David Schleich, PhD
It is very good for the expansion of the profession that Bastyr University has committed to establishing a new program in southern California. While the structuring of the program in terms of its being a stand-alone institution or a program within an existing institution is not yet public knowledge or known among members of the Association of Accredited Naturopathic Medical Colleges (AANMC), that it is in the pipeline in some form and created by an established Council on Naturopathic Medical Education–accredited parent program is important. Such a development actually invites us to ponder what shape this new programmatic presence will take. Will it imitate directly the arrangements for naturopathic medical education at Bastyr, or will there be some new manifestations to its design and delivery? There are many influences that can affect not only the process but also the outcome of this new program’s arrival on the scene. In the literature of higher education, there are three categories of influence that are interesting for us to apply to what is happening in California and to what has already taken place in Arizona, Oregon, Washington, British Columbia, Illinois, Connecticut and Ontario. The categories are called coercive isomorphism, mimetic isomorphism and normative isomorphism.
Burton Clark writes eloquently about the dynamic impact with which higher education systems evolve among state or bureaucratic influences but little about the kinds of colleges and programs in the naturopathic world. Nevertheless, there are similarities such as the pressures of collegiality among the professoriate and administrative staff, as well as the higher education market generally. Clark’s commentary about “normative/professional isomorphism” is well worth recounting, although he did not have us in mind, as we observe this latest example of the gradual expansion of capacity in naturopathic medical education.
In this regard, it is useful to dig out the early documents of the National College of Natural Medicine (NCNM) and John Bastyr College of Naturopathic Medicine (JBC), where we find that the first college administrators and teachers very definitely imported into their creations the “norms” of their previous institutions, particularly in terms of curricular content and methodology preferences, organizational structures and terminology; however, the persistent “individualism” of professional practitioners conjugates through our naturopathic programs more than has been the case in public sector and secular higher education institutions. For example, shortly after JBC was launched in Seattle, Dr. Spaulding lauded the “individualism and customizing genius of Drs. Boucher, Bastyr and Carroll,” advocating that “our new school must remember in its very corridors that naturopathic medicine is a medicine of individualists” (letter to John Bastyr, Aug. 4, 1978). At the same time, in faraway Ontario at the time of the launching of the part-time program at the Ontario College of Naturopathic Medicine, Gordon Smith, ND (now practicing in the Yukon Territory) reminded Dr. Eric Shrubb that “if we don’t keep up the university standard, like they used to have at Western States, our school will be weak” (letter to Dr. E. Shrubb, chair of the Ontario Naturopathic Association, Sept. 12, 1978).
From this location in the early history of our colleges, it is fascinating to consider what has happened since then. Is the program being contemplated in southern California going to mimic Bastyr’s existing assumptions as a regional comprehensive university about programmatic effectiveness and reach, or will a different isomorphism emerge? Daniel Levy describes how where a program’s influences originate can significantly affect what form that program will adopt and sustain. Levy’s ideas about “fold[ing] the normative and mimetic isomorphism into a broad noncoercive category” (19) may not apply in the case of this new school or program within a school. If it is a stand-alone rendering of naturopathic medical programming, mimetic isomorphism is likely. If it is a program within an existing institution, certain coercive isomorphism features may evolve. The former means strong imitation based on what the organizing designers know from their institutional experience; the latter means that the institution in which the program is sown will significantly shape the form and function of the new offering, likely diluting the institutional preferences and memory of the implementers.
Watching how Bastyr’s new program evolves can be intriguing ground for the naturopathic professional and educational leaders in our schools and programs and in the AANMC. As contemplated in the literature of organizational theory and institutional theory (DiMaggio and Powell, Levy and Merry, Mintzberg and Cameron), what emerges could constitute evidence of the presence of isomorphism, a “process of convergence that yields similarities among organizations” (Levy 16) operating in the institutional development of not only the new California program but also the existing programs in Tempe, Portland, Kenmore, Lombard, Vancouver, Bridgeport and Toronto. Indeed, despite its “presence in the sectoral ground least conducive to it” (i.e., the realm of private postsecondary education) (Levy 17), we could well decide that isomorphism seems to have counteracted the “organizational diversity” often seen as an “inevitable outcome in all places that are part of the extraordinary privatization occurring in contemporary international higher education” (Levy 17), including the small cadre of naturopathic schools.
Our naturopathic colleges and programs, from their location in the private sector, have long been heavily influenced by the profession they serve, impacted for many years not only by the early sacrifices of physicians such as Boucher, Bastyr, Farnsworth, LaPlante and others as volunteers and clinical touchstones for professional formation but also by the nonprofit characteristics of their organization, capitalization and accreditation. Overall, our colleges and programs within other institutions have not displayed an organizational distinctiveness so often reported in the literature describing the rapid growth of private higher education. Rather, in the absence of pressure in the early decades from the world of the U.S. and Canadian universities and their higher education frameworks (coercive isomorphism), they were free to and wanted to copy the successful mainstream medical model (mimetic isomorphism). Indeed, NCNM, JBC and the old Ontario College of Naturopathic Medicine (OCNM) leaders from the beginning mimicked what they knew from their own “prior socialization” (normative isomorphism) as students of naturopathic or chiropractic colleges or as members of professional organizations struggling for recognition.
A close reading of the founding documents detailing the choices and decisions taken by the early college administrators and board members frequently referenced their prior socialization not only during their educational experiences but also during their professional association activities. “I know that if we don’t continue to train our NDs the way we were trained by the greats at Western States or in Seattle and Portland, we’re going to lose our medicine,” said Dr. Gordon Smith (memo to Dr. E. Shrubb, Nov. 4, 1977). As Levy explains, “normative isomorphism involves a mimicking of established norms”, and there emerge numerous references by the early deans and board members of JBC and Southwest about the “desirability of keeping alive the professional collegiality that kept the first college, NCNM, from the brink.” At the same time, some trustees and governors (e.g., at the new OCNM in Ontario) wanted their new school to be “like a good university faculty of medicine, only with our medicine as the curriculum” (Ontario Naturopathic Association minutes, Jan. 20, 1978). The question stands out: are our colleges likely to get more like each other or less like each other as we are expanding capacity in different markets, employing various delivery methods and counting more and more on regional accreditation to enrich our programmatic accreditation platforms?
It seems that three types of “schools” are coming into focus. There remain three stand-alone programmatic schools (Boucher, Southwest and Canadian College of Naturopathic Medicine), three small regional comprehensive universities (Bastyr, National University of Health Sciences and BU) and one dual-program college (NCNM). Of the three types, the first is most unlikely to be duplicated extensively going forward, as is the third. It is the middle group, the small comprehensive university within which ND programs will exist alongside other professional preparation programs and related undergraduate programs, that is likely to be the terrain of growth. For that reason, coercive isomorphism may be the characteristic we see most often as new programming evolves.
David 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
Cameron, Kim S. “Organizational Adaptation and Higher Education.” Journal of Higher Education. 55 (2), 1984: 122-44.
Clark, Burton R. Values in Higher Education: Conflict and Accommodation. Tucson: Center for the Study of Higher Education, 1983.
DiMaggio, Paul and Walter Powell. “The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields.” American Sociological Review. 48, 1983: 147-60.
Levy, Amir and Uri Merry. Organizational Transformation: Approaches, Strategies, and Theories. New York: Praeger, 1986.
Levy, Daniel C. “Private Institutions of Higher Education.” Encyclopedia of Higher Education. Ed. Burton Clark and Guy Neave. Oxford: Pergamon, 1992.
Mintzberg, Henry. Power In and Around Organizations. Englewood Cliffs, N.J.: Prentice-Hall Inc, 1983.
