Naturopathic medical education has come a long way since the inception
of National College of Natural Medicine (NCNM) in 1956, when it was
the only surviving college of naturopathic medicine left in the United
States. Our 50th anniversary this year has prompted us to review where
we came from and where we are today and to look at where we are going
in this new century. The outlook is bright.
The information explosion beginning in the 1990s has had an impact on education,
on the way information is disseminated and used, and on expectations of students,
patients, and practitioners. Conventional treatment of disease supposedly has
been based on science, while the "alternative" forms of medicine
supposedly have been based on historical treatments and philosophy. That history,
science, and philosophy are in some way polar opposites is a strange dichotomy.
And the information explosion that we are now experiencing is proving that
this has always been a myth, which may have endured more for political than
Naturopathic education is collaborating with scientists and physicians and
healers of all kinds, to use that information explosion to bring about what
is best for people suffering from disease. The last ten years have shown that
all healers must have the same goal: to make sick people well to the best of
our ability. To this end, physicians and students are listening to each other,
cross-pollinating science and philosophy with different perspectives that do
not oppose each other, but support and provide depth.
After spending twenty years at NCNM, I have seen the shift from historical
use of the medicine to historical use of the medicine in combination with the
burgeoning science that supports and extends the practice of naturopathic medicine.
What a joy it has been to administer hydrotherapy treatments and really understand
that what we claim is effective has been shown to be so by concentrated analysis
of the treatment results. This analysis, of course, does not make the treatment
work, since it worked before we did the studies. But now we can better explain
why the treatment works. Additionally, a better understanding helps us to make
the use of such treatments more effective in individual cases and also create
Medicine has ever been in a state of flux. Therapies have come and gone over
the centuries and millennia, with some therapies falling out of favor because
they were found to simply not work. Or, in the case of more invasive measures
like surgery and toxic drugs, the side effects were found not to be worth the
benefit. Sometimes, therapies were abandoned because someone discovered an "easier" way
to do something that did not require as much effort or change on the part of
the patient. And we are finding that sometimes that more difficult road is
actually more effective. There are simple examples of this, like the perceived
ease and convenience of modern processed foods as contrasted with the more
labor-intensive preparation of nutritious whole foods. Americans have been
participating in a poorly controlled dietary and lifestyle study over the past
fifty years, and it seems clear to us now that some of the "old ways" are
better for the success of the human body. Whole food is superior to processed
food. Now that we see the results, perhaps we can do something about it.
Medicine has always been political, which is part of the reason for the state
of flux we see over the history of medicine. In the twentieth century, "scientific" medicine
took ascendance over other forms of care, because it was new and dramatic and
because there was money to be made. Food processing made eating "easy," and
antibiotics made curing infectious illnesses "easy," and, indeed,
the concept of "better living through chemistry" seemed to be becoming
a reality. Such advances reduced infectious diseases for a time (until stronger
bugs came along), and lack of exercise, poor food, and sedentary lifestyles
have taken their toll. As a result of this experiment, we have new problems
now and more serious chronic diseases. This experiment has not worked.
This fact is the main reason why the alternative medical field has thrived.
More importantly, alternative (or complementary, or whatever you want to call
it) medicine has come of age. In the current climate, alternatives are sought,
and they are examined by the patients. Patients want to know why our medicine
works, and they want to know that we know why. They want to know if a naturopathic
treatment works better than the conventional ones. And they look for information
on the Internet to find out what they should do. Our patients are better informed
than they ever have been before. (Unfortunately, sometimes they become informed
through reading advertising thinly disguised as medical information.) And they
are still looking for miracles.
As a result of the changes in information dissemination in this day of the
Internet, medical schools have had to change, as physicians have also had to
change. Medical doctors are a little better-informed about non-conventional
medicine, and non-conventional practitioners also have to be more informed
about conventional practices. The lines are blurring. We are no longer always
in opposite camps but making sometimes tentative overtures towards each other.
We work with each other in integrated clinics in some places, we exchange students
between allopathic and naturopathic schools, and we do research together.
I think the most important of these is doing research together, publishing
research that all practitioners can access, and talking about that research.
We look at the results in patient care that we are both getting and use that
information to help other patients. Medicine is in flux, because it is the
nature of change when new information is accessed. Sharing experiences makes
for better information. This makes for better care of patients.
NCNM is in the process of changing its naturopathic medical curriculum to evidence
a more "outcomes-based" assessment of the skills of our students.
Medicine is also in this process. Theory, science, philosophy, and history
are all part of the knowledge we bring to healing and teaching, and outcomes
assessment is the measurement by which we know that what we are doing is working.
My personal vision for naturopathic medical education encompasses more research,
more critical thinking about what we accept as useful in healing, and more
understanding of the concept of outcomes, both in education and in healing.
I am vastly encouraged by the amount of research being conducted collaboratively
with the simple intention of finding new ways to stimulate healing and to validate
those that have been used for centuries. Knowledge is power, as the old saying
goes. And it would seem to me to be in the best interest of the health of human
beings if we could continue to pool information and honor the different methods
available. This requires tolerance of procedures and approaches different from
our own. That tolerance comes from good information and communication.
This is an exciting time to be a naturopathic physician, as the educational
and practice opportunities are expanding. The chances for collaboration and
true integration are invigorating. The fears that some have expressed that
naturopathic medicine will be subsumed into conventional medicine are in my
opinion unfounded. There is plenty of work for all of us to do with our patients.
Open communication and shared research simply make that job easier.
The bottom line is that we treat the patient, not the disease. We use our science,
our history, and our philosophy to treat a person. We use whatever it takes,
knowing that in an informed world, there will be support for the various methods
and there will be information and collaboration to help us.
The future of medicine is still in flux. This is healthy, since needs change
and new information colors what we do. Natural medicine is finding its place
in the new paradigm of healing yet again. It is doing so by being in step with
the information we have and influencing the integrity of that information.