Foundations of Naturopathic Medicine Project to Cast Light on the Basis of Integrative Medicine and Integrated Health Care

Summary:  The past 20 years of the dynamic renewal of naturopathic medicine as a discipline have created a new set of pressures and opportunities for the profession. A multi-faceted Foundations of Naturopathic Medicine (FNM) Project has recently emerged, under the leadership of Pamela Snider, ND, and with participation of all of the profession's leading agencies. The focal product of the FNM Project will be the first textbook of naturopathic medicine in more than a half century, to be published by Elsevier Publications. But the two dozen editors and over 100 authors see that what is at stake here is more fundamental than a typical textbook. Through a series of retreats and written products, the FNM Project has a goal of "codifying (naturopathic) knowledge." The project may cast interesting light on the parallel emergence of integrative medicine.

2.   Origins: From Elsevier Book to Expansive Profession-Wide Project

A half-decade ago, Marc Micozzi, MD, PhD, began laying groundwork for an additional volume in a series of books on complementary, integrative and alternative medicine topics. He was overseeing the multi-volume project for Elsevier Publications. Micozzi contacted Pamela Snider, ND, to write a 300 page book on naturopathic medicine.

Snider had been a long-time national leader for her profession and in the broader integrative health care arena. Her resume included co-chairing a 1987-1989 profession-wide process which led to the drafting of a widely-cited, principles-based, definition of naturopathic medicine. From 1994-2003, Snider served in policy leadership as associate dean of naturopathic medicine for Bastyr University. She was intimately involved in the drafting of the enabling legislation for the National Center for Complementary and Alternative Medicine and was appointed to a Medicare Coverage Advisory Committee panel on preventive services. As an organizer, Snider later co-founded the National Education Dialogue to Advance Integrated Healthcare and served as the founding executive director of the Academic Consortium for Complementary and Alternative Health Care.

Elsevier may not have foreseen all that his invitation to Snider would eventually entail. Snider believed that the book needed to be an edited volume, allowing diverse voices. She also saw the Elsevier book as an opportunity for the profession to create the

, the founder of the American Association of Naturopathic Physicians; and three international leaders Stephen Myers, PhD, BMed, ND (Australia), Roger Newman Turner, ND, DO (United Kingdom) and Don Warren, ND, DHANP (Canada).

Pamela Snider, ND. at the retreat. Photo credit Sarah Spring, NCNM

The group began to understand that what was needed was a deep, formal, profession-wide engagement. An editorial structure was created which included a group of associate editors and section leads for various content topics. These began overseeing inputs from over 100 authors. The profession's leading organizations - for accreditation, testing, professional advancement, student activity and education - all established formal liaisons to the project.

On April 1-5, 2007, FNM Project held its first annual editor's retreat at Skamania Lodge on the Columbia River in Southwestern Washington. The breadth of professional inclusion was evident in the participation. In attendance were 35-45 professionals representing naturopathic organizations and all 7 North American naturopathic medical colleges, plus some invited guests and presenters.

Home of the FNP Project

I had the opportunity to experience two days of the retreat. The precise contents of the meeting are presently embargoed from publication. Yet the general themes engaged suggest both the depth and the connectivity which the editors are attempting to achieve. Work focused on editors sharing drafts of their sections. But to kick-off the discussion, the group spent the better part of a day exploring modern understanding of the Vis medicatrix naturae (the healing power of nature), the core principle around which the profession is organized.

Outside experts were used to stimulate discussion. Among these were: Wayne Jonas, MD, the director of the Samueli Institute whose current work focuses on practical integration of healing healthcare practices; Iris Bell, MD, an international leader in whole systems thinking and complexity theory as applied to medical practice; Christa Louise, PhD, whose professional work has included applying complexity theory to naturopathic practice; Chris Grontkowski, PhD, an academic with expertise in the philosophy of science; and Mary Koithan, RN, PhD, an expert on formation of theory in health professions and nursing practice.

FNM Project panel on the Vis Medicatrix Naturae: (l to r) Myers, Leanna Standish, PhD, ND, LAc, Bell, Jonas, Sensenig and Zeff. Photo credit, Sarah Spring, NCNM

“What physicians think medicine is profoundly shapes what they do, how they behave in doing it, and the reasons they use to justify that behavior….whether conscious of it or not, every physician has an answer to what he [she] thinks medicine is, with real consequences for all whom he [she] he attends….the outcome is hardly trivial…It dictates, after all, how we approach patients, [and] how we make clinical judgments.” (1)