President's Message: Changes at the AANP and in the Health Industry Landscape

By Carl Hangee-Bauer, ND, LAc
AANP President

It’s a busy time at the AANP (as always) and has been particularly busy for me with the leadership changes on the horizon. Many wheels are turning and progress is being made. Let me bring you up to date on a few key events and activities.


Executive Director Transition Planning

Last month I reported on the Executive Director Transition Team and our first steps. I’m happy to report we’ve made significant progress and are moving ahead at a steady pace. Most of the past month we’ve been involved in talking with experts, reviewing and discussing the future needs and goals of the association, and visualizing what personal and professional attributes are most important in our next ED. After reviewing multiple executive search firms and holding in-depth interviews with our top three contenders, I’m pleased to report that after Board approval and legal review, we have contracted with Association Strategies, Inc. (ASI), of Alexandria, Virginia, to work with us in our search.

ASI fits the needs of the AANP quite well. They have significant experience in both the non-profit world and health industry. ASI is a woman-owned and -managed organization with 25 years of service and hundreds of associations served. Their systematic approach includes an organizational assessment, a rigorous nationwide search and screening process, transition planning, and follow-through after the hire of our next ED. They have high satisfaction rate and good credibility in their industry. If you want to know more about them, here is their website: http://www.assnstrategies.com/

The AANP has selected Association Strategies, Inc., to aid in the search for the next Executive Director.

Now this process is going to speed up! It takes at least three months and more typically close to six months for a process like this to come to fruition. The latter time is more likely, given that the search will be in process over the holidays. Karen Howard has been as busy as ever, perhaps even more so recently, as she approaches the end of her tenure at the close of November. Terri Deerr will be stepping in as Interim ED December 1st. We hope to have identified and hired our new ED by the end of March.

We’ve received feedback from many of you and welcome your input. Please watch your e-mailboxes over the coming weeks as we will be surveying the AANP community to find out your wishes, vision and feedback. We’ll be talking with national and state leaders past and present, NDs across the country, teachers, staff and others intimately connected with the naturopathic community. If you have any ideas or feedback that you think would help us be most successful, please send it to me at Carl@SFnatmed.com. We will listen to all voices. If you want to apply for the position, you can contact me directly and I will connect you with ASI once our search is actively underway.

Trends Affecting Naturopathic Medicine

It has been interesting to observe some of the societal trends that have an impact on our profession recently. First, I’m certain most of you have observed some of the negative studies released in the past few weeks on vitamins and health, including the Iowa Health Study on middle-aged women, and another about associations between Vitamin E and prostate cancer risk. Since a majority of our doctors have in-office pharmacies and almost all recommend nutritional supplements as part of their treatment protocols, the public perceptions of health risks associated with vitamin use present us with challenges and opportunities. It is incumbent upon our profession to consider these studies carefully and respond intelligently and effectively. The AANP has issued a press release to this effect and I look forward to the analyses of the strengths and weaknesses of these studies in the coming weeks.

The American Medical Association (AMA) and its affiliates continue to attack and oppose expansion of practice scope and titles for a number of health professions, naturopathic physicians included. In recent weeks we have seen the news about the American Association of Family Physicians (AAFP) opposing "any expansion of naturopaths' scope of practice that is not strictly supported by their training, such as extending them liberal prescribing authority or permitting them to perform work/school physical exams or surgery." And in no case, said the delegates, should these individuals be granted "primary care physician" status. The AMA opposes use of the term "doctor" for any doctorate-level provider who is not a medical doctor (MD). I recently submitted a letter to the New York Times editor on this topic.

The AANP is working with others within our profession to craft thoughtful responses to the AAFP and AMA. With our partners such as the Coalition for Patient Rights, we are keeping an open dialogue and working to educate and inform these groups about our training, practice and professionalism. There are many misconceptions to correct, and this kind of "turf protection" argument doesn’t serve our professions or the public in this time of need for better health care. I for one believe that all health-care professions are first about doing good and working with people to improve their health. It’s a shame we can’t work together better, with good communication and mutual respect. We as NDs need to lead from the high road as we work to change this dynamic.

Welcome to the Party

By Bill Benda, MD, FACEP, FAAEM

Photo by LS Lam via Flickr, used under the Creative Commons License.

I spent this past weekend at Southwest College of Naturopathic Medicine, where I teach a 50-hour emergency medicine course to students who must sit there and wonder, “Why am I learning this stuff?” But today’s rant is not about conventional vs. alternative or botanical vs. pharmaceutical, but about a more pervasive political movement apparently sweeping the country and, yes, our own little naturopathic family.

I often break up the classroom monotony of trauma and myocardial infarctions and wound closure with philosophical diversions – public policy, healthcare reform, influence of the neutraceutical industry on medical education, and such. But this past weekend we talked a bit about the Tea Party, and how its not just for mainstream politics anymore.

You see, this strange wave of populism that has taken us all by surprise is lapping at the shores of our particular profession as well as flooding the red and blue bastions of conservative and liberal thinking across the land. As an MD, I have limited interest in such important clinical ND issues as CPT codes and scope of practice – these simply do not impact my personal life. But I am fascinated by the internal politics of this field and the personalities that nudge and pull on the ship of naturopathic medicine like tugboats, each chugging towards its own desired destination. And what I see in today’s political horizon is our own little populist movement announcing unhappiness with the status quo and calling rather insistently for that nebulous yet ubiquitous concept of change.

What kind of change is, as with the rest of the country, still a bit nebulous and undefined, but we will let this detail work itself out over the ensuing months. The fact is that, as an AANP Board member for the past four years, I have been able to identify and get to know a few of the players and a few of the issues. The AANP, its Board, its executive director, the state associations, their Boards, their executive directors, the schools, their presidents, past AANP presidents, future AANP presidents, journalists (including myself), the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), the Integrative Healthcare Policy Consortium (IHPC), the Naturopathic Coordinating Council (NCC), the Naturopathic Medical Student Association (NMSA) and on. And on. Tugboats pulling and pushing on the good ship Naturopathy. Stay the course. Change direction. Return to the past. Dive into the future. Toot toot.

Before any of the above mentioned begin to take this analogy a bit too personally, I wish to make one point quite clear: This is all a very, very good thing. Should we take a look at our national political system as a larger illustration, I believe we must come to the conclusion that no matter our individual views on the Tea Party movement and its leaders, we cannot but admit that our current political system has become mired in dysfunction and inertia, and it may well take an entity as disruptive as the Tea Party to shake some sense into us. In the same vein, I believe it is time for the profession of naturopathic medicine, at the national, state, academic, political, media, and individual levels to take a long, hard look at our own dysfunctions and inertia (We all have them! Yes we do!) and come to a communal course of, well, change. Naturopathy is no longer under the social and professional assault from that it was twenty years ago. Conventional medicine is no longer the ogre trying to eat our children (well, maybe the AMA might still be). We must put past thinking where it belongs – in the past.

So change is in the air, as it must be. But we must realize that change does not mean returning to past thinking, or past policies. It does, however, require transparency and openness on the part of those instigating change. Personal agendas have no place here, and will serve only to create further dysfunction and inertia. Unfortunately for me, I will no longer have a front row seat after December 31st, when my Board term expires.

But I’ll be watching from the sidelines nonetheless . . .

President's Message: A Summer of Community

By Carl Hangee-Bauer, ND, LAc
AANP President

May was a wonderful month for the AANP and the naturopathic profession. Our annual Federal Legislative Initiative (aka the DC FLI) and our historic meeting with the AMA were significant successes. Thankfully, there has been a period of calm in my AANP duties before beginning to ramp up our summer activities, culminating with the ever-wonderful AANP Convention in August. It’s always good to have these more quiet times to reflect on all the trends and projects in progress, as well as take a few deep breaths. Having just returned from a Hawaii vacation, I feel refreshed and ready to focus on the next steps, and to see you all in August.

Summer is a season where we tend to get out more and be with others. The longer days and warmer weather foster opportunities like picnics, beach time, barbeques, and other activities that reinvigorate and deepen our connections with friends and family.

The naturopathic community reflects this greater seasonal trend. In early summer, the various elements of our profession begin to communicate more frequently as August approaches. Committees of both the Board and House of Delegates are meeting in preparation for the business of the convention. Our scientific community is busy preparing for the Naturopathic Research Summit on August 16. Students and NDs are preparing for the ZRT Cup.

At least as important as these formal relationships is the gathering of our tribe. This year we find ourselves back at the Biltmore in Phoenix, the most popular site for the AANP Convention, as well as at the East Coast remote convention site in Stamford, Connecticut. At both venues we will come together to learn new skills, find out what’s new in our field, be exposed to new products and diagnostic tools, have fun, and reconnect with our old friends and acquaintances. The latter is one of my favorite reasons for attending the convention. It is the one week each year that I can immerse myself in my profession and deepen my relationships with my colleagues. This always leaves me reinvigorated when I return to my practice.

Whether you are an AANP member or not (why not?), please join us at either site and experience the uniqueness of our community and the joys of being together.

A few reminders:

Vote! This year we are electing a new Treasurer to the board as well as three board positions. We have eight people running for these three positions so it will prove to be a competitive election. Packets containing candidate statements and other materials will be mailed to Members shortly. Voting will begin online on July 17 and continue into the Convention until August 19.

Nominate one of your colleagues for an award. The AANP is calling all of its members to nominate qualified candidates for the 2011 AANP Physician of the Year, Corporation of the Year, VIS, and New!!! Champion of Naturopathic Medicine Award (the "Champion Award"). This year's award recipients will be recognized at the closing banquet of the AANP's 26th Annual Convention and Exposition on Saturday, August 20, 2011, in Phoenix, AZ. All nominators and nominees must be members of the AANP in good standing. Click here to learn about the individual awards and download the nomination forms.

I am already thinking about who will get this year’s Presidents Award. So many deserving choices…

Our unity is our strength, and our community – represented by the AANP – is the vehicle we have to tell the wonderful story of naturopathic medicine. I invite all of you to help us build it even better. There is much to do. So, with all of the changes in health care, advances in medical knowledge and trends, and successes in our profession, the AANP Convention is the place to be to digest, absorb and grow – and connect.

I look forward to seeing you all there.

President's Message: Advocating for Naturopathic Medicine

By Carl Hangee-Bauer, ND, LAc
AANP President

American Medical Association headquarters in Chicago, IL. Photo by Steve Silverman via Flickr, used
under the Creative Commons License.

It’s been quite a busy time over the past few weeks, with trips to Washington, D.C., and Chicago to educate and advocate for the naturopathic profession.

2011 DC FLI

In late April, I flew to Washington to spend three days at DC FLI followed by our Spring Board meeting. This was my fourth DC FLI and I have to say it is one of the most fun and interesting events put on by the AANP. Most of us come together at our August conventions, but this gathering has its own flavor.

150+ people were in attendance this year, and at least 100 were students from the naturopathic colleges. There were a number of our more experienced doctors present, many of whom are active in either state licensing or federal legislative issues, as well as AANP Board members and some NDs local to the East Coast and D.C. area.

We started Saturday morning with a meeting of the State Alliance, where general trends and issues were discussed affecting state licensing efforts. There were some great conversations and sharing as we learned from each other’s gains and obstacles. For me, the most interesting part was when a representative from each state where licensing or scope expansion is being sought updated the group on their progress so far this year. It is very encouraging to hear the gains that have been made recently, and I am certain that, by following the lead of North Dakota, we could see as many as three to five states successfully gain licensure in the next year or so. The momentum is palpable and all of the due diligence that has been carried forward in different states by dedicated naturopathic doctors and their patients appears to be on the cusp of paying off.

Saturday afternoon began in earnest with presentations by representatives from the chiropractic profession, sharing with us their lessons learned in the legislative arena and overviews of the current political landscape in D.C. On Sunday, we spent the day reviewing our key messages and goals for this year’s federal political agenda, largely around two topics: offering a definition of “integrative health care practitioner” (described but not defined in numerous sections of the PPACA passed last year), and seeking sponsors or co-sponsors for a bill amending the Public Health Services Act to ensure equity for naturopathic physicians in federal loan programs, scholarships, and primary care residencies funded by the federal government. Of course, while these are our stated goals, our ongoing agenda is to inform and educate legislators and their staff members about naturopathic medicine and the role we play in our health-care system. It’s about building relationships.

On Monday, we fanned out across Capitol Hill, carrying our messages to congressional offices as well as other agencies including the Veteran’s Administration (the largest managed care system in the world) and the National Institutes of Health. From the feedback I’ve heard so far, we were well received and our messages were heard. And, as always, our reception In the Rayburn Foyer was a huge success with many staffers and a few U.S. Representatives present. One experience I can briefly relate was watching Rep. Dennis Kucinich arrive and make a beeline to Dr. Joseph Pizzorno’s table. I was told that Rep. Kucinich is a great admirer of Dr. Pizzorno’s books, keeping them in his living room at home.

The success of DC FLI is in large part due to the tremendous enthusiasm of our naturopathic medical students who take time away from their studies, fundraise, and make the long journey to D.C. to be a part of the change in the health-care system this profession promises. In many ways they are our strongest voices, and there is no doubt that the future leaders of our profession are cutting their teeth at DC FLI.

AMA Meeting

After a few days back in San Francisco seeing patients and getting a bit of rest, it was off to Chicago for our meeting with the American Medical Association (AMA). Karen Howard and I represented the AANP as part of the Coalition for Patient Rights (CPR), a group of 35+ health professions who came together in response to the AMA’s Scope of Practice Partnership (SOPP) campaign. This campaign is part of the AMA’s goal to educate their state constituencies and state legislators about scope of practice bills, largely opposing other health-care professions who seek either expanded scope or independent practices. One of the data series produced by the SOPP concerned naturopathic medicine and was filled with many inaccuracies about our training and practice.

Karen and I were joined by representatives from other groups including the American Nurses Association, American Association of Nurse Anesthetists, American Psychological Association, and American Physical Therapy Association. Our group met with some of the top brass at the AMA including the Chair of the Board of Trustees and CEO.

I’m happy to say it was a cordial and respectful meeting on all sides, and I believe it is a start to a productive dialogue with our medical colleagues. There was general consensus in the room that we all need to work better together in integrative and collaborative settings, and this starts with thoughtful communication and a willingness to engage in productive dialogue. Our coalition gave specific feedback that I believe was heard.

I left the meeting encouraged but realistic. These issues won’t change overnight and it will take a lot of further conversation and willingness on both sides to effect the change we are all working toward. This meeting felt to me a bit like a first date; getting to know one another and seeing where things can go. But the conversation was elevated from the usual and I’m optimistic that we can build on this start.

I Know You Are, But What Am I?

By Bill Benda, MD



Photo by dotjdotsmith via flickr under the Creative Commons License.

There is a lexicon war going on this year, have you noticed? The first shots were fired last February at the Institute of Medicine Summit on Integrative Medicine in Washington, DC, where non-MD practitioners (specifically nurses and social workers) lined up at the microphone during the public commentary sessions to insist on the substitution of “healthcare” for “medicine” in all future language. Then, over the summer, the American Medical Association launched the first wave of its Scope of Practice Partnership, intent upon preventing doctorate-level professions from calling themselves “doctors” and “practicing medicine” and defining exactly what a “physician” is. On the other hand, a few short weeks ago, the US Department of Labor confirmed the legislative validity, among other things, of the official titles “naturopathic physician” and “naturopathic doctor.” So in general it appears people are happy being called “doctor,” unless they don’t want to be, or aren’t legally qualified, or someone else doesn’t want them to be, and that “healthcare” is the politically correct phrase from now on, unless we are talking about naturopathic “medicine” or Traditional Chinese “medicine,” in which case “medicine” doesn’t mean MDs, unless we are talking about the AMA, in which case “medicine” or “doctor” can only mean MDs. Or DOs. Or dentists.

Sheesh. What ever happened to Why Can’t We All Just Get Along? Where has the egalitarian, its-about-the-patient-not-us, change-the-paradigm conversation gone? If we agree that we all want a new definition of healthcare, why are we arguing over old classifications of entitlement? Don’t get me wrong – classifications are essential in the bureaucratic world of reimbursement and such. But doesn’t this war of the words seem a bit childish when so much is at stake in both the national and global arena?

I am, by all traditional criteria, a doctor who practices medicine. And I actively discourage anyone knowing this particular fact before they first get to know me as a person, as I usually will encounter one of two reactions – either an undeserved deference or an equally undeserved dismissal as likely being a jerk (which, by the way, if true is unrelated to my medical degree). In fact I propose that anyone making a restaurant reservation using the title “Dr,” whether medical or naturopathic or veterinarian, should be immediately seated next to the bathroom and then ignored.

The fact is that none of us is actually a doctor, or a nurse, or a naturopath, or an acupuncturist. We are simply human beings who have chosen a particular profession in our desire to help other fellow human beings, which is by definition the antithesis of entitlement. And to fight over a title while denigrating the AMA for its aggressively jealous obsession with that particular idiom is not simply childish; it’s hypocrisy.

And anyone that confused needs to see a doctor.