Political Clout from the AHMA-AANP-AHNA? The Vision of Bill Benda, MD, the Interlocking Director
Written by John Weeks
Healthcare Reform Clout from an AHMA, AANP and AHNA Collaboration? The Vision of Bill Benda, MD, the Interlocking Director
Summary: In 2004, Bill Benda, MD, quietly began working to create collaboration between three organizations of healthcare professionals: the American Holistic Medical
Association, the American Association of Naturopathic Physicians and
the American Holistic Nurses Association. "The potential for communal impact is enormous," says Benda. He brought the leadership of these organization together into a retreat in 2005. He presently sits on the boards of the first two and is on the advisory council to the latter. What might these organizations accomplish together? What do you think is the very best use of this collaborative trio in advancing health care transformation? The Integrator sent Benda some queries via email. Here are his responses on his effort to create some new clout for holistic and whole person primary care.
Send your comments to
for passing on to Benda and/or inclusion in a future Your Comments article.
Bill Benda, MD
History has its interesting twists. The late 1970s marked the founding of both the American Holistic Medical Associationand the American Holistic Nurses Association. A few years later, a group of naturopathic physicians from the same generation of incoming leaders formed the American Association of Naturopathic Physicians to give new direction to a profession which was experiencing an influx and renewal. From 30,000 feet, these three have always seemed sibling organizations. Each was birthed of a cultural movement toward environmentally sound, holistic and whole person health care. Each held a core idea that the patient is presenting with his or her problem as a message that the body, in its wisdom, is attempting to teach, and that the practitioner's role is to help the patient remove the obstacles and aide and abet the healing abilities.
The twist here is that two decades later it was Bill Benda, MD, a graduate, of the first year of the flagship fellowship in integrative medicine at the Program in Integrative Medicine (PIM) at University of Arizona, who has set the ground for creating collaboration between these three organizations.
Benda had worked with the AANP leadership, and leaders of the AHNA and AHMA to create a small gathering of leaders at the EsalenInstitutea year earlier. Benda, an Integrator adviser, reasoned that the leaders needed to meet each other in an unencumbered environment to shuck the vestiges of professional differences and open themselves to new inter-professional possibilities. Benda was since elected to the boards of the AHMA and the AANP and is an advisor to AHNA's leadership.
Why these three organizations? What value may come of this collaboration? What has Benda accomplished thus
far? I emailed Benda some questions on these topic. Here is his report on this effort to create a collaboration which may prove to be bringing more potency to some key issues than any of the three parts acting alone.
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Integrator: You start with the American Holistic Medicine Association, the American Holistic Nurses Association and the American Association of Naturopathic Physicians. Why not the environmental
doctors? Why not the chiropractors?
Benda: Many of us in healthcare are driven by an
inner desire to make a meaningful contribution to our world. Some provide exceptional clinical care. Some labor in the research lab to ensure
greatest benefit and least harm from our technologies. My personal goal is to unify large numbers of
licensed, credible, thoughtful practitioners who hold the public trust to
advocate for change towards more humanistic healthcare. My strategy is to first
engage those membership organizations representing holistic primary care,
meaning healthcare from cradle to grave.
"Each
organization’s strengths offset the limitations of the other two, all the while
holding very similar goals and ideology.
"The potential for communal impact is enormous."
MDs are still our cultural healthcare
icons, nurses are beloved for their personal touch and attention, and
naturopathic physicians have refined the efficacy of natural medicine over
decades of experience. And true to the definition of integrative care, each
organization’s strengths offset the limitations of the other two, all the while
holding very similar goals and ideology.
The potential for communal impact is enormous.
The agenda that eventually emerges –
whether backing legislation and political candidates, objecting to undesirable
bureaucratic or industry trends, or garnering public support – will be
determined by the membership organizations themselves. As far as expanding to include organizations
representing other professions and specialties, yes, of course. But we need a foundation to build upon, and
MDs, nurses, and naturopathic physicians seem the ideal cornerstones.
Integrator: You took the lead in bringing leaders of these organization together for a meeting at Esalen in 2005. Why?
Benda: In May of 2005 we hosted the Summit in
Humanistic Medicine, an invitational conference of educational and political
leaders of our field. Unbeknownst to
most of us, Esalen had created the Program in Humanistic Medicine(1972-1974),
a group of 14 influential doctors, nurses, and other healthcare professionals
who met monthly to discuss unconventional approaches and philosophies. The effort resulted in two published books,
as well as introduction and passage of the 1976 Health Professions Education
Assistance Act (PL-94-484), the first federal legislation to require funding of
projects “establishing humanism in health care centers.” Sukie and Stuart Miller, the founders of the
Esalen program, were then approached by the fledging American Medical Student
Association (AMSA) to give a week-long training in the principles of humanistic
medicine. This eventually morphed into
the AMSA Humanistic Medicine Task Force, progenitor of today’s Humanistic
Medicine Action Committee (HuMed).
My intention in 2005 was to bring together
the presidents and presidents-elect of the AHMA, AHNA, and AANP to explore who
we each are as fellow humans, and through this process to discover how we might
share resources and expertise in pursuit of common goals. We also invited student representatives from
these organizations, the president of ACAM, and a host of “elders” such as
Wayne Jonas, Joe Pizzorno, Sheila Quinn, and David Matteson The group met for
three days, and as rooms at Esalen are double occupancy, I placed people
together that I felt would benefit from hearing each other snore as well as
speak.
"Rankism, the
unacknowledged professional hierarchy that exists within our healthcare system is our primary impediment to true integration."
Our invited speaker, Bob Fuller,
discussed “rankism” as the last remaining unspoken class prejudice in the
United States. Rankism, the
unacknowledged professional hierarchy that exists within our healthcare system,
is our primary impediment to true integration.
Integrator: What has come out of that meeting? Benda: To add some context, it is my belief that
individuals, organizations, institutions, and cultures must all come to
awareness of and acceptance of the inevitable limitations and dysfunctions that
persistently challenge growth and evolution. We all hold unspoken and often
unconscious judgments towards each other, usually projections of our judgments
towards ourselves, and the integrative medicine movement is no exception. I had hoped to start such a process of inner
inquiry and acceptance among representatives of these groups. In hindsight, I would say we were not
collectively ready for such deep work. However, relationships were formed and a
number of collaborations did spin out that have proven beneficial and
sustainable. Notably, the AHMA and AHNA held a joint convention last year, the
AANP has invited the leadership of the other two to attend a special session at
their upcoming national convention, and reciprocal membership in these
organizations is once again a live issue.
In addition, Wayne Jonas did create a number of potential collaborative
projects, some of which I believe are being carried forth.
And somewhere inside, each participant
still carries the taste of that weekend.
Integrator: In your wildest drive-time daydreaming imagination, what comes
of these 3 groups working together? What are they accomplishing?
Benda: My wildest daydreaming imagination usually
engages other arenas. But if I did choose this one, I would have the executive
directors and boards participating in regular teleconferencing calls regarding
specific, mutually beneficial collaboration and support. Each group would host at their annual
convention a one-day, face-to-face strategy session to define common goals and
agendas. And once a year, we would meet
for a weekend at the Esalen Institute to strengthen our personal commitment to
each other.
The end result would be a unified voice of
over 6,000 organized, licensed, and publicly recognized professionals
representing the mission and values of humanistic practitioners and their
patients across the country.
But of course, the conversation must first
be started, and that is often the most difficult step.
Integrator: I do a good bit of organizing between different disciplines myself.
It’s always a challenge to get these already under-funded groups to find the
extra, mostly volunteer time, to devote to collaborative work. Why should they?
Benda: When I was in high school in South Florida,
integration was defined as blacks and whites in the same classroom. Today we realize that human integration
includes blacks, whites, browns, yellows, gays, straights, Republicans,
Democrats – everybody.
The question we face now is not so much why should we integrate at the
organizational level, but when will
we? As in, are we ready yet? Are we there yet? As we begin to truly comprehend
the nature of our philosophical foundations - that everything is connected to
everything else, for better or worse - we will eventually see the inevitability
of relationship. Readiness is a matter of organizational maturity. You might
say that right now integrative medicine is in a kind of adolescence, concerned
with differentiation from the parental institution, anxious about its ability
to actually stand alone. We are focused upon basic, achievable integration,
concerned with combining botanicals and pharmaceuticals, acupuncturists and
allopathic physicians. Blacks and whites. But the time will come when we
understand that true integration in healthcare begins with each individual’s
personal journey to physical, emotional, and spiritual health, and
"The end result would be a unified voice of
over 6,000 organized, licensed, and publicly recognized professionals."
spreads
outwards to include organizational, institutional, political, social, and
cultural acceptance that we are all connected; that harming another harms
oneself and that in caring for another we are always taken care of. A mad, confusing, beautiful mix of passion
and logic, never to be truly understood but the foundation of all spiritual
teachings.
If the above three groups, or any
organization or individual, professes to be integrative, they must seek
connection with others of same mind and mission, moving beyond their own fear
of scarcity and into service of humankind.
When this philosophy is followed, outcomes take care of themselves. When it is not, all efforts to fulfill
personal agendas eventually fail. It’s
the law.
Benda: I believe these organizations to be
essential for the eventual integration of all CAM/allopathic practitioners, as
their work lays the foundation for understanding of the various professions and
serves as a large database for standardization of protocols and policies. However, I often get lost in the complexity
of their strategic intent and the magnitude of their published materials.
I am by personality and by instinct an
emergency physician – I want to get things fixed now. And I believe that some
things do need fixing now. In addition
to the aforementioned benefits, an AHMA/AHNA/AANP collaboration could serve as
a rapid-response entity, reacting to breaking events such as legislative
challenges to DSHEA and threats such as the AMA Scope of Practice
Partnership. 6,000 organized, licensed,
and publicly recognized professionals.
Integrator: What value have you brought to these 3 organizations so far by
being involved with all 3? Benda: To date I’ve worked mostly with the AANP
and naturopathic physicians. Karen
Howard, the executive director, understands that an outside perspective,
especially from the “other side,” provides insights unavailable to board
members encumbered by professional attachments.
I will attend my first AHMA board meeting
this June, and have a very good relationship with Karen Lawson and Larry Palevsky,
past presidents who attended the Esalen Summit.
I also have experience with and respect for Carla Mariano, president of
the AHNA. Both leaderships understand
collaboration as essential to the evolution of their respective
organizations. Possibly the greatest
value I bring to the table is a consistent willingness to illuminate or mirror
our personal and institutional learning edges that are roadblocks, holding back
our evolution. This is usually a rocky road, uncomfortable, and often avoided.
I happen to really like it.
Integrator: Do you ever feel conflicted, wearing the 3 hats?
Benda: Not a bit.
One benefit of being independent is that I am not influenced by the
personal agendas of any organization or profession. In addition, as I am engaged academically and
politically rather than clinically at the moment, I have no financial gain or
loss to consider. And I never did like
hats.
Integrator: What’s your next step?
Benda: My next step is to attend my first board
meeting this June at the AHMA convention in Portland. Unfortunately, I cannot attend the AHNA
convention as it takes place the same week.
"Something I am very interested in is the
student activism that is rising within these three organizations."
Something I am very interested in is the
student activism that is rising within these three organizations. AMSA and HuMed have been around for decades,
the Naturopathic Medical Student Associationis in the early stages of
formation, and the AHNA has just created a student consortium in partnership
with their national organization. The
next generation is not yet burdened by the necessary biases and financial
constraints that will inevitably complicate their lives after graduation. They remind me of our own idealism in the 60s
and 70s, before we “grew up,” and I love being in their presence. And in a few years, they will comprise the
boards of directors of our national organizations.
But the truth is that we already know the
answer to the healthcare dilemma. Just
as we cannot kill all the terrorists or destroy all of the opium fields in the
Wars on Terror and Drugs, we will never kill all the bacteria and viruses or
legislate all of the risk out of living in the War on Disease and Injury. All of our “enemies” will simply out-mutate
and out-evolve our technology through sheer numbers and the efficiency of
natural selection. We can only affect
change by addressing the environment in which our problems take root and
grow. A healthy society will breed far
fewer terrorists. A healthy economy will
give opium or coca farmers other options for feeding their families. And a healthy body will resist getting sick,
especially from chronic illnesses. We
will always have terrorists and drugs and disease. But we can greatly mitigate their effect, and
therefore their cost. But such a
paradigm shift requires not greater technology (technology will never trump
the perfection of nature), but a new cultural philosophy of personal and social
responsibility originating from the highest political levels and manifesting in
each of us as individuals. We cannot
depend upon the healthcare industry for answers - by definition it thrives only
if we are ill. So we have to depend on
our political leaders, who are, after all, ‘us’, constantly informed and
prodded by think tanks and students and consortiums of membership organizations.
Comment: I realized part way through reading Benda's responses that my own impatience to see specific examples of collaborative action now were not only misaligned with the timing of Benda's work, but also disrespectful to what I have learned in my own multi-disciplinary organizing work over the years. These things take time, yes. Shoot, I can recall discussing with others the value of a holistic-naturopathic combo in 1987. Pregnancy is a low percentage likelihood from the perspective of the individual sperm. For years, such thoughts haven't managed to bear much fruit.
This inter-association, AHMA-AHNA-AANP collaboration may appropriately be described as pregnant, presently. What good will come of this? Here's hoping Benda will be successful in getting key members of the boards on regular calls together, identifying shared agendas, and moving them. I look forward to a follow up article one day when we can see the action which has been birthed. Got any ideas on the very best use of this collaborative trio in advancing health care reform?
Send your comments to
for passing on to Benda and inclusion in a future Your Comments article.
Benda: Many of us in healthcare are driven by an
inner desire to make a meaningful contribution to our world. Some provide exceptional clinical care. Some labor in the research lab to ensure
greatest benefit and least harm from our technologies. My personal goal is to unify large numbers of
licensed, credible, thoughtful practitioners who hold the public trust to
advocate for change towards more humanistic healthcare. My strategy is to first
engage those membership organizations representing holistic primary care,
meaning healthcare from cradle to grave.
Benda: 
Benda: 
