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The Best, and Worst, of Natural and Alternative Medicine

Joseph E. Pizzorno, Jr., ND
President, Bastyr University

The Best

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 now measurable.

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.

The Worst

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 medicine.

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.


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