In June 2021, the Institute for Natural Medicine (INM) created an interdisciplinary Advisory Board to truly deliver on the promise of a new model of integrated whole health. The professional community must begin effectively collaborating. To help in this regard, the INM built the advisory board over the next year, focusing on integrative-minded medical doctors (MD) and doctors of osteopathy (DO).
The concept for the board was initiated by Leonard A. Wisneski, MD, FACP, faculty of Georgetown University, George Washington University, University of Colorado; Chair Emeritus of the Integrative Health Policy Consortium and author of Scientific Basis of Integrative Health.
“Primary care should focus on whole-person medicine,” said Dr. Wisneski. “Naturopathic doctors are educated as specialists in lifestyle and behavioral medicine, which hones in on healthy habits supporting chronic disease prevention. And as such, they should be more readily integrated into primary care settings. This board will help facilitate that process.”
Dr. Wisneski also sits on INM’s ND Advisory board which I chair and which includes Ryan Bradley, ND, MPH, Arvin Jeneb, ND, John Finnell ND, LAc, MPH, PHD(C), Tori Hudson, ND, Jacob Hwang, ND, Bruce Milliman, ND, Manna Semby, ND, Natalie Walsh ND, MS. It was the original vision of the ND board to create a series of lectures featuring multidisciplinary panels of practitioners discussing approaches to team-based integrative medicine approaches that focus on a whole health approach to select challenging health conditions.
No one practitioner, profession or discipline has all the answers. In the ideal case, practitioners best suited to the patient’s particular needs are included to bring their relevant training and skills to bear. Take chronic pain, for example. In 2014, more than 240 million prescriptions were written for opioids.1 And we know that patients who receive long-term opiate prescriptions from primary care physicians have a one-in-four chance of struggling with addiction,2 according to the Centers for Disease Control3 and Prevention.
The American College of Physicians released a systematic review of 160 studies that urged physicians to first look to non-drug approaches like tai chi, physical therapy, stress reduction or yoga before even considering NSAIDS (non-steroidal anti-inflammatory drugs), much less opioids. I would add naturopathic physicians along with these evidence-based approaches. The ND general approach to health starts from a foundation of patient empowerment/education, then moves to active clinical health counseling, nutritional and herbal supplemental advice, and finally to legend drugs and surgery as a late-stage intervention. These stages are flexible and based on the specific needs of the patient.
Naturopathic Whole Practice Research Shows Promise
A cost analysis trial conducted at the Canadian College of Naturopathic Medicine (CCNM) by P. Herman et al.4 compared whole-practice naturopathic care to physical therapy for low back pain and found several interesting distinctions. The overall cost of the ND approach was more costly, $1,469 vs. $337; however, it resulted in less absenteeism (4.8 days) vs. a loss among the PT group of 1.9 days. Adjunct visits to other providers were a cost savings of $840 for the ND group vs. the PT group, which saw an increase in additional provider costs of $363. These effects combined showed that the ND group had a $188 benefit vs. a $1,212 cost for the PT group. When comparing the Quality Adjusted Life Years (QALY), an attempt to quantify the total number of healthy years a therapy adds to a person’s life, the ND QALY was 10 times the PT QALY. Quantifying the whole practice effect of naturopathic medicine is not easy and needs to be more thoroughly researched. With a growing interest in Whole Person Health, the door may begin to open to create these research opportunities for our profession.
INM Lecture Series Launched June 2023
Meanwhile, INM sponsored the first in what we aim to be a series of interprofessional education lectures. The first took place June 16, 2023, and was part of the Strauss Wisneski Lecture series at the University of Colorado Anschutz Medical Center. The lecture, “Whole Person Pain Care: Integrative Models in a Federally Qualified Health Center and the Veterans Health Administration,” was presented by John Finnell, ND, PhD(C), MPH, LAc, and Sharad Kohli, MD.
Dr. John Finnell is the whole health flagship program manager for the South Texas VA (Veteran Affairs). He is a naturopathic physician, acupuncturist and epidemiologist. He is also an associate clinical scientist at Bastyr University and a PhD candidate in Epidemiology at the University of Texas School of Public Health. His current research is on the Interdisciplinary Management of Complex Chronic Pain and Comorbid Psychiatric Symptoms in Veteran Populations.
Dr. Sharad Kohli is a family physician who serves as the medical director of the Integrative Pain Management Program at People’s Community Clinic, a Federally Qualified Health Center in Austin, TX. He is a co-founder of the nonprofit, interprofessional organization Integrative Medicine for the Underserved (IM4US), a member of the Board of Governors at AOMA Graduate School of Integrative Medicine, and an affiliate faculty member in the Department of Population Health at the University of Texas at Austin Dell Medical School.
Drs. Finnell and Kohli discussed Whole Person Pain Care as an interdisciplinary stepped-care strategy incorporating a biopsychosocial approach to address all aspects of a person’s health, life and relationships. They examined the implementation of Whole Person Pain Care within a Federally Qualified Health Center and the Veterans Health Administration. They explored the implications for broader use across the health care system. The lecture will be archived and available to view at: https://library.cuanschutz.edu/resources/library-collections/strauss-committee/lectures.
Health care is being re-imagined in the U.S. The medical profession is at a critical crossroads as the public gains greater awareness, acceptance and desire for integrative therapies, and institutions are seeking to learn how to adopt and maximize this approach to health. INM aims to be at the forefront of the conversation by envisioning and delivering high-quality education featuring interprofessional panels of providers demonstrating how to make the ideals of whole health a reality.
If you are interested in participating in this lecture series or our Advisory Boards or have a topic idea for this series, please contact me at email@example.com.
1 Department of Health and Human Services. The Opioid Epidemic: By the Numbers. Accessed at www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf.
2 Boscarino JA, Rukstalis M, Hoffman SN, et al. Risk factors for drug dependence among out-patients on opioid therapy in a large US healthcare system. Addiction 2010;105:1776–82. http://dx.doi. org/10.1111/j.1360-0443.2010.03052.
Michelle Simon, PhD, ND President & CEO, Institute for Natural Medicine
In 1992, the leadership core of naturopathic doctors established the Institute for Natural Medicine (INM) as a not for profit organization dedicated to advancing natural medicine. The purpose of the INM is to increase awareness of, broaden public access to, and encourage research about natural medicine and therapies. Among its milestones the INM counts the launch of the Association of Accredited Naturopathic Medical Colleges (AANMC) as an independent organization, leading California’s efforts to obtain licensure, developing an interactive childhood education program focused on healthy eating and lifestyles called Naturally Well in 2017, and expanding residency access by establishing and funding a residency program in 2018. INM has joined forces with the American Association of Naturopathic Physicians (AANP), serving as the charitable arm, to deepen access to naturopathic care, public education and research. Dr. Michelle Simon serves as president and CEO of INM, is a licensed naturopathic physician, clinician, educator and leader in many organizations dedicated to improving the quality and delivery of health care. In addition to holding a naturopathic doctorate from Bastyr University, she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill. Dr. Simon has served on the boards for the Integrative Healthcare Policy Consortium (IHPC), the AANP and the Naturopathic Physicians Research Institute (NPRI). Dr. Simon also served nine years on the Washington State Health Technology Clinical Committee which is part of the Health Technology Assessment program that examines the scientific evidentiary basis for efficacy, safety and cost effectiveness of health care technologies. She was also an invited participant for health care economics at “Summit on Integrative Medicine and the Health of the Public” at the Institute for Medicine (IOM) in 2009. Dr. Simon was recognized as the 2018 Physician of the Year by the AANP. Twitter: #inaturemed Facebook: @INMWeAreNaturalMedicine]