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Political Clout from the AHMA-AANP-AHNA? The Vision of Bill Benda, MD, the Interlocking Director PDF Print E-mail
Written by John Weeks   
Tuesday, 05 June 2007

Healthcare Reform Clout from an AHMA, AANP and AHNA Collaboration? The Vision of Bill Benda, MD, the Interlocking Director

Summary:  In 2004, Bill Benda, MD, quietly began working to create collaboration between three organizations of healthcare professionals: the American Holistic Medical Association, the American Association of Naturopathic Physicians and the American Holistic Nurses Association. "The potential for communal impact is enormous," says Benda. He brought the leadership of these organization together into a retreat in 2005. He presently sits on the boards of the first two and is on the advisory council to the latter. What might these organizations accomplish together? What do you think is the very best use of this collaborative trio in advancing health care transformation? The Integrator sent Benda some queries via email. Here are his responses on his effort to create some new clout for holistic and whole person primary care.
Send your comments to
for passing on to Benda and/or inclusion in a future Your Comments article.

Image
Bill Benda, MD
History has its interesting twists. The late 1970s marked the founding of both the American Holistic Medical Association and the American Holistic Nurses Association. A few years later, a group of naturopathic physicians from the same generation of incoming leaders formed the American Association of Naturopathic Physicians to give new direction to a profession which was experiencing an influx and renewal. From 30,000 feet, these three have always seemed sibling organizations. Each was birthed of a cultural movement toward environmentally sound, holistic and whole person health care. Each held a core idea that the patient is presenting with his or her problem as a message that the body, in its wisdom, is attempting to teach, and that the practitioner's role is to help the patient remove the obstacles and aide and abet the healing abilities.

The twist here is that two decades later it was Bill Benda, MD, a graduate, of the first year of the flagship fellowship in integrative medicine at the Program in Integrative Medicine (PIM) at University of Arizona, who has set the ground for creating collaboration between these three organizations.

Benda had worked with the AANP leadership, and leaders of the AHNA and AHMA to create a small gathering of leaders at the Esalen Institute a year earlier. Benda, an Integrator adviser, reasoned that the leaders needed to meet each other in an unencumbered environment to shuck the vestiges of professional differences and open themselves to new inter-professional possibilities. Benda was since elected to the boards of the AHMA and the AANP and is an advisor to AHNA's leadership.

Why these three organizations? What value may come of this collaboration? What has Benda accomplished thus far? I emailed Benda some questions on these topic. Here is his report on this effort to create a collaboration which may prove to be bringing more potency to some key issues than any of the three parts acting alone.
________________________________________

Integrator: You start with the American Holistic Medicine Association, the American Holistic Nurses Association and the American Association of Naturopathic Physicians. Why not the environmental doctors? Why not the chiropractors?


Image Benda
: Many of us in healthcare are driven by an inner desire to make a meaningful contribution to our world.  Some provide exceptional clinical care.  Some labor in the research lab to ensure greatest benefit and least harm from our technologies. My personal goal is to unify large numbers of licensed, credible, thoughtful practitioners who hold the public trust to advocate for change towards more humanistic healthcare. My strategy is to first engage those membership organizations representing holistic primary care, meaning healthcare from cradle to grave.


 

"Each organization’s strengths
offset the limitations of the
other two, all the while holding
very similar goals and ideology. 

"The potential for communal impact
is enormous."



  
 
MDs are still our cultural healthcare icons, nurses are beloved for their personal touch and attention, and naturopathic physicians have refined the efficacy of natural medicine over decades of experience. And true to the definition of integrative care, each organization’s strengths offset the limitations of the other two, all the while holding very similar goals and ideology.  The potential for communal impact is enormous.

The agenda that eventually emerges – whether backing legislation and political candidates, objecting to undesirable bureaucratic or industry trends, or garnering public support – will be determined by the membership organizations themselves.  As far as expanding to include organizations representing other professions and specialties, yes, of course.  But we need a foundation to build upon, and MDs, nurses, and naturopathic physicians seem the ideal cornerstones.


Integrator: You took the lead in bringing leaders of these organization together for a meeting at Esalen in 2005. Why?

ImageBenda: In May of 2005 we hosted the Summit in Humanistic Medicine, an invitational conference of educational and political leaders of our field.  Unbeknownst to most of us, Esalen had created the Program in Humanistic Medicine (1972-1974), a group of 14 influential doctors, nurses, and other healthcare professionals who met monthly to discuss unconventional approaches and philosophies.  The effort resulted in two published books, as well as introduction and passage of the 1976 Health Professions Education Assistance Act (PL-94-484), the first federal legislation to require funding of projects “establishing humanism in health care centers.”  Sukie and Stuart Miller, the founders of the Esalen program, were then approached by the fledging American Medical Student Association (AMSA) to give a week-long training in the principles of humanistic medicine.  This eventually morphed into the AMSA Humanistic Medicine Task Force, progenitor of today’s Humanistic Medicine Action Committee (HuMed).

My intention in 2005 was to bring together the presidents and presidents-elect of the AHMA, AHNA, and AANP to explore who we each are as fellow humans, and through this process to discover how we might share resources and expertise in pursuit of common goals.  We also invited student representatives from these organizations, the president of ACAM, and a host of “elders” such as Wayne Jonas, Joe Pizzorno, Sheila Quinn, and David Matteson The group met for three days, and as rooms at Esalen are double occupancy, I placed people together that I felt would benefit from hearing each other snore as well as speak. 
  
 
 

"Rankism, the unacknowledged
professional hierarchy that
exists within our healthcare
system is our primary impediment
to true integration."



Our invited speaker, Bob Fuller, discussed “rankism” as the last remaining unspoken class prejudice in the United States.  Rankism, the unacknowledged professional hierarchy that exists within our healthcare system, is our primary impediment to true integration.

Integrator
:
What has come out of that meeting?

Benda: To add some context, it is my belief that individuals, organizations, institutions, and cultures must all come to awareness of and acceptance of the inevitable limitations and dysfunctions that persistently challenge growth and evolution. We all hold unspoken and often unconscious judgments towards each other, usually projections of our judgments towards ourselves, and the integrative medicine movement is no exception.  I had hoped to start such a process of inner inquiry and acceptance among representatives of these groups.  In hindsight, I would say we were not collectively ready for such deep work. However, relationships were formed and a number of collaborations did spin out that have proven beneficial and sustainable. Notably, the AHMA and AHNA held a joint convention last year, the AANP has invited the leadership of the other two to attend a special session at their upcoming national convention, and reciprocal membership in these organizations is once again a live issue.  In addition, Wayne Jonas did create a number of potential collaborative projects, some of which I believe are being carried forth.

And somewhere inside, each participant still carries the taste of that weekend.


Integrator: In your wildest drive-time daydreaming imagination, what comes of these 3 groups working together? What are they accomplishing?

Benda: My wildest daydreaming imagination usually engages other arenas. But if I did choose this one, I would have the executive directors and boards participating in regular teleconferencing calls regarding specific, mutually beneficial collaboration and support.  Each group would host at their annual convention a one-day, face-to-face strategy session to define common goals and agendas. And once a year, we would meet for a weekend at the Esalen Institute to strengthen our personal commitment to each other.

The end result would be a unified voice of over 6,000 organized, licensed, and publicly recognized professionals representing the mission and values of humanistic practitioners and their patients across the country.


But of course, the conversation must first be started, and that is often the most difficult step.


Integrator: I do a good bit of organizing between different disciplines myself. It’s always a challenge to get these already under-funded groups to find the extra, mostly volunteer time, to devote to collaborative work. Why should they?

ImageBenda: When I was in high school in South Florida, integration was defined as blacks and whites in the same classroom.  Today we realize that human integration includes blacks, whites, browns, yellows, gays, straights, Republicans, Democrats – everybody.

The question we face now is not so much why should we integrate at the organizational level, but when will we? As in, are we ready yet? Are we there yet? As we begin to truly comprehend the nature of our philosophical foundations - that everything is connected to everything else, for better or worse - we will eventually see the inevitability of relationship. Readiness is a matter of organizational maturity. You might say that right now integrative medicine is in a kind of adolescence, concerned with differentiation from the parental institution, anxious about its ability to actually stand alone. We are focused upon basic, achievable integration, concerned with combining botanicals and pharmaceuticals, acupuncturists and allopathic physicians. Blacks and whites. But the time will come when we understand that true integration in healthcare begins with each individual’s personal journey to physical, emotional, and spiritual health, and
 

"The end result would
be a unified voice of
over 6,000 organized,
licensed, and publicly
recognized professionals."


 
  
spreads outwards to include organizational, institutional, political, social, and cultural acceptance that we are all connected; that harming another harms oneself and that in caring for another we are always taken care of.  A mad, confusing, beautiful mix of passion and logic, never to be truly understood but the foundation of all spiritual teachings.

If the above three groups, or any organization or individual, professes to be integrative, they must seek connection with others of same mind and mission, moving beyond their own fear of scarcity and into service of humankind.  When this philosophy is followed, outcomes take care of themselves.  When it is not, all efforts to fulfill personal agendas eventually fail.  It’s the law.


Integrator: How does your thinking and planning dovetail with other multi-disciplinary efforts, like the Integrated Healthcare Policy Consortium and Academic Consortium for Complementary and Alternative Health Care?

Benda: I believe these organizations to be essential for the eventual integration of all CAM/allopathic practitioners, as their work lays the foundation for understanding of the various professions and serves as a large database for standardization of protocols and policies.  However, I often get lost in the complexity of their strategic intent and the magnitude of their published materials.

I am by personality and by instinct an emergency physician – I want to get things fixed now.  And I believe that some things do need fixing now.  In addition to the aforementioned benefits, an AHMA/AHNA/AANP collaboration could serve as a rapid-response entity, reacting to breaking events such as legislative challenges to DSHEA and threats such as the AMA Scope of Practice Partnership. 6,000 organized, licensed, and publicly recognized professionals.

Integrator: What value have you brought to these 3 organizations so far by being involved with all 3?

Benda: To date I’ve worked mostly with the AANP and naturopathic physicians.  Karen Howard, the executive director, understands that an outside perspective, especially from the “other side,” provides insights unavailable to board members encumbered by professional attachments.

I will attend my first AHMA board meeting this June, and have a very good relationship with Karen Lawson and Larry Palevsky, past presidents who attended the Esalen Summit.  I also have experience with and respect for Carla Mariano, president of the AHNA.  Both leaderships understand collaboration as essential to the evolution of their respective organizations.  Possibly the greatest value I bring to the table is a consistent willingness to illuminate or mirror our personal and institutional learning edges that are roadblocks, holding back our evolution. This is usually a rocky road, uncomfortable, and often avoided. I happen to really like it.


Integrator
:
Do you ever feel conflicted, wearing the 3 hats?

Benda: Not a bit.  One benefit of being independent is that I am not influenced by the personal agendas of any organization or profession.  In addition, as I am engaged academically and politically rather than clinically at the moment, I have no financial gain or loss to consider.  And I never did like hats.

Integrator
:
What’s your next step?

Benda: My next step is to attend my first board meeting this June at the AHMA convention in Portland.  Unfortunately, I cannot attend the AHNA convention as it takes place the same week.

  
 
 

"Something I am very
interested in is the
student activism that
is rising within these
three organizations."



Something I am very interested in is the student activism that is rising within these three organizations.  AMSA and HuMed have been around for decades, the Naturopathic Medical Student Association is in the early stages of formation, and the AHNA has just created a student consortium in partnership with their national organization.  The next generation is not yet burdened by the necessary biases and financial constraints that will inevitably complicate their lives after graduation.  They remind me of our own idealism in the 60s and 70s, before we “grew up,” and I love being in their presence.  And in a few years, they will comprise the boards of directors of our national organizations.

But the truth is that we already know the answer to the healthcare dilemma.  Just as we cannot kill all the terrorists or destroy all of the opium fields in the Wars on Terror and Drugs, we will never kill all the bacteria and viruses or legislate all of the risk out of living in the War on Disease and Injury.  All of our “enemies” will simply out-mutate and out-evolve our technology through sheer numbers and the efficiency of natural selection.  We can only affect change by addressing the environment in which our problems take root and grow.  A healthy society will breed far fewer terrorists.  A healthy economy will give opium or coca farmers other options for feeding their families.  And a healthy body will resist getting sick, especially from chronic illnesses. We will always have terrorists and drugs and disease. But we can greatly mitigate their effect, and therefore their cost.  But such a paradigm shift requires not greater technology (technology will never trump the perfection of nature), but a new cultural philosophy of personal and social responsibility originating from the highest political levels and manifesting in each of us as individuals.  We cannot depend upon the healthcare industry for answers - by definition it thrives only if we are ill.  So we have to depend on our political leaders, who are, after all, ‘us’, constantly informed and prodded by think tanks and students and consortiums of membership organizations.

Comment
:  I realized part way through reading Benda's responses that my own impatience to see specific examples of collaborative action now were not only misaligned with the timing of Benda's work, but also disrespectful to what I have learned in my own multi-disciplinary organizing work over the years. These things take time, yes. Shoot, I can recall discussing with others the value of a holistic-naturopathic combo in 1987. Pregnancy is a low percentage likelihood from the perspective of the individual sperm. For years, such thoughts haven't managed to bear much fruit.

This inter-association, AHMA-AHNA-AANP collaboration may appropriately be described as pregnant, presently.
What good will come of this? Here's hoping Benda will be successful in getting key members of the boards on regular calls together, identifying shared agendas, and moving them. I look forward to a follow up article one day when we can see the action which has been birthed. Got any ideas on the very best use of this collaborative trio in advancing health care reform?

Send your comments to
for passing on to Benda and inclusion in a future Your Comments article.


Last Updated ( Saturday, 30 June 2007 )
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