role of the natural medicine physician within the new health care paradigm - joe pizzorno
DESCRIPTION
Role of the Natural Medicine Physician Within the New Health Care Paradigm by Joe Pizzorno, ND.TRANSCRIPT
Role of the Natural Medicine Physician Within the New
Health Care Paradigm
Joseph Pizzorno ND
President Emeritus Bastyr University
Editor Integrative Medicine A Clinicianrsquos Journal
President SaluGenecists IncMail2DrPizzornocom
Copyright copy 2011
1
Dr Joseph E Pizzorno NDbull Academic
o Founding president of Bastyr University first accredited natural medicine university
o Editor Integrative Medicine A Clinicianrsquos Journal
o Speaks worldwide to academic institutions healthcare professionals public and legislators
o Textbook of Natural Medicine 3nd ed 2009 4th edition now in process
o Adjunct Professor South Pacific College of Natural Therapies
bull Policy
o Member Medicare Coverage Advisory Committee 2003-2005
o Member White House Commission on CAM Policy 2000-2002
bull Public
o Chair Board of Directors Institute for Functional Medicine 2006-
o Encyclopedia of Natural Medicine 1998 (1000000 copies in six languages)
o Encyclopedia of Healing Foods 2005
bull Example Awards and Recognitions
o Juror for Rogerlsquos Prize - 2009
o Institute for Functional Medicine ndash Linus Pauling Award 2004
o American Holistic Medical Association Pioneer in Holistic Medicine 2003
o American Association of Naturopathic Physicians Physician of the Year 2002
o Natural Health Magazine Leading health educator in the past 30 years 2001
o Alternative Healthcare Management 1 of the 4 most influential CAM leaders 2000
o Seattle Magazine 1 of the top 20 national intellectual leaders from Seattle 1996
Overview1 Why do patients come to see us
2 Do we believe in wellness
3 How does a wellness orientation in primary care contrast with the conventional medicine approach to patients
4 How can this fundamental change in patient care impact the healthcare crisis
5 Is there any research to support a wellness rather than disease-centric approach
6 What are the political and insurance reimbursement hurdles that need to be overcome to provide an environment to not only allow but nurture this better approach to healthcare
7 Finally what does an optimal healthcare system look like and how does the natural medicine physician fit in
3
Conventional Medicine
Many Successes
bull Huge success in acute illness trauma and life-
threatening disease
bull This was accomplished through
o Disease-treatment focus
o Standardization of disease diagnosis therapy and
unfortunately people
o A huge investment of our countrylsquos resources
o Active suppression of other ideas and practices
bull However
o Many problems and limitations have surfaced (as
predicted by natural medicine doctors a century ago)
Why Do Patients Come To Us
bull Heavy DISEASE BURDEN
o And it is getting worsehellip
bull High incidence of SIDE EFFECTS
bull Out-of-control COSTS
bull The MYTH of increased longevity
Heavy Disease Burdenbull Only adults 18-64 yo
bull Only 6 most common dzs
bull Does not include ―ill-
healtho Adds 15-20
bull Those with the poorest
health habits develop
chronic disease 5 years
earlier and their disease is
twice as severe
Wilper AP et al A National study of chronic disease prevalence and access to care in uninsured
US adults Ann Intern Med 2008149170-176
Vita Aj et al Aging health risks and cumulative disability NEJM 19983381035-41
1
2
3+
0
10
20
30
40
50
Incidence of Chronic
Disease
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Dr Joseph E Pizzorno NDbull Academic
o Founding president of Bastyr University first accredited natural medicine university
o Editor Integrative Medicine A Clinicianrsquos Journal
o Speaks worldwide to academic institutions healthcare professionals public and legislators
o Textbook of Natural Medicine 3nd ed 2009 4th edition now in process
o Adjunct Professor South Pacific College of Natural Therapies
bull Policy
o Member Medicare Coverage Advisory Committee 2003-2005
o Member White House Commission on CAM Policy 2000-2002
bull Public
o Chair Board of Directors Institute for Functional Medicine 2006-
o Encyclopedia of Natural Medicine 1998 (1000000 copies in six languages)
o Encyclopedia of Healing Foods 2005
bull Example Awards and Recognitions
o Juror for Rogerlsquos Prize - 2009
o Institute for Functional Medicine ndash Linus Pauling Award 2004
o American Holistic Medical Association Pioneer in Holistic Medicine 2003
o American Association of Naturopathic Physicians Physician of the Year 2002
o Natural Health Magazine Leading health educator in the past 30 years 2001
o Alternative Healthcare Management 1 of the 4 most influential CAM leaders 2000
o Seattle Magazine 1 of the top 20 national intellectual leaders from Seattle 1996
Overview1 Why do patients come to see us
2 Do we believe in wellness
3 How does a wellness orientation in primary care contrast with the conventional medicine approach to patients
4 How can this fundamental change in patient care impact the healthcare crisis
5 Is there any research to support a wellness rather than disease-centric approach
6 What are the political and insurance reimbursement hurdles that need to be overcome to provide an environment to not only allow but nurture this better approach to healthcare
7 Finally what does an optimal healthcare system look like and how does the natural medicine physician fit in
3
Conventional Medicine
Many Successes
bull Huge success in acute illness trauma and life-
threatening disease
bull This was accomplished through
o Disease-treatment focus
o Standardization of disease diagnosis therapy and
unfortunately people
o A huge investment of our countrylsquos resources
o Active suppression of other ideas and practices
bull However
o Many problems and limitations have surfaced (as
predicted by natural medicine doctors a century ago)
Why Do Patients Come To Us
bull Heavy DISEASE BURDEN
o And it is getting worsehellip
bull High incidence of SIDE EFFECTS
bull Out-of-control COSTS
bull The MYTH of increased longevity
Heavy Disease Burdenbull Only adults 18-64 yo
bull Only 6 most common dzs
bull Does not include ―ill-
healtho Adds 15-20
bull Those with the poorest
health habits develop
chronic disease 5 years
earlier and their disease is
twice as severe
Wilper AP et al A National study of chronic disease prevalence and access to care in uninsured
US adults Ann Intern Med 2008149170-176
Vita Aj et al Aging health risks and cumulative disability NEJM 19983381035-41
1
2
3+
0
10
20
30
40
50
Incidence of Chronic
Disease
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Overview1 Why do patients come to see us
2 Do we believe in wellness
3 How does a wellness orientation in primary care contrast with the conventional medicine approach to patients
4 How can this fundamental change in patient care impact the healthcare crisis
5 Is there any research to support a wellness rather than disease-centric approach
6 What are the political and insurance reimbursement hurdles that need to be overcome to provide an environment to not only allow but nurture this better approach to healthcare
7 Finally what does an optimal healthcare system look like and how does the natural medicine physician fit in
3
Conventional Medicine
Many Successes
bull Huge success in acute illness trauma and life-
threatening disease
bull This was accomplished through
o Disease-treatment focus
o Standardization of disease diagnosis therapy and
unfortunately people
o A huge investment of our countrylsquos resources
o Active suppression of other ideas and practices
bull However
o Many problems and limitations have surfaced (as
predicted by natural medicine doctors a century ago)
Why Do Patients Come To Us
bull Heavy DISEASE BURDEN
o And it is getting worsehellip
bull High incidence of SIDE EFFECTS
bull Out-of-control COSTS
bull The MYTH of increased longevity
Heavy Disease Burdenbull Only adults 18-64 yo
bull Only 6 most common dzs
bull Does not include ―ill-
healtho Adds 15-20
bull Those with the poorest
health habits develop
chronic disease 5 years
earlier and their disease is
twice as severe
Wilper AP et al A National study of chronic disease prevalence and access to care in uninsured
US adults Ann Intern Med 2008149170-176
Vita Aj et al Aging health risks and cumulative disability NEJM 19983381035-41
1
2
3+
0
10
20
30
40
50
Incidence of Chronic
Disease
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Conventional Medicine
Many Successes
bull Huge success in acute illness trauma and life-
threatening disease
bull This was accomplished through
o Disease-treatment focus
o Standardization of disease diagnosis therapy and
unfortunately people
o A huge investment of our countrylsquos resources
o Active suppression of other ideas and practices
bull However
o Many problems and limitations have surfaced (as
predicted by natural medicine doctors a century ago)
Why Do Patients Come To Us
bull Heavy DISEASE BURDEN
o And it is getting worsehellip
bull High incidence of SIDE EFFECTS
bull Out-of-control COSTS
bull The MYTH of increased longevity
Heavy Disease Burdenbull Only adults 18-64 yo
bull Only 6 most common dzs
bull Does not include ―ill-
healtho Adds 15-20
bull Those with the poorest
health habits develop
chronic disease 5 years
earlier and their disease is
twice as severe
Wilper AP et al A National study of chronic disease prevalence and access to care in uninsured
US adults Ann Intern Med 2008149170-176
Vita Aj et al Aging health risks and cumulative disability NEJM 19983381035-41
1
2
3+
0
10
20
30
40
50
Incidence of Chronic
Disease
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Why Do Patients Come To Us
bull Heavy DISEASE BURDEN
o And it is getting worsehellip
bull High incidence of SIDE EFFECTS
bull Out-of-control COSTS
bull The MYTH of increased longevity
Heavy Disease Burdenbull Only adults 18-64 yo
bull Only 6 most common dzs
bull Does not include ―ill-
healtho Adds 15-20
bull Those with the poorest
health habits develop
chronic disease 5 years
earlier and their disease is
twice as severe
Wilper AP et al A National study of chronic disease prevalence and access to care in uninsured
US adults Ann Intern Med 2008149170-176
Vita Aj et al Aging health risks and cumulative disability NEJM 19983381035-41
1
2
3+
0
10
20
30
40
50
Incidence of Chronic
Disease
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Heavy Disease Burdenbull Only adults 18-64 yo
bull Only 6 most common dzs
bull Does not include ―ill-
healtho Adds 15-20
bull Those with the poorest
health habits develop
chronic disease 5 years
earlier and their disease is
twice as severe
Wilper AP et al A National study of chronic disease prevalence and access to care in uninsured
US adults Ann Intern Med 2008149170-176
Vita Aj et al Aging health risks and cumulative disability NEJM 19983381035-41
1
2
3+
0
10
20
30
40
50
Incidence of Chronic
Disease
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Despite Increasing Use Of Drugs And Surgery
httpwwwcdcgovnchsdatadatabriefsdb42htm
Coronary artery stent proceduresPrescription drug use past month
1 in 7 restenose within just 1 year
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Surprising Incidence of Adverse Drug Reactions
bull Not anti-medicine but real undisclosed problems
bull Doctor adverse event in 4-18 outpatient visits
bull Patient 25 of 661 outpatients 13 seriousbull Result
o 116 million extra physician visitso 77 million extra prescriptionso 18 million ER visitso 8 million hospital visitso 199000 additional deathso $77 billion extra costs (equivalent to diabetes)
Wiengart SN et al Epidemiology and medical error BMJ 2000320774-7
Gandhi TK et al Adverse drug events in ambulatory care 20033481556-64
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Increased Longevity
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Out of Control Costs
10
Marshall E Science and the stimulus Medicine under the
microscope Science 2009 Nov 27326(5957)1183-5httpwwwcdcgovmmwrpreviewmmwrhtmlmm5
813a5htm
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Walter Bortz II MD in Next Medicine
bull Symptoms of ―Current Medicine
o Excessive cost
bull Ex Health insurance costs rising 4x faster than workers earnings
o InjusticeInequity
bull Although he advocates for universal health care he is ―convinced that
adopting a universal health insurance policyhellipwill by itself contribute
only marginally to Americanslsquo health
o Harmfulness
bull Annually iatrogenesis causes equivalent of 3 747lsquos crashing every day
o Corruption
bull Ex Vioxx amp Merck unnecessary surgeries etc
o Inefficiency
o Irrelevance
bull This symptom he considers to signify a complete disconnect between
our health and health care system
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Walter Bortz II MD ndash
Irrelevance of ldquoCurrent Medicinerdquo
bull ―Current medicine lacks the philosophical moral
and scientific conceptual framework that would
make it capable of helping [diabetes aging and
obesity]
bull ―It reaches into its black bag for a remedy In the
bag are the fundamental tools of the medical
industrial complex surgery and pills
bull ―These two treatments represent nearly all of
Current Medicinelsquos $25 trillion annual budget but
they are powerless against aging and diabetes
bull 72 of physician visits are now due to chronic
conditions12
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Walter Bortz II MDbull Mission of medicine is to assure and assert human
potential
bull Calls for a new paradigm in medicine which
restores the balance between Hygeia and
Panacea (health preservation and repair
respectively)
bull In legend Hygeia is the daughter of the god of
medicine and is closely correlated with the origin of
the vis medicatrix naturae
13
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Do We Believe in WELLNESS
bull Is NATURAL MEDICINE about therapies Or about
concepts amp intent
bull Despite assertions of ―treating the person not
disease most therapies focus on selecting the
appropriate herb nutrient manipulation
acupuncture technique etc No matter how
natural many still have a focus on disease
bull Do we truly believe in the bodylsquos ability to heal and
does this not trump disease Do we believe in
wellness14
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
What Really is Nature Curebull NATURE CURE is simply restoration of
wellnessmdashby whatever means most
appropriate for each unique personmdashas this
is how the body removes disease
bull Isnrsquot it our profound ability to recognize the
inherent striving for wellness inherent in life
that differentiates us
bull And isnrsquot this what our patients aremdashoften
unknowinglymdashseeking15
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Treating Symptoms With Natural
Therapies is Still Allopathy
bull When a person is depressed it is not due to a lack
of Prozac
bull Nor is it due to a deficiency of St Johnlsquos wort
bull It could be due to a lack of sunshine and vitamin D
bull Are they toxic are they eating the wrong foods or
not enough of the right ones or is their life without
meaning
bull Isnlsquot seeking and acting on this understanding the
core of NATURE CURE
16
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Is a Belief in Wellness aRecognition of the Vis
bull The VIS embraces VITALISM
bull Natural medicine is fundamentally a vitalistic
practice (vis medicatrix naturae)
bull The best doctors facilitate their patientlsquos belief in
their health and ability to get healthy
o Placebo is still more effective than virtually every drug
bull Without understanding the vis how do you know if
your patient is actually improving rather than just
suppressing symptoms
o Is the patient HEALTHIER after your treatment
17
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Pizzorno (2007)
I have been involved in naturopathic medicine for
35 years and I still canrsquot define it Nonetheless we
can see the Vis in othersmdashit is something we all
sense As a clinician you watch the level of a
patientrsquos vitality when it increases you know you
are on the path to cure but if it decreases then you
are only palliating symptoms and suppressing the
individualrsquos expression of the Vis
18
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Bill Mitchell NDbull 1948-2007
bull Co-Founder Bastyr University
bull Inspiration teacher for 20 years
bull My friend
The following slides on Billlsquos philosophy used with permission from Leanna Standish PhD ND LAc
19
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Billrsquos ConceptsVMN = the healing power of nature
VNM = the self-organizing property
The VNM functions in any given living system as the tendency to organize that system so as to maintain existencelsquo
The Vis is universal
A fascinating assumptionhellip is that life on other systems contains an internal intelligence for self-maintenance as well meaning that the Vis exists universally and is a cosmological realitylsquo
20
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
But Bill Goes on to Sayhellip
The Vis is not weakened or strengthened by the weakness or strength of the individual The VMN exists internally and universally
This is best thought of as an equation that exists during the life of the systemhellip
And while the inputs into an equationhellipcan change the value of X Y or Z the equation itself exists as a structure in which these values interact with each otherlsquo
21
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Wisdom from Dr Standish
bull Naturopathic medicine distinguishes itself
philosophically from mainstream medicine by its
core principle Vis medicatrix naturae the healing
power of nature
bull Its insistence on referring to the vital forcelsquo has
served to isolate and perhaps sideline
naturopathic medicine from mainstream
conventional and pharmaceutical medicine of the
second half of the 20th century which has been
historically based exclusively on scientific
materialism
22
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Dr Standish Concludes
bull However the experimental findings from quantum
mechanics in physics neuroscience and the
distant healing literature suggest that scientific
materialism is an incomplete description of reality
and thus cannot be the sole philosophy of modern
medicine
bull The findings of the new sciencelsquo support the
concept of biological field effects macro-
entanglement non-local interaction and
downward causation A new medicinelsquo is
emerging in the 21st century
23
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
My Current Thinking
Vis is the manifestation of the universal
Consciousness in biological form Our environment
beliefs interactions with others actions lifestyle
diet etc modulate the manifestation of Vis as our
vitality but Vis itself is immutable As we harmonize
with the Vis our consciousness expands
24
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Jeffrey Bland PhDbull Conversation with Dr Szyf McGill University
o ―Rather than these diseases being hard-wired into our
genes our responses that give rise to disease are adaptive
responses to an altered environment in which the outcome over time through the epigenetic modulation
becomes a disease In other words we dont have diseases
wired into our genes we have physiologic responses to
environmental modulation wired into our genes that then
creates an outcome thats later called our phenotype of
health or disease
25FMU November 2010
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Wellness vs Conventional Orientation in Primary Care
bull Former head of CDC and
Surgeon General ―We spend
well over 90 percent of our
national health budget
treating diseases and
complicationsmdashmany of which
could have been prevented in
the first placehellip ―
bull ―I hope that the day will come
when all health care providers
will write prescriptions for
prevention for patients
26
Satcher D The prevention challenge and opportunity Health Aff (Millwood)200625(4)1009-11
Schroeder SA Shattuck Lecture We can do better--improving the health of the American
people N Engl J Med 2007 Sep 20357(12)1221-8
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
How Does Fundamental Change in
Patient Care Impact Healthcare Crisis
bull Reduced Disease Burden
o Ex Myocardial infarction amp INTERHEART STUDY
o Risk of myocardial infarction almost entirely attributable to
modifiable risk factors specifically lifestyle behaviors
o Although genetic predisposition influenced physiological
function and risk of disease it was largely modifiable by
how people lived
o Preventable illness is thought to make up at least 70
percent of the burden of illness and the associated costs
27
OKeefe JH et al Primary and secondary prevention of cardiovascular diseases a practical evidence-based
approach Mayo Clin Proc 2009 Aug84(8)741-57
Fries JF et al Beyond health promotion reducing need and demand for medical care Health Aff (Millwood)
1998 Mar-Apr17(2)70-84
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Change Cuts Health Care Costs Too
bull Reduced healthcare costs
o Even a modest focus on prevention early intervention and
behavioral change could save annually in treatment and
productivity loss costs an estimated $217 billion and $16
trillion respectively
o Greater emphasis on primary care and health promotion
less specialty care
bull Greater function longer healthspan
28
A wellness initiative for the nation 2008 httpihpcinforesourcesresourcesshtml
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Research Supporting Wellnessbull Prospective study of over 20000 men and women
o Individuals that did not currently smoke were physically active
moderate alcohol intake and plasma vitamin C indicative of at
least 5 servings of fruits and vegetables a day have a 4-fold lower
risk of mortality than the those with the least healthy behaviors
o Greater than a 2-fold difference in stroke risk
o Equivalent to 14 years in chronological age
bull Diabetes Prevention Program Trial
o High risk for diabetes adopted minimal lifestyle change
o Compared to placebo lifestyle changes delayed the onset of
diabetes by 11 years metformin only 3 years
o Lifestyle intervention was found to be $1100 per quality adjusted
life year (QALY) while metformin was $31300
29
Khaw KT et al Combined impact of health behaviours and mortality in men and women the EPIC-Norfolk prospective
population study PLoS Med 2008 Jan 85(1)e12
Myint PK et al Combined effect of health behaviours and risk of first ever stroke in 20040 men and women over 11 years
follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk) prospective population study
BMJ 2009 Feb 19338b349 doi 101136bmjb349
Herman WH et al The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with
impaired glucose tolerance Ann Intern Med 2005 Mar 1142(5)323-32
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
How About Our Own Research
bull Duke reports annualized $2200employeeyear
savings from integrative wellness program
bull t Ford plant indicates acupuncture mindbody
chiropractic reduces back pain medication amp costs
bull WA state finds CAM-using insureds with heavy
disease burden cost $1420year less
bull Naturopathic medicine effective and saves
$1025person for Canada Post employees
bull Australian government finds acupuncture and
natural products lower healthcare costs
bull Tennessee Blue Cross Blue Shield finds 20-40 lower
costs for LBP patients who see chiropractors first30
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Hurdles to Overcomebull Pharmaceutical amp device manufacturers have
powerful lobbies to prevent change
o Penetration into all realms of medical care including
medical education is extensive
o Recent survey of health professionals 88 thought
commercial sponsorship of CME was biased yet only 12
wanted to eliminate it and less than frac12 would pay higher
fees
o Also penetration into public perception about causes of
health and disease
31Tabas J Clinician Attitudes About Commercial Support of Continuing Medical Education Archives of Internal
Medicine Vol 171 No 9 May 9 2011
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
More Hurdlesbull Insurance reimbursement pays for drugs and
surgery not wellness medicine
bull Frequent changing of jobsinsurance company ndash
not as much incentive to cover preventionwellness
bull Loss of interest in primary care vs specialized care
bull Dominance of teaching hospitals with focus almost
entirely on specialist care
bull Efficacy research mostly based on single modality
vs outcomes
o Wellness is about systems of healing not isolated therapies)
bull Cherry picking of natural therapies without
understanding of underlying concepts of health
bull Even minimal focus on prevention does not equal
wellness ie prevention versus early detection 32
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Optimal Healthcare Systembull Fully embraces
o Basic scienceslsquo remarkable advancements in
understanding human physiology and pathology
o Conventional medicinelsquos incredible diagnostics and at times miraculous ability to cure many types of disease
o Natural medicinelsquos vitalizing healing wisdom and health
promoting therapies
o Public healthlsquos considerable effectiveness in fundamentally improving the environment and decreasing disease risk of
populations
o Healing as our fundamental motivation
33
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Optimal System ndash Role of Natural Doctor
bull Currently broad support in the US for ―personalized
medical home
bull Integrated acute care disease prevention wellness
promotion personalized care core of which is
primary care doctor
bull Allows for primary care providers to facilitate care
by other providers with wellness as central goal
bull Who better suited to be this bridge than the natural
medicine physician
34
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Natural Medicine Physician of the Future
bull Fully understands and embraces the vis
bull Nature cure foundation
o Whole foods (more than supplements)
o Lifestyle etc
bull Excellent patient communication and behavioral
change skills
bull Advanced personalization of care
o Biochemical individuality
o Diagnostic tools
o Health informatics
bull Primary care family doctors
bull Experts in integration35
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
Dramatic Change in Legislative Acceptance
bull Both the senate and house of the Washington State legislature unanimously passed a resolution honoring Bastyr University and
natural medicine
bull This is the same legislature where for decades we walked the
halls as beggars knocking at the door pleading to not be
made outlaws
bull As I watched legislator after legislator stand and proclaim to
their colleagues how naturopathic medicine had saved their
life helped them get pregnant or cured a treasured child the
conventional medical system had failed
bull The prophetic words of Dr Bastyr came back to me ―No
matter the obstacles they place the truth of our medicine will out
36
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
What is the Future of The Natural Medicine Physician
The future IS NATURAL MEDICINE
It is not
o Green drug allopathy
o Holistic medicine
o Integrative medicine
o Functional medicine
o Anti-aging medicine
bull It is FULLY embracing the VIS
37
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
38
The Future of Natural Medicinebull Changing healthcare by practicing true natural
medicine is the future of natural medicine And it
has started
bull The truth of our medicine will continue to inspire and
transform healthcare
bull Paraphrasing Margaret Mead
In fact the truth of our medicine is the only thing
that can change healthcare
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