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 medical reasons.

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 new uses.

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.