The Posse is Coming: Competition in the Naturopathic Education Sector

David J. Schleich, PhD

Private education keeps expanding in this age of LMS capability and Millennials. This continuing growth in the higher-education food chain, some argue, persists despite the recent aftershocks of student loan levels and default rates for those same private operations. The market demand for professional preparation, especially in the business and health sectors, is growing too. Even the Department of Education (DOE)’s “financial responsibility” watch-list does not significantly deter the market. Demand is characterized by interest in flexible delivery systems alongside increasing accountability from accreditors and funding sources. These trends are happening within a field long-dominated by publicly supported universities, who themselves see the future writ large because of spiraling costs and shrinking state support.

Proprietary Schools

These businesses are also called “proprietary schools.” They are known to rely heavily on tuition to meet operating costs at the same time as they carve out a profit. The market for their services is robust. In America, they enroll about 1.6 million of the 20 million college students nationwide, and operate 28% of all 2-year colleges. What is worth noting is that their cohorts are assembling at 4 times the rate of the entire sector. The Apollo Group is the star performer. The University of Phoenix is their lead brand. Cumulatively, Apollo enrolls, in 176 locations, 307,400 students in the United States, Puerto Rico, and Canada. The largest US state systems (eg, California, Florida, Georgia) have comparative populations. This is big business.

Conservatives once hailed the robust for-profit college phenomenon as a welcome infusion of free-market forces into an otherwise bloated higher-education sector. In recent years, though, these same post-secondary entrepreneurs have been criticized for taking far too much money from the student financial aid purse, with questionable results. In the heyday back at the beginning of the last decade, a top official at the DOE making decisions about higher education – Bush appointee Sally Stroup – was previously a lobbyist for the Apollo Group. A vigorous champion of proprietary schools, Richard Vedder of AEI (American Enterprise Institute for Public Policy Research), a think tank promoting free enterprise capitalism, was named in those halcyon days to a blue-ribbon DOE commission on the future of higher education. Their aim was to tackle problems such as the soaring cost of program design, development and delivery, particularly in the public post-secondary and higher-education sectors. This sector has been described as being dinosaur-like in its insistence on spending more money for sports teams, new buildings, and branding than on quality education.

Sometimes we are lumped in with them. Wherever we are slotted, though, like them we face a volatile, increasingly commodity-driven education and training market, influenced by an arsenal of commercial interests, global capital, and customers born after 1982. That date is the demarcation line now occupied by the largest demographic in America, the Millennials, bigger after the middle of 2015 than the infamous Baby Boomers who have ruled the roost for decades. The lesson, though, for the observer of this prolonged shift is that always tugging at the boundaries of comprehensive transformation is the unrelenting pull of certainty anchored in the familiar and the established (Maturana, 1987).

The Familiar and the New

The “established” in the world of naturopathic education, though, is transforming too. For example, even though NCNM, CCNM, John Bastyr College, and SCNM began as single-program institutions, today there remain only 3 such colleges: BINM, CCNM, and SCNM. All the other CNME-accredited programs coexist in institutions, all of them non-profit and private so far, and which have multi-program mandates with the accompanying challenges of transforming academic and institutional governance. They all operate, however, within a larger landscape of private education where education is a commodity. The posse is coming to chunk out a piece of that business, now that “integrative medicine” is in vogue.

There are many new players these days in the “education as a commodity” business, yanking at the vestments of the established, mostly public-sector, institutions. They are challenging the certitude held for generations in North America that public-sector universities are better for civil society than private ones, that the “public good,” at least in terms of education, is best manifested in such places. Apollo’s University of Phoenix, or the complex network of Corinthian Colleges, because they are focused on working adults at the same time as they are offering programs ranging from entry-level vocational training to professional degrees, make no bones about their profit motives even as they defend allegations of wobbly standards and loan default rates well above the norm in the public sector. These same institutions train nurses, dieticians, and physician’s assistants. Next?

Rather than a standalone institution delivering graduate naturopathic medical education as its singular offering, appearing on the scene in areas of high demand such as southern California or New York, it is beginning to look likely that one of those private post-secondary players who have survived the recent shakeout in the private sector, or an agile publicly-supported university, will initiate a naturopathic medical program as part of its program mix. There is money to be made. The opportunity posse is coming.

Geoffrey Cox, former vice-president for academic affairs and continuing education at Unext.com and former provost of Cardean University, some years ago commented on incursions into areas such as natural medicine as inevitable. Dr Cox moved from Stanford a long time back – where he was vice-provost and dean for institutional planning, learning technologies, and extended education – to an entirely new, private higher-education enterprise of the day called Unext. He predicted a decade and a half ago, “the past 200 years have witnessed a Cambrian Explosion of institutional types … just as diverse life forms emerge and either thrive or disappear, so too have institutions of higher education with their appetite for new programming opportunities” (Cox, 2000).

Alongside Dr Cox’s crystal ball ruminations, the National Center for Postsecondary Improvement (NCPI) reported yet another pattern at the beginning of this explosive era, linked, as it was, to the rise of the Internet. In the United States, the data then and now confirm that at the same time as “public higher education has become state-assisted rather than state-supported” (NCPI, 1999), private institutions are “spending more on instructional services and infrastructure to offset the low-cost advantage of the publics and that they are offering ‘better-quality’ instruction in brand new areas in convenient formats to justify high tuition costs.” (NCPI, 1999). These demands and patterns have been emerging within a framework of continuing dialogue about the aims and roles of higher education, particularly universities. A quarter century back, Williams, for example, explained that industry’s dependence on university laboratory research and the concomitant commercialization of higher-education management, with its growing hunger for high-return programming and credentialing opportunities, are not only key patterns in the evolution of the university in modern society, but are also here to stay (Williams, 1992). He has been proven right.

Following the Tuition Dollars

Another of the closest students of private education during those earlier years when we might have wanted to pay more attention, Roger Geiger, commented on the growing tension between market-driven education demand and public institution monopoly on credentialing: He reminded us, in terms of state educational policy, that “the state ineluctably plays a significant role in the existence of the private sectors” (1991) by virtue of “conscious policy decisions.” Some of these decisions in the ensuing years have indeed led to “stop and go mass private sector growth where institutions with inadequate resources, part-time staff and generally low standards stimulate much regulation, although much of it ends up being ineffective“ (Geiger, 1991, p.225). Geiger warned that “this regulatory impulse undermines innovation in otherwise decentralized and adaptive systems” (p.234). It is, however, what Geiger further describes as the “peripheral private sector” which may concern the leaders of naturopathic medical education as opportunistic – that is, agile program developers, not remotely attuned to the philosophical grounding of naturopathic education, enter the market chasing “integrative medicine” tuition dollars. They see growing numbers of Americans choosing natural medicine, and they understand the need to train practitioners to serve those patients. They also see mainstream allopaths wanting serious credentials to attach to their shingles. AIHM (The Academy of Integrative Health & Medicine) knows that. Andrew Weil, too, knows that the posse is coming for him too.

Currently there are almost 2000 organizations loosely described as “corporate colleges and trainers,” some of which have an eye on the rich US and Canadian health education markets. “Natural Medicine” is among those discipline areas which attract these groups. Whether it’s the Apollo Group or even a more traditional venue – such as Southern California University of Health Sciences or the 232-acre Maharishi University of Management in Fairfield, Iowa – naturopathic curriculum and related areas such as homeopathy, naturopathy, Ayurvedic medicine, and TCM are on their radar as business opportunities in this post-ACA era of integrative medicine and Section 2706.

There are numerous private-sector learning innovators who pointed long ago to the gathering momentum of post-secondary transformation. Jeanne Meister, former president of Corporate University Xchange [CUX] predicted 15 years ago that private educational “institutes for learning” would actually outnumber traditional universities by the year 2015 (Morrison, 2000). While this has not been borne out, the numbers are close. So-called corporate universities or training institutes started out by insisting that they did not want their primary function only to be granting degrees. Rather, according to Morrison, back at the beginning of the new century, they wanted to “partner with universities to provide customized programs for major job families in areas such as management and health sciences, usually within their organizations” (Morrison, 2000). However, it is in the interactivity, along those points where the public and the private meet, that influence is sharply felt and anxieties run high. Old certitudes continue to be nudged by new patterns.

For example, Geoffrey Cox, referenced earlier, 15 years back wrote enthusiastically about the “promising signs” that on-line instruction – in fact, entire on-line university programs – are doable “with quality and integrity” (Cox, 2000). He and his colleagues at Unext intended then to “build technologies that emphasize the best pedagogical theories, such as Problem Based Learning.” Cox insisted back then, “There is nothing inherent about a for-profit structure that limits an institution’s ability to provide quality education” (Cox, 2000). Parker-Hannifin College in Cleveland is a case in point. Guess what program Parker-Hannifin wants to implement next? Yes, Naturopathic Medicine. And in an unlicensed state, to boot.

One can be neo-liberal and have the perspective that the impersonal, inexorable, and global nature of the market will invade the special segment of higher education where we are, no matter what we do to defend the certainty of our hard-won and carefully built traditional naturopathic college programs, mandates, and character. Alternatively, we can be more inclined to a post-Keynesian mindset and witness without surprise the quickening role of higher education in crucial areas such as techno-science, health sciences, and industrial policy. The intellectual property strategies that constitute the heart of corporate, global societies are all about market share and heavy duty competition for abundant tuition and training dollars. Such pressures hatch systemic change and stimulate the very kind of convergence of science and technology, health promotion, curriculum development, access, finance, and modified autonomy in which private higher education can thrive.

A final, powerful point is that within the foundation of our naturopathic colleges and their programming is a principle related to “public good.” Our programs are about preparing physicians to serve communities and not about profits. Going forward, we will want to be engaged in debates about the responsibilities of private higher education (that is, the complex conversation about public and private good) and insist in our various jurisdictions (state, federal, provincial) that these values of “good” are very much part of the parameters of private higher education, and especially about health education. Gorostiaga (1999, p.192), as a case in point, argues that public, social good is not a commodity. Buchbinder (1988, 1993) states that “the objectives of higher education that are expressed as the production and transmission of knowledge as a social good are being replaced by an emphasis on the production of knowledge as a market good, a salable commodity” (p.143). The food chain can be an unforgiving place. Some posses can become single-minded in food chains.

David_Schleich_HeadshotDavid J. Schleich, PhD, is president and CEO of NCNM, former president of Truestar Health, and former CEO and president of CCNM, where he served from 1996 to 2003. Previous posts have included appointments as vice president academic of Niagara College, and administrative and teaching positions at St. Lawrence College, Swinburne University (Australia) and the University of Alberta. His academic credentials have been earned from the University of Western Ontario (BA), the University of Alberta (MA), Queen’s University (BEd), and the University of Toronto (PhD).

 

 

References:

Buchbinder, H. (1993). The market-oriented university and the changing role of knowledge. Higher Education, 26, 331-347.

Buchbinder, H., & Newson, J. (1988). The University Means Business. Toronto, Ontario: Garamond Press.

National Center for Postsecondary Improvement. (1999). Looking back at revenue and expenditure trends: are we privatizing higher education? Change, November/December, 61-64.

Cox, G. (2000). Why I left a university to join an Internet education company. Change, November/December, 12-18.

Geiger, R. L. (1991). Private higher education. In: Altbach, P. G. (Ed.). International Higher Education: An Encyclopedia. New York, NY: Garland Publishing, Inc., 1, 233-246.

Gorostiaga, X. (1999). In search of the missing link between education and development. In: Altbach, P. G. (Ed.). Private Prometheus: Private Higher Education and Development in the 21st Century. Westport, CT: Greenwood Press.

Maturana, H. R., & Varela, F. J. (1987). The Tree of Knowledge: The Biological Roots of Human Understanding. Boston and London: Shambhala.

Morrison, J. L. (2000). Corporate universities: an interview with Jeanne Meister. Vision, July/August, 22-31.

Williams, G. (1992). Higher education and society. In: Clark, B. R., & Neave, G. (Eds.) The Encyclopedia of Higher Education, Volume 2. Oxford, England: Pergamon Press. 841-851.

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