Reflections: Naturopathic Medicine, Convention and Volunteerism

By Sara Thyr, ND

The Arizona Biltmore. Photo by AANP President Carl Hangee-Bauer, ND, LAc.

Upon returning this week from the AANP convention at the Biltmore in Arizona, I have been very busy. Which is fantastic. I’m very grateful. But it has not allowed much time for reflection on all that has happened, one of the gifts that being away from our usual circumstances often affords us. But being at the convention barely allows time for a few deep breaths, much less assimilating what we are learning and assessing our place in our national association. So I will take a few moments here to offer some of my musings regarding our time together, a family of healing professionals, basking in the sun and the desert heat.

First of all, while naturopathic medicine is still not more than a blip on the national landscape of health care, I was reminded yet again at what an amazing roll we might have in really, truly repairing not only the health-care system in America, but the health of all Americans. As we move into a new era of leadership in our community, I hope that this opportunity is realized.

Which brings me to thoughts about the resignation of our executive director for the past nine years, Karen Howard. I have a love-hate relationship with Karen and possibly always have. Let’s not call it love-hate. Let’s call it love-irritated relationship. We have very different styles of communication. I’m soft, squishy, and easy to tears—and dream of acquiring tactful disagreement skills. Karen is strong and outspoken and has no problem sharing her opinion, even if that may mean (what feels like) steamrolling over quieter voices. That said, I believe with all my heart that she has been the right person for our association for most of the last decade.

Karen has brought incredible awareness of our profession to our nation's capital—a stark change from the beginning of this decade. She has created networks within our own profession to assist more states in licensing naturopathic physicians, to help states with standing licenses to work together in improving scope of practice and marketability of NDs within those states, and she has taught so many of us how to come to our legislators with our information and expertise and ask for what we want. The DC FLI was an incredible undertaking and has blossomed with incredible success over the years. Most legislative health aids and legislators today know what a naturopathic physician is. This was not the case before Karen Howard took over the roll as full-time steward of our profession ten years ago.

Within the framework of the State Association Leadership Team (SALT), Karen taught us about strong associations and strategic planning. Many of us in our states' leadership roles brought this knowledge back to our states to assist local leadership in becoming more organized and stronger—not to mention becoming more proactive than reactive, learning to quit operating via putting out fires and start planning for the future.

When Karen took over as executive director, our association was fractured and deeply in debt. She thrives on picking up pieces in great disarray and building something that is stronger than it was before. And that she did. While I felt her resignation like a blow to the gut, once I recovered and began to breath again, I realized that she has equipped us with the ability to move forward and continue to achieve our goals as an association. And as one physician who has worked with her for many years, I feel that I will continue to be able to achieve my own goals with much of the knowledge and experience that she has helped me acquire. I am deeply grateful for her touch in my life.

While I was working as president of the New Hampshire Association of Naturopathic Doctors, I was inspired at a SALT conference to bring in a consultant to work with our association on strategic planning. It was a challenging process, but one where we moved forward as a group and all learned a lot. One thing that I have always held from those days of meetings was about volunteerism: our consultant impressed upon me that we should never separate our volunteers from their passion.

It takes a great deal of time and commitment to volunteer for any work—and perhaps most especially for this profession—because there is so much to be done and so few people to share in the tasks, which at times seem larger than life. I have worked on putting together speakers for the AANP Convention for the past four years—task which I think Karen inherently knew was my passion, and could rely upon me to spend many hours trying to perfect the process. It is bittersweet to let go of chairing that committee—made easier only by leaving it in such capable hands as those of Dr. Jacob Schor.

Karen Howard had an innate ability to recognize people’s passions – and help them find a way to fit service to our organization into their busy lives. I am not certain if it is testament to my lack of backbone or her great persuasive skills that I could not say no to her. Maybe I’ll try to hide for a while from our new ED! :’)

Hiring Rebecca Takemoto and her staff at Sync-Opate to handle our convention and other meetings such as the SALT and FLI was another insightful move on Karen’s part. Rebecca makes the convention run incredibly smoothly, and is perfectly cut out for a job where she is juggling 40 things at once and smiling calmly as she deals with the latest crisis. And let’s not forget the food. She makes sure that the chef’s anywhere we go provide fresh, green, allergy-sensitive foods—and as seen at the Biltmore—that taste wonderful.

When I look at our profession as a whole, from topics as diverse as the national legislative process to the process of trying to figure out what topics at a conference will be most interesting, I find myself perplexed. We are both so alike and yet so incredibly different. As Dr. Matthew Baral so eloquently said in his closing keynote address, there is no me, only us. There is no mine, only ours.

I wish many blessings for Karen as she finds a new place to share her incredible strengths.

Fame!

By Bill Benda, MD

This article is reprinted with permission from the peer-reviewed journal Integrative Medicine: A Clinician’s Journal (www.imjournal.com), vol 7 issue 1, pp 64. Copyright 2008, InnoVision Health Media (www.innovisionhm.com).

“Some struggle and strive and make a vast difference on our planet, only to die in obscurity. Others are born on third base and go through life thinking they’ve hit a triple.”

I received a call several months ago from a good friend of mine, a naturopathic physician with years of clinical experience, one book, and several prior political offices hanging like Christmas ornaments from her resume. She was distraught and angry, fortunately not with me in this particular instance. It seems she had picked up a copy of a popular “news” journal at the supermarket, drawn to the cover story touting the effects of dietary changes on fertility, her specific area of expertise. I’ve read the article myself; it’s basically a glossy six-page excerpt from a new book by two Harvard medical doctors.

So why was this accomplished ND up in arms over a mainstream public magazine espousing an arena reflecting her own hard work and professional expertise? Simply this: After years of fighting the allopathic tide, taking hits for suggesting a non-pharmaceutical approach for an issue of great emotional impact, and helping numerous women achieve their reproductive ambitions, a couple of envoys from an ivory tower of medicine were about to garner the reverence, influence, and income that accompany the royalty and royalties bestowed through public acclaim.

This was not the first time such a perceived offense had confronted her. And not the first time it has confronted me. Indeed, my address book is replete with souls who have, through great effort and persistence, subtly affected the medical paradigm that is slowly loosening its grasp on our healthcare system. Yet perhaps only a dozen or so of their names would be recognized by either the integrative professional or integrated layperson. Even for those who have achieved national acclaim, fame has often been as much the result of cultural timing as sheer talent—as talent is a not uncommon attribute in our field.

I can imagine the absolute frustration of seeing one’s own sermons, so carefully prepared and nurtured, splashed through the pages of Time or Newsweek. “This is mine!” thunders the ego, not without reason. “I gave up income, security, and comfort to walk this path! If anyone’s face belongs on that cover, it’s mine!” I know such words well; I’ve had this internal dialogue with myself on more than one occasion over the years. Indeed, a desire for personal recognition was one of the original motivations that launched my expedition from the shores of conventional medical. But slowly, and not without significant discomfort, I’ve begun to let go of such desires.

Partially this has been due to the natural aging process, as I’m beginning to accept that I will never be president or cure cancer. But mostly it’s because I am beginning to understand what the sages have always known—that it ain’t about me, babe, as much as I hate this particular deduction. It’s about what I do with my time on earth, whom I touch, how I love. Because for all of our plans and dreams, the fact is that the recompense for living is as unpredictable as life itself. Some struggle and strive and make a vast difference on our planet, only to die in obscurity. Others are born on third base and go through life thinking they’ve hit a triple. This is nowhere more evident than in our field of integrative medicine, where a moment on Oprah trumps a decade in the laboratory, and an Ivy League degree confers a moniker of brilliance, no matter the actual grade point average.

So to comfort my dear acquaintance, and my own fragile ego, I would say this: Life appears to be not a mirror but a window. It will never disclose to us who might be the fairest of the fair or reflect back to us the true meaning of the long and convoluted thread that unravels as a result of our efforts. It will simply reveal to us where we must travel next, who still remains to be healed, what still requires our continued attention.

Yes, I still long for the kudos and cash that might come from seeing my face on a popular website or in the conference brochure between the pictures of the palm trees and the girl in the yoga pose. But reality continues to trip me up each time I meander down that particular path. I no sooner start than I find myself once more trudging towards the hospital or back at the computer keyboard trying to make sense of this irrational realm we call healing and healthcare. But every once in a while, I am awarded with a thank you card from a patient I have since forgotten or the thoughtful note spawned by my last editorial. And I remember that, for me, fame has been a drug without a disease, leading only towards addiction and abuse—and that, whenever I have tasted it, I have come out the worse for the experience. And somehow, in this thought, I find a sense of peace.

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.

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.

Federal Policy Priorities for the Naturopathic Community: Reflections on the DC FLI

By Carl Hangee-Bauer, ND, LAc
AANP President

The Cannon House Office Building on Capitol Hill.
Photo by cliff1066^TM via Flickr, used under the Creative Commons License.

Here it is, mid-May already, and it’s been a busy time at the AANP.

I’m sure you have read Karen Howard’s report on this year’s DC FLI. It was a busy four days in Washington, D.C., as over 150 people, including more than 100 naturopathic medical students, met on Capitol Hill to refine our leadership skills, meet with legislators and their staff, and create a visible presence in our nation’s capital. For a profession as small as ours, we have managed become known in the Halls of Congress. This year was my 3rd DC FLI, and I noticed that we spent much less time explaining what naturopathic medicine is and who we are and more time discussing issues important to our profession, our members and our patients.

One of our key messages involved inclusion of naturopathic doctors in various loan repayment programs created or extended under the new Patient Protection and Affordable Care Act. It’s ironic really. Both the Department of Education and the Carnegie Institute classify the ND degree as a First-Professional Degree on par with MDs and DOs. All naturopathic medical schools are accredited by the CNME which is recognized by the Department of Education and each of our schools are regionally accredited by authorities recognized by the Dept. of Ed. Naturopathic medical students are eligible for the same federal loan programs as MDs and DOs. Yet, naturopathic doctors are not named in a number of federal programs which allow us to serve in underserved communities and are excluded from participation in all federal loan repayment programs, including the Public Health Workforce, the National Health Services Corp, and the Indian Health Care Improvement Act. This is clearly unfair and is a significant barrier to NDs participating in federal programs, and in the meetings I attended, this was clearly heard by the health staff people with whom we spoke.

Our doctors and students also advocated for a consensus definition of “Integrative Health Practitioner,” a term used but left undefined in the health care reform language, and reminded legislators of our support for DSHEA, which frequently comes under attack from various legislators and agencies.

I think that at least as important as our messages and issues discussed is our presence in D.C. and the building of relationships with legislators, their staffs, and the various regulatory agencies that oversee the transformation of bill language into laws.

On another note, members of the AANP should be receiving their elections packets from the AANP very soon. This year a number of candidates have stepped up for Board positions and for the first time ever we have a competitive election for AANP President-Elect. I am impressed by the quality of our candidates and the wealth of experience, knowledge and dedication to the profession that they all bring to their candidacies. Please read over the candidates' statements and vote for your choice of our next AANP leaders. Your interest and participation are critical to the future of the AANP.

Finally, watch for materials coming soon about the AANP convention in Portland, August 11th-15th. It should be a great one as we celebrate the AANP's 25th anniversary, learn from some of the elders in our profession, and spend time with old and new friends. I hope to see all of you there.