The Best, and Worst, of Natural and Alternative Medicine
Joseph E. Pizzorno, Jr., ND
President, Bastyr University
Many might point to the gratifying dramatic increase
in public awareness and utilization of natural medicine as one of our
greatest accomplishments. However, I believe far more significant is
the remarkable advancement in the quality of our practitioners and the
health care they provide. Several factors have contributed to the increased
efficacy of natural medicine practitioners. Four are especially significant:
burgeoning research in nutritional and other specific natural medicine
therapies, improved quality of education, increased availability of
high quality natural medicines, and newly available laboratory assessments
that allow more objective evaluation of our patient’s health and function.
The quantity of good quality research supporting natural
medicine interventions has increased substantially the past two decades.
Many conventional and natural medicine educational institutions are
actively engaged in research and the US Congress’s elevation of the
Office of Alternative Medicine to an NIH Center and increase in budget
to $70 million is providing ever more funding and opportunity. The newest
edition of the Textbook of Natural Medicine now cites over 10,000
peer-reviewed research studies documenting much of our practice.
Education in natural medicine has been dramatically
improved by accreditation. This was accomplished by the willingness
of the natural medicine professions to engage in the onerous process
of establishing accrediting agencies of sufficient quality to meet US
Department of Education standards and then subjecting natural medicine
institutions to the rigors of the process. Also of importance to improving
practitioner quality has been national standardized professional examination
boards, increased numbers of states establishing licensing and the continuing
efforts of the professions to establish standards of care.
Product quality has been significantly improved by the
increased utilization of pharmaceutical production standards by many
of the manufacturers of natural medicines. The relatively recent availability
of standardized botanical extracts has greatly facilitated more objective
research. Equally important has been the internet and other electronic
tools which have made all this information much more readily accessible.
Finally, I am especially excited by the great increase
in number and quality of laboratory methods for assessing patient function
and health. For so long the only laboratory tests available were only
for the detection of diseaseóuseful but too late! Instead of having
to guess, we can now detect physiological imbalances long before they
progress to far more difficult to treat pathology. Systemic toxic load,
bowel toxemia, efficacy of the liver’s detoxification enzymes, immune
dysfunction, all these age-old natural medicine treatment precepts are
Public access has also been greatly improved through
both political and financial progress. Insurance companies now compete
with each other to offer alternative medicine benefits to attract enrollees
while more and more state legislators now mandate insurance equality.
Public officials and legislators, after successfully using natural medicine
themselves, no longer blindly believe the medical political lobbies.
They are systematically dismantling the system of special privilege
for medical doctors that created so many barriers to public access to
natural medicine. Especially significant has been the establishment
and funding of demonstration projects such as the landmark King County
Natural Medicine Clinic. Fully funded by a combination of Federal, State
and County funds, this innovative program demonstrated that natural
medicine and conventional medicine practitioners could work together
in a public clinic for the benefit of their patients, Their pioneering
successes engendered tremendous media attention.
The public is voting with their feet and their pocketbooks.
They want a new health care system. They want respect, personal control
and better health. They want what we are offering.
Despite these important advances, serious problems plague
the continued acceptance and utilization of natural medicine. I am especially
concerned about the misunderstanding that natural medicine is simply
substituting herbs and vitamins for synthetic drugs, the inconsistent
quality of natural medicines available to both the public and professionals,
the health damage caused by unqualified practitioners, and the inadequate
funding for research of the precepts and therapeutic protocols of natural
The growing public enchantment with natural medicine
is exciting. Yet to many, natural medicine is no more than green magic
bullets. The fundamental precepts of our medicine, the promotion of
wellness through healthful living and supporting the body’s own natural
healing processes, is lost in the rush to ever more glamorous “miracle
herbs” and “breakthrough” nutrients. Our deeply insightful understanding
of health and healing is why we have so much to offer in developing
a true health-care system rather than our current disease-treatment
system. Let’s not lose our way.
Several formal and informal studies have publicized
the inconsistent quality of the therapeutic agents we use. So many of
the manufacturers are responsible and work hard to ensure the quality
of their products. But what do we, as practitioners, do to recognize
and align with them? How do we decide which products are of sufficient
quality to recommend them to our patients? When are the responsible
manufacturers going to stop being intimidated by those whose only interest
appears to be how profitable they can make the label, regardless of
the actual contents of the product?
I am especially concerned that the lack of public sophistication
in natural medicine makes them very vulnerable to uncredentialled fakes
and those promoting nostrums which not only have no efficacy but are
at times damaging. Even medical doctors, credentialled and skilled though
they are in conventional medicine, have no business presenting themselves
as natural medicine practitioners without proper training. And how about
states with no licensing? Lack of licensing means no standards allowing
anyone who feels like it to use a title they did not bother to earn
through education and credentialling. While some are well intentioned,
I have sadly interacted with far too many whose only interest was their
ego and their income.
We can be proud of having developed a much better understanding
of the activity of many natural therapeutic agents, e.g., Gingko biloba.
However, there continues to be essentially no research on systems of
healing or the multifactorial protocols we all actually use in our practices.
Yes, fish oils will help the patient with eczema, but how about the
combination of food allergy control, zinc supplementation, HCl supplementation
and, (add your favorites here)? We believe our patients are healthier
from following our therapeutic and lifestyle recommendations, but where
is the data? Virtually all of the very limited funding available is
allocated to researching the treatment of diseases with specific natural
medicine agents (e.g., St. John’s Wort for depression). While valuable,
this is not the most important research we should be doing. It fits
the medical model of treating disease. It does little to advance our
understanding of how to improve health.
Some Thoughts for the Future
Natural medicine has so much to offer to improve the
health and wellbeing of the human community. Yet, we will never fulfil
our full potential until we mature yet another step. We must help the
public understand our foundational concept of living healthfully in
the world, we must establish mechanisms to ensure product quality, we
need to ensure that when our skilled care is sought that the practitioners
are safe and effective, and we must advance the state of our art through
research that evaluates the validity of our precepts, not just the efficacy
of specific products.