Winterstein/NUHS Explore New Ground for Multidisciplinary/Integrated Education
Written by John Weeks
Monday, 25 September 2006
Winterstein/NUHS Explores New Ground for Multi-Disciplinary, Integrated Natural Health Care Education
Summary: The idea of a
multi-disciplinary, academic health center with a natural health mission
has evolved in the United States since the mid-1980s. Under the
leadership of James Winterstein, DC, the 100-year-old National College
of Chiropractic has transformed into National University of Health Sciences. The institution houses programs in chiropractic, acupuncture, naturopathic and Oriental medicine,
acupuncture, massage, and biomedical sciences together with relationships with diverse mainstream institutions,
including hospitals, insurers and conventional academic health centers.
Can this institutional model become a countervailing influence for new paradigm health care?
The idea of transforming the former National College of Chiropractic into the National University of Health Sciences (NUHS) began percolating in president Jim Winterstein, DC, over 20 years ago. "I read a book in 1984 called Alternative Medicine by J. Warren Salmon, a PhD at the University of Illinois, that suggested chiropractic should be working with others."
National University of Health Sciences, Lombard, Illinios
The kernel germinated slowly, in those pre-integration years of the
1980s when chiropractic fought its 10-year, successful legal battle,
there in Chicago and ibefore the US Supreme Court, against restraint of
trade by the American Medical Association. But in 1993, with the first signs of glasnost
in US medical politics, Winterstein and his team at the now 100 year
old beacon of broad-scope chiropractic began an exploration in earnest.
Winterstein explains, simply: "We wanted to find a way to help the various CAM providers become colleages and thought the institution would be
better off if it had more than one program." The model was there in
conventional academic medicine. More programs could mean more full-time
faculty, the vibrancy of multi-disciplinary exchange and a
broader base for research and for policy and community participation. I
spoke with Winterstein this summer about NUHS and this institutional
direction.
__________________
Some Multi-Purpose Institutions Universities with Natural Health Sciences Focus
Diverse arts
and sciences,
including
Chiroporactic
medicine
Acupuncture (+)
Naturopathic Medicine
Human nutrition
National College
of Natural Medicine (OR)
Naturopathic
Medicine
Acupuncture(+)
National University
of Health Sciences (MN)
Chiropractic
medicine
Acupuncture(+)
Naturopathic Medicine
Massage Therapy
Master of Science
in Radiology
Advanced Practice
Chiropractic Assistant
Bachelor programs
New York College
of Chiropractic (NY)
Chiropractic
medicine
Acupuncture(+)
Applied Clinical
Nutrition
Master of Science
in Diagnostic Imaging
Bachelor program
Northwestern Health
Sciences University
Chiropractic
medicine
Acupuncture(+)
Integrative Health
& Wellness
Massage Therapy
Southern California University
of Health Science (CA)
Chiropractic
medicine
Acupuncture(+)
Tai Sophia (MD)
Acupuncture(+)
Herbal Medicine
Masters of Applied
Healing Arts
Western States
Chiropractic College (&)
Chiropractic
medicine
Massage Therapy
Bachelor prorgam
(*) The professional programs are all suitable for meeting federally-recognized
accrediting processes where such processes exist.
(+) Those listed as "acupuncture" may also include broader AOM studies. (&) Additional note: Some unlisted chiropractic schools, in particular, have adjunctive massage
programs, and may have bachelors programs, such as Western States. The focus here
is on additional professional degree programs.
_________________________________
Integrator: This direction is certainly not for all of the chiropractic schools. Why do you think it's a fit for National?
James Winerstein, DC, NUHS president
Winterstein: Well you know that until the 1950s a number of
chiropractic schools had naturopathic programs. National was one of
them. Our chiropractic physicians are taught to be more than just "back
doctors." We've always had nutrition training. We began researching
acupuncture back in 1970. So for us it is a natural direction. There
are other schools - Northwestern, Southern California, who are heading in the same direction.
Integrator: Get much push-back?
Winterstein: We changed the name in 2000 and sent a letter to 8000 alums. We maybe had 2 dozen negative responses. National people are generally broad-minded. Integrator: You mentioned that
your model is different than what you have seen in other places, and
even in conventional academic settings.
Winterstein: We chose at the outset to try to keep the disciplines more connected. We didn't set up a College of Naturopathic Medicine, College of Chiropractic Medicine, in that model. We formed a College of Professional Studies to have them all together. Inside of the college we have departments of chiropractic medicine, of naturopathic medicine, of Oriental medicine - which is separate from the MS in acupuncture - and of acupuncture. We decided to not set up the invisible walls, and the fighting for budget money between separate colleges. We wanted a structure that would be conducive to
collaboration. We are trying to make colleagues out of these people,
rather than competitors. Integrator: There is certainly a history of fights, particularly in the state legislatures, between chiropractic and naturopathic doctors and AOM professionals.
Winterstein: We don't need this kind of competition among CAM groups. If we don't start mending these relationships in education, where do you start? Integrator: Is there a significant overlap in coursework?
Winterstein: Between chiropractic and naturopathic medicine, it's about 70% of the curriculum. Much less but some with acupuncture. Integrator: One hears of interest in "bridge programs" where practicing NDs can gain training as DCs, or vice versa. Is this a target group for you?
Winterstein: We've looked closely at it and there are serious problems. There is no getting around that the fact that it would be a lengthy, ponsite educational program to cover all the differences. It would be a major commitment for practicing doctors. So while it might be possible, it would be difficult at best. At the present time, we anticipate that some of our ND and DC students will stay to obtain both degrees, but so-called 'bridge programs' remain a question mark. We will not do anything that is not educationally sound. Integrator: How is first term enrollment?
Winterstein: We have just four enrollees in ND and and seven in Oriental medicine and acupuncture. Interest is picking up. We expected it to be slow. We are hanging in there. We're going to do what we say we're going to do. Integrator: Where are you in your accreditation processes?
Winterstein: In February, we gained approval through our institutional accreditor, North Central Association Commission on Accredition to offer the naturopathic medicine, Oriental medicine and acupuncture programs. We've been in touch with the Council on Naturopathic Medicine Education (CNME) and will apply for candidacy status and we have a process with the Accreditation Commission on Acupuncture and Oriental Medicine which starts this fall. Integrator: You've got a challenge for clinical training in naturopathic medicine there in Illinois, don't you, with no license for NDs? Winterstein: We have an arrangement with Bastyr to send our interns there for clinical experience if that is necessary. In Illinois, we can use an allopath to oversee naturopathic clinical training so that probability is also in process to begin next summer. We will be in dialogue with the CNME on this, as this may be new territory. Meanwhile, we're working hard to get licensing. The Illinois Chiropractic Society has agreed not to fight it.
Integrator: I have heard some chiropractic leaders scorn the multi-purpose CAM school - the 'universty of natural health sciences - saying that the better direction should be to get chiropractic education into conventional, state schools, like the recent effort in Florida. Winterstein: I supported that concept then and welcome it. It's been tried in Vancouver, York, Texas and Florida. It's failed in all because ultimately the faculty of the university, and usually an outside effort of the medical doctors in the university, stop it. This will happen eventually, some place. But I don't want to just see all of the educational integration in state-run universities. Integrator: My first connection with you was around your work with Alternative Medicine Integration Group (an Integrator sponsor), in setting up their network of chiropractors for that most unusual DC as primary care provider managed care model through HMO Illinois. With what other external institutions has NUHS formed relationships? Is this part of the same mission?
Winterstein: We have residents doing rotations at provena Hospital in Elgin, Illinois and Graduate Hospital in Philadelpbia. We have also just sent our second resident to work in Bethesda Naval medical Center with Dr. William Morgan. We are looking at a potential opportunity with a group of others, including two area medical schools, in an effort to create an exceptional, multi-disciplinary CME program in therapeutic nutrition. We have five community clinics here where we deliver free or low-cost chiropractic services. I would say the answer is yes. Integrator: Is there any formal association or gathering among the dozen or so of you multi-purpose CAM institutions?
Winterstein: Nothing formal. I talk with other presidents from time to time. Integrator: Brave new world you are forging. Winterstein: I just want to see at least the beginning of the ending of those old battles in my time here.
Comment: The logic of such a consolidation was deeply ingrained in me 20 years ago when I was part of a team working to gain regional accreditation for an institution that was then aspiring toward the multi-disciplinary institution it has become, Bastyr University. To fund FTE faculty, have a base for research, and even significant participation in policy, a broader institutional base is required. Without the latter a strong position in research and policy - most conventional academic health centers have state and federal lobbyists - the game will always be in another's control.
What I wasn't so aware of back then is how even a multi-disciplinary institution of natural health sciences tends to recapitulate the educational silos which are so problematic in conventional academic health centers. Our experience tells us that unless we consciously forge new paths (breathe ... meditate ... cognitively restructure), even the holistic and whole-person oriented are likely to find themselves stumbling blindly into discipline-centric cul de sacs which hinder movement toward integration of care.
Kudos to Winterstein and his team for
working, at the outset, consciously, to structure the institution in a
way which will break down rather than maintain barriers.
The idea of transforming the former National College of Chiropractic into the National University of Health Sciences (NUHS) began percolating in president Jim Winterstein, DC, over 20 years ago. "I read a book in 1984 called Alternative Medicine by J. Warren Salmon, a PhD at the University of Illinois, that suggested chiropractic should be working with others."
