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.

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 . . .

You Like Me, You Really Like Me

By Bill Benda, MD, FACEP, FAAEM
2011 Naturopathic Champion Award Winner

Dr. Benda accepts the Naturopathic Champion Award at the 2011 AANP Convention Gala.

I received an award at August’s AANP annual convention at the Biltmore, a brand new one entitled the Champion Award, which from this time onward will be given to a non-naturopathic individual recognized for his or her contributions to the field. It was a bit of a bittersweet moment, for a number of reasons, which, in my semi-shocked and semi-intoxicated state, I revealed to the gathered audience of several hundred.

You see, since the end of my second term on the AANP Board this past January, I have been contemplating my interprofessional affair with naturopathic medicine. I’ve come to realize that this relationship has followed the course of most of the intimate personal romances I’ve wandered through during my adult life: the shy, hesitant initial contact; the heady discovery of mutual interests; flirtations via email; commitment to a two-year trial, followed by another. The inevitable red flags, mixed messages, minor jealousies, extraorganizational dalliances, threats of abandonment. And finally, that inevitable choice to be made as we separate: Can we still be friends? If only for the children?

But more on this in a minute.

Back to the award presentation. After Sally LaMont came to my table and explained that I really had to step up on the stage and say a few words, I made my way to the microphone and, given that I had no clue and therefore no opportunity to prepare, had no other option than to blurt out what I had been thinking just minutes before.

I revealed that I had spent that particular day in my hotel room on the bed watching bad television and figuring out how to extricate myself from the evening gala without too much notice. How to weather the emotions that arrive whenever a relationship changes. I actually revealed to the audience that whenever I’ve thought of naturopathic physicians over the past decade I’ve felt a combination of a “deep love and a desire to kill you.” Really, I said that. It came from years of appreciation of brilliance and commitment, as well as exasperation with avoidance of dealing with internal issues. The irony of helping a profession with such beautiful and pure principals while constantly hearing about the evils of my own chosen vocation. The puzzled looks when I brought up my frustrations to my fellow Board members, as in “What are you talking about?”

Ah, well. The good news is that we will still be friends, especially for the children, as I get to continue working with Naturopathic Medical Student Association leadership knowing that they will be college deans and presidents and AANP officers and Board members in just a few years. And that I can still maintain some sort of contribution to our health-care system outside of the daily grind.

And there is something else I said on that stage that I know to be true, and will always believe to be true. Something I’ve preached and written and lectured about and sort of made my own personal integrative crusade. And that is that, when we get down to it, there are no MDs, or NDs, or RNs, or DOs in this world. No titles, no social standing, no one-upmanship. There are simply people who have chosen a particular path in their desire to help their fellow human. It is, I believe, how some of us choose to manifest love—not something we feel, or express through song, or poetry, or touch. Love is simply what we are, and it is made manifest in all of its beauty by what we do when another needs us to act on their behalf. It is this—not the money, or prestige, or social conscience—that makes the insanity of working in such a dysfunctional system tolerable. And makes living such a complex and, at times, such a painful life end up being worthwhile.

So thank you, everybody. I like you, too.

Final Convention Thoughts and Planning for the 2011-2012 Fiscal Year

By Carl Hangee-Bauer, ND, LAc
AANP President

The next Board meeting will take place this November at Bastyr University in Washington.

It’s hard to believe it’s September already! After a very busy summer leading up to the AANP convention in Portland, it’s been nice to wind down and catch our breaths before moving into Fall.

For those of you who joined us in Portland, it was a fun and busy week. Great presentations, great food, great friends - our 25th convention/celebration met all of our goals as we looked back on what we’ve accomplished and look forward to our future. Some of the highlights spots for me were:

• Hearing Dr. Jim Sensenig, our 1st AANP President, speak to our community at the banquet.
• Learning from Dr. Steve Austin about nutrition updates.
• Laughing with Jacob Schor, ND, and Rena Bloom, ND, in their Gelotology presentation.
• Celebrating with a few hundred of my closest friends and colleagues.
• Reflecting on our history with Dr. Jared Zeff and Dr. Joe Pizzorno.
• Getting a glimpse of the big picture from Josephine Briggs, MD, Director of NCCAM.

There were many moments like these for all of us. As usual, I returned home reinvigorated, refreshed and ready to apply the lessons I learned in my practice.

Results of our elections were announced and I am pleased to welcome Dr. Michael Cronin as our next President-Elect and Dr. Joe Pizzorno, Dr. Holly Lucille, Dr. Keri Marshall, Dr. Cindy Breed, and Carrie Runde, ND (Cand.) as our new Board members. Their terms begin January 1, 2011. I am extremely impressed with the knowledge, professionalism and experience these doctors bring to the AANP Board, and look forward to working with all of them over the next few years.

As you know we had the first competitive elections for President-Elect in the AANP’s history and were fortunate to be able to choose between two well-qualified candidates, Dr. Michael Cronin and Dr. Tim Birdsall. I want to congratulate Mike for his campaign and election and will work closely with him as he takes on a greater leadership role, and I want to acknowledge and thank Tim for his service to the profession and his leadership over the years. We are fortunate to have these doctors representing naturopathic medicine and serving our profession in the many ways they do.

Our outgoing Board members Bill Benda, MD; Tabatha Parker, ND; Michelle Clark, ND; Sara Thyr, ND; and Lise Alschuler, ND, have given so much to the AANP and the naturopathic profession during their time on the Board, their accomplishments are too numerous to mention here. Dr. Benda is a bridge-builder who sees the big picture of where we need to move forward and reminds us of how to live this in our daily lives. He has truly been the soul of our Board. Dr. Parker reminds us of the global impact of our medicine and the opportunities we have to affect true healthcare change; she has been our visionary. Dr. Clark is our expert on state licensing and political trends; she has guided us in politics and policy. Dr. Thyr has organized and guided the educational offerings at our conventions and has thus served as our teacher. And finally, Dr. Lise Alschuler has been the heart of our Board. Through her term as President and all of the various roles she’s played, Lise has been steady, reliable, dedicated, and impassioned to see the naturopathic profession become a credible piece of the health care system. We have been so fortunate to have these people step up for naturopathic medicine. They will be sorely missed and we wish all of them well in their future endeavors. Please thank them for all of their hard work and dedication the next time you see them.

Now that the dust has settled, we get back to work. This Fall, the Board and staff will focus on the AANP work plan and budget for 2011-2012, evaluating and improving internal processes as we prepare for 2012. The work plan and budget are key areas where the Board and staff work together to plan for and prioritize our near-term goals. The Board sets the strategic vision and goals, emphasizing areas to focus our intention upon. The staff takes this input and translates it into action steps with budget allotments. There is much back-and-forth in this process, and it is some of the most important work we do in our annual planning process. Our next Board meeting will be at Bastyr campus on November 13-14th.

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.

Honoring the Past While Present in the Moment: The 2010 AANP 25th Anniversary Convention

By Karen Howard
AANP Executive Director

AANP President Carl Hangee-Bauer, ND, LAc, Executive Director Karen Howard and Board Member Bill Benda, MD, FACEP, FAAEM. Photo by Michele Hangee-Bauer.

AANP’s 25th Anniversary Celebration and Convention was everything we hoped it would be! Creative and collegial, celebratory and cerebral, composed and complete. Celebrating the Foundation of Naturopathic Medicine included the inspiration of Dr. Jared Zeff and the profound insight of Dr. Joe Pizzorno. Sandwiched in between, we were honored to hear from Dr. Josephine Briggs, Director of NCCAM. And I leave it to you, the doctors, to comment on the continuing education offered by your peers. They work hard to give you their best and enhance the care you provide to patients all over the country.  Click here to view and purchase photographs from this year's convention!

Honoring the past, while present in the moment, for the sake of generations to come – this is the heart of a naturopathic gathering with the force of the AANP Convention. Thank you to Dr. Jared Skowron and ITI for initiating our Legacy Program with the creating of a 22 minute video. It features our Past Presidents and Executive Directors, and it documents the history of the AANP’s 25 years with sincere reflection and humor.

Special recognition to our 2010 Awardees!

NDNR, Corporation of the Year, for giving voice to the entire naturopathic community in a publication known for excellence.

Dr. Susan DeLaney, recipient of The President’s Award, whose presence in her state work and her mentorship deeply reflects the principles of naturopathic medicine.

Dr. Steven Bailey, recipient of The VIS Award, our award created to honor the spirit of Dr. William Mitchell, for his work as teacher and his embodiment of The Vis Medicatrix Naturae.

Dr. Christine Girard, Physician of the Year, whose visionary work will continue to inspire for years to come, especially for the students to whom she dedicated her award.

The special moments at the convention are too numerous to document. But my special thanks to all our corporate partners who enable us to gather and support us throughout the year. Please know these companies hold your expertise and commitment to quality with the deepest respect. I offer my gratitude to The Foundations Project for their incredible timeline detailing naturopathic history. My thanks to those who took extra time to participate in the Naturopathic Coordinating Council Summit held prior to the start of the Convention. Thank you to the numerous volunteers who support the work of the AANP and all of the naturopathic agencies. For those of you who are unaware, meeting after meeting after meeting compete with continuing education every day of the convention. Our volunteers support the furtherance of our mission at the sacrifice of their individual needs.

We indeed face many challenges, and collectively we will boldly face them. The next 25 years offer much in the way of possibility. Let us step up to the challenges we face and recommit to this organization. The AANP is yours to own and cherish, so give it the support it needs to transform the world!

AANP President’s Annual Meeting Message 2010

By Carl Hangee-Bauer, ND, LAc
AANP President

The Oregon Convention Center.  Photo by Matthew Santoro, AANP Communications and Media Associate.

The following are my remarks from the 2010 AANP Annual Meeting in Portland, OR, on Wednesday, August 11, 2010.

On behalf of the AANP Board of Directors, I am honored to welcome you to Portland and the AANP’s 25th Anniversary convention and thank you for your dedication to the naturopathic profession.

The AANP is a member-driven organization. There are many people whose work comes together under the banner of the AANP. We are fortunate to have a dedicated executive director in Karen Howard whose love for this profession runs deep as well as her dedicated staff who gets things done. The AANP Board of Directors works on a daily basis to understand the forces impacting our profession and develop strategies to be proactive and grow the legitimacy of naturopathic medicine. Everything the board does is filtered through the question: How does this benefit our membership? This House of Delegates comes together on an annual basis to amend our bylaws; adopt official Code of Ethics, definitions, standards, and position papers; hear reports from AANP officers and leadership; advise or recommend action to the Board of Directors by means of house resolutions; represent our constituents and communicate to them AANP information and actions; and provide leadership and participate as members in committees and taskforces. And you, our members, contribute in so many ways, from your volunteer work on both the state and national levels, educating the public and patients about naturopathic medicine, and, most importantly, providing your patients with the best care naturopathic medicine has to offer.

The Board of Directors has just completed two days of meetings where we took time to improve our internal communications, get updated on the business and challenges facing the association, and discuss our strategic vision to inform the 2011-2012 workplan. Some of the key areas of board interest include promotion of state licensing and increased scope of practice, sustaining and expanding our presence on the federal level, fostering naturopathic outcome studies and scientific affairs, developing strategic coalitions with other groups and associations, and developing programs and strategies to improve the success of our ND graduates.

Thoughts Ahead of the 2010 Convention and Elections

By Carl Hangee-Bauer, ND, LAc
AANP President

The days of summer are filled as we approach our annual convention and elect our newest AANP leaders.

As I write this, the AANP convention in Portland is only 3 weeks away! All over the country and especially in Washington, D.C., preparations are underway to make this one of our best gatherings to date. As I’m sure you all know, this year we mark our 25th anniversary as an organization and we plan to celebrate in a big way as we look back at the accomplishments the AANP has made and, more importantly, look to the future and imagine what we can accomplish in the next 25 years.

In the days before the convention opens, leaders from the naturopathic profession will gather in Portland to focus on business and planning. The AANP Board has a two-day meeting planned including a one-day board retreat to focus on how to increase our effectiveness as a team. The House of Delegates will meet and consider a variety of topics including ethics and standards of care. The Naturopathic Coordinating Council, a summit of leaders from across our profession, will come together at NCNM to develop a strategic vision for the viability, sustainability, and success of the naturopathic medical profession in the context of global health and wellbeing. These are but a few of the meetings held in advance of the big event.

On Wednesday, August 11th, the fun begins as our tribe comes together for four days of education, reconnection, and celebration. The quality of the continuing education sessions is outstanding, with many of our favorite speakers and teachers presenting, including Dr. Steve Austin, Dr. Jared Zeff, Dr. Joe Pizzorno, Dr. Michael Traub, Dr. Lise Alschuler, Dr. Dickson Thom, and a host of others who are very popular with our convention attendees. Personally I’m really looking forward to Drs. Schor and Bloom’s session on gelotology and hope my busy schedule allows me to attend as many sessions as possible.

As great as our sessions are, the reconnections we make each year (seeing old friends and making new ones) and the alumni events and receptions are what reinvigorate and inspire me the most. We are a relatively small profession, which makes it possible to know many of our peers on a very personal level. The friendship and intimacy we have as a group is very special and becomes especially evident when we come together.

There will also be more time for fun with a family picnic planned for Friday afternoon and, of course, our gala awards banquet and dance on Saturday night. We have quite an evening planned, where we will honor our leaders and pioneers as well as look forward to the potential this profession has in improving the health of our patients, the nation, and the world. This is an event not to be missed! As the Beatles would say, “A splendid time is guaranteed for all.” I hope to see you all there.

On July 24th, our voting opens for our next President-Elect as well as new board members. The AANP is a member-driven organization. We elect our leaders to represent our interests, and the officers and board members of the AANP consider this with every discussion and decision we make. We are here to serve you and to meet your needs as best we can, and your input into the elections process and your vote are crucially important in choosing our leaders and the direction the AANP takes.

I am very impressed by our list of candidates this year. All have demonstrated leadership and a desire to serve. We have two of our finest running for President-Elect: Dr. Tim Birdsall and Dr. Michael Cronin. Both have extensive leadership experience, are committed to the profession and the AANP, and have a clear vision as to how to move this profession forward. Please take the time to read the candidates statements and the responses to the weekly “Meet the Candidates” emails you’ve been receiving so you can choose who best fits your vision for the AANP.

And most importantly, VOTE. The voting is easy, will be online this year, and will close August 6th. Make your voice be heard!

I look forward to seeing you all in Portland at what promises to be a memorable event!

Village People

By Bill Benda, MD

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

I have a sort of interesting gig. I teach emergency medicine, my particular specialty for the past 35 years, to students at Southwest College of Naturopathic Medicine. 20 hours the first term, 30 hours the second, bopping down to Phoenix from Big Sur every month or two to impart information based more on experience than textbook teachings to future clinicians who may, or may not, someday witness a patient in the throes of a myocardial infarction or anaphylactic shock. This has given me a unique, and most valuable, insight into the machinations of naturopathic medical education, and an appreciation for both the similarities and differences between your students and ours (I’m an MD).

Each term I elect to spend a bit of time discussing health care politics once the “required” information is neatly tucked away in their inquisitive minds. The topics range from D.C.’s recent legislation, to the AMA, to the AANP, to the NMSA, to the AHMA, to the medical school SGAs, and all acronyms in between. It’s amazing how the energy in the room shifts from somewhat bored attention to intellectual engagement – instead of two or three in the audience raising their hands in response to some clinical query, half the class at any one time vie to be called upon to state their personal perspectives on all things non-clinical. These young (and not-so-young) scholars are hungry for real-world social and political discourse, a very good omen for the future of the field.

But something is missing. This hunger for information as to how the real world actually works is actually a referendum on where we have fallen a bit short as mentors. Yes, there are caring, passionate practitioners willing and available to impart clinical knowledge, and a cadre of political junkies at the state and national level available to provide direction if asked. The AANP and NCC (Naturopathic Coordinating Council) have both invited the president of the NMSA to sit at the boardroom table, and the AANMC is working to ensure fiscal support to the national student organization. But resources are stretched to their limits, and each aforementioned soul who volunteers their time and energy to students also has a medical practice and teaching duties and family and financial responsibilities. There simply is not enough human resource to shepherd this profession through the national and state and local and academic labyrinths, and still find the time to parent our students as we do our own children.

The thing is, though, they are our virtual children, as well as the future of naturopathic medicine. And to be quite honest, their inexperience is a stumbling block on their path to becoming our legacy and future leaders. So I believe this to be an opportune moment for those of you reading this blog to consider what it is you might contribute to their, and your, coming success in navigating this big, confusing world of ours. If you live near a medical college, volunteer your clinic or office and have them shadow you on your rounds. If you are part of a state association, invite them to your next meeting and solicit their input. If you are a national leader, push for fiscal and political support for their fledgling organizations.

It takes a village, people . . .

Keynote Presentations at AANP Convention

By Jacob Schor, ND, FABNO

Chair, AANP Conference Speaker Committee

Something unique is about to occur at this year’s AANP convention in Bellevue, Washington.  A number of the keynote speakers have presentations that revolve around and attempt to inform a common theme, the question of how our medicine works.  To my knowledge this has never been attempted at our conferences before. 

Actually William Mitchell, ND, spoke at length about the vis medicatrix naturae but this is going to be different because we are trying to understand and explain our medicine in the context of modern science. I have been asked to write briefly about these presentations and how they will tie together, so that’s what I will attempt here.

Valter Longo, PhD, from the University of Southern California, is going to review his research on fasting and cancer chemotherapy.  Fasting triggers an adaptive response that reduces the damage chemotherapy causes in healthy cells while increasing the cytotoxic impact it has on cancer cells.  While Longo’s results are of great interest to those of us who work with cancer patients, the concept of adaptive response is of interest to all of us.  This same adaptive response triggered by fasting underlies many of the traditional nature cures our profession has long endorsed. 

Robert Rountree, MD, is going to lecture on hormesis and how this applies to the action of many of the modern phytochemicals we use in practice.  Hormesis is the idea that small amounts of seemingly toxic substances can have the opposite effect, triggering an adaptive response that benefits the organism rather than harming it. 

Dana Ullman is going to take this idea of hormesis a step further and apply it to homeopathy.  Could homeopathy be another example of hormetic action used to elicit an adaptive response, just using smaller and weaker triggers?   Dana tells me he is ready to try. 

These three presentations focus on triggering an adaptive response by either stressing the organism or pretending to stress it in order to elicit a healing response.  There is another approach we employ in our practices that is the opposite.

More and more what we try to do is to remove stress and the resulting absence of stress allows restoration of health.  We have two presentations that examine this approach.  David Katz, MD, of the Yale School of Public Health will focus on basic lifestyle modifications.  Getting a patient to stop smoking or lose weight reduces the physical stress on their body.  Our own Lise Alschuler, ND, will speak on the effects of emotional stress and its impact on health and, in particular, on cancer.

We have two additional keynote speakers scheduled.  Dave Macallan, ND, is what I would describe as a serious “talker.”  A one time BBC correspondent, Dr. Macallan will help us define naturopathy to the public. 

Our last speaker is Clemont Bezold who is a part of a unique profession. He is a Futurist and will describe the potential future of naturopathic medicine.

Our Path to Integration

Carl Hangee-Bauer, ND, LAc
AANP President

Dr. Hangee-Bauer with Dr. Mehmet Oz and Lisa Oz.

May was an interesting month for me, and I want to share a few of my recent experiences with you. I’ve found that my role as AANP President has given me many opportunities to be curious about different facets of the naturopathic profession and have experiences which are not so common in my day-to-day practice.

One of my goals during my two-year presidency is to visit each of the naturopathic medical colleges. I want to understand better the questions, dreams, aspirations and fears our naturopathic medical students have as they envision their futures as naturopathic physicians as well as understand the challenges and successes of the naturopathic colleges.

Last week I had the honor of being invited to Bastyr University to attend a celebration where Dr. Mehmet Oz and his wife Lisa Oz were given honorary doctorates from Bastyr for the work both have done to improve people’s health and educate and empower them to make better health choices. They are a remarkable couple to meet: charming, obviously intelligent and we had a nice conversation around building bridges between naturopathic and conventional medicine. The Bastyr community welcomed the Ozes with open arms and open hearts.

I spent the rest of my time at Bastyr touring the campus and clinic, having a brown bag lunch session with students, and getting a tour of the new LEED Platinum-certified student housing. It was a remarkable experience for me. When I graduated from Bastyr in 1984, we were housed in an old elementary school in North Seattle, and the school had a small clinic in the University district. It had been at least five years since my last Bastyr visit. I am so impressed at the many ways the college and community have grown and matured since my time as a student there. Between the state-of-the-art clinic facilities, the expansive campus, and the great dialogue I had with the students, I came away impressed at how far our profession has grown since my days as a student in the early 1980s.

It’s a funny thing. When I was a student, we knew instinctively we were on to something, even though hardly anyone knew what naturopathic medicine was at the time. I have to say it is truly remarkable how this profession has grown both in size and respectability, and it only makes me wonder how we will continue to evolve and grow in this era of health care change as we continue to expand our presence and the impact of the medicine.

Which brings me to another experience I want to share with you. I was in New York in February at the Integrative Health Symposium where I met a young (to me) ND who had graduated from Bridgeport in 2003. He was in San Francisco a few weeks ago attending a urology conference and we met for lunch. He told me about his journey from naturopathic school to his present position as a naturopathic doctor in a urology practice in New York City. It was fascinating to hear. When I got out of school, opportunities for NDs were fairly limited. Most went into private practice, mostly solo or small groups, or went into teaching or to work for supplement companies. He described to me how it works in his office and how his training and treatment focus meshes with those of the surgeons and urologists with whom he works. It’s a win-win-win situation. He has a good job that keeps him busy in a specialty practice he enjoys and at which he is successful, the medical doctors have an ND to whom they can refer patients, their group practice benefits from the naturopathic services offered, and patients of this practice have more treatment opportunities.

I strongly believe that we are entering an era of integration as opposed to separation, where health care providers of different training and skills come together with mutual respect and understanding to improve the health of people and our planet. In his book Nature Cures: A History of Alternative Medicine in America, author James Whorton makes this case quite effectively and succinctly. The old ways are dying, and there are great opportunities for naturopathic medicine in this paradigm shift. There are ever-increasing examples of how our graduates can utilize their skills in a variety of settings. We can continue to emphasize our differences from other health professions or we can seek ways to come together. It is up to us.

My experiences in May have reinforced this for me and have given me much to think about as the naturopathic profession moves forward into the next phase of our evolution.

The Problem with Research

By Tim Birdsall, ND, FABNO
2009 AANP Physician of the Year

Photo by US Army Africa via Flickr, used under the Creative Commons License.

I’ve been out of the office for a few days, and was way too busy catching up on all of the countless things which don’t get done when you’re not there attending to them. So perhaps I can be forgiven for not seeing it immediately. But, at the end of the day, there it was in my Inbox, leering at me, daring me to open it up. “Selenium Does Not Benefit -- and May Harm -- Most Patients With Non-Small-Cell Lung Cancer.” What? Not again… Yet another study showing that antioxidants may do more harm than good. First it was beta-carotene. Then vitamin E. Now selenium. And that’s just the antioxidants.

To top it off, the reason I was out of the office last week was that I was attending the National Advisory Council for Complementary and Alternative Medicine, the advisory body to NIH’s NCCAM. On that council, we have talked about just this issue – why do therapies which seem to make biological and physiological sense, which have some epidemiologic data to support their use, and which naturopathic physicians (and other alternatively-minded practitioners) have been using for decades (or much longer), seem to fail in double blind, randomized clinical trials?

The reasons are multiple, complex, and often convoluted. And conventional medicine is all too willing to accept a negative study of a natural therapy, proclaim that “it doesn’t work,” and wash their hands of the entire mess, while leaving the public with the impression that alternative medicine isn’t really worth much. In reality, these therapies often fail in clinical trials because those trials are designed to answer simple, straightforward questions, and as anyone who has provided care to patients can attest, clinical medicine is anything but simple and straightforward. The typical randomized, placebo-controlled, double-blind study can only answer a limited set of very specific questions, and if the wrong question is being asked, or if it is being asked in the wrong patient population, the answer may be equivocal, confusing, or just plain wrong.

In the lung cancer study I saw today (J Clin Oncol 28:7s, 2010 (suppl; abstr CRA7004)), selenium actually appeared to show benefit in one sub-group – those who had never smoked. True, that finding did not reach statistical significance, but then neither did the finding of potential harm (P=0.15). But which one made the headline? You already know the answer.

And so I began to ponder the question, “What’s wrong with research?” A part of me becomes enraged at the reductionistic, allopathic, biomedical model, which breaks things down into components so small that all synergism, all interdependence is stripped away, and then declares those components to be ineffective. Another part argues that the wrong component was selected, or was a synthetic form (although in the lung cancer study, they used selenium yeast). But ultimately, I find myself becoming offended because I believe that these therapies work… Whoa! Believe? OK, but where is the role for evidence? I used to believe that stress caused gastric ulcers. And then along came Helicobacter pylori, and I had to change my belief to match the evidence.

For naturopathic medicine to survive and thrive in the 21^st century climate of evidence-based medicine, I think at least three things must happen. First, we should be willing to judge ourselves critically and objectively, and subject our therapies (and ourselves) to scientific scrutiny. Scary and intimidating? Perhaps. Essential? Absolutely.

Second, we need to step up and recruit and train naturopathic physicians to be world-class researchers. We make great doctors – our patients tell us so every day. We have yet to prove that we can also make great researchers, although we have begun to lay the groundwork to create this success. We are playing catch-up with academic institutions that have a 50-60 year head start, but we have the advantages of being able to learn from their mistakes and of having a public who demands the type of care we provide. While the schools will bear much of this burden, it will require the concerted effort of the entire profession to create the infrastructure necessary to make this reality.

Third, we should collaborate with other professions and institutions to craft the research models necessary to adequately perform “whole systems” naturopathic research. There are examples of this type of approach already existing in the health systems research literature which can be adapted to our needs. In the end, we must create and validate the tools to dethrone the randomized controlled trial as the gold standard, and construct new ways to validate clinical approaches to health issues. Much as the homeopaths of 2+ centuries ago created the proving as a way to better understand and utilize their remedies, we must refuse to be limited by the way conventional medicine views health and disease.

We must boldly strike out to create the systems needed to transform both our research questions and the systems we use to generate the answers. Only then will we be able to use the tools of research to promote and defend naturopathic medicine, instead of feeling beaten over the head by them. Research as an advantage, instead of an impediment. Imagine that.

Inherently Political: Student Leadership and Legislative Success

By Carrie Runde, 2011 ND Candidate
AANP Student Representive for Bastyr University

Drs. Jamey Wallace and Jane Guiltinan (center) with the entire student
contingent from Bastyr University at the 2010 DC FLI.
Photo by Clark Porter.

This May marked my 3^rd year attending the AANP’s DC Federal Legislative Initiative (DC FLI), and I am excited to report that this year’s event was the best by far. I was proud to lead the group of 34 Bastyr ND students, from all years in the program, to Washington, D.C. Our crew had been tirelessly fundraising since last fall, generating over $15,000 to offset the travel and accommodation costs associated with the trip. I am incredibly impressed by the effort all members of the group contributed to our cause. Despite the distance from Seattle and the trip’s proximity to midterm exams, I heard only positive feedback from the Bastyr students who attended. Everyone was so glad to have made the trip, as it was a truly unbelievable learning experience.

When talking to students about participating in the DC FLI, I commonly hear claims that they are uninterested in, or overwhelmed by, general politics. My response to that is simple: the FLI teaches us about specific legislation and political issues pertinent to naturopathic medicine. Once they learn about the politics that directly affect them as students (such as loan repayment programs), as future physicians (like state licensure and scope of practice), and their patients (such as access to supplements), students become interested in the political work of the AANP and our home state affiliates. The first two days of training sessions ignited the students with a curiosity that translated into very effective lobbying on the third day of the DC FLI.

One thing that resounds clearly at each DC FLI is that students have a powerful voice in the legislative process and the future policies of naturopathic medicine. The passion, intelligence, and perspective that we bring to conversations on health care are true mediators for change. The work that we have done in the past is paying off. As AANP President Dr. Carl Hangee-Bauer pointed out in a previous post, this year’s FLI was remarkable because healthcare staffers on Capitol Hill now know the AANP. We spent less time educating them about naturopathic medicine, and more time discussing how we can best be utilized in our nation’s healthcare system. I have specifically experienced this over the last three years in meetings with Massachusetts Senator John Kerry’s health care staffer, who is encouraged by visits from a positive group of people so dedicated to health and wellness.

The student presence at the FLI is, in my slightly biased estimation, the most important. This year, 100 of the 171 participants were ND students representing four U.S. naturopathic schools! We need to continue to increase our numbers at the event each year. The FLI has a greater political impact because students represent many home states, thus allowing us to deliver our message to as many representatives as possible. The FLI helps students as well. It allows us get outside of our medical school bubbles and into the real environment in which we will someday practice our medicine. Despite the challenges associated with missing class and clinic rotations, the FLI gives a new perspective on naturopathic medicine and recharges students when they return to the daily grind of medical school. The FLI also acts as a catalyst for involvement with the AANP, setting students up to be leaders at our respective schools and to become involved in state legislative work early in their careers.

The work that the AANP does for our profession is invaluable, and my personal goal is to increase student involvement in the organization. The more students that have the opportunity to attend the DC FLI and get involved with the AANP, the stronger the AANP will be in the future. The success of our professional organization has a huge impact on our future as naturopathic physicians, and students are a vital part of the equation. I hope that political work, like that done at the DC FLI, will become part of the naturopathic curricula at all schools because, as Dr. Bastyr was known to say, being a naturopathic physician is inherently political. Each year the FLI leaves me with the oft-quoted Margaret Mead adage in my head: “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.”

Carrie is a 3^rd year ND student at Bastyr University and is originally from Baltimore, Maryland. Carrie is the Bastyr student representative to the AANP and can be contacted at AANPrep@bastyr.edu.

Double Vision

By Bill Benda, MD, FACEP, FAAEM

Photo by Lomo-Cam via Flickr, used under the Creative Commons License.

“Visionary.” Now there is a word we’ve all heard countless times as we meander the naturopathic path. Merriam-Webster defines the term as “one having unusual foresight and imagination.” We tend to view our visionaries as those among us who can see into the future, imagine unimaginable realities, lead us to promised lands if we are intrepid and willing enough to follow. We laud our visionaries, follow their writings, award them at our banquets.

As we should, should we hold to that particular definition. But from my boundless perspective, and limited experience, a visionary is not necessarily a prophet or clairvoyant, but rather someone who can actually discern the truth of the present moment – a point of view requiring far more courage to express than any tale of potential future pleasantries. Visionaries who can discern reality are fewer in number than the prescient variety, and those with the courage to voice their views are fewer still, given the political price that must invariably be paid, because the reality of our culture -- and of our healthcare system, and of our profession -- is not always pretty, and definitely not as pretty as our conference and clinic brochures tend to proclaim.

Now do not misinterpret these words –- the underlying beauty of the naturopathic and holistic and integrative et al. philosophies and therapies is alive and well, and more than worthy of love and support. But we in our optimistic, energy-medicine, “hugs heal” mentality are often more than hesitant to take a long, hard look at our internal dysfunctions, dysfunctions that are an essential part of our very humanity rather than an unwanted and obnoxious uncle who has overstayed his welcome. We hold onto historical injuries that are no longer relevant. Our organizations avoid dealing with whispered dissent from their membership. Industry fails to note that their journal advertisements and promises of health are not that much different than those of the conventional brethren we condemn.

And why am I writing these words on this particular blog at this particular time? Because as an AANP board member and associate editor of your journals and adjunct faculty at one of your medical colleges, and especially as a non-ND, I believe your profession is at a crossroads, an adolescent-to-adulthood moment of your evolution when it is time to let go of the past and create a new future. And this shift cannot, and can never, occur without first making a difficult and objective assessment at what is real in the present.

So the next time one of your fellow professionals or employees or students or board members stands up and points out the pachyderm in the pad, see if you can refrain from withdrawing from the inevitable discomfort and instead take a long, hard look at the actual information being presented. You may well find that you have a bona fide visionary in the room.

President's Message: Progress in State Licensure

By Carl Hangee-Bauer, ND, LAc
AANP President

Legislation to license NDs had passed the North Dakota Legislative Assembly
as work continues in other nearby states!

By now you’ve likely heard the good news that North Dakota will become the 16th state to license naturopathic doctors!

This is a great step forward for the profession and is largely the work of one person, Beth Allen, ND, who has the vision and foresight to take her inspiration and turn it into perspiration to accomplish this momentous task. It shows how the power of one dedicated person can change the world.

Hearing this news makes me think back to our licensing campaign in California nearly a decade ago, and ponder what’s in store in North Dakota. For the many of you reading this who have been involved in licensing campaigns, both successful and unsuccessful, I’m sure you share my observation of the depth of work and dedication it takes to pass a licensing bill. Creating educational pieces for legislators, dealing with misinformation campaigns around naturopathic education and safety, navigating the political landscape, and “touching” each legislator are all vital pieces to creating a successful outcome. It takes a tremendous amount of work and sacrifice to achieve this goal.

I am personally of the mind that state licensing is driven by those in the states seeking licensure. They know the local terrain and issues, have the personal connections with the legislature, and have the will and passion to see that they are able to practice openly and bring the choice of seeing a naturopathic doctor to all citizens of their state. The role of the AANP is to be actively supportive. By providing training, support for educating legislators and the public, knowledge of trends in other licensed states, support at legislative hearings, and a sounding board as issues arise, the AANP is there to help those NDs in states with legislative campaigns be as successful as possible. I can tell you that even though California NDs led the campaign for licensing, we would not have been able to accomplish that if it were not for the AANP being there with us every step of the way. Every state has different conditions and influences that affect what may fly in the legislature and what may not. They say “politics is the art of compromise,” and we certainly see that in the different bills that are submitted and pass or fail. Knowing what to compromise on and what not to is one of the arts of successful passage.

Now the real work begins in North Dakota. Rules and regulations need to be written, a board formed, and a million other details that take a passed bill into law on to regulatory oversight. The North Dakota Association of Naturopathic Doctors, I’m sure, will rise to meet these challenges with the leadership that Dr. Allen has already clearly demonstrated.

Meanwhile, there are active licensing campaigns ongoing in a number of other states and I believe that the passage of the law in North Dakota will inspire and encourage those hardworking people that this can be accomplished and we will see more states licensed in the near future.

Please join me in thanking Dr. Allen and all of those who worked to achieve this significant victory. This is a significant step forward in the history of the naturopathic profession and opens the door for many more people to benefit from naturopathic medicine.

Horsing Around at the NIH

By Bill Benda, MD, FACEP, FAAEM

Image by the NICHD via Wikipedia.org, used under the Fair Use Doctrine.

An interesting thing happened to me back in February – I received a request from the National Institutes of Health to serve on a panel that would determine how to dole out quite a few millions of dollars to fund research in what the NIH refers to as Human-Animal Interaction (HAI), usually referred to as animal-assisted therapy. Apparently the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Nursing Research, and the WALTHAM Center for Pet Nutrition (the pet food division of the Mars company) had entered into a public-private partnership to pursue research on this topic.

My invitation, I am sure, was the result of having published two prior research studies (one part of an NCCAM Center grant) investigating the effect of hippotherapy (physical therapy on horseback) on children with spastic cerebral palsy. It seems that all of the other “experts” in this relatively tiny field had in fact applied for the current grants, leaving yours truly as a rather singularly available authority. The rest of the 35-plus members on the March review panel consisted of sociologists, psychologists, and behavioral scientists, with one or two other MDs thrown in for good measure.

The rather impressive vows of confidentiality we were asked to give preclude me from mentioning who was at the table, the nature of the submissions, or any aspect of the ensuing discussions, but that is not relevant to the gist of this blog report. What was most surprising was that exploration of this rather unique arena did not come from NCCAM, or in fact from any realm associated with the practice of alternative, or complementary, or holistic, or integrative, or naturopathic, or whatever-shall-we-call-it medicine. It came from pediatrics, nursing, and a pet food company. Surprising, as it awoke me to the fact that we do not have dominion over unconventional therapies, as our marketing brochures and indeed last February’s Institute of Medicine Summit on Integrative Medicine or last May’s North American Research Conference on Complementary and Integrative Medicine would have us believe.

This is a very, very good thing, especially for naturopathic medicine, because it confirms that no medical field, conventional or other, is able to usurp any clinical or research field as some have feared – the realm of healthcare is simply too slippery to remain within the grasp of any one profession. It’s sort of like the power of the Internet in China, or even here in the U.S. No government, or industry, or social experiment will ever control any culture or country or endeavor as long as people can find a way to share information with each other. Like in a blog.

By the way, if you may be wondering why the NIH has a new-found interest in the human-animal bond as a healing modality, keep in mind that there are over 750 equine therapy centers and over 2000 canine therapy programs up and running in our hospitals, cancer centers, nursing home, prisons, et al. – each with certified therapists and each with a waiting list stretching around the proverbial block. In other words, it exists, people are using it and paying for it out of pocket, and so we might as well research it and give it our medical stamp of approval.

Sound familiar?

Massachusetts Law Falls Short

Michael Cronin, ND
AANP President

Governor Deval Patrick, of Massachusetts, did not sign the Naturopathic Practice Act. The bill passed both chambers of the legislature in a special session in December 2012 and required his signature to become law.

This brings up many thoughts and emotions for me. I feel disappointment over a legislative process that seems slow and unfair. And there is anger at a process that placates the desires of the Massachusetts Medical Society over serving the health needs of the public and the desire of the Commonwealth. However, my dominant emotion is pride and amazement at the dedication of our ND colleagues who for 18 years have worked to achieve licensure for the Massachusetts NDs.

Our profession is now at a new legislative high water mark for licensure in the United States. According to our history as described in the Textbook of Natural Medicine (pg. 71 Vol. I, 3rd edition), it is described in the California based International Society of Naturopathic Physicians 1948 membership directory as 13 states, the territory of Hawaii and 3 Canadian provinces. There were 32 state associations then.

There are currently licensing laws in 16 states (up from 5 in 1978), the District of Columbia, the United States territories of Puerto Rico and the U.S. Virgin Islands, and 5 Canadian provinces. We have 7 healthy, accredited North American colleges and there are now 43 state associations..

Naturopathic Medicine is a profession that thrives on the passion of its doctors and the generosity of its volunteers.

• We have the tremendous efforts of our state associations that are operated by volunteer board members and supported by member dues. These organizations fight to improve licensing laws where we have them and acquire laws were we do not. 
• We have the dedicated members of our state licensing boards. These NDs do the difficult and often unrecognized work of regulating the professional activities of our licensed NDs and bear that unique burden of judging unprofessional conduct and administering remediation and punishment. 
• The members of the Federation of Naturopathic Medicine Regulatory Authorities provide support to the licensing and regulatory authorities. 
• The members of the Council on Naturopathic Medical Education (CNME) which accredits naturopathic medical education programs. North American Board of Naturopathic Examiners (NABNE) and Naturopathic Physicians Licensing Examination Board which work together to manage the NPLEX examination process. 
• I applaud the NDs who are board members of the colleges and the many faculty and other committees that keep our colleges improving. 
• I appreciate those who forward our medicine by serving on specialty societies such as HANP, OncANP, PedANP, AANM, INGM, NAEM, NMSA, NP-GA, AANMC, SpiritMed, and IV Micronutrient Therapy. 
• The serious work of the innovators, those who create the Naturopathic Education and Residency Consortium (NERC/STAIR) and Naturopathic Physician Research Institute, (NPRI).

All this work begs the question, “Why do we do this?” Well…what else would we do? We have our health; we have a noble profession that we love, serve the needs of our communities, and forward the understanding of true healthcare for the coming generations. Indeed, I know no better outlet for my daily bread.

I send the highest kudos to our ND brothers and sisters in Massachusetts. May you heal your wounds and come out fighting.

2010 Year in Review

By Carl Hangee-Bauer, ND, LAc
AANP President

The AANP turns the page on another year. Image by andy.brandon50 via Flickr, used under the Creative Commons License.

As we approach the final days of 2010, I find myself in a reflective frame of mind, looking back at the past year as well as ahead to 2011 with hope and anticipation. Personally this represents my halfway point as AANP President. It’s been an active, exciting and challenging journey so far, and my suspicions have been confirmed that being in this position in the AANP is an opportunity for growth. I think all of my fellow officers and Board members past and present would agree.

The Board and Staff have just completed the work and budget planning for the next two-year cycle and it has made me think about the present state of the AANP and naturopathic medicine.

The AANP is in a very good place. Unlike many associations struggling in these economic times and tapping into their reserves to continue to function, the AANP ended the year with a balanced budget. We are living within our means, in no small part due to the vigilance and management of our executive director, Karen Howard. The AANP is fully staffed as we close out the year, having hired a new marketing and membership associate (Mandisa Jones) and state government relations director (Eugene McGill). In the coming year you will see more resources dedicated to state licensing, inclusion in the federal healthcare system, and benefits to support our membership, among other things.

The AANP Board continues to grow and evolve. This month we say “au revoir” to our departing board members Lise Alschuler, Michelle Clark, Bill Benda, Tabatha Parker and Sara Thyr. We thank you for your service and dedication to the naturopathic profession and wish you much success and happiness as you move on to other opportunities and challenges. On January 1, 2011, we are welcoming Holly Lucille, Joe Pizzorno, Carrie Runde, Keri Marshall and Cindy Breed to the Board as they begin their two-year terms. We are very excited to welcome these new members who bring a wealth of experience and willingness to serve the association and profession. Michael Cronin begins his term as President-Elect in 2011 and is taking on a greater leadership role within the Board as he prepares for his presidency.

As a profession, I believe that naturopathic medicine is in a better position to “take off” and serve more people than perhaps it has ever been. More states are on the cusp of licensure and, with the help of Gene McGill, I hope to see new licensed states soon. We are making inroads on Capitol Hill as Congress and regulatory agencies begin to implement healthcare reform, and I look forward to seeing ND inclusion in federal programs including loan repayment opportunities. Our DC FLI event in May is growing every year and we are now known in D.C.

As I write this it appears that CNME will be re-accredited by the US Department of Education for the next 5 years, the longest time allowed under the rules. Enrollment in the naturopathic medical schools is growing with plans for new schools in the next few years, and more NDs are graduating and bringing naturopathic medicine into their communities. Science and research opportunities are increasing with new NIH grants awarded to ND researchers, and the founding of Naturopathic Physicians Research Institute (NPRI), led by Carlo Calabrese, which will focus on developing studies to examine whole-practice naturopathic care. The Naturopathic Post-Graduate Association (NPGA) is up and running, coordinating residency opportunities amongst the colleges to increase the number of residencies offered and matching residency sites with candidates to improve the residency experience.

Our state naturopathic associations are becoming more sophisticated and active, developing marketing as well as continuing education programs to serve their membership. Better communication and coordination between AANP and state associations is occurring. Rick Marinelli, ND, was recently appointed to the Institute of Medicine (IOM) committee on advancing pain research, care and education, the first ND on any IOM committee.

So 2010 has been a good year for naturopathic medicine and the future looks bright. We have much to be thankful for as we take stock of 2010 and look forward to 2011 and beyond. As always, it comes down to the people who make things happen and the relationships we form—with each other, our patients, other like-minded groups and organizations, our local, state and federal representatives, and so forth.

YOU are the AANP; YOU are the profession. Everything the AANP does is filtered through the question: How does this serve our membership? As 2010 comes to a close, I want to thank everyone reading this for all you do, great and small, as every step moves us that much closer to realizing our dreams and goals for our profession and for the health and vitality of the communities in which we serve.

Have a joyous holiday season and a healthy and prosperous 2011.

President's Message: Running for Naturopathic Medicine

By Carl Hangee-Bauer, ND, LAc
AANP President

The Run: Moving Natural Medicine Forward

Some people walk their talk; others run with it.

On July 17, 2011, Dennis Godby, ND, of Sacramento, California, with his two sons and his nephew, will begin The Run across the USA to increase awareness of naturopathic medicine. The Run will start in San Francisco, and 123 days and 3,250 miles later, will arrive in Bridgeport, Connecticut (to the University of Bridgeport, the only east coast naturopathic medical school). The Run will expose thousands of Americans to naturopathic medicine and raise awareness of natural medicine options for creating a healthier America. Dr. Godby believes that The Run, through participation of NDs across the country and through grassroots efforts, can dramatically increase national naturopathic awareness.

I had lunch with Dr. Godby a few weeks ago and we talked about what motivated him 16 months ago to plan this run and to set out on this arduous journey. Dennis recalled how he came to naturopathic medicine relatively late in life compared to other students; he graduated from the National College of Natural Medicine in 2004 at 48 years old (he turns 55 during his run). Though he has practiced for only 6 years, Dr. Godby related how many “miracles” he’s seen using naturopathic medicine to help his patients in addressing their health problems and improving their health and vitality. Seeing so many of his patients’ improved health has only increased his passion to deliver the message to all of America that naturopathic medicine exists and may help them meet their health goals.

His run is an example of how one person can act to make a real change in his profession and in the health of this country, as well as a tremendous opportunity for the naturopathic profession to raise its visibility. Along the course of his run, Dr. Godby and his team will pass through both licensed and unlicensed states, 30 cities of over 100,000 people, past 25+ naturopathic clinics and ≈300 naturopathic doctors. All told, over 65 million people live in cities and towns along his route.

Of course, Dr. Godby is not planning this alone. NDs Rebecca Asmar, Holly Lucille, and Jaime Schehr are also on The Run leadership team, along with many others. Organizers are already planning local events, connecting with local media outlets and planning the public relations arm of this event. Over 260 events and press conferences are in the works. This will not only raise the public’s general awareness of our profession, but also serve as an invaluable opportunity for NDs along the route and those in states seeking licensure to gain significant local media exposure for their practices and legislative goals.

Dr. Godby is out there running and networking with NDs across the country for our profession and to improve the health of all Americans. I urge you to support him, The Run, and our profession. Get involved where you can to further these goals. There are many ways you can participate:

• Go to The Run website and endorse The Run.
• Make a financial contribution. A penny a mile for each of the four runners for 3,250 miles is $130 to help pay for motor home, food, insurance, marketing, running shoes, etc.
• If The Run is passing through your area, or even if it is not, get involved on the local level planning media and PR events, sponsoring a segment of The Run, and linking your practice to this event. Wisconsin NDs are driving down to Illinois to host an event.
• Come to the April 16th FUNraiser Dinner in Sacramento for an evening of celebration and fun!
• Be the support person on the motor home with the running team.

Following Dr. Godby’s lead, we can all make this one of the most successful events in modern times for raising the public’s awareness of naturopathic medicine and the choices it offers to health-care consumers.