I learned plenty during my first year of naturopathic medical school. I discovered how dynamic and resilient our cells and tissues are. I saw first hand how well organized we have been assembled. I even witnessed how long an individual could survive sans sleep on a dark chocolate and coffee diet. And while the human body is a spectacular machine that never ceases to amaze or inspire, I found looking into the circumstances surrounding naturopathic licensure to be the most enlightening. Observing the politics of medicine led me to reflect on my own experiences and refine my understanding of how naturopathic medicine fits into the current medical model.
I come from a decidedly strong allopathic background. During my undergraduate studies, I felt I needed to solidify my desire to pursue a medical doctor education, and I thought the emergency room would be the best place to be exposed to the inner-workings of the hospital system and medicine in general. Unfortunately, the plan backfired as I witnessed the ugly realities of medicine today. Patients were flooding the waiting rooms only to be greeted with horrid wait times and distracted, overworked staff. The chronically ill regularly cycled through, their familiar faces being hand delivered by EMS workers like fresh produce off the back of a truck. Patient reports became almost comical in their redundancy. A mere formality since everyone would know why the patient was there (again), but we each played our part in the tragedy. Doctors were chained to their Press Ganey
scores and seemed to be in an endless battle with Medicare and private insurers to get every scrap of reimbursement they possibly could, which would eventually end up only being pennies on the dollar. “Go be a dentist or a lawyer, anything but this,” they would say. I agreed. Everything seemed backwards and wrapped with irony. The respiratory therapists were the worst smokers, the hospital cafeteria served the unhealthiest and tasteless food imaginable, doctors took deliberate measures to escape patient interaction, and no one was healthy or happy. Not exactly the beacon of health and human service I imagined it to be. There had to be a better way.
It turns out there was a better way, and I applied to naturopathic medical school to learn it. But the more engrossed I became with naturopathic medicine, the more I found myself trying to defend it. I suddenly had a medical philosophy inferiority complex. I felt the need to justify my decision to pursue a career as a naturopathic physician to anyone and everyone, especially my colleagues in healthcare. This drive to “prove” the legitimacy of the medicine led me to learn more about what the conversation was like in the political arena. I wanted to be better able to articulate and debate the key aspects of my new profession. What were our strong points? What were our weaknesses? How were we presenting ourselves to the general, and mostly uninformed public? I suppose I expected to find some philosophical and academically charged debate on the state’s senate floor where ND’s and MD’s were making fiery exchanges in the name of science and progress. In my naivety, I thought the fight for licensure was about the scientific validity and credibility of naturopathic medicine. Instead, I found politics as usual.
I still remember my undergraduate economics studies. It is there I learned market control often shifted between buyers and sellers depending on the conditions of supply and demand. If that control shifted to one seller on the supply side then suddenly you had a monopoly. Monopoly is something of a dirty word here in America, but if you should gain “strategic influence” over a market then you would be applauded. State medical boards maintain this type of influence over the physician market through licensing. In this way they are able to reduce physician supply, drive up costs, and eliminate competition in the medical services market. None of this is explicit of course. All regulation is done in the name of quality control and patient safety. But one doesn’t have to look far to see the tremendous resources and political influence that these governing bodies maintain. In short, the effort against naturopathic licensure isn’t about it’s validity, safety, and efficacy. All of that has been well established and documented. It’s about money, power, and the interests of industry. No wonder the hospital system is so backwards.
Having this realization has been liberating. I no longer carry the burden of scientific proof with me to cocktail parties and family get-togethers. Instead, I can speak to what naturopathic medicine has to offer the public and industry alike, and why naturopathic physicians are in a unique position to bring choice, efficiency, and value to an imbalanced market. I don't need to persuade people to see the strengths in naturopathic medicine. I only highlight the opportunities for improvement in the current healthcare market. I can offer insight on how issues like primary care shortages, chronic disease burden, and equitable access to quality, affordable care could all be addressed by naturopathic medical licensure. I can show how naturopathic medicine is neither antagonistic or redundant to the current system. It is collaborative and necessary, filling a very specific need. And I can point them to examples of states in which all of this is already being proven.
I suppose what I’ve gained the most this past year is perspective. I have a much deeper understanding of naturopathic medicine and the context in which it is successfully developing and expanding. Knowing that licensure and scope of practice debates are political gives me unique direction in how I present naturopathic medicine to others and how I interpret resistance to it. In politics, ideas unite people. Naturopathic medical licensure is a powerful idea that stands to benefit the majority. As voters and legislators gain their own perspective they too will see this and work to lessen the grip medical licensing boards have over their respective markets. In that economics class we were taught that in any market there are winners and losers. I think its about time the patients win and with naturopathic licensure they will.