Guest Column: David Matteson on the Shared Destiny of Integrative Medicine and Natural Products
Written by John Weeks
Guest Column: David Matteson on the Shared Destiny of Integrative Medicine and the Natural Products Industry
Summary: How connected is the growing natural products industry and the industry that is represented by the vast expansion of complementary, alternative, integrative and holistic practitioners? Does the public separate the two? Do elected officials? Are their destinies intertwined? What is the optimal relationship between these two entities? David Matteson, a consultant and strategic thinker with deep connections in both these universes, has given a good deal of thought to the "parallel play" of these two natural health care forces. His guest column opens an Integrator dialogue on the optimal relationship between these two entities.
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David Matteson, MPM, MURP, MS
David Matteson, MPM, MURP, MS, makes a part of his living in the natural products industry. He owns a piece of a product company. Matteson also volunteers in various strategic and policy issues facing the dietary supplement industry's leadership.
The most significant other part of Matteson's living comes from working with complementary and alternative healthcare practitioner groups and their educational institutions. He has consulted recently with Bastyr University and Tai Sophia Instituteon strategic planning and policy. He also regularly assists the American Association of Naturopathic Physicians in various policy, political and strategic initiatives. His recent experience has also included consultation with acupuncturists, chiropractors and massage therapists.
Matteson's two worlds have led him to reflect on how these two universes - products and practice - are connected. He argues that they are deeply linked in minds of the public and policy makers. He wonders if perhaps each would be served to more consciously be connected for their mutual advance. Last summer Matteson headlined a panel that looked at practitioner and natural products industry relationships before scores of executives of natural products companies at the Newport Summit. I asked Matteson if he would write up his perspective for the Integrator.
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Parallel Play or a Potent Alliance?
Alternative Medicine Practitioners and the Natural Products Industry are Stronger Together
- David Matteson, MPM, MURP, MS
"The Natural Products Industry (NPI) and the complementary
and alternative medicine (CAM) industry are each in the midst of a major
transformation. Their ability to learn how to 'play' together may be
crucial to how well these industries grow and succeed over the next few
years.
"There is a natural relationship
between these two industries. Many policy makers and many consumers see
them as flip sides of the same coin. Yet, these two industries have not really acknowledged their
interconnectedness, let alone taken active steps to collaborate on their common
political and market interests.
"There is a natural relationship
between these two industries.
Many policy makers and many
consumers see
them as
flip sides of the same coin.
"Yet, these two industries
have not really acknowledged
their
interconnectedness,
let alone taken active steps
to collaborate on their common
political and market interests."
- David Matteson
"If you have ever observed two toddlers engaged in something
called 'parallel play,' you would have noticed how the way they interact is
quite different than how two older children might play together. Each baby
knows that the other one is there. They play side-by-side, but they never
directly interact. And yet, each of their behaviors is influenced by the other. They are in relationship.
"The relationship between CAM and the NPI can be
likened to the parallel play of two toddlers. They both know the other one is
there, and they 'play' side-by-side. But they never really interact. And yet,
each of their behaviors is influenced by the other. "Each of these industries has emerged and evolved in adjacent
market spaces over the past 30 years. Each has benefited from increasing
public demand and increasing acceptance from regulators over that period. Consumers in one industry tend to be
consumers in the other. There has been a version of parallel play going on. Each industry tended to think of itself as
novel and independent, yet the success of one industry certainly impacts the
other.
"From outside each of these industries no one paid much
attention, until in the early 1990s data about the economic impact and consumer use began to cause
people to take notice. When people
did notice, they tended to line up for or against some vague notion of 'natural health.' Policy makers, thought
leaders, and regulators supporting one industry have tended to also be
supportive of the other.
"As each has
matured and market penetration has increased, these two industries have begun
to experience new market and regulatory pressures. Many of these pressures come naturally
as part of the maturing of any business cycle.
Each is experiencing increased regulatory scrutiny, increased
competition from big players in the traditional health and nutrition sectors,
increasing sophistication from oppositional view points, and increasing demands
for validation and accountability. "Like most successful ventures, each of these industries is
now moving into a business cycle where it has to defend its success as well as
advance it. Traditional medicine is
challenging CAM’s advocacy for a place in healthcare reform. Big food and big pharma are circling the NPI
sniffing out opportunities to control the NPI to their market advantage. Policy
makers and regulators are asserting stronger scrutiny to reign in the mavericks
and clean up shoddy practices within each industry.
"What happens to one
industry very much affects
the
other, and vice-versa.
These two industries sit
side by side. The public
sees them as part of the
same family.
- Matteson
"They might see themselves as separate but they aren't separate in the realm of perception by outside audiences. What happens to one industry very much affects the
other, and vice-versa. These two
industries sit side by side. The public
sees them as part of the same family. And the public does this despite the fact that these
are two siblings of the same consumer movement have paid little attention to
each other up to this point. "It is too simplistic to say that these groups don’t
interact. But their interaction has been quite limited. In my experience, NPI companies are more conscious of
their relationship with CAM practitioners than the other way around. NPI companies exhibit at CAM
convention. They are often members of CAM associations. They support naturopathic doctors and acupuncturists and massage therapists and integrative physicians on various issues, such as support for state licensing and efforts to protect the right of medical doctors to integrative practice.
"This action of natural product companies is linked to their vested marketing interest in the
practitioners and their patients. Practitioners buy
or recommend natural products.
"In
contrast, practitioners seem to have difficulty seeing natural product
companies as something related to them. Even though most CAM conventions have exhibit halls filled with natural
product companies, many practitioners tend to view these companies as no more than vendors
trying to sell them something that they don’t necessarily want or need. They do not relate to natural products companies as partners in the success of CAM or as entities whose actions could have negative consequences for them. "Interaction and collaboration between the two industries has
been even less on the legislative and public policy front. Recent governmental attention on natural
health, such as the White House Commission on Complementary and Alternative
Medicine Policy, the FDA’s recent CAM Guidance document, and the recent
current Good Manufacturing Processes, to name a few, has lumped discussions of the two
industries into the same conversation. Yet, the two industries have consistently failed to coordinate
strategies and testimony.
"If there could be a
tighter definition or
declaration of the
synergy between
the two, perhaps
both CAM an NPI can
have a
greater voice
in what they become."
- Matteson
"Perhaps necessity is driving these two industries
into working more closely together. One
notable effort is the recent addition of the American Association of
Naturopathic Physicians (AANP) to the board for the Coalition to Preserve DSHEA
(the Dietary Supplement Health and Education Act of 1994). This landmark piece of legislation ensures
broad consumer access and choice to supplements, vitamins, herbs, and
botanicals, which is critical to the successful practice of several CAM
professions. Not only would consumers
potentially have difficulty purchasing products as part of a natural medicine
regime, but tightening the regulation might be problematic for
practitioners who make revenue by selling products out of their clinics. The
AANP is the first practitioner group to openly support NPI in its legislative
efforts.
"Likewise,
restriction of access and choice to CAM services could adversely affect the
NPI. Consider the Scope of Practice
Partnership (SOPP), a coalition that the American Medical Association announced in April of 2006 to assist various physician organizations facing scope of practice 'battles.' SOPP basically advocates that MD physician organizations should
determine what is best for other licensed healthcare professionals. SOPP is
considered by many CAM providers to be divisive because it will likely impede
patient access to CAM practitioners. A portion of the campaign directly seeks to limit licensing of naturopathic physicians in new states. Is it mere coincidence that this happened
right after the naturopathic profession passed a licensing law in California
over the objections of the California Medical Association? Some find this to be
further evidence that the AMA is on a mission to discredit CAM and limit its
expansion. If patients have to depend on
conventional medicine alone to educate them about alternative medicine and
natural products, there is little doubt that this will also impact NPI.
"Perhaps the greatest question is how well each of these
industries succeed in sustaining their growth and securing a place on the
changing landscape of health and healthcare.
Natural products seem to be caught in between being defined by big food
or big pharma. CAM hasn’t found a successful way to collectively define itself,
so insurance companies and regulators are defining what their professions are
and how are they regulated. If there could be a tighter definition or
declaration of the synergy between the two, perhaps both CAM an NPI can have a
greater voice in what they become. They are a continuum from service to product. This could be used for leverage, if they could only learn to
play together."
Comment: This topic is a great zone to enter, for many reasons. Matteson makes the excellent point that, in the mind of politicians and consumers, there may be no distinction between products and practitioners. As the Vidal Sassoon ads used to say: "If you look good, we look good." And if you don't, we suffer too. Then, of course, this dialogue opens under the long shadow of the unsavory aspects of the MD-Big Pharma relationship. The Integrator actively solicits your comments on this subject and plans to include additional guest columns on the topic.
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