MD Bashing, ND Bashing & Integration: Amato, Sportelli, Lee-Engel, Ballard, Glidden, King & Benda on Benda's Comments
Summary: If one cares about one's cultural competency for practice with practitioners from other disciplines, this set of comments is excellent, raw and eye-opening material for reflection. In a recent Integrator column, Bill Benda, MD asserted that "integrative medicine" will always be MD-centered. Then he responded to prior columns by Tom Ballard, ND and Peter Glidden, ND, strongly arguing that it was time to stop bashing medical doctors. These new comments - alternatively conciliatory, insightful, re-focusing, direct, congratulatory and inflammatory - are from naturopathic student leader Cheri King, 40+ year chiropractic practitioner and NCMIC president Lou Sportelli, DC, Inner Harmony Group founder Peter Amato, AANP board member Michelle Clark, ND, and Bastyr University educator and clinician Christy Lee-Engel, ND, LAc. Their contributions surround responses to Benda from Ballard and Glidden, each of whom felt Benda was engaging in his own bashing. I sent these to Benda prior to printing, who comments again. I conclude with some words from the poet Robert Graves.
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A confession: More than once, in this sometimes contentious dialogue over recent weeks, I have suppressed the urge to censor some of the strongest language commentators have presented. I twice asked writers if they really wanted to be saying what they were saying, while assuring them I would print what they want. One changed his tone, but only a bit; the other didn't change a word.
"Until we explore the two extremes,
we are
unable to find the middle
ground. [This] helps all of us see
both sides
of the coin and that is
critical to changing the
way we
all think about health care."
- Commentator Michelle Clark, ND
Much of this is raw material, exposing open wounds. Commentator Michelle Clark, ND prefaces her viewpoint with a phrase that explains why the value in highlighting these themes: "Until we explore the two extremes, we are unable to find the middle ground. [This] helps all of us see both sides of the coin and that is critical to changing the
way we all think about health care."
This content can potentiate a "healing crisis" among the disciplines if we approach it "with less volume and rhetoric" as recommended by Lou Sportelli, DC. These comments take us into the realm of the "historical power inequities across the professions" and our shared need to "affirm diversity." These two phrases are from the competerncies and values in practitioner-practitioner relationship in the exceptional Pew-Fetzer work on this subject. (I included their chart of competencies, skills and values at the bottom of this this article. Do yourself a favor and read it first, then come back to these comments. How can different sets of practitioners be
fully available to patients as parts of teams if we do not deal with
some of the depths of our deeply disturbed history.
The immediate precipitator of these 8 responses was a September 7, 2008 Integrator column by Bill Benda, MD. (See From Bill Benda, MD: Tough Love on Who Owns "Integrative Medicine" and Associated "MD-Bashing.") Benda's column was itself precipitated by his reading of a series of columns, especially those by Peter Glidden, ND and Tom Ballard, ND, which are noted and hot-linked at the bottom of this article.
Cheri King - a student leader's voice for the future
I could not agree more with Bill Benda’s “Clarifying a
Point and Taking a Stand on Another in the (Sometimes Acrimonious) Dialogue
Over “Integrative Medicine” (although the title could be a wee bit
shorter.)
While we squabble back and forth over whose medicine is
better or who is being treated like a second class citizen, nothing gets
accomplished. Instead of slinging mud or engaging in turf wars, we
need to put the patient in the center and ask ourselves “what does the patient
want?”
Obviously, the public is not abandoning allopathic medicine
any time soon. However they are demanding holistic health care
options integrated into the current conventional model. If in our
heart of hearts we truly advocate patient centered medicine then aren’t we
obliged to ”stop complaining about each other and get down to the business of
providing decent healthcare” so we can truly serve our patients?
King:
In a previously downtrodden profession
like naturopathy,
it’s hard to let go of
yesterday’s bitterness. But if we dwell
on
yesterday’s darkness, tomorrow
will never be sunny.
To err is human
and
many have erred on all sides. We
must let our divinity shine forth,
forgive,
and begin working on the massive
problems ahead of us TOGETHER.
In a previously downtrodden profession like naturopathy,
it’s hard to let go of yesterday’s bitterness. But if we dwell on
yesterday’s darkness, tomorrow will never be sunny. To err is human and
many have erred on all sides. We must let our divinity shine forth,
forgive, and begin working on the massive problems ahead of us TOGETHER.
All that said, as the professions collaborate and integrate,
I would espouse one caution. It is crucial that each profession keep
their own philosophy intact and distinct. Patients benefit by a fruit
salad of health care options. Allopathic, chiropractic, osteopathic,
acupuncture/Chinese medicine, massage, midwifery and naturopathic modalities
each contribute their own unique flavor to a healthcare
smorgasbord. If the professions “assimilate” we risk turning a fine
fruit salad into a smoothie and delivering watered down modalities that lose
their sharpness and help no one.
It is the evolved person who can celebrate another while
maintaining their own value and individuality. As we step into this new
age of collaboration, we must strive to do just that.
Cheri
King, President
Naturopathic
Medical Student Association
National
College of Natural Medicine - ND3
Portland,
OR
303-817-0530
Comment: It is my experience that many integrative medical doctors - and certainly those who see themselves as holistic - are precisely trying to change the philosophy of conventional medicine, rather than keep it "intact." Witness the calls from integrative MDs to "transform," to connect the mind and body, to support the body's natural healing ability and to focus on health creation. I would hope that they do anything but keep their own discipline intact. This theme - of not fully separating the "integrative MD" from the typical "AMA MD" - runs through the commentary below.
Tom Ballard, ND
2. Tom Ballard, ND: "calling my remarks a negative against MDs obfuscates ..."
I was dismayed to see my comments on integrative medicine characterized
as “MD bashing”. I worked as an emergency RN for a dozen years and, as they
say, some of my best friends are MDs. I never accused MDs of not being caring.
I’m sure that for the most part they are sincerely trying to help patients. To
personalize my remarks into a negative against MDs obfuscates my points.
My concern is that integrative medicine, as Bill Benda, MD, wrote,
“… is, and always will be, allopathically-centered,” and that because of this
naturopathy stands a good chance of being assimilated into non-existence. The
political and economic power of allopathic medicine enables MDs to freely move
into “alternative medicine” whether they have training or not and that because
of this the core values of naturopathy are being eroded into a kind of
green-pharmacy medicine. This erosion is also showing up among NDs who have
lobbied for more prescription rights while they practice in an allopathic
style.
Ballard:
I agree with Dr. Benda’s description of allopathic medicine
as an “aging medical paradigm.”
What I don’t agree with is using that outmoded
paradigm as the foundation of integrative medicine.
I’d also like to comment on Dr. Benda’s request, “If
naturopathic medicine or ayurvedic medicine or any other philosophy of healing
and healthcare wishes to serve the greater good, I suggest they step forward
and help guide this new experiment called integrative medicine – teach us.” From
my point of view, perhaps more limited than his, NDs are not being asked to
step into the integrative tent to serve what he calls the “greater good”. The
AANP and state organizations hold conventions and educational seminars
regularly and I see few MDs in attendance except when they’re invited to speak,
which is often. I haven’t heard of MDs enrolling in ND schools. On the other
hand, when I read about integrative medicine programs, I rarely see an ND
listed as a presenter (with the exception of Joe Pizzorno, ND). Are NDs being
ask to “step forward” and refusing? I doubt it. Again, Dr. Benda said it well, integrative
medicine is “… allopathically centered…”
I agree with Dr. Benda’s description of allopathic medicine
as an “aging medical paradigm” What I don’t agree with is using that outmoded
paradigm as the foundation of integrative medicine. Naturopathy offers a 21st
Century scientific paradigm rooted in thousands of years of traditional,
empirical science.
Please, if we keep these discussions on the level of core philosophical
and practice principles rather than accusatory and defensive, we stand a better
chance of learning and growing in our service to the greater good.
Sincerely,
Tom Ballard, RN, ND
Lou Sportelli, DC
3. Lou Sportelli: "eternal vigilance, with less volume and rhetoric, is needed ..."
Lou Sportelli, DC is a chiropractor who, since the early 1970s, has comfortably integrated his practice with medical doctors in his Palmerton, Pennsylvania community. He is also president of Integrator sponsor NCMIC Group.
It is easier for Dr. Benda to take the road he
has taken, largely because he is an MD, and while his thought process is far
afield from the every day medical practitioner, he is still a medical doctor.
My point to Dr. Benda, is that the high road is the road obviously to be taken,
but he must remember in his admonition(s) to Naturopaths, Chiropractors (which
I note he did not mention by name), to homeopathic practitioners and TCM
practitioners that they reduce the rhetoric and anti-medical
bashing. What Dr. Benda must also understand is that the medical
bashing is not unfounded, not only have they done some of the most egregious
acts upon professions (see the history of their anti-chiropractic activity),
but because of their position and policy have literally poisoned the well of millions of people who may
have been helped with non-medical intervention but chose not to seek
that care out of fear and reprisal.
Sportelli:
I agree it is time for
all the groups to stop the rhetoric, but it is also time for the AMA to
acknowledge that other philosophies, hypothesis
and approaches do in fact have merit, whether the AMA approves or
not.
Until then, eternal vigilance, with less volume
and rhetoric is needed.
I agree it is time for
all the groups to stop the rhetoric, but it is also time for the AMA to
acknowledge that other philosophies, hypothesis
and approaches do in fact have merit, whether the AMA approves or
not.
I think the most compelling point is that there is a huge
difference between clinical medicine (medical physicians who care about their
patients) and political medicine whose goal is to dominate the health care
delivery in a monopolistic fashion where every other group is
subservient. That model will only go away when political medicine
is knocked from it's pedestal and the caring clinical medicine folks, like Bill
Benda have control over the direction their political organizations take.
Until then, eternal vigilance, with less volume
and rhetoric is needed.
Lou Sportelli, DC
Comment: Sportelli's point is good, and goes right to the "historic inequities across the professions" which are so poorly understood. Again, my guess is that most "integrative MDs" don't see themselves as AMA-aligned. At the same time, the AMA's history and organizational background still sticks to integrative MDs, in the minds of many who have been knocked down. I have come to believe that affirmative action by integrative MDs to reach out to include other disciplines is a necessary form of reparation. And this is even if the integrative MDs see themselves as disrespected, bastard step-children of the AMA and don't feel they need to own the sins of their fathers.
Peter Amato
4. Peter Amato: "the integrative industry continues the egocentric debate ..."
Peter Amato, is a meditator, an educator, an integrative clinic pioneer and founder of Inner Harmony Group.
He was also a leader of an early effort to bring diverse integrative
practice interests together for policy purposes as the National Integrative Medicine
Council. Benda served that short-lived effort as medical director. Amato focuses on the
meaning he sees in "integrative medicine."
John, the essence of
integrative medicine is found within. For me it is comical to observe as
the industry, and all its tentacles, is no different than all other antiquated
aspects of our traditional worldview. (We) continue the egocentric debate of who
coined the phrase, how can we manipulate the terminology, and where do we go
from here.
To become the medicine we are looking for, integrative medicine, or
whatever you would like to call it, for those who are attached at that level,
anything short of personal transformation and applying the journey of human
consciousness is just more rhetoric. To move beyond the debate toward a direct
experience of our essential state through optimum health is to uncover the
symptoms and experience the root problem of health.
Amato:
To become the medicine we are looking for, integrative medicine, or
whatever you would like to call it, for those who are attached at that level,
anything short of personal transformation and applying the journey of human
consciousness is just more rhetoric.
I feel health is
impersonal, as we can not locate the "who " which is not vibrating at
an optimal resonance anyway. Treat the matter, treat the energy and discover
the illusion of attachment which defines the illness. Release the symptom ( if
the patient client wants to heal?), or educate potentially for the next
time.
Integrative Medicine is about the holder of the medicine bags, more than
what is in the bag. Modalities are props, yet needed as tools. The
unfoldment of an integrally-informed medicine or a multi-disciplinary treatment
plan would be only about the consciousness of the intention, the place or
origin of how the plan comes in to awareness of practitioner or team ( which is
the emergent quality of the consciousness of the practitioner and/or group ),
and the availability of the patient/client to move through the protocol with
grace. If we treat the thinking, the thinker and the thought, cleanse the in
and the out, the mind and the cell, all we can do is Love and observe and
witness someones elevation to authencity, vigor, and union or Integration or potentially
learn that this person this time is unable, or chooses not to
elevate their consciousness and cellular resonance to a high vibrant quality
and recognize that their are seven levels of consciousness making the whole and
that some stay back no matter what is applied or implied. Good medicine is the
merger of higher and lower self along with culture and nature.
As Ghandi says
Be the Change. Go Within! Deepak Chopra says we are not in the world the world
is within us. Therefore we are not always the sick one, however the sickness
"itself" may dwell within any one of us at any time unless and untill
we elevate our health toward a critical mass of what was just said. One day I
hope to merge with whoever said it, as there truly is no me! Thanks John. I Love
you!
Peter Amato, Founder
Inner Harmony Group
Scranton, Pennsylvania
Michelle Clark, ND
5. Michelle Clark: "the end of our warring is long overdue ..."
Michelle Clark is a board member of the AANP, on which Benda serves, Her board role is to head up that profession's work to expand licensing into new states. She prefaced her comments with a side note to me which said, in part: "Until
we explore the two extremes, we are unable to find the middle ground. You
help all of us see both sides of the coin and that is critical to changing the
way we all think about health care."
I agree strongly with Dr.
Benda: “The time has come to end this perpetual denunciation”
As chair of the AANP Alliance
for State Licensure, I have certainly had my share of being “marginalized” by members of the American Medical Association, and have occasional succumbed to
the temptation to return fire, but this does not make it right. And if I
have learned anything in my years of legislation it is that legislation is a
slow and arduous task. It rarely reflects an accurate understanding of
current knowledge and belief systems. There are always millions of old
statutes to work around and three to thirty years are spent on any one bill.
Therefore, legislative trends are a view at yesteryear and not what we
should base our future belief system on. Students are and always will be
our window into the future, and as our student associations become affiliates
of one another [a reference to the AMSA-NMSA relationship], the future of health care should be clear to all of us.
Clark:
Our professions may have been
at war for a century, but no one is around today to remember “who started it”
let alone “why.” We may all have theories and we have all taken up the
battle at one time or another but this is clearly no longer our war.
Our professions may have been
at war for a century, but no one is around today to remember “who started it”
let alone “why.” We may all have theories and we have all taken up the
battle at one time or another but this is clearly no longer our war.
Largely due to Dr. Benda’s influence over the years, I have come to the
realization that it is time for us to stop throwing stones at the other camps
and simply agree that any exchange of information that results in better care
for a patient is a win for every profession, every patient and every health
care professional. We all have a lot to learn about each other’s
professions and always will. It would take more then one lifetime to
fully master two health care approaches let alone three or four.
Therefore all of our professions are necessary as we grow towards an
integrative future in health care for all people. This brings me to my
second point.
The clarification point is
Dr. Benda's statement that "integrative medicine is, and always will be, allopathically-centered,
simply by the fact that it is the unplanned, and often unwanted, child of our
aging medical paradigm. It was conceived by allopathic physicians and
resides academically within conventional medical colleges”
This is
where Dr. Benda and I disagree, until I see Integrative Medicine written with a
registered trademark symbol, I feel it belongs to all of us. I find it is
wiser to place titles with respect to standardized training and
education, not due to marketing efforts or turf wars.
Clark:
Whether we want to believe it or not, we all began integrating our collective
knowledge of the human body more then 50 years ago, and the end of our warring
is long overdue.
Integrative
medicine has stood to represent any natural medicine combined with any
pharmaceutical or surgical medicine for decades. All of us already
practice integrative medicine in one form or another, since all of our
professions have largely overlapping fields of knowledge and none of us can
truly say which field the knowledge was derived from. For example most
pharmaceuticals have roots in Botanical Medicine. Anatomy has strengths
in the Chiropractic world that differ greatly from the collective knowledge of
Surgeons. Many advances in nutrition have been the result of
contributions from Medical Doctors and Dentists. And Naturopathic Doctors
are now entering hospital based residency programs.
No one field is so
great as to deserve ownership of a common adjective in the English language.
Whether we want to believe it or not, we all began integrating our collective
knowledge of the human body more then 50 years ago, and the end of our warring
is long overdue. Maybe we need to decide on a new name that represents
our new, collective efforts whether it is called “functional, integrative,
alternative, complementary, natural, holistic, progressive, preventative or
new” medicine.
Michelle Clark, ND, Board Member
AANP
Peter Glidden, ND
6. Peter Glidden, ND: "Benda misses my point ..."
Peter Glidden, ND kicked off some of this dialogue, or parrying/counter-parrying as the case may be, with a column last spring which he dared me to publish. I eventually did. (See Guest Column: Peter Glidden, ND, Lashes Out Against His Idea of MD-led "Integrative Medicine," July 2, 2008.) He seeks to clarify his prior position then proposes a model of integrative medicine which he believes would be a more equitable arrangement that that which he believes to be the case.
Dr. Benda’s commentary
in the last Integrator misses the
ENTIRE point of this VERY IMPORTANT conversation regarding “Integrative
Medicine.” His dissertation is a strange mixture of sour-grapes frustration,
misinterpretation,and
“politically-correct” pathos. As innuendo like this only serves to divide the
tribe, it therefore necessitates a rejoinder.
Neither I, nor Dr.
Ballard EVER asserted that allopathy is: “inherently corrupt or malevolent.” This is simply ridiculous, and casts us in the light of
marginalized whiners. Methinks Dr. Benda doth protest too much. What Dr.
Ballard and I did says is that MDs have gone out of their
way to demean, criminalize, and slander Wholistic medical disciplines – and
now that they realize that the ship they are on is sinking, they scurry about
in a panic, bring
naturopaths, homeopaths and acupuncturists on board to try and fix the leaks –
and then make us sleep in the boiler room.
Glidden:
If you just wish to dismiss 100 years of
history because it paints you in a REALLY BAD light, then you have no firm ground from
which to argue your point, and you will not be able to understand how to
proceed in the future.
This of course is
ironic, because all of the ND’s that I know (including myself and Dr. Ballard)
are happy, ready, willing and able to work side by side with MD’s in the
treatment of disease. It is too bad that the allopathic community does not want
to reciprocate – as they would rather work above us, than beside us. More’s the
pity.
Dr. Benda’s comment that "there is no truth to the
proposition that …naturopathic
or any other medicine is the only true answer to our healthcare crisis” is yet another COMPLETE
misinterpretation of my and Dr. Ballard’s comments. Neither I, nor Dr. Ballard
EVER said: “naturopathic…medicine
is the only true answer to our healthcare crisis.” That would be a ridiculous claim. Here IS what I said: “THE ONLY THING that is necessary to bring parity to the
medical arena in the United
States is securing equal access for
the public to ALL TYPES of licensed health care, including our own
(Naturopathy).” Isn’t that just a tad bit different?
Dr. Ballard and I do
not bring our views to the “Integrator” table because we have an axe to
grind with the allopaths, or because we subscribe to some pie in the sky, “My
way is better than your way,” world view, but because the historical
relationship between the allopathic medical profession and all other wholistic
medical professions directly impacts the issue of “Integrative Medicine.”
If you just wish to dismiss 100 years of
history because it paints you in a REALLY BAD light, then you have no firm ground from
which to argue your point, and you will not be able to understand how to
proceed in the future. Instead of being informed by the past, you just dismiss
it, and say whatever you want (regardless of the facts), trying to drive your
position home by manipulating readers’ emotions: “I find it quite distressing that
members of professions that have been marginalized throughout much of their
history find the need to marginalize another profession that is doing its
clumsy best to take root and grow.” You have GOT to be kidding…
Let me make my position
perfectly clear - once and for all. It is not hard to understand:
Glidden:
Nothing is integrated in an Integrative Medical
model. Integrative medical models ALWAYS use allopathic treatments as PRIMARY
care and use Wholistic treatments as adjunctive, secondary, or tertiary.
Nothing is integrated in an Integrative Medical
model. Integrative medical models ALWAYS use allopathic treatments as PRIMARY
care and use Wholistic treatments as adjunctive, secondary, or tertiary. If a
clinic or hospital really followed an Integrative Medical model, it
would look like this: The hospital would employ licensed physicians who specialized
in different medical disciplines (Homeopaths, Naturopaths, Ayurvedic doctors,
Traditional Chinese Medical doctors, Acupuncturists, Chiropractors, MD’s,
etc.). There would be an objective gatekeeper that all of the new
patients would get screened by. The gatekeeper would determine which type of
medicine was best suited to that patient’s condition, and would then make a
referral to the proper physician in the clinic who would handle that patient’s
Primary care. All of the other doctors who worked there, each practicing a
different medical discipline, would be available to deliver adjunctive
treatments should the need arise, as determined by the Primary care doctor.
Furthermore, the hospital would be structured as
a “Non-Profit” organization. Sounds great, doesn’t it? Too bad it doesn’t
exist.
If Dr. Benda is correct
in his assertion that: ("…integrative medicine is, and always will be,
allopathically-centered…”), then I want nothing to do with it – because as such, it
will ALWAYS use Wholistic therapies as adjunctive, secondary or tertiary. This
is yet another
example of allopathic (psychological) hegemony - and perhaps now you can see why
this position
frustrates the hell out of “we who have been marginalized.” If allopaths
really want to work with
wholists in the noble attempt to relieve
human suffering, then STOP MARGINALIZING US!
Glidden:
Your historical relationship with my profession would make a
reasonable person completely unwilling to even enter into this conversation.
The fact that we are still here, listening to what you have to
say, is a testament to the magnanimity of our spirit –a fact which is
completely overlooked by you.
If you (the allopath)
are trying to enroll me (the naturopath) into becoming part of an “Integrative
Medical Team,” then don’t criticize me for pointing out that your profession
has pro-actively tried to bankrupt and jail members of my profession for the
last 100 years. Your historical relationship with my profession would make a
reasonable person completely unwilling to even enter into this conversation in
the first place. The fact that we are still here, listening to what you have to
say, is a testament to the magnanimity of our spirit –a fact which is
completely overlooked by you. If you REALLY want to forward the concept of Integrative Medicine, then hire an ND as a 50% PARTNER
in your medical practice, or make it a tangible goal with a realistic
time-table for completion to get naturopathic medicine licensed in your state,
and the 2 states next door.
Lastly – it is not we
(ND’s) who need you. We have done quite nicely over the last 50 years in spite
of your professions attempts to eliminate us, thank you very much. It is you
who need us, and unless you say: “I’m sorry” - and stop marginalizing us
– then don’t get upset when
you try to play on our side of the fence (the fence that you erected) –
and it pisses us off.
Comment: I had a chance to meet with Glidden in August, after his first column was published, and before Benda's. I shared with him my own experience that his apparently monolithic view of "integrative medicine" hadn't shown much awareness of the passion and motivation that moves most of the integrative MDs I know. I also tried to give him a sense of respect for the
political-cultural-economic challenges of transforming U.S. medical
education, in shifting the care as prioritized in U.S. hospitals and health
systems and in introducing an ND or DC to one's conservative, powerful MD colleagues. I seemed to have had a failure event in transforming, or shifting at all, Glidden's beliefs. While this column, like Glidden's last, is filled with honest perception, which I believe is shared by many, I am guessing his ability to communicate would be helped if he took Sportelli's advice and dampened the tone and rhetoric.
Christy Lee-Engel, ND, LAc
7. Christy Lee-Engel, ND, LAc: "capacity for grace should be an educational competency"
I
LOVE Bill Benda's comments and your commentary [quoted here] on his comments:
"Breathe deep and look at
these recommendations. 'Self awareness.' 'Knowledge of
historical power inequities across professions.' 'Affirmation of
diversity.' 'Humility.' 'Capacity for grace.'
"Benda asks the naturopathic profession to move
into such transformational depth when he asserts that for a positive future 'an understanding of and forgiveness for past sins, real and imagined, is
the only appropriate response to MDs ...' Medical doctors, integrative or
not, nurses, chiropractors and other parties must go there as well.
"We can wish that such forgiveness can come through
self-will, or via decree that we're over that now. I'd guess that
years of directly and routinely incorporating these issues, and through
directly including individuals from other disciplines in our academic training
programs, in our continuing education, and in professional meetings, until 'they' are 'us,' will be a necessary antidote to
the sins, real and imagined, that all parties are feeling. I'd give it more
than one generation for its resolution, especially if we don't get going now.
Yes yes yes - all
true - it's time for incorporating and including and being big enough for
everyone to be "us" even as we each remain true to our original
tradition and "faith"
I really love that "capacity for grace" - I want to make that an ND
educational competency!
Christy Lee-Engel, ND, LAc One Sky Wellness Associates
Seattle, Washington
Bill Benda, MD
8. Bill Benda, MD responds:
I sent this group of comments - I didn't yet have Cheri King's piece - to Benda, to give him an opportunity to respond. Here are his reflections.
I’ve read with appreciation the varied responses to my
earlier commentary on integrative medicine, and what has come to be labeled
“MD-bashing.” I am gratified for the
emotional tenor of the writing as well the emotional content, for this proves
the conversation is worth such an uncomfortable examination of our deepest
beliefs, as well as deepest fears. I
confess my original submission was charged with such energy, and I regret
should I have offended through words fueled by my own passion and my own fear. But this dialogue needs to take place, and
now, if we are going to impact the next healthcare paradigm, and we are
fortunate that this Blog is allowing the first communal venue. I commend John’s willingness to print our
rhetoric unedited.
Benda:
With
regards to ownership of integrative medicine, in retrospect I erred in even
addressing the concept, as no one can own any philosophical approach, whether
in medicine, or law, or religion. I am
not attached to the words.
This posting will be less provocative, but just as cogent,
and I will keep my points simple. With
regards to ownership of integrative medicine, in retrospect I erred in even
addressing the concept, as no one can own any philosophical approach, whether
in medicine, or law, or religion. I am
not attached to the words. My
defensiveness stemmed from my reaction to and passion around the second, more
essential point:
I have been disturbed by an undercurrent of blame and
denigration within our communal culture of conventional medicine as the
perpetrators of our healthcare ills. I
have sat through keynote addresses at our annual conventions and listened to
laughter and applause as my profession was indicted, often by an MD invited to
give the presentation. Such animosity
may be meant for the pharmaceutical or insurance industries, but the surrogate
target is often, by association, the medical doctor.
I am aware of our failings and faults - my journalistic
offerings routinely chronicle the dysfunction of conventional medicine, and the
damage it has inflicted, and is still inflicting. And I am aware that our offenses have
included the very marginalization I am objecting to now. People in power do
that, most unfortunately. But I have also for 30 years been witness to practitioners
and technologies of conventional medicine helping countless people in deep
distress, and I believe the good they encompass deserves the professional
respect owed all of us.
Benda:
We say our medicine is different,
heart-centered,
accepting. I
believe the people are
awaiting
confirmation that this is true.
We have the opportunity,
through these conversations,
to oblige
them.
It has been a lack of acceptance and forgiveness for past
harm that has historically fueled the flames among blacks and whites, and gays
and straights, and blues and reds, and these battles have simply and repeatedly
taught us nothing more then that we must transcend claiming another’s censure
as justification for our own. If a singular apology for my profession’s past
and present sins can make any difference whatsoever, I tender one
willingly. But I find I must also stand
by the good in my profession of origin, just as I stand by naturopathic
medicine and our students and anyone who wishes to join this movement to
reclaim our healthcare system.
We say our medicine is different, heart-centered,
accepting. I believe the people are
awaiting confirmation that this is true.
We have the opportunity, through these conversations, to oblige
them.
Comment: Theologian Reinhold Niebuhr's Serenity Prayer, as adopted by Alcoholics Anonymous and other 12-Step programs, may be a useful reference point as we seek a way out of our damaging and arguably addictive polarization.
"Give us grace to accept with serenity the things that cannot be
changed, courage to change the things that should be changed, and the
wisdom to distinguish the one from the other."
The poet Robert Graves has some similar words for any situation with a haunting past.
Outrageous company to be born into Lunatics of a royal age long dead. So reckon time by what you say and do Not by epochs of the war they spread. Hark how they roar, but never turn your head. Nothing can change them. Let them not change you.
- From "To Lucia at Birth"
The history of strife between our distinct disciplines has indeed created outrageous company for optimally respectful integrative teams to be born into. It's filled with its share of lunacy, and much of it, unfortunately, is not yet long dead at all. Our deep past and our aspirational future co-habit. But we can't make the best use of each other unless we apply ourselves to seeing each other better. Graves would seem to agree with Sportelli's comment that vigilance remains necessary as we seek to change what can be changed.
