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MD Bashing, ND Bashing & Peace: Amato, Sportelli, Lee-Engel, Ballard, Glidden, King & Benda PDF Print E-mail
Written by John Weeks   

MD Bashing, ND Bashing & Integration: Amato, Sportelli, Lee-Engel, Ballard, Glidden, King & Benda on Benda's Comments

SummaryIf 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.
Send your comments to
for inclusion in a future Your Comments Forum.


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.


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Cheri King - a student leader's voice for the future
1.  ND student leader Cheri King:
"while we squabble, noting gets accomplished"


Cheri King is a 3rd year naturopathic medical student at National College of Natural Medicine in Portland, Oregon and the president of the Naturopathic Medical Student Association (NMSA). As an NMSA leader, King has been instrumental in successful efforts to create formal relationships with the American Medical Student Association for both NMSA and for the American Association of Naturopathic Physicians
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.

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Tom Ballard, ND
2.   Tom Ballard, ND: "calling my remarks a negative against MDs obfuscates ..."


In the prior commentary by Tom Ballard, ND (See
Time for a Heretical Model? Ballard, Quinn, Manahan & Simpson on 'Integrative Medicine,'" July 28, 2008), Ballard expressed his frustration which he has felt as non-inclusion from the integrative MD community.  
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

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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.


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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

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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

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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.


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Christy Lee-Engel, ND, LAc
7.   Christy Lee-Engel, ND, LAc: "capacity for grace should be an educational competency"


Christy Lee-Engel, ND, LAc weighed in on an early part of this discussion. (
Your Comments: Bradly Jacobs, MD, MPH & Christy Lee-Engel, ND, LAc on Rakel's Integrative Medicine, July 16, 2008.)  She is an educator who has served in a variety of capacities at Bastyr University. Her own blog is "life cultivating life."
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

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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.
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