Talk to anybody who has worked long enough in one of the nutrition oriented healthcare disciplines and it is easy to hear the echo of a voice in the wilderness, one of a whole chorus of voices, isolated but in unison, on the fringes of what was considered healthcare. Listening to them now, however, is to hear of a wilderness tamed, a busy, well-lighted place with roads and powerlines and high speed internet.
Listen to them now and the word spoken most often might be “collaboration.”
Collaboration has a become an institutional edict in mainstream medicine. An influential paper on the death toll and costs tied to medical errors, publishedby the Institute of Medicine in 1999 and titled “To Err Is Human,” made collaborative medicine almost mandatory.
It is in that collaborative mission that nutrition and supplements are finding their greatest penetration into mainstream medicine. Elizabeth Goldblatt was one of those voices in the wilderness, active in the education piece of alternative medicine for decades, including stints at the Oregon College of Oriental Medicine and the Council of Colleges. She is now the executive director of the Academic Collaborative for Integrative Health. She knows the power of collaboration.
If one discipline approaches a mainstream medical institution, “they may or may not open the door.” “When we as a collaborative knock on the door, they open the door,” she says, recalling a recent meeting of the National Academy of Medicine Engineering and Science, a gathering attended by the American Medical Association, the kind of place where the alternative medicine crowd might not have been welcome in the past. “They invited us right in. When we went in, we actually gave them a text book that we wrote, a clinical and encyclopedic desk reference. I gave everybody a copy.”
That kind of welcome is being seen across mainstream medicine. In 1999, there were eight integrative health centers attached to medical schools, hospitals and other mainstream institutions. Now there are 71.
In the classroom
The opposite is happening too. Southern California University of Health Sciences President John Scaringe is inviting the mainstream in. Blurring the boundaries is essential, he says. “We train all our healthcare practitioners, holistic and conventional, in silos,” he says. SCUHS was known for its programs in chiropractic, eastern medicine, integrative health and Ayurveda.
Now they have a physician assistant program, training students to provide frontline care in the mainstream medical settings.
A physician assistant and a doctor of eastern medicine would seem headed to different destinations, but they share some of the journey, coming into their profession with a familiarity and appreciation of the alternative modalities. “In 40 percent of the physician assistants program, those classes are shared with doctors of chiropractic and doctors of eastern medicine sitting side by side.That’s the future of alternative medicine,” he says. “Let’s get them together early so that they are coming into the practice setting without these preconceived notions.”
Dan Lukaczer is a naturopathic doctor and the director of medical education at the Institute for Functional medicine. The preconceived notions are fading fast, he says. He can see it in the flow of information, a change in the current of collaboration between IFM and conventional medical institutions. It’s a “back and forth” now, he says. Medical schools are calling the IFM. The science is growing, and the demand from patients is growing with it. “It’s not shoved to the side anymore,” he says. “They need to be a part of it.”
The next crop of care
Education is one part of bringing alternative medicine into the hospital hallways. Another might be a game of numbers. Michael Stroka is the executive director of the Board for Certification of Nutrition Specialists. He doesn’t want to make it easier to get such certification. It’s a demanding role that demands top-notch education. But he does want to make the pathway clearer. He wants certification to be more common in more states. He wants the expectations and accreditation to be rigorous but standardized. He wants more certified nutritionists in more places, and the profile for the profession to gain a greater presence in the future of healthcare.
Stroka is involved with a nutrition consortium of groups that include his BCNS and organizations like the American College of Nutrition, and heads the Nutrition Leaders Council, which brings together supplement companies in and outside of the practitioner channel to further the message and the mission. It’s all about advocacy at every level, he says. Making certified nutritionists a profession accepted and licensed in every state is a pivotal next step in making nutrition more central to healthcare, Stroka says. The registered dieticians working with the medical establishment aren’t doing that nearly enough. They offer the nutritional equivalent of disease care the allopathic world is known for. Nutrition, as practiced by nutrition professionals, is “healthcare. It’s about creating and preserving and returning people to health.”
When doctors start collaborating with the certified nutrition specialists Stroka advocates for, he believes they will begin to seek them out. It won’t be just another lifestyle medicine discipline slipping in from the edges.
“As nutrition becomes a recognized healthcare profession, it’s just a totally different system.”
A system, by its nature, built by collaboration.
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