Showing posts with label naturopathic profession. Show all posts
Showing posts with label naturopathic profession. Show all posts

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.

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.

President's Message: Convention Notes and the Search for a New Executive Director

By Carl Hangee-Bauer, ND, LAc
AANP President

AANP President Carl Hangee-Bauer, ND, LAc, and President-Elect Michael Cronin, ND, with their
wives Michele Hangee-Bauer and Kyle Cronin, ND, respectively.
It’s been two months since my last President’s blog and there has been a lot of water under the bridge since.

The 26th AANP Convention at the Arizona Biltmore has come and gone and was a success by all measures. I had a great number of people come up to me and tell me that this was the best conference they could recall, from the quality of the sessions to the results of the elections and annual awards. Everyone seemed to enjoy him- or herself at our favorite convention venue.

There are many congratulations in order. Dr. Michelle Simon is our newly-elected Board member, with Drs. Kasra Pournadeali and Dr. Michael Reece re-elected to second Board terms. Dr. Joe Pizzorno will succeed Dr. Corey Resnick as our next Treasurer, and Dr. Bruce Milliman was elected the next Speaker of the House of Delegates. And, as you all know, Dr. Michael Cronin will be succeeding me as your next AANP President in January.

Thank you to all who ran for Board or House leadership positions, congratulations to all who were elected, and thank you to all who have served and will be moving on to more challenges and opportunities, particularly Board member Dr. Trevor Holly Cates and House Speaker Dr. Helen Healy.

Our 2011 awardees were met with great appreciation and applause by attendees at the annual awards banquet. Dr. Shiva Barton is our 2011 Physician of the Year, Dr. Louise Edwards received the Vis Award, Dr. Bill Benda received the new Champion Award, and Dr. David Field received the President’s Award. Emerson Ecologics was named AANP Corporation of the Year and Dr. Ryan Bradley and Joshua Goldenberg, ND candidate, received research accolades. These awardees have all demonstrated great dedication to the naturopathic profession and have accomplished great things, some over a lifetime of service. They are examples to us all and we thank them and congratulate them from the depths of our hearts.

Just a few days before the start of the convention, Karen Howard called to inform me that after nine years as AANP Executive Director, she has decided to retire and move on. The announcement was later made to the Board, House of Delegates and the convention attendees at our annual meeting. Karen’s decision has reverberated through our community and set a tone at the convention that was reflective of her many accomplishments, her impact on the naturopathic profession, and the mixed emotions in the community with her moving on.

Karen joined the AANP during a time of great change and has been an instrumental force in our move to Washington, D.C., and our greatly increased federal presence. She has overseen many developments in our organization that we take for granted today, including development of practice development resources, the state alliance, our website, strategic coalitions with groups aligned to our purposes, and of course our annual DC FLI.

Her fiscal prowess has been exceptional. When she started as Executive Director, the AANP had a $276,000 deficit. As of the end of 2011, we have a positive balance of $402,000. We owe much of our prosperity and fiscal good health to her steady hand.

Karen has offered to stay on as Executive Director while we begin our search for her successor, and there will be plenty more to say before she completes her work with the AANP. I plan to devote one of my next blogs to Karen and the impact she has had on the AANP and the naturopathic profession, so stay tuned!

With Karen’s announcement, I immediately activated our succession planning process and appointed an Executive Director Transition Team (EDTT) consisting of Dr. Michael Cronin, Dr. Joe Pizzorno, Dr. Keri Marshall, Dr. Lise Alschuler, Dr. Harry Swope, David Matteson, and me. The EDTT has been meeting weekly to establish a rational process for succession. Our first steps have been to assess strategically the current state of the association, the needs and goals of the organization over the next five years, and the assets and profile of an ideal executive to fit our needs now and in the near-term future. We anticipate completing our assessment and posting a job description in October, and hope to begin the interview process soon afterwards.

We will do our best to keep in good communication with you as we move through this process, and appreciate the community feedback we have already received. This is some of the most important work we will do as an association over the next three to six months and the choices we make will affect the progress and goals of the AANP over the next five to ten years. The better the job we do now, the better we will meet our common goals. 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 plan to keep you up-to-date with these monthly blogs and in other venues as needed or appropriate.

President's Message: A Summer of Community

By Carl Hangee-Bauer, ND, LAc
AANP President

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

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

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

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

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

A few reminders:

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

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

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

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

I look forward to seeing you all there.

DC FLI Report

Written by Michael Cronin, ND, AANP President

But you must remember, my fellow-citizens, that eternal vigilance by the people is the price of liberty, and that you must pay the price if you wish to secure the blessing.  It behooves you, therefore, to be watchful in your States as well as in the Federal Government. 
- Andrew Jackson, Farewell Address
March 4, 1837
The AANP had its 9th DC Federal Legislative Initiative May 7, 2012. It was attended by nearly 140 NDs and students with 529 visits organized.  Our goal is to find legislative allies to work with to improve federal recognition of NDs which will empower our state legislative efforts.  

Our legislative asks at the DC FLI were simple and straight forward. We asked legislators to write a letter on our behalf urging Secretary Sebelius, of the Department of Health and Human Services, to include naturopathic physicians in all HHS programs.  When NDs are recognized by HHS, jobs for NDs in community health centers, tuition forgiveness and federal programs may begin to open up. We also requested legislators to contact Secretary Shenseki and recommend that NDs be included in the Department of Veterans Affairs programs. We could still use your help. Please take action and contact your Members of Congress today!

The Affordable Care Act enables the “inclusion of licensed naturopathic physicians as full participants in all federal initiatives and programs relating to citizen access to health care is in alignment with the federal government’s goals concerning access to health care.” Implementation of Articles 2706 (non-discrimination), 3502 (medical homes), and 5101 (workforce) would increase choice, potentially leading to citizens choosing less costly interventions and providing greater access to those clinicians capable of providing those interventions.  NDs can play an important role in addressing the national shortage of primary care providers which is expected to significantly worsen in the immediate future.

Good work is being done with your membership dollars. We recently saw a great success with the inclusion of NDs in the Indian Health Services Loan Repayment Program.

NDs are a small but effective community with a large mission. The AANP needs more members so that we can do more. Help the naturopathic profession’s progress by asking your colleagues to join our AANP.

If you read this, please drop me a note at mjcronin@earthlink.net.

Michael Cronin, ND
AANP President

Doing the DC FLI

By Susan DeLaney, ND, RN

Susan DeLaney, ND, and Trevor Holly Cates, ND, feed body and mind at the
2010 DC FLI reception on Capitol Hill.
Washington in the spring is a lovely place to visit, especially when you get to do it with a mini-convention of naturopaths and naturopathic students from around the country. The first weekend in May each year, we gather at the Capitol to learn from each other, about the basics of politics in Washington and what we can do to move our message of naturopathic health care forward. This year's event is planned for April 30 - May 2!

Each year I go I learn something new, meet new people, and reconnect with old friends. For two days, we are listening to valuable speakers, sharing ideas, and practicing how to talk to legislators about our issues. The third day, we put into practice what we have learned. Traveling in groups, we visit our respective state Senate and House members in their offices. Locating their offices in the maze of the Capitol Buildings is a bit like a scavenger hunt. Most of the discussions are with their health-care staffers, who do listen and convey the information to the representative. Meeting face-to-face in their offices with legislators and staffers provides us an opportunity to have in-depth discussions about who we are and what we do.

At first I was not sure that what we did mattered until one staffer recalled that she remembered our visit from last year! It is truly the presence of so many doctors visiting Washington that makes such a difference. Before our first annual fly-in event, no one really knew who we were. Now they know faces and stories that connect them to naturopathic medicine.

And then there is the famous, late afternoon naturopathic reception where we have earned our reputation in D.C. as the best place to hang out with healthy food and wine. Smoked salmon, fresh fruits, nuts and a fabulous kale salad have really made us the toast of the Hill! They come early and stay late to enjoy the delicious food, and socialize with their constituent NDs and naturopathic students.

When the work is all done in the evening, we walk the city, enjoy fabulous meals with friends, stand before majestic monuments that are so beautifully illuminated every evening, and find ourselves filled with awe that we have the freedom to be there. We have the freedom to do this work, and by letting our voices be heard in the halls of Washington, we help grow naturopathic medicine.

Wishing you can all be there with me this year! Registration is FREE for all members, and closes April 15!  Click here for more information and to register today!

President's Message: Running for Naturopathic Medicine

By Carl Hangee-Bauer, ND, LAc
AANP President

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.

The Circle Game

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

Photo by Helen White via Flickr, used under the Creative Commons License.
So. It’s time to find a topic for the next edition of the Physicians Who Listen blog. I know because a week or so ago I received the gracefully worded request from Matthew Santoro, the Communications and Media Associate of the AANP, gently reminding me that Friday is the deadline.

And Friday came and went, bringing to my consciousness the fact that my Integrative Medicine: A Clinician's Journal editorial was also overdue by two weeks, and the Journal of the ACM deadline is only a week or so away, and that my mind is and has been a total blank. It’s not writer’s block—I could blather on for hours about various idiocies inherent to the conventional health-care system or how the emerging theory of basing physician pay on patient satisfaction would be the clinical kiss of death in the Emergency Room.

Nope. I’ve come to the sad conclusion that I really have nothing left to say about the field of integrative/holistic/naturopathic medicine that I haven’t said before, and others’ oft-employed editorial option of describing how the purity of our natural therapies reminds me of the first breath of Spring just isn’t my style. And of course I still do not have the courage to remark on Karen Howard’s leaving or how totally predictable our major conferences have become, as it may hurt some people I still like and admire (but stay tuned).

So I am stuck with nothing to say, and therefore have no choice but to talk about why there is nothing to say. Primarily because this grand experiment of ours is no longer grand or an experiment, at least to me, but simply another chapter in the Big Book of Health-care Tales. Not to sound a discouraging note—this conclusion is simply evidence of an inevitable step in the evolution of all great ideas. First the excitement and purity of discovery (this is so cool and makes so much sense), followed by the heady rise against all odds (from ridicule and ostracization (no, its not a word) to the emergence of Weil, Ornish, NCCAM, IOM reports, and countless billions spent out of pocket), all highly seasoned with the seductive flavor of danger (what if we can’t ever make a living doing this? What if we can’t even find a job?).

But then, with every “victory” comes the inevitable price.

“We can’t prove all of this because the reigning research paradigm was created for reductionistic trials” has become “we must make research a priority because it’s the only way the reigning paradigm will accept us.”

“Should we even consider accepting insurance reimbursement?” has transmogrified into “naturopaths are now on the federal CPT committee!”

Our pioneers are now not only writing even more books but also selling their household products online and hosting daily television shows that remind me of a cross between Oprah and Phil Donahue.

And if I get one more “Dear Bill, this is a personal note to you, and I hope you will join me in an exciting seven-day program to cure you patients and increase your income by 25%,” I’ll have to reach for the Nux Vomica.

It ain’t what it used to be, folks, and I guess that can be considered a good thing in today’s social media/newest/greatest culture. It means we’ve arrived. But it makes me want to leave again, to find whatever the next cutting edge is, the one that will challenge the integrative/holistic/naturopathic model I helped create. To feel the resistance rather than the acquiescence, to worry again that I may not really have a clue as to what I am doing.

I want some new paradigm, fresh idea, brilliant concept - one whose purity will remind me of the first breath of Spring . . .

President's Message: Thanking and Honoring Karen Howard

By Carl Hangee-Bauer, ND, LAc
AANP President

Exiting Executive Director Karen Howard poses with AANP President Carl Hangee-Bauer, ND, LAc (left),
and Bill Benda, MD, FACEP, FAAEM (right), at the 2010 AANP Convention.
It is a time of great change for the AANP and perhaps the most significant is that Karen Howard, our Executive Director for the past nine years, will be moving on at the end of November. Karen has left a huge mark on the AANP and the naturopathic profession and she will be missed. As I pondered what fitting words to say to mark this occasion, I turned to other AANP Past-Presidents to ask them what they would like for us to remember about Karen as we thank her and honor her work. So, without further ado...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Red Leaves in Fall

By Jacob Schor, ND, FABNO

Photo by Mike Gifford via Flickr, used under the Creative Commons License.
We traveled to the east coast recently. Ostensibly we were going to a wedding and for Parents Weekend the following weekend at our daughter’s college, with the days between spent at the family cabin in Maine. In truth, we were going to see the leaves.

The leaves of deciduous trees change colors in autumn before they fall off the trees. Obviously this process gives name to the season. Less obviously, the Greek term for this leaf falling phenomenon is the etymologic base for the modern term ‘apoptosis,’ which describes the process of cellular suicide, an honorable and desirable decision when initiated in cancer cells. Why trees exhibit such a wide range of colors has been one of those unanswered questions for both the questioning mind and modern biologists.

A series of papers now provide an interesting answer to this question, and lead to an even greater appreciation of fall colors while forcing us toward some interesting ruminations.

Your basic, generic leaf is green. This is because chlorophyll is green and leaves contain lots of chlorophyll. Plants use chlorophyll to absorb energy from sunlight and convert it into sugars and starch, your basic elements of what we call food.

When leaves begin to die in the fall, the chlorophyll green fades away and no longer blocks out the underlying yellow pigments. Leaves turn yellow when they die. Yet some leaves turn brilliant red.

Red leaves are a different story. Chemicals called anthocyanins are responsible for this red color; they weren’t present in the leaves during the summer. Some trees actively make anthocyanins as their leaves start to die. Why would a tree go to the effort (expense) of filling leaves with anthocyanins just before they become ground litter? An even better question is, why are red leaves common in New England and rare in Western Europe?

Anthocyanins serve a number of functions in plants. The list gets longer every few years.

In 2003, William Hoch of Montana State University, reported that anthocyamins helped send nutrients to the plants roots.  Blocking anthocyanin production resulted in the plant sending fewer nutrients to the roots for winter storage.i

In 2007 Habineck reported that trees that grown in nitrogen-poor soils produced anthocyanins because the pigments protected the leaves and kept them alive a bit longer giving them the chance to store  more nutrients in their roots before winter set in. Thus the red hues in the fall are the sign of a stressed tree trying to squeeze out a few more days of photosynthesis, to make every last bit of food to survive..ii

Anthocyanins also protect leaves from freezing as the temperature gets colder in the fall and actually help the leaves absorb more warmth from sunlight postponing the inevitable.

Anthocyanin pigments also protect against damage caused by insects. This ‘insecticide action’ explains why autumn leaves are redder in the U.S. than in Western Europe.  Oddly enough this explanation comes from Simcha Lev-Yadun of the University of Haifa in Israel, a country not known for fall colors. While earlier theories focused on the red leaves serving as a warning to insects that ‘we don’t taste good,’ Lev-Yadun’s explanation focuses on the insecticidal properties of anthocyanins.  A carpet of anthocyanin rich leaves surrounding a tree through the winter decreases insect breeding and subsequent attack from insects the following year.

North America and Europe have underwent repeated eras of ice ages during which trees have evolved to become deciduous, adapting to fluctuating seasonal and climatic conditions. In adapting to both seasonal cold and dry periods, trees also learned to repel seasonal insect attacks. Many trees learned the value of seasonal anthocyanin production. (We should note that in the tropics, many plants produce anthocyanins year round.)

There is a key difference between the pressures put on trees in North America versus Europe. In North America, the challenge to trees during the ice ages was different; plants and insects could gradually migrate north and south as the ice fields waxed and waned. In Europe the trees were trapped, along with the insects that wanted to feast on them, between ice sheets that advanced from the north and from the Alps. According to Lev-Yadun’s thesis, these European insects largely died out: "The anti-herbivore component in red leaf coloration was relaxed, and northern Europe became dominated by trees with yellow autumn leaves." The European trees didn’t need to make anthocyanins, so they lost the habit. Thus European trees turn yellow with little red.iii

Here in Colorado, our thoughts quickly turn to Aspen leaves, which evolving high in the Rockies with reliable cold winters also had less need for insect defenses than trees in our eastern hardwood forests.

While solving this basic question of why leaves change colors just before they fall provides some relief, Lev-Yadun’s theory reminds us of a bigger question.

NDs often promote consumption of foods and nutritional supplements because of their high anthocyanin content.

Plants with high anthocyanin levels include the Vaccinium species (blueberry, cranberry and bilberry), the Rubus berries (black raspberry, red raspberry, blackberry, and blackcurrant), and a number of other plants including cherry, grape, red cabbage, violet petal, eggplant peel, black rice and black soybean.

Many nutritional proponents include these foods on their lists of the most beneficial things to eat.

Anthocyanins are but one example of chemicals that plants make that have insecticidal properties. When we start looking at other plant chemicals considered good for us, we eventually discover that the plant made them to be poisonous.

The yellow alkaloids in berberine and curcumin, the isoflavonoids in soybeans, the isocyanides in cruciferous vegetables and so on were all meant to be poisonous to bacteria, fungus, insects or animals.

Why is it desirable for us to swallow a botanical hodgepodge of poisons?

If we want to really understand this, we need to go back to basics. We need to view this question against an understanding of the basic laws of nature.

The first law of thermodynamics is often called the conservation of energy and says that, “Energy can be changed from one form to another, but it cannot be created or destroyed. The total amount of energy and matter in the Universe remains constant, merely changing from one form to another.”

The second law of thermodynamics tells us, “In all energy exchanges, if no energy enters or leaves the system, the potential energy of the state will always be less than that of the initial state." This is also referred to as the law of entropy. The universe always moves towards states of greater entropy or disorder. (I also refer to this as the Law of Socks, as in “Fewer pairs of sock will emerge from the dryer than I wore last week.”)

Everything in the universe moves toward states of greater entropy, except of course for things that are alive. Life is the opposite of entropy, always striving toward levels of greater complexity and order.

Things that are alive have the capacity to use energy and resist entropy. Living things react and adapt to forces that would drive them toward entropy.

The second law of thermodynamics: “if no energy enters or leaves the system…”
Living things are able to resist entropy because they constantly bring more energy into the system: they eat! Food contains stored energy. Resisting entropy takes energy; creating states of greater order takes energy. To do either takes food. We eat in order to resist entropy.

Thus, in a primal sense, we might define life as the ability to utilize the energy in food in order adapt, maintain order and resist entropy.

The stored energy in food all comes from sun, which at some point is stored through photosynthesis in plants.

Without food, living things lose their ability to resist the forces of entropy; they lose the ability to adapt.

How do you know if something is alive? You poke it. If it’s alive it moves. Living things respond to the world, to stimuli.

‘Poke it, see if it is alive’
Living things adapt and respond in someway to external forces; they adapt to maintain order, either to get out of harm’s way or to move toward food or less entropic environments.

These basic definitions of the universe lead us to a biological term called “adaptive response.” In its simplest definition, adaptive response means “an appropriate reaction to an environmental demand” (Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier).

A fuller definition might read “The ability of a cell, tissue or organism to better resist stress damage because of prior exposure to a lesser amount of stress, observed in all organisms in response to a number of different cytotoxic agents.”

Adaptive response is now often applied to the ability to repair genetic damage and can be triggered by exposure to cytoxic exposure, to phytonutrients such as anthocyanins. Adaptive responses can also be triggered by whole organism stressors.

An example of whole body stressors is the Scandinavian habit of cold water swimming. Researchers there have done some interesting work on adaptive responses in individuals who enjoy this practice, which entails taking hot saunas and then leaping into holes cut into the winter ice of lakes for a swim.

One Finnish study tells us that this habit changes an individual’s response to cytokines: “These stresses appear to challenge both the neuro-endocrine and the immune systems and the results indicate that adaptive mechanisms occur in habitual winter swimmers.”iv

As an aside, as we look at the many traditional practices of nature cure that were and are promoted by members of the naturopathic profession, we can see how many of them trigger adaptive responses.

Coming back to red leaves in autumn and anthocyanins, if we view anthocyanins as elements that will trigger various adaptive responses, such as triggering DNA repair and preparing our bodies to adapt to stressors, we can see how and why these chemicals can be both poisonous to insects and health-promoting to humans at the same time.

As we watch leaves turn red this autumn, perhaps we can also find some pleasure in the understanding of these complex relationships that give rise to these leaf colors that our minds simply perceive as a thing of beauty.

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iHoch W, Singsaas E, McCown B. Resorption Protection. Anthocyanins Facilitate Nutrient Recovery in Autumn by Shielding Leaves from Potentially Damaging Light Levels Plant Physiology 133:1296-1305 (2003)
iiHabineck, EM. Correlation of soil development and landscape position with fall leaf colors. Paper No. 81-15 2007 GSA Denver Annual Meeting (28–31 October 2007)
iiiLev-Yadun S. The shared and separate roles of aposematic (warning) coloration and the co-evolution hypothesis in defending autumn leaves. Plant Signal Behav. 2010 Aug;5(8):937-9.
ivDugué B, Leppänen E. Adaptation related to cytokines in man: effects of regular swimming in ice-cold water. Clin Physiol. 2000 Mar;20(2):114-21.