work is sit somewhere else.

Why am I again chairing the conference speaker committee? It’s because like everyone in our profession I believe that the future can be better than the present—especially when it comes to our conferences. I think we can recreate our conferences and turn them into a different experience, an experience that is more congruent with whom we are both as people and a profession.

Next year is OUR chance to do it differently. As many of you already know, the conference is going to be held in Keystone Colorado in July, a week after the Fourth of July. This is a beautiful time of year to be in the Colorado Mountains. The wildflowers should be in bloom, most of the snow melted, and the mountain meadows moist and lush.

This is a location that you should be happy to visit, glad to come early to and stay on after the conference is over. In fact we are hoping to create excuses so that you do exactly that. We want you to bring your families. We want to meet those children of yours in person, not just look at their photos on your computer in the back of lecture rooms. In fact, I plan to bring my dog. We want to merge recreation with education and have you leave the conference rejuvenated. We have ambitious plans but can’t make them happen without all of you. We need your help.

This year’s Call for Abstracts is out. We need your creative ideas of things you can do, things you can teach, things that will further your colleagues’ knowledge and their ability to help patients. Submit these ideas as abstracts. Our good AANP president, Michael Cronin, has told me it is time we left behind the long marathon lectures of the past. He is eager to hear submissions that are shorter, particularly 30-minute lectures. Think short, sweet and if possible outdoors. Also think about long and slow lectures, the kind that you can stretch over an hour or two-hour hike. Maybe what you want to teach will only work with a small group of people. We will consider it! Perhaps you may get to repeat it a few times. Leave behind the old formats. We don’t have to repeat what was done in the past.

I may not be a big fan of our current conferences but I think we can make them a whole lot better. Let’s make this happen.

AANP's Greatest Hits, Volume 25

By Bill Benda, MD, FACEP, FAAEM

The pre-Gala reception at the AANP's 25th Anniversary Convention in Portland, Oregon. Photo by Daniel Atlas.

Well, time for another blog submission and mental search for inspiration and hopefully somewhat coherent dialogue. But this time I find the task quite easy, as I get to talk about a few of my favorite people in lieu of philosophy or politics.

This year’s Saturday AANP Gala in Portland was visibly different than those of prior years, notable for the recognition of both past presidents and past recipients of the Physician of the Year award – twice the stage was filled with these luminaries of naturopathic history. It is the organization’s 25th anniversary, after all. But time constraints also necessitated curtailing of the usual recognition of another batch of unsung heroes who have contributed immeasurable time and energy for the benefit of everyone reading this page – those AANP board members whose terms come to a close on December 31st. Given I did not get to stand and applaud for each at the Gala event, I’ve taken blog liberty to remedy this oversight. So without further ado, the envelopes please . . .

I’ll start with Lise Alschuler, as I get to save time by not having to list all of her quite visible achievements, challenges, and contributions as President-Elect, President, and Past-President of the AANP. What has been invisible and underappreciated by our membership is the fact that Lise carried this organization through its transition from what it was to what it is to become, much like a mother carries a pregnancy to term, and likely with the same feelings of unwieldiness and fatigue and “I’m ready to deliver this thing.” Carl Hangee-Bauer gets to birth this new baby, not a comfortable process in itself, but Lise was the lifeblood that ensured its healthy development in the womb.

Sara Thyr was shepherd to the flock of submissions, abstracts, speakers, scheduling, conflicts, and God knows what other machinations that are required to put on the annual conference each year. I personally have attended countless conferences of countless organizations over the years, and the AANP annual event has never had close competition as the premier event of the year, and Sara is the reason why. Plus she had the wisdom to move to the central coast of California.

Michelle Clark has been our Alliance chair and policy wonk, I believe, since she was born. For those of you who have engaged in the parallel universe of politics, her contributions will become clear once you contemplate the mishmash of licensed states and unlicensed states and state medical boards and legislative bodies and 15 different scopes of practice in 15 different jurisdictions and Boyd Landrys and health freedom movements all flavored with the occasional (OK, frequent) last minute disaster.

Which brings me to Tabby Parker, leaving the board after her first term to have her second child. As founder of Natural Doctors International, Tabby has chosen to spend her very lengthy days caring for the underserved on the island of Ometepe in Nicaragua, all the while hosting endless teams of naturopathic physicians and students trekking down to learn and serve alongside her. Tabby has been, for me, the heart and conscience of our board, and she will be missed deeply.

I am leaving the board as well, and I can say it is with mixed longing and relief that these four years are coming to a close. I’m more than certain that all five of us share these contradictory feelings. But as those of you who attended the Gala did not have adequate opportunity to see these people stand in recognition and hold the eternal-flame-recognizing-our-past-and-welcoming-our-future-before-the-band-starts-candles, I ask you to take a moment to silently thank Lise and Sara and Michelle and Tabby. Or better yet, drop them a line and thank them personally. Your lives, and your patients’ lives, are better for their service.

Hitting the Ground Running

By Carl Hangee-Bauer, ND, LAc
AANP President


Photo by aarmono via Flickr, used under the Creative Commons' License.

Greetings and Happy New Year/ New Decade! After the trials, tribulations and struggles of the first decade of the new millenium, I think we are all looking forward to 2010 and the coming years with optimism that better things lie ahead.

This is my first message to you as incoming President of the AANP. As I write this, we have already hit the ground running in 2010 as we prepare for the first Board meeting of the year taking place January 16-17th in San Francisco. Last month Dr. Lise Alschuler thanked our exiting Board members Dr. Chad Aschtgen, Dr. Vanessa Esteves, and Dr. Steven Bailey for their service to the AANP and to the profession. I echo her comments and add that they will be missed and their contributions are greatly appreciated.

For all of us, I want to thank Dr. Alschuler for her service as AANP President over the past two-years. Her steady hand, grasp of the complexities of the issues facing the AANP, inspiring words and ability to see the big picture and guide this organization are unsurpassed. Believe me, she's a very tough act to follow and is a role model for me as I begin my term. Thank you so much, Lise!
This is a time of turnover on the Board with newly elected members coming onboard for their 2-year terms. I want to take a few moments to welcome and introduce our new members.

Dr. Helen Healy joins the Board in her dual position as Chairperson of the House of Delegates. She is a long time leader in the naturopathic profession and her pioneering work in Minnesota led to the recognition of NDs in that state. I might add that Helen and I served together on the first Board of the AANP in 1986, both of us the new kids in the room in awe of Dr. Sensenig and the other leaders of the AANP. It will be great to work with her again.

Last year, the House of Delegates passed a bylaws change adding a representative from the American Association of Naturopathic Medical Colleges (AANMC) to the AANP Board of Directors. Dr. Guru Sandesh Khalsa, Dean of the naturopathic program at Bridgeport University, joins the board in this capacity.

Dr. Corey Resnick, a past Treasurer of the AANP, rejoins the board as our newly elected Treasurer, bringing his past AANP experience as well as his proven business savvy to this position.

Dr. Michael Reece, past president of the Pennsylvania Association of Naturopathic Physicians, brings his years of experience and leadership to the AANP Board. Besides his impeccable naturopathic credentials, you may know Michael for his skills on the drums at our convention dances.

Dr. Trevor Holly Cates is also joining the board in 2010. Dr. Cates is the first woman in California to receive a license as a Naturopathic Doctor and was appointed by Governor Schwarzenegger to the Bureau of Naturopathic Medicine Advisory Council.

We round out our list of new members with Dr. Kasra Pournadeali. He is a past president of the Washington Association of Naturopathic Physicians, and an appointed board member for the Washington State Medical Association (WSMA)-accredited Foundation for Care Management.

All told, the AANP Board consists of 13 members. As you can see, almost half of the board consists of new members, joining myself and Dr. Alschuler, Dr. Michael Cronin, Dr. Tabatha Parker, Dr. Sara Thyr, Dr. Bill Benda and Dr, Michelle Clark. All of these Board members bring a great deal of experience and leadership to the AANP and will help this organization meet its goals now and in the future.

In the coming months, one of my goals is to keep you informed of the work the AANP is doing and and the issues we are facing, both as an organization and as a profession. 2010 promises to be an exciting and challenging year. As most of you know, the AANP is celebrating its 25th anniversary this year and we are already planning for the convention in Portland in August. This is a convention not to be missed as we look back on the first 25 years of the AANP and forward to the future.

Externally, as health care reform takes shape in Washington, we will be watching as well as educating legislators and staff so naturopathic medicine is represented and more people will have access to naturopathic care. President Obama promised change and we are going to get it; the challenge is guiding this change to improve the health of all Americans. Naturopathic medicine is an important piece of true health care reform, and our board and staff are working diligently on this issue.

Lastly, I want to remind you that the AANP is a member-driven organization. The membership elects its leaders to represent them and our common interests. From the perspective of the Board, you are our bosses. Everything we do we do in the interest of furthering our common goals, helping NDs be more successful and advancing the naturopathic profession. One of the basic goals of the AANP is best expressed in what we call our "Global End Statement: "People will experience optimal health and wellness through the principles and practices of naturopathic medicine, and actions towards this End will not exceed the operating budget of the Association."

Give us your feedback. Tell us your goals and dreams. Let us know what we're doing right and where we could improve. Make sure your voice is heard.

Till next month,

Carl Hangee-Bauer, ND, LAc
AANP President

2012: Be here now.

By Michael Cronin, ND
AANP President 

I invite you to ‘take a deep breath’ and appreciate our Naturopathic profession for a moment with me. We are a relatively small profession with strong institutions and deep roots, we have: nearly 4,000 ND licenses in the U.S., five U.S. colleges, legal recognition in 16 states (plus D.C., Puerto Rico and The U.S. Virgin Islands) and full scope in eight of those states. Meanwhile, the profession in Canada includes another nearly 2,000 NDs and an international Naturopathic community is taking form in India, England, Australia and New Zealand. Our community in America is growing and we have a distinct professional identity.

As people recognize that they must take more personal responsibility for their health, they will come to understand the advantages of our medicine. Our patients appreciate our expertise and clinical work: our doctors are in demand with successful practices and innovative approaches. There is a growing body of work that supports the methods we use and we are working to increase the amount of evidence of ND effectiveness.

It is essential to build a stronger and more effective professional community in 2012 in order to license new states, expand laws to full scope, improve how we educate the public, manage our media affairs and recruit patients for our members.

In the area of government affairs, an urgent and immediate opportunity for the AANP is the Affordable Care Act (ACA), which was signed into law last year. The inclusion of the term “licensed CAM (Complementary and Alternative Medicine) provider and integrative health practitioner” could be a game-changer for our profession as well as our patients, if NDs are included in the pending rulemaking process. Short of having NDs specifically mentioned, we believe there may be opportunity to ensure against insurance caps on CAM services. It is my belief that the Obama Administration, despite this being an election year, is working to determine the rules and regulations surrounding the implementation of the ACA.

I note, however, there is a legal challenge to the ACA by 26 states that will be heard by the United States Supreme Court. This suitchallenges the mandate that every person not covered by a government or corporate policy must purchase private health insurance. Once the Justices make a ruling on whether the mandate is constitutional, the issue of severability remains a question. However, it is possible the other sections and definitions of the ACA will stand.

The most important component of the ACA may be section 2706 on non-discrimination, which is planned to go into effect January 1, 2014:

Providers - A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law.

There are other sections of law that recognize “licensed complementary and alternative practitioners and integrative health providers” and their involvement in (1) community health teams (2) national prevention, health promotion and public health council (3) the national health care workforce commission, (4) patient centered outcomes research, and (5) demonstration projects concerning individualized wellness plans. For a summary of the components of the Affordable Care Act, take a look at this guide at theintegratorblog.com

Outside the ACA, the AANP’s Government Affairs strategy includes seeking ND eligibility for tuition forgiveness in rural health care and recognition of NDs within the Veterans Administration or Department of Defense.

2012 brings challenges we plan to use as opportunities. I encourage all NDs to be involved with your state associations and the AANP. I invite you all to join our DC Federal Legislative Initiative (DC FLI) on May 5-7, 2012 to engage with the Federal legislative process so we as a community shape our future.

My Final Message as AANP President

By Lise Alschuler, ND, FABNO
AANP President
Vice President, Quality and Education, Emerson Ecologics


Photo by Dare*2*Dream via flickr, used under the Creative Commons License.

This is my last message as President of the AANP. Thank you for giving me the opportunity to share my ramblings with you in this venue over the past two years. As my last one, I am taking some liberty and exceeding my word limit just a bit. I have a lot of gratitude to share. As I sit here reflecting upon my time as President, I feel good. We have done a lot! Despite the turmoil of the past many months in our economy, our globe citizenry, and our national health, the AANP has thrived. Naturopathic medicine is more visible in proposed Federal legislation, we have a multi-series documentary on naturopathic medicine and an intricate PR campaign about to launch around it, we have a stellar on-line journal, we have more and deeper alliances with other professional and trade associations. The AANP is actively advancing its mission, has added new members, and has expanded its corporate support. The AANP has matured into a governance model which facilitates visionary leadership. So, as my tenure as President of the AANP draws to a close, I am filled with gratitude and optimism. Let me dwell on these for a moment…

I am grateful for many, many things. I am grateful for the incredible integrity and intelligence of my fellow Board members. The AANP Board has thoughtfully and gracefully transformed itself into a Governance Board. This model has allowed the visioning and leadership activities of the Board to blossom. I am also grateful for the exceptional dedication, passion and talent of the AANP staff and consultants. We are extremely fortunate to have such a capable staff implementing the work of this Association. I am deeply appreciative of all that I have learned from the staff and for their friendship over these past years. I am grateful to every member of the AANP. These doctors understand the criticality of supporting the national association of naturopathic physicians in order to both solidify and grow naturopathic medicine. I am also grateful to those companies who are our corporate sponsors. They understand the integral role that naturopathic physicians have in optimal healthcare and are investing in our future. Finally, I am grateful for the patients that have sought care from naturopathic physicians. Not always an easy thing to do, these individuals have stepped out and sought a different kind of healthcare. Their willingness to experience the benefits of naturopathic medicine is the bedrock of our profession and our continued success is absolutely dependent upon our patients.

My optimism emerges from the confidence that I have in people who comprise the AANP and in the future landscape of healthcare. There is a place in healthcare for naturopathic physicians, and while this place has always existed, more and more people outside of our profession now recognize this place and want it to be larger and more visible. I can think of nothing more exciting than knowing that soon, in my lifetime, many more people throughout this country will enjoy access to naturopathic doctors.

I want to thank you for allowing me to serve at the President of the AANP. I carry the honor of this service deeply. I hope that I contributed to the profession’s well-being and made it easier in some way for each member to be more proud about the AANP and about our profession. Everything I have done is the result of the work of the entire board. I want to thank Dr. Vanessa Esteves, Dr. Chad Aschtgen, and Dr. Steve Bailey for their service as Directors on AANP Board. Their terms have come to a close and these individuals have enriched the Board with their perspectives and have donated extraordinary amounts of their time to this profession, often at the expense of time with their loved ones and other professional endeavors. I also want to extend my deepest gratitude to the current board members, who, as immediate past-President, I will have the pleasure of continuing to learn from and work with. Drs. Michelle Clark, Bill Benda, Tabitha Parker, Sara Thyr, and Michael Cronin. Leaving the role as President is easier with such a fabulous next President in the waiting. I welcome Dr. Carl Hangee-Bauer as our next AANP President. I cannot imagine anyone I would rather hand the baton to. He brings his immense talent, huge passion and great integrity to this role. Dr. Carl, at 12:01 EST January 1st, 2010, it’s all yours! I bow to all with immense respect and love in my heart.

President's Message: A Final Farewell

By Carl Hangee-Bauer, ND, LAc

AANP President

Winter is upon us as I write this, my last blog as AANP President. It is a time for drawing inward, reflection and preparation for growth as well as new things to come as the light begins to return and Spring is right around the corner. We see this season reflected in our microcosm of the AANP, with our Executive Director of the past nine years having moved on, Board members departing (Thank you so much, Trevor Holly Cates and Corey Resnick!), Helen Healy finishing her term as HoD Speaker, and other changes in AANP staff. It is truly a time of great change and with that change comes challenges and opportunities.

AANP's renewal is already taking shape, like an early Spring thaw. Terri Deerr has stepped into the role of Chief Operating Officer (COO) and will manage the association during the interim period as we seek our next ED. Michael Cronin takes the reins of AANP President on January 1st and brings vigor, passion and new ideas for moving the AANP and profession forward. Bruce Milliman is stepping up as the next HoD Speaker, and the Board welcomes new member Michelle Simon. 

As I like to say, "Change is the order of the Universe." I believe these changes are timely and I'm optimistic about the growth and future of the AANP. We must embrace change if we are to adapt and grow.

Please renew your AANP membership or rejoin if your membership has lapsed. We have so much to accomplish with regards to changes in the federal health care landscape, state licensing and scope of practice issues, PR & Branding, member support and a host of other ongoing projects. We need your help, your active participation and your support if we are to meet the challenges ahead. Your actions and your voice are a vital part of this process.

In August, I gave my farewell speech to those gathered at our annual Awards banquet. As I re-read it, it still reflects my thoughts and observations as I finish my term as AANP President. I have reprinted it below: 

"Last year the AANP celebrated its 25^th anniversary. At the gala we formally recognized those who founded this association, our past leaders and award recipients and my speech envisioned what the next 25 years would bring to this profession and to the AANP. It was a very formal event befitting of the time and venue.

This year I am going to be less formal and speak more from my heart and share a few of my experiences and insights. I have served nearly four years on the Board and my last year as AANP President is coming to a close. It has been a very interesting, challenging and, as I tell many who ask, a growth experience. There have been moments of great joy as well as moments of struggle and conflict.

It’s said that change is the nature of the universe. It is certainly true for the naturopathic profession. Over the past year we’ve suffered losses with the passing of Dr. Konrad Kail, Friedhelm Kirchfeld and others who have led, taught and inspired us. We’ve learned that our next naturopathic medical school will open in San Diego in 2012; meanwhile our other naturopathic colleges are growing as we’ve never seen before. We’ve seen another state licensed with more poised to follow. We’ve been inspired by how one man, Dr. Dennis Godby, with great personal sacrifice and dedication is acting to change the world by running across the United States to raise awareness of naturopathic medicine and how it can improve the health of all Americans. The AANP membership has grown and surveys show member satisfaction with the AANP is very high.

We bear witness to the renaissance of naturopathic medicine in the US.

Change is also on the horizon for the AANP.

We have a dynamic board dedicated to making naturopathic medicine a household name and have elected new board members who are stepping up as our future leaders.  

The House of Delegates has worked diligently to improve its process and has set an ambitious agenda as well as the work the House and the Board will do together will move this profession forward. 

Our next president, Michael Cronin, a long time pioneer and leader in Arizona and founding board member of the AANP, takes office in January at a time of great challenges and changes at both the federal and state levels, and I believe he is ready and up to the task. 

Our executive director, Karen Howard, who has dedicated herself to serving this profession for the past 9 years has decided that it is time to move on to the next challenges and opportunities that life presents and we will sorely miss her. With the support of her professional and dedicated staff, she has worked tirelessly to make naturopathic medicine known on Capitol Hill and the houses of Congress, to build bridges with other professions and coalitions, to support the growth and success of our members and to build our organizational structure, finances and resources so we can meet our goals as the national association representing naturopathic physicians. Please join me in thanking Karen and wishing her much success wherever her future takes her.

On a more personal level, serving as AANP President has been one of the greatest challenges and opportunities of my life and I have had a few insights along the way I want to share with you now.

Some of you in this room who know me know I love the outdoors and our garden. Often if I’m stressed out or feel overwhelmed with everything, I’ll make time to get out into my backyard, repot some orchids, pull some weeds, prune a few plants and get my hands dirty. There’s something about getting my hands in the earth that I find grounding. During these activities I often reflect on problems and issues I’m dealing with and something about gardening helps me step back and get the bigger picture.

In these moments, one train of thought I’ve followed recently is how the naturopathic profession is alike and different from other health professions. For example, allopathic medicine, for all of its great strengths and weaknesses often favors a mechanistic approach and relies on specific diagnoses to treat disease; prevention, for example, often focuses on vaccinations or screening tests. It has produced major advances in medicine and surgery to be sure, but can sometimes miss the forest for the trees.

We naturopathic physicians are most like gardeners in the care of our patients and we must apply these principles in our professional associations and in our interactions with one another. We must nurture our community like we nurture our patient’s health.

We must focus on the soil.

In Metchnikoff’s discussions with Pasteur, he argued that “it’s not the germs but the soil” that is most important to focus on in health care. As NDs we learn how to improve our patients’ health by laying the foundation with proper diet, exercise and play, adequate hydration and sunlight. We check for mineral levels, pH and indications of imbalances. We focus on achieving health and wellness as much or more than disease itself.

The AANP, our state, specialty and other associations as well as our colleges prepare the soil and the environment for the growth of our profession by educating our doctors, passing licensing laws, creating board exams, nurturing federal recognition, and other steps to insure that naturopathic care is available for all Americans and that the sprouts of our graduates have the opportunity to grow, thrive and become fruitful. Our corporate partners help us nourish the soil by their support for our goals and our programs.

We care for and tend our gardens.

Naturopathic Physicians are trained as systems thinkers. In patient care, we are wholistic in our approach even while focusing on specific health issues. Even while we help our patients manage or overcome their challenges, we encourage their growth, vigor and hardiness through preventive strategies and by dealing with health problems in context with the individual in all our aspects-body, mind and spirit.

As an association the AANP nurtures the growth and robustness of our profession.

We companion plant by building coalitions with our natural partners and creating deep ties with external organizations with mutually supportive goals. However effective as we are, we know that we cannot do this alone.

We pay attention and we tend the garden of our profession. When we are engaged, focused, thoughtful, attentive and have our vision, we produce beautiful and productive ecosystems in balance with nature. If we don’t pay attention or have a plan, we see a few plants thrive, many struggle to survive, our soil become deficient and the weeds take over.

We are the gardeners and it’s our responsibility to take care of the land.

Sustainability depends on good caretaking. If we are good caretakers, our harvest will be the health of our patients and the health of this profession. How well we do this will determine our yield. We must work together, knowing that while we may have differences of opinion and approach, we are all working toward the same goals and ends. Respectful debate and listening will yield better solutions. And we must take care of each other and nurture one another, because our greatest strength is our community and our relationships with one another. We are a small and growing health profession yet together we are much greater than the sum of our parts. Our strength does not lie in our numbers but our connectedness to each other.

In closing, I want to thank you for the good work you all do everyday to benefit the health of your patients and this planet and for your dedication to this profession. And from my heart, I want to thank you for the honor and privilege to serve as AANP President."

President's Message: Thanking and Honoring Karen Howard

By Carl Hangee-Bauer, ND, LAc
AANP President

Exiting Executive Director Karen Howard poses with AANP President Carl Hangee-Bauer, ND, LAc (left),
and Bill Benda, MD, FACEP, FAAEM (right), at the 2010 AANP Convention.

It is a time of great change for the AANP and perhaps the most significant is that Karen Howard, our Executive Director for the past nine years, will be moving on at the end of November. Karen has left a huge mark on the AANP and the naturopathic profession and she will be missed. As I pondered what fitting words to say to mark this occasion, I turned to other AANP Past-Presidents to ask them what they would like for us to remember about Karen as we thank her and honor her work. So, without further ado...

From Michael Traub, ND, DHANP, FABNO (AANP President 2002-03):
Today I was telling a new Bastyr grad the story of how the AANP moved its headquarters across the country shortly before I became AANP President. We left all our staff behind in Seattle and put ourselves in the hands of a professional association management firm outside of Washington, D.C. Although initially we made some improvements in the professionalism of the AANP, in less than a year, the executive director (ED) that the management firm had hired for us resigned. Little by little, the remainder of the staff they had assigned to us dwindled and we found ourselves in debt by half a million dollars. It was in this context that the AANP decided to break our contract with the management firm and return to being a self-managed organization.

After several months of essentially serving both as President and de facto ED, I needed to hire a new ED and I hired Karen Howard. It was a complicated operation to extricate the heart, soul, membership and financial records and bank accounts from this cancerous relationship that had developed between the AANP and the management firm, and it was Karen’s first task as ED. It took several months, but the operation was successful, we rebuilt the AANP from the ashes, and in a year's time of severe financial austerity, we turned around our $500K deficit to a $250K net profit.

Karen Howard deserves most of the credit for saving the AANP in its darkest hour. She also deserves most of the credit for all the progress the AANP has made since that time.

From Nancy Dunne, ND, MA (AANP President 2004-05):
Karen Howard came to us a powerful and skillful woman. From Day One, we have challenged her, and she has challenged us. And she has lead us throughout the single most fruitful and effective era of achievement and maturity our profession has yet known.

Karen's fiscal acumen, political savvy and extensive, beyond-the-fold relationships have embedded in our institutions, as well as in our expectations, a level of sophistication and professionalism that is precisely what we have needed and had not heretofore owned. She has not become everyone’s friend—that’s normal. She has sown many seeds and not all have taken—that’s natural. She has stabilized and massively enhanced our economic position; she has established naturopathic physicians as a presence on Capitol Hill with consistency and wit; she has created leadership training and opportunities for inclusion and advancement that honor and engage each successive generation of new doctors. She has stabilized our rocky foundations and given us a resilient ground from which we can continue to grow. She has changed us, for so much the better, and she has allowed herself to be changed and grow as well. Karen Howard exemplifies passion and mature discernment, unflinching self-assessment and integrity. We are so much better for what she has done.

From Jane Guiltinan, ND (AANP President 2006-07)
I’d like to thank Karen for her outstanding stewardship of the AANP over the last nine years. What did Karen accomplish? Here are a few achievements:

• When she was hired, we were on the verge of bankruptcy; now we’re financially solvent with a solid revenue base and reserves in the bank.
• Membership has grown significantly and the vast majority of members are very satisfied with the direction the AANP has taken during Karen’s tenure.
• Six states and territories have gained legal recognition for naturopathic doctors.
• The DC FLI has become a signature event on Capitol Hill, with many important impacts.
• The convention continues to be brilliant.  Our smaller state associations are stronger and more organized.
• Partnerships and collaborations with external groups have flourished and resulted in increased awareness of naturopathic medicine.

All these things are great accomplishments and deserve appreciation and thanks. Most of all though I thank and honor Karen for her passion and dedication to help us achieve our dreams. She believed in us, embraced our vision, and worked tirelessly on our behalf every single day. She did this because she believes with all her heart and soul that naturopathic medicine can improve the health of families, communities and the planet. She believes that the principles of naturopathic medicine can help create a better world for her own children, grandchildren and their children.

Thank you Karen for walking with us these last years. Your legacy is stellar. Namaste, dear friend. I bow to the divine in you, with great love, appreciation, gratitude and best wishes for your next journey.

From Lise Alschuler, ND, FABNO (AANP President 2008-09):
The AANP will be forever indebted to Karen Howard. Karen’s passionate embrace of naturopathic medicine motivated an incredible stewardship of the AANP at a critical time in the organization’s history.

From the outset, Karen saw how the principles of naturopathic medicine could be used to guide the organization from the brink of disaster to tremendous success. She identified the root causes of the financial challenges, she rallied the innate healing powers of the organization by mobilizing and organizing members into political action. Karen removed obstacles to our success by creating collaborative relationships with like-minded organizations. She used the healing powers of Nature to set recurrent inspirational themes for our increasingly successful conferences. All of this resulted in AANP stability and growth during a time period in which most other non-profit associations were struggling and even collapsing.

Karen is leaving the AANP in much, much better shape than she found it in. Over the past several years, the AANP has become a strong, vital force in health care and a resource and source of inspiration for its members.

I consider myself blessed to have had the opportunity to have worked so closely with Karen throughout her tenure at the AANP. She is a strong woman, a visionary, highly intelligent and someone who leaves her heart on the table in every endeavor that matters. I have learned much from Karen and I am personally grateful for her amazing dedication to the AANP and to naturopathic medicine. The world is in desperate need of visionary leaders. The AANP benefited from one such leader, in the person of Karen Howard, and we are so much better for it.

From Carl Hangee-Bauer, ND, LAc (Current AANP President 2010-11):
What more can I add? I  have worked closely with Karen for the past four years as a board member, President-Elect and as President. I will be departing on her heels once my term ends December 31st. Over this period I have worked closely with and have gotten to know Karen quite well.

I continue to be amazed at how much she can hold in her head as she does the work of three people. She has worked not only with the AANP but with the Naturopathic Coordinating Counsel, Association of Accredited Naturopathic Medical Colleges, and has been our link to such organizations at the Coalition for Patient Rights and National Foundation of Women Legislators to name just a few.

Under her leadership and guidance, we have grown from a small, new presence in Washington, D.C., to a known organization and profession who's footprint appears much larger than we truly are. She has helped us grow up, and we are forever in her debt.

So, Karen, thank you so much for everything you have done and for your many accomplishments, and personally for all of the guidance and support you have given me. We will miss you and wish you much happiness and success in whatever the future holds for you. You will always be a part of the naturopathic community.