Eric Yarnell, ND, RH (AHG)
Many people within and outside natural medicine like to blame the Flexner Report and the rising power of the “allopathic” medical establishment for the near demise of natural medicine in the early part of the 20th century in the United States. However, Flexner and the American Medical Association were fighting a greatly weakened opponent_one torn apart by infighting. Only such a weakened structure could be toppled so quickly.
Though natural medicine has rebounded, infighting is still rife. Naturopathic physicians fight with naturopaths, herbalists fight with naturopathic physicians, homeopaths fight with everyone, chiropractors fight with massage therapists, and the list goes on. Meanwhile, the mainstream medical establishment continues to expand, use up available resources, dominate the health-care landscape, develop enormous institutions to advance themselves and their agenda_all while we struggle for crumbs.
Take the National Center for Complementary and Alternative Medicine. While natural medicine advocates fought long and hard to get our fair share of the research money spent by the National Institutes of Health, we ended up with an institution that is run by allopathic practitioners pursuing a largely allopathic agenda with a budget that is incredibly paltry compared to the money spent on mainstream research. Even the name is an insult to natural medicine. We are merely complementary and alternative; not mainstream, not strong on our ground; useful only as quaint adjuncts to the dominant paradigm.
All directors of the center (including those during the time when it was the Office of Alternative Medicine) have been medical doctors with one exception: Stephen Groft, PharmD, first acting director of OAM. The other directors include Joseph Jacobs, MD, first director of OAM; Alan Trachtenberg, MD, MPH, acting director of OAM; Wayne Jonas, MD, second director of OAM; William Harlan, MD, acting director of NCCAM; and Stephen Straus, MD, first director of NCCAM (NCCAM 2005). While these men may be somewhat outside the dominant paradigm, none of them came from within natural medicine. The most current organization chart on the NCCAM Web site shows there are no natural medicine practitioners in any positions of authority within the administration of the center (NCCAM 2005). The current National Advisory Council for NCCAM has among its 18 members just two natural medicine practitioners_Carlo Calabrese ND, MPH and Joel Pickar PhD, DC (there is also one osteopath who may qualify, Murray Goldstein DO, MPH).
How is it possible that a government bureaucracy, with a current budget of more than $120 million dollars and designed supposedly to scientifically assess natural medicine, is not run by natural-medicine practitioners? How is it that it has minimal input from natural-medicine providers and mainly funds studies on practices that are not standard in natural medicine (such as use of single chemical agents or highly refined extracts in isolation from any other therapies)? While it might be simple to blame it all on the political and economic strength of mainstream medicine, the truth is that natural medicine is so fragmented and incoherent that it could not possibly stand up for what should rightfully be ours. What is worse, there are trends within natural medicine that continue to fight against any attempt to professionalize or gain political power. An example is the anarchist herbalist Stephen Buhner who eschews any standardization of the herbal profession (Buhner 2003).
If natural medicine is going to advance in any way, it will require that some significant portion of its members join together. While some fights will surely not be resolved any time soon, others can surely be cleared so that a larger purpose can be served. All those professions that are already, at least peripherally, part of the medical system in the U.S., either through state regulation, insurance reimbursement, referral networks and/or institutionalized and accredited instruction (naturopathic physicians, chiropractors, licensed acupuncturists, massage therapists), are best poised to make this transition to cooperation.
The research agenda at NCCAM should and will be decided by natural-medicine practitioners. The larger research agenda on natural medicine should and will be decided by natural medicine practitioners. Equal access to health-care financing for natural-medicine practitioners should and will be the norm. Equal access to state-financed health-care institutions by natural-medicine practitioners should and will be the norm. The American people have been showing they want this to be the case as much as they are allowed to through health-care expenditures and their votes. It can only ever be realized if natural medicine pulls at least some of itself together into a united front.
References
- Buhner, S.H., 2003; Some Arguments Against the Standardization of Herbalists; www.gaianstudies.org/articles.htm
- NCCAM, 2005; National Center for Complementary and Alternative Medicine; www.nccam.nih.gov
Eric Yarnell, ND, RH(AHG) is a 1996 graduate of Bastyr University. He completed a two-year residency with Silena Heron, ND and served as chair of botanical medicine at the Southwest College of Naturopathic Medicine. He is past senior editor of the Journal of Naturopathic Medicine. Dr. Yarnell is a founding member and current president of the Botanical Medicine Academy and author of numerous textbooks and articles including “Naturopathic Urology and Men’s Health,” “Naturopathic Gastroenterology” and “Clinical Botanical Medicine.” His area of clinical focus is urology and men’s health. He is adjunct faculty in botanical medicine at Bastyr University and Tai Sophia Institute; www.dryarnell.com
