Teaching in schools - Feb 2014

What are we teaching in our schools?

jacob

Message 1 of 50 , Dec 21, 2012[-- Image: Frame1 --]



View Source

What is it that our schools are teaching future naturopathic
doctors anyway?

I recently had the pleasure of reading a group of essays written
by NCNM students applying for scholarship money.  Having done so
I feel the need to comment about them but don't quite know the
correct venue.  I'm going to post these thoughts here as there
is some degree of privacy, that we can keep these thoughts
amongst ourselves rather than have them end up on public
websites.

The students were asked to write an essay of less than a
thousand words in response to this question: "What is natural
medicine, anyway? Discuss your personal path to NCNM and your
chosen profession, your philosophy of natural medicine, and
concept of its scope of practice. How does a practitioner fit
into the "big picture" of healthcare?"

Granted that as NCNM has undergone a name change, I guess it is
no longer appropriate to ask students, who may be there to
study acupuncture, to write about naturopathic medicine
anymore, so using the term 'natural medicine' may be more
appropriate, but I find that a little awkward from the school
that tries to brand itself as 'the profession's school.'

Our schools continue to attract a diverse student body, perhaps
more than ever... these essays were written by an interesting
group of people, many who I found to be compelling, inspired,
idealistic, romantics.  No harm in that.  That's my cup half
full bit.

Now for my criticisms:

First off, I may be old school but I was shocked by the number
of grammar and spelling mistakes in what I would have expected
to be polished pieces of writing.  In an era of spell-check and
grammar-check built into everyone's word processing software, to
have glaring mistakes in both came as a shock.  I wasn't looking
for or expecting great writing, yet I wasn't expecting as many
mistakes as I found.  I was tempted to send some essays back
and ask for the writer to resubmit a corrected copy.

Second, and perhaps of greater concern was content.  About half
of the applicants ignored the question, 'What is natural
medicine?' and instead simply wrote about themselves.  I am
certainly curious about how their own life experiences informed
their own definition of what natural medicine is, but often all
I read were pleas for sympathy and empathy.  It would seem from
these essays that our student body isn't very healthy; they
suffer from a long list of disabilities that make life a
challenge.

Of those minority of students who did address the question of
defining natural medicine, only one stood out by providing an
answer that was reminiscent of what we learned in school.  Of
course we learned about naturopathic medicine, so maybe there
is a difference.  Personally I think the answer should be very
similar.

I would think the answer should include a few basic points.

First, that there is a natural healing capacity in the body.

What we once called the vis medicatrix naturae (but I was
content with any words used to express that concept, from vital
force to adaptive response).

Second, that natural medicine (aka naturopathy) uses, takes
advantage, relies on, or in someway interacts with that force
in one of several ways.  It may stimulate or trigger that Vis
(call me a traditionalist) to get it to act and cause a healing
response.  Or natural medicine may remove some obstacles,
blocking the Vis from healing the body, or it may aid and abet
the Vis by supplying it with something it needs (thinking
nutrient, information, etc).

Instead of hearing this I read a fair number of essays about The
Laws of Nature.  I'm pondering what is mean't by that phrase,
Laws of Nature, as no one provided details.  All I know is that
it's common in the student vocabulary at NCNM.  I assume it's
not the same usage  fundamentalist religious groups use when
arguing against proposed changes in marriage laws.    A few
mentioned Jared's hierarchy of treatments as a definition of
natural medicine.  Kind of like "following this hierarchy makes
medicine natural."

No one came close to Wade Boyle's elegant differentiation that
he once made between naturopathic herbalism and allopathic
herbalism.

Thus I am lead to believe that NCNM is no longer putting
adequate emphasis on defining naturopathic medicine at its
fundamental core.

As to the later part of the question, as to how natural medicine
fits into the 'big picture of healthcare?', oh my goodness, the
answers were all over the map.  Most focused on some cosmic,
karmic thing.    My reaction was that the student body was
perhaps spending too much time taking yoga classes or smoking
pot.  Not one writer pointed out that a large fraction, if not
the majority of chronic illnesses, and thus expenses covered by
our healthcare system, are related to basic life-style choices,
in particular smoking, exercise and diet.  No one saw fit to
point out that our profession is trained to improve these life
style choices and improve general health and reduce costs.
 There were all sorts of curious expositions that made it seem
that the school is promising to create enlightened practitioners
who by their simple presence in the exam room create a shift in
the patient's evolutionary path.

But no one mentioned the obvious.

Thus, being late for work, I want to sum this up and say, I'm
not sure what they are teaching in the schools anymore.  It
seems that judging by these student essays, that they are a
little off track.

I think we might offer to help the schools out if and when the
opportunity presents, especially  on curriculum development and
in particular on the basic course work that might have once been
called naturopathic philosophy.

Jacob Schor

Denver CO

James Prego, ND

Message 2 of 50 , Dec 21, 2012[-- Image: Frame2 --]



View Source

I'd be curious what some NDs who teach at the schools think.  Is
this an NCNM thing, or something happening all over the place,
or just a 'back in my day' thing.  Did many of the students
back in jared's time understand the concepts better?



I did recently have a conversation with a recent NCNM graduate
and she was lamenting a bit about how some of the great
old-time NDs werre being pushed out of the school becasue
students were annoyed by their teaching style and current
students didnt seem to be that interested in the philosphy of
healing.



I teach health science courses at a local school of acupuncture
and massage therapy and I was called into to talk to the dean
becasue I apparently got low scores on my class evals by
students.  It turned out, when I made him break the
aggeegate score down by class and topic, the low scores were
from one class, and it was becasue I did things like make
students take quizzes and tests in class instead of making them
take-home, I used the whole class time instead of sending them
home early, and I wouldn't give them all the exam questions
before the exams.  It was interesting to start the conv being
told I got one of the worst scores in the school, then have it
end with being told I was a very good professor, lol.  So I
wonder if it is a larger educational issue, either in schools
of alternative medicine, or in all the educational system, or
different expectation by students thinking they are 'entitled'
to get good grades/win just by showing up.



Jim 'good is bad' Prego ND

Islip NY

PCOSDoctorDunne

Dec 22, 2012[-- Image: Frame3 --]



View Source

I agree, Jacob, that some things sure seem different. A NCNM
grad of a couple years ago recently told me, having invested
what it costs to complete a degree at our mothership
institution, that s/he may or may not even pursue a clinical
practice career. S/he is giving clinical practice a shot, but
has a very light grip on the intention. It was a moment of
amazement for me.

My first thought was to wonder what the heck this person had
been 'initiated' into- where was the power, the impact, the
bedazzlement that made us old people ignore common sense and
bean-counting realities and push on, push ahead-- I suspect
that our transition from the clinging-by-finger-nails,
crisis-to-crisis institution-building era to something
apparently more stable, has changed the character of the school
experience such that it no longer produces that same sort of
group loyalty and cohesion that group members experience when
the oppressed minority status we shared has even greater
reality that is has currently.

I have also been amazed and saddened by what new grads don't
know about naturopathic therapies. I has stunned to learn that
hydrotherapy is an ELECTIVE, not core, required curriculum! I
have heard "nature cure" referred to as if it did not represent
a current, useful, viable bastion of foundational therapies
employed by NDs but rather as a curiosity, something known to
exist but not of any great relevance, use or interest. I have
experienced sitting in exam rooms with new grads and watched
the intellectual processing employed be an exercise in trying
to recall which bottle of which pills from which company is the
correct prescription, rather than what does this patient need to
be taught regarding his/her self care, as first line therapy.

I also see that this is what patients want and expect. It seems
our concerns about 'green pharmacy' replacing the practices
teaching patients to live in vis-enhancing ways are coming
true. Naturopathic medicine is devolving, like every
"successful" financial entity in our current economic system,
to the lowest common denominators, a danger that will beset
every human endeavor that depends on generating a monetary
profit to exist. Efficiency = profit, so the time real
naturopathic medicine takes to teach and to support in actual
practice, will always look un-doable. Insufficiently
profitable, that is.

I'm afraid nature cure, if it survives as a living practice with
an evolving knowledge base and experienced, expert
practitioners, will only do so as a small specialty available
only to the very wealthy.

Or! my favored scenario, is that we will achieve a single payer,
universal health care system that integrates nature cure at the
very heart of it's brilliant commitment to preventative
medicine and employs NDs as the leaders and architects of
effective programs.

I too have read essays submitted for monetary awards in the ND
community and been startled at the lack of scholarship. I think
it is a national problem. What an interesting time to be alive,
and old enough to have some decades of perspective on change.
It happens! Dang! We CAN steer it, and if we don't it's gonna
happen anyway. Hmmm, just when I was thinking I could rest...

;)

Thanks Jacob, for writing the way you do, you cranky old man.
It's extremely valuable.

Nan Dunne Byington, RN, MA, ND
Missoula MT

Mike Whitney

Message 4 of 50 , Dec 22, 2012[-- Image: Frame4 --]



View Source

Hi folks,

Morphing toward an integrative system marches ever onward.
 Osteopathy now offers physical medicine as an elective.
 Chiropractors are processing rx rights.  ND's are losing
focus on viz to teach evidence based medicine.  Although this
passes for progress and now it appears that our institutions
will drive naturopathic philosophy out to the edge of the
curriculums.  It will live on and move forward.  It lives in
those who carry it, practice it and teach it.  From this group
it will move back to the schools and become a central core of
curriculum.  This is true because our medicine at its core is
true.

All my best in this holiday season..

Mike

Sent from my iPad

Michael W. Whitney NMD DC FABNO

Fellow of the American Board of Naturopathic Oncology

Board of Directors Oncology Association of Naturopathic

Anne Van Couvering

Dec 22, 2012[-- Image: Frame5 --]



View Source

Having just graduated from NCNM, and fought the entire time to
find professors who taught, doctors who practiced and residents
who didn't cut you to shreds for trying nature cure or even
botanical medicine, I have to say you've hit in something
fundamental, Dr Schor.  There is something of a student
movement to put nature back in naturopathy, but it's led by
just a few students.  I went outside of school to get my bot
med teaching, and took every class I could (electives) on
nature cure.

To correct one point: Hydrotherapy and hydrotherapy lab are both
required classes.  Unfortunately, the lecture is a history class
consisting mostly of memorizing the names of the great
hydrotherapists, and lab is a how to of constitutionals and hot
fomentations.  We had one term of hydro in the clinic, but for
many students, there are no patients on those shifts. Also, it
is second year, and we are technicians in scrubs - there is no
critical thinking required - it's practice taking vitals and
asking about contraindications.  Not once did I see a
modification or the reason why one would do such.

I thought about the reasons behind this trend a great deal while
I was in school.  To my mind there are several reasons this is
happening (and yes, it is happening, it hasn't "happened" but
it is on the way).

1) in Oregon, NDs are going for "primary care doctor" status.
 Which means learning all the allopathic modalities or risking
being sued for malpractice.  And because those modalities take
four years (and residency) for MDs to learn, and we're trying
to learn them in addition to naturopathy, the ND stuff gets
shunted aside.

2) more and more students are applying and being admitted, and
younger every year - we are not a group of driven, mature
mavericks, we are a much more mainstream group.  Practicing
something that is not green allopathy takes a major paradigm
shift - I think students in their third and fourth year are
more likely to have made the shift, but the more mainstream the
student body is, the less likely they are to make such a radical
consciousness shift.  Also, considering that many have gone
straight from high school to college to NCNM, with maybe a year
or two of work experience, there is a lack of life experience
tempering the learning.  One thing that is VERY concerning to
me is a push by Dr Schleich to have the first two years of
basic science classes be on-line - its not just  information
that is imparted the first few years, it is being in a
community where natural healing is a lifestyle that teaches one
how to be a naturopath.  I think the online idea is something we
should make a huge stink about, now.

3) NCNM is on a drive to get students who want to do research,
with a dual degree in research just started.  In my experience,
the research-oriented students were less interested in the
clinical training, and more interested in the material,
countable side of things. Individualized medicine doesn't fit
very well in that mind set.  Obviously, people can do both, but
not every person can.

4) learning styles have changed considerably.  I was one of a
handful of older students (45+) and it was a constant
revelation to me to be in class with the 20 & 30 somethings.
 The answers are online, not in the classroom, teachers are
less used as resources and wise leaders than they once were.
 If notes aren't organized and available online, if students
aren't given answers to the test or lists of what they're
supposed to study, they get very hot under the collar. I was
shocked by this.  To give them credit, the program is packed
beyond human capability, and spending time ungarbling a
teacher's notes is time you don't have to spend.

Dr Thom was positing that there will be a split in the
profession in the next 10 years, between people practicing in a
manner that is acceptable to insurance companies and MDs (not
too threatening, adjunct to the "real" doctors) and people
practicing nature cure, homeopathy, and other modalities that
don't fit well with the mainstream models...

I saw this shift happen with massage therapy too.  The balancing
act between being accepted and being co-opted is a delicate one.
 And one of the reasons we need preceptors who know the
medicine!!!

Anne Van Couvering, ND, LMT

Sag Harbor, NY

"Whosoever undertakes to set himself up as a judge of Truth and
Knowledge is shipwrecked by the laughter of the gods."

                    --Albert Einstein

Tara Skye Goldin, N.D.

Message 6 of 50 , Dec 22, 2012[-- Image: Frame6 --]



View Source

All I have to add to this discussion is my experience with a few
preceptors fairly recently who were disillusioned by their
training, and were just eating up the old school and "unsexy"
basic  homeopathy, nutrition, and botanical medicine etc that I
was doling out to my patients in an unlicensed state!  As if it
were a revelation to them! I just chalked it up to the idealism
and enthusiasm of students (oh yeah, I was there once!) but
perhaps there was something deeper at play there...

Tara Skye Goldin, N.D., Naturopathic Doctor
2825 Marine St. #203, Boulder, CO 80303
www.taraskyegoldin.com
phone:(303)443-2206
"Natural Medicine that Gets Results!"

Emily Kane

Message 7 of 50 , Dec 22, 2012[-- Image: Frame7 --]



View Source

Earlier in 2012 at the first OncAMP gathering in Scottsdale I
had the pleasure of dining with some of our "elder" ND leaders,
including teachers at SouthWest and NCNM.  Both were very
disturbed at the trend away from teaching "real" naturopathy,
and remarked that the boards of the accredited naturopathic
schools no longer have ANY NDs on the boards.  I have not taken
the time to verify this statement, but that certainly was
shocking to me -- that the schools would be driven more by
corporate, mainstream interests that aren't even about the
students, but the institutions becoming financially
"successful."  Nan, as a past prez of AANP, do you have
perspective on how we doctors who live and breathe naturopathy,
and have a patient body that cherishes these methods and our
attention to their wellness, can re-insert ourselves into the
policy making?  Dr. Bastyr just about single-handedly (maybe
along with OJ Carroll and Harold Dick and Dr. Turska and Wade
Boyle) prevented naturopathic medicine from completely
disappearing in the days after the formation of the AMA and the
Flexner report-induced  "witch hunts."  I think dear Dr. Bastyr
would be squirming in the earth if he could see the current
trend.  Mona -- I wonder if somehow we could persuade the
schools to require all prospective and first years students to
silently participate on this forum?

Emily Kane ND

Juneau AK

www.DrEmilyKane.com

www.naturopathic.org

"Let your highest aspiration organize your life."

Jared Zeff, ND

Dec 22, 2012[-- Image: Frame8 --]



View Source

Dear Jacob,

As you know, there is a naturopathic philosophy, a coherent
naturopathic clinical theory.  Naturopathic medicine is not a
random collection of ideas.  Neither is it arbitrary.  Lindlahr
laid this out in his Nature Cure, published first in 1913.
Naturopathic clinical theory is based upon the observation of
the nature of illness and of health, and of the healing
process.  Jacob, you were presented with a logical, coherent,
progressive explanation of this theory.  You were taught a
course in your first year that spanned three terms.  It began
with a review of the history of the development of the
profession, which included a presentation of the how in
1986-1989 the profession, as it then existed, developed a
six-point definition of itself based upon this philosophy.
 Then each of these six points of philosophy were explained in
detail, with reference to clinical relevance.  This explanation
began with the development of the concept of Vis Medicatrix
Naturae, and how that unfolded into the other five aspects of
the philosophy. You were shown that, in seeking the working of
the "Vis" in practice, one would first seek, clinically, the
causes of illness and remove them.  One would put into place a
comprehensive regimen to reestablish health in the patient
(including spiritual health, as we are whole beings), following
a logical order of therapeutic intervention, always keeping in
mind to do no harm. One would stimulate this "Vis", this
self-healing tendency and wisdom, through methods such as
hydrotherapy, homeopathy, exercise, and even needling
techniques. One would assess and address any needs of the
various organs and systems of the body, keeping in mind the
emunctory function and the relation between structure
to function, especially through the application of botanicals,
specific nutritional agents, physiotherapeutic techniques,
manual corrections, and other methods.  The concept of
suppression and its consequences was addressed, as was the
concept of "Hering's Laws", as means to evaluate the progress
of the patient.  Each of the various naturopathic medicinal
modalities was discussed in relationship to the overall
clinical theory and philosophy.  This was illustrated with case
examples.  In the Course, you were required to develop a
"naturopathic" first aid kit.  The course ended with a
presentation of naturopathic first aid techniques, emphasizing
homeopathic, botanical, hydrotherapeutic, and a few other
methods to address acute medical issues.

Jared L. Zeff, ND, LAc

Salmon Creek Washington

Mary Shackelton

Message 9 of 50 , Dec 22, 2012[-- Image: Frame9 --]



View Source

Sent from my iPhone

[-- Image: Frame10 --]

Show message history



All I have to add to this discussion is my experience with a few
preceptors fairly recently who were disillusioned by their
training, and were just eating up the old school and "unsexy"
basic  homeopathy, nutrition, and botanical medicine etc that I
was doling out to my patients in an unlicensed state!  As if it
were a revelation to them! I just chalked it up to the idealism
and enthusiasm of students (oh yeah, I was there once!) but
perhaps there was something deeper at play there...

Tara Skye Goldin, N.D., Naturopathic Doctor
2825 Marine St. #203, Boulder, CO 80303
www.taraskyegoldin.com
phone:(303)443-2206
"Natural Medicine that Gets Results!"

PCOSDoctorDunne

Message 10 of 50 , Dec 23, 2012[-- Image: Frame11 --]



View Source

Hi Em,
Nope, I don't really have any ideas about how nature cure
champions can become more influential in policy-making, other
than how these things usually happen. Which will be that there
will be a slowly growing demand, about which a small group of
activists will eventually organize, and their passion and
commitment and annoying but effective persistence will win out
and they will learn by the seat of their pants how to do
things, maybe ask a few old people how it used to be done, and
the pendulum will swing back a bit, until the next cycle....

It's the economy. Evidence-based medicine (meaning "effective",
meaning efficient/profitable), consumer fads,
just-buy-the-easy-way-out, are all driven by successful
profit-makers, not common sense, or healing. Can't change a
now-global economy overnight, but the economy is a human
invention, not a law of nature, so we CAN do something
different. I am beginning to focus on how to work nature cure
outside the dominant economic system. It's crazy, and not at
all a pure effort. I still have to participate in the dominant
system, of course. All such steps toward an different, a
sustainable economy will be very personal solutions at first.
It seems totally overwhelming and utterly useless to try to get
agreement and cooperation to systematically change the
established global economy. So, just work outside it. Weird,
tiresome really, to have to "fight" to stay on the edge, to
stay cranky and complaining and unsatisfied with the status
quo. We won, I guess, we have been clawing at the door of the
dominant system and here we are barely embraced, hardly central
to anyone's idea of the health care system, and already some of
us barely recognize our medicine. Fascinating.

Is that effort called The Gathering still happening? If I recall
correctly that came out of SCNM and other school's students
wanting to hear from teachers on original naturopathy. This is
a conversation that's been going on since at least whenever
that event began. I wonder who the next generation of nature
cure champions will be? I look forward to meeting them!

Nan Dunne Byington, RN MA ND
Missoula MT

Mona Morstein

Dec 23, 2012[-- Image: Frame12 --]



View Source

Hello, Folks,

Okay, hearsay is scary and frightening, and also hearsay. It was
sad of us to read from Anne about her unfulfilling experiences
at NCNM, to learn from an actual student of the educational
problems at that school.

I've been a teacher at SCNM for 10 years. I am Chair of
Nutrition and Gastroenterology Professor and a clinical
supervisor. I am also the Faculty Representative on the Board
of Trustees (which also has a student rep on it). Trust me,
SCNM has some on-going real and significant problems, some of
which are negatively affecting student education (although
action is involved trying to reverse that), but it teaches
hydrotherapy, has hydro labs where students learn all the
techniques, and has an extremely active clinic shifts using it,
taught mostly by Dr. Hazel, who solidly represents nature cure.
Her shifts are very busy, loads of patients, and students love
it. We have an excellent homeopathic department and many of us
do classical homeopathy on our shifts. Dr. Gaines is Chair of
Botanical Medicine and students learn excellent education from
her and many of us use botanical medicine on our shifts. In our
new curriculum, students have to have the most of their
education from the docs at SCNM, and are allowed less education
outside the school, to ensure they are taught by the Chairs of
departments and have many solid family practice type shifts
with a basis in naturopathic medicine.

Most of our students as I understand graduate with a desire to
practice and a high percentage of them have jobs set up upon
graduation. My nutrition and gastro classes abound with
naturopathic philosophy and using naturopathic medicine to
treat conditions. I'm just adding in a new class next
quarter--just one hour, but all about teaching students how to
analyze diet diaries in regard to the condition the patient
has, in terms of understanding how that diet is affecting them
biochemically, nutritionally, hormonally. Then they will be
taught which dietary handout to use and to develop Docere
skills in disseminating the nutritional information to educate
the patients and motivate them to make necessary dietary
changes. I had done a free seminar on that one Saturday and 80
people showed up--students and NDs in the community; it got
great feedback. Since it was so popular, the administration was
100% supportive about me adding that new class into my
curriculum along those lines.

In one of my nutrition courses I teach how to use naturopathic
medicine to treat acute illnesses. Students really appreciate
that. I think one of the quickest ways we are losing students
from naturopathic care is via treating acute conditions, like
strep throat and such without antibiotics. We've discussed this
on the list before, and some folks got a bit riled by me stating
that in 99% of the time there is no reason, zero reasons to use
antibiotics for ear infections, strep or other pharyngitis,
bronchitis, flu, etc. But, grabbing for that antibiotic pad due
to lack of education about how to treat acute illnesses is a
huge slope students quickly slide down into "green allopathy",
distrusting the benefits of naturopathic medicine.

It would really sadden me if the profession loses, well, the
profession. One of the reasons I began NaturoapthicChat was to
give us all a way to get help in difficult cases from other
naturopathic practitioners focusing on naturopathic medicine
and also to discuss these type of professional concerns. I can
tell you that naturopathic medicine is what students want to
learn, absolutely. At SCNM they crave nature cure--the are not
interested in getting a green allopathic education. I can't
know what they are learning on all shifts and in all classes,
but there are many of us "elders" and mid-"elders" who do good
solid ND care at SCNM and are actively doing what we can to
represent and teach naturopathic medicine.

It's too bad that not every student got those three quarters of
naturopathic philosophy from the magnificent Jared Zeff, as I
was also lucky enough to have at NCNM. That is a huge deficit
to all students. However, many of the rest of us in the
trenches still are doing what we can to keep naturopathic
medicine going as we were taught and have practiced.

Mona Morstein, ND
Mesa, AZ

horsesense2011

Message 12 of 50 , Dec 23, 2012[-- Image: Frame13 --]



View Source

This is such a wonderful question! I am new to NatChat and love
this:) I graduated from NCNM and I must say that learning is
really life-long. In school, we are given LOTS of information
in a relatively short period, and it is hard to digest
everything to perfection in an instant. Philosophy (like many
sciences) is a subject which takes marinating and digesting. I
can remember studying things like chemistry and philosophy with
my 18-year-old brain only to have a different understanding with
my 24 year-old brain and now with my 30-something year-young
brain. That is the beauty of learning, it blossoms. We are not
experts once we graduate, which is why I feel mentorships and
residencies for everyone are imperative in this profession.
Four years of school cannot prepare you for the unknown.

As we graduate from school, we are armed with our unique
understanding of what we learned. We have resources through the
writings of our predecessors of the history of natural medicine,
the philosophy, observed science, etc. Some learning continues,
some begins. With adopting the philosophies of natural
medicine, it is important not to live in the past, but to apply
the medicine as we can today and tomorrow. Being open to
learning can take the historical natural concepts into the
future and this is a discovery, not nostalgia. Realizing new
ideas and ways are just as important as learning old
philosophies.

The divide that is discussed in natural medicine is an example
of the discord of this application. Our space in time today is
to wrestle with natural medicine and the climate of insurance,
I am not convinced this will change the medicine, but will
change our paperwork. Politics and medicine are two different
things and to speculate a divide is presumptive and
pessimistic. After all, united we stand, divided we fall.

What are we learning in school? This becomes a personal
perspective because learning is a dynamic place in time and it
also hinges on individual understanding. Learning is not
parroting information, but assimilating it for yourself. Can
curriculum be better? Of course. Evolution in school happens,
this is why we don't use slide-rules anymore, but we do use the
fundamental understanding of addition in quantum physics. Some
classes fell short, some were inspiring. Don't look back at
school to asses your knowledge, look at now and tomorrow to
know what to focus upon.

Happy Trails!
Amy Nelson, ND
www.ridingwithamy.com

Colleen Gagliardi

Message 13 of 50 , Dec 23, 2012[-- Image: Frame14 --]



View Source

Dear Mona,
It would be wonderful if the courses you are teaching for diet
evaluation and also that of acute prescribing (and to others in
the
community regarding nature cure, philosophy, etc), could be
offered via
the schools to the ND's in practice via webinars. Any
possibilities
there?

Thanks,
Colleen Gagliardi, ND LAc
Westminster, CO

Laura Schissell

Message 14 of 50 , Dec 23, 2012[-- Image: Frame15 --]



View Source

Yes please!

Laura Schissell, ND, DC

Vancouver, WA

Dear Mona,
It would be wonderful if the courses you are teaching for diet
evaluation and also that of acute prescribing (and to others in
the
community regarding nature cure, philosophy, etc), could be
offered via
the schools to the ND's in practice via webinars. Any
possibilities
there?

Thanks,
Colleen Gagliardi, ND LAc
Westminster, CO

Joshua Moninger

Message 15 of 50 , Dec 23, 2012[-- Image: Frame16 --]



View Source

I would like to second everything stated my Dr. Van Couvering. I
too am an older (37) 2012 NCNM graduate, and Anne is SPOT-ON
with her assessment of the current paradigm within NCNM. I feel
fortunate to now be in an unlicensed state. I am almost forced
to practice what I call real Naturopathic Medicine, or what
many current students may refer to as "old school" Naturopathic
medicine. In my last quarter at NCNM, in a chat with Dr. Deborah
Frances, she congratulated me on my mission to take this
medicine to the unlicensed state of Ohio.

It is unfortunate the direction the schools are taking, at least
unfortunate for our community. I think it may be fortunate for
the general public, at least for now, which tends to prefer
baby steps than giant leaps. Let the public be first introduced
in a more accepted manner. It is better than nothing, and from
there a stepping stone to the real deal of being mentored by
those of us with firm roots in our philosophy.

Joshua Moninger, ND
www.thetanagerclinic.com
Westerville, Ohio

Zia Robles Hernandez

Dec 24, 2012[-- Image: Frame17 --]



View Source

This is a wonderful discussion, thank you for giving your
perspectives...in my personal journey what I have found is that
we all gravitate to different modalities in healing, even if we
go through exactly the same philosophy classes and nature cure
classes...many of us branch out into different modalities, but
I think the important idea to take away from this is that no
matter how we choose to practice, that we maintain ourselves
rooted in the philosophy that sets us apart...we are governed
by our own board, and as such, when we know a particular method
of healing is effective and if the patient has been duly
educated on its execution, alternatives, risks and benefits,
then we are doing our duty as physicians. Millions of people
have died using conventional treatments, and treatment failures
are expected. We are not infallible, the important thing is that
we act in the best interest of our patients and following our
philosophy to get them feeling better, and using the knowledge
we have been given...the outcome is not necessarily in our
hands after that. We set the stage and it is imperative we set
it conscientiously..the healing process takes over..we guide,
encourage and intercede to help the body regain health...I have
heard cases from my patients where very obvious issues were
missed , most likely because the practitioner was coming from
treating something based on protocol rather than by actually
examining the case. I think the danger comes when we become too
entrenched in protocol and stop listening to the patient.  I
have found that oftentimes the patients give you all the clues,
it is up to us to act according to what their body requires
rather than protocols we have been taught. The beauty of
naturopathic philosophy is it's flexibility and diversity...it
is not a dogma and each of us has to define it for ourselves -
nature has its rules, hierarchies, but within that there is
great diversity...
I remember that when I was a student, I did wish we had less
'standard care' education and more naturopathic training..but
looking back I realized that having the basics....our
philosphy, has given me what I need to practice , the rest we
learn along the way...but knowing the standard of care helps us
be conversant with the care our patients have gotten and the
tools already available in terms of diagnosis and labs...with
that I am so glad that natchat exists because after school is
done...this is a great fount of knowledge and practical
experience!

Zia (just rambling)L. Robles Hernandez ND
220 5th Ave. SW  Albany, OR
www.nemhealth.com
541-926-0510 opt. 4

Sent from my Motorola

ballard2doc

Message 17 of 50 , Dec 24, 2012[-- Image: Frame18 --]



View Source

Zia (and all of you ND primary care docs),

You are a very wise physician and I am happy that you have
learned what you have and shared it here. "Dogma" is the
physician's mind killer, whether you are MD, DO or ND(NMD),
ARNP, PA, etc. This incessant "us and them" with regards to how
many refer to our colleagues in allopathic medicine only
demonstrates how insecure we are in the naturopathic
profession. Who cares where a good solution comes from? Does it
have to originate from NDs to be "naturopathic" or can we
stomach letting a little ND ego get real?! Do we need to care
whether allopaths co-opt what NDs have discovered? Just use
what helps your patients, if the evidence is there, whether
testimonial or double-blind placebo- if you really want to
learn what works just test it out and then discern. If you do
choose to, as Cynthia has stated, go out of standard of care
for all primary care medicine when managing a patient's care
and put that patient at risk, you are to be held responsible,
believe it! All wise physicians continue to learn and
incorporate what works to help patients and set aside what
doesn't work as well, or makes better sense given a specific
context. As you point out Zia, there is much "ecclectic" about
naturopathic medicine as we have the freedom to incorporate or
integrate diagnostic and treatment measures that follow ND
philosophy and improve patient outcomes, depending on your
locale of course. Some of us would believe that there is one
way to practice medicine and look for historic precedents to
defend it but that will prove a mistake because the nature of
medicine is not static. The ability to practice excellent
primary care medicine is dynamic, it means on one hand being
critical/skeptic in your thinking, as all good physicians are,
and it means being open minded to the best solutions on the
other hand, whether they be "natural" or "conventional" in
origin. My advice to all aspiring to practice excellent primary
care is to keep an open mind and use any and all useful
modalities that you are competent in to better your patient's
health and let things go that don't stand up to medical rigor.
By the way, I will stir the controversy with the following
statements: I do presently know that vaccines have helped the
world and I believe that pharmaceuticals, judiciously
prescribed also help; I also believe that botanical medicine,
hydrotherapy, physical medicine, nutrition, counseling,
exercise prescription and homeopathy have helped. I also
believe that all of these things have likely done harm when
applied inappropriately or rarely, in accident, because even
great physicians are "human" and make mistakes. That's the
truth of it really- all of these tools have the potential to be
useful in primary care medicine and they all need to be applied
judiciously as they are absolutely neither good or bad. Our
philosophy makes room for it all as long as it follows the
principles. Uh, oh, look out I have opened a can! Here comes
the dogmatists to "correct" me! Hopefully all physicians,
despite the title, do our best to listen and read from a
diversity of sources with an open mind and then apply what
makes sense- I implore you to continue to do the same and
implore the schools to include this open minded, firmly rooted
in non-dogmatic approach to medicine.

Much love to you all this Winter holiday,
Jonathan Bell

Jonathan Bell, ND
Ballard Neighborhood Doctors
5416 Barnes Ave NW
Seattle, WA 98107

Nancy Dunne

Message 18 of 50 , Dec 24, 2012[-- Image: Frame19 --]



View Source

Lovely! Excellent! Amy your student-perspective response is a
healing balm.

Nancy E. Dunne , MA, ND
naturopathic physician/nutrition & metabolic therapies

Past President, American Association of Naturopathic Physicians

Black Bear Naturopathic
2204 Dixon Avenue
Missoula, MT 59801
406 542 2147
www.drnandunne.com

Nancy Dunne

Message 19 of 50 , Dec 24, 2012[-- Image: Frame20 --]



View Source

Hey Mona, I wasn't reporting hearsay, I was reporting what an
individual told me about his/her NCNM experience and the
quality of interest, commitment and hope s/he was left with
upon graduation. An individual's experience doesn't define
anything beyond that singularity, but in this case it does seem
to be a window onto a shift in the learning experience, and the
philosophical emphasis of naturopathic medical education.

I know very well the frustration of being in leadership and
administration, where most of the work is about how to make
things run ever-better; success is constantly redefined and
celebration and rest are fleeting. Naturopathic medicine is
only evolving, not disappearing. Thank you, dear friend, and
all of the rest of you reading this who are teachers and
administrators and volunteer leaders for the profession. Thank
you thank you thank you for keeping the lamps lit!

Nancy E. Dunne , MA, ND
naturopathic physician/nutrition & metabolic therapies

Past President, American Association of Naturopathic Physicians

Black Bear Naturopathic
2204 Dixon Avenue
Missoula, MT 59801
406 542 2147
www.drnandunne.com

drtimgerstmar

Dec 24, 2012[-- Image: Frame21 --]



View Source

Jonathan,
I can't argue with anything you've posted and I appreciate your
perspective. I also feel that you're flattening the field too
much. Yes, ALL health care practitioners are in the "job" of
helping people. We should use any/all tools that we are
competent with as the situation requires. All of us will agree
(I hope) that there's a time and a place for drugs (even the
most 'hardcore') and surgery (even the most intensive).

But beyond that, we are NOT all the same. If I may use an
analogy, it's like saying all dogs are dogs. Yes, that's true.
They all share similar characteristics. But then there's a
deeper level. A Great Dane and a chihuahua are not the same.
They are both dogs, but they are different. To reduce them to
simply dogs, strips them of much of their uniqueness and does
them both a disservice.

Similarly, we are medical professionals. But we are not MDs.
There's no need for us-them dynamics, but understand and a
mostly "oppressed" and definitely misunderstood minority, we
are used to "fighting" against others. We don't need to
polarize the situation, but we also don't need to become them
either. We have a professional philosophy that is different
from the professional philosophy of an MD, which means we
approach the situation (person) differently than an MD does.
Our ultimate goals are the same (help the person), but the ways
our philosophy directs us to go about helping that person are
different.

I look forward to continuing the discussion if you're
interested.

Best,
Tim Gerstmar, ND
Redmond, WA

Mona Morstein

Message 21 of 50 , Dec 24, 2012[-- Image: Frame22 --]



View Source

Oh, well, gee, I have no idea.  Maybe I could do a lecture on it
at the AANP or something, except I think I missed the deadline,
Perhaps next year.  Or, perhaps a webinar, sure, if someone
helps me set that up.  I could contact SCNM or the AZNMA, I
guess.  I'm happy folks agree it's a good idea for a class.

Mona Morstein, ND

Mesa, AZ

It would be wonderful if the courses you are teaching for
diet evaluation and also that of acute prescribing (and to
others in the
community regarding nature cure, philosophy, etc), could be
offered via the schools to the ND's in practice via webinars.
Any possibilities
there?

Colleen Gagliardi

Message 22 of 50 , Dec 24, 2012[-- Image: Frame23 --]



View Source

Hello all,

Thank-you Mona for being willing to do webinars - I really look
forward
to learning more from you. Is there anyone out there familiar
with the
webinar world? I'd be happy to help coordinate this.

As a thought, I'm wondering if we could broaden this concept
further
and have monthly or twice per month webinars featuring the
elders in
our community discussing Naturopathic medicine - we have the
technology
now to facilitate this. I've followed this discussion about our
education with interest Having graduated in 2004 from Bastyr,
and
being in practice now for 8 years, I'm continually striving to
learn
and implement naturopathic medicine into my practice. I find
that with
my Naturopathic education, I am excellent when it comes to the
"science" of naturopathic medicine, but still feel sorely
lacking on
what to do (nature-cure wise) for my patient in my office right
then
and there. Of course I start with diet, lifestyle (Dr. Zeff's
therapeutic hierarchy), etc, but I know I could be better and do
better
for my patients, with more knowledge of Naturopathic medicine.

If there is an interest in having webinars from the elders of
our
medicine, and if you are an elder willing to share, please chime
in and
I will help facilitate this for our community.

Happy Holidays,
Colleen Gagliardi, ND LAc
Westminster, CO

Mesa, AZ

It would be wonderful if the courses you are teaching for
diet evaluation and also that of acute prescribing (and to
others in
the
community regarding nature cure, philosophy, etc), could be
offered
via the schools to the ND's in practice via webinars. Any
possibilities
there?

Laura Schissell

Message 23 of 50 , Dec 24, 2012[-- Image: Frame24 --]



View Source

Sign me up to take the monthly webinars!

Laura Schissell, ND, DC

Vancouver, WA

As a thought, I'm wondering if we could broaden this concept
further
and have monthly or twice per month webinars featuring the
elders in
our community discussing Naturopathic medicine - we have the
technology
now to facilitate this.
Colleen Gagliardi, ND LAc
Westminster, CO

Mona Morstein

Message 24 of 50 , Dec 24, 2012[-- Image: Frame25 --]



View Source

Hello, Nan,

I'm sorry, I was not clear on my hearsay statement. I apologize
for that. I meant hearsay in terms of no NDs on Boards at
schools, (as I am on the Board of Trustees at SCNM), and also
regarding some of the philosophy being spread by "all" the
schools. I don't know what is happening at other schools,
except for what folks say, but wanted to clarify some points
about SCNM. I already have had one student from SCNM thank me
for sending my previous email, and agreeing with what I had
written about SCNM from a student's POV.

I hope this clarifies what my "hearsay" comment was referring
to.

Mona Morstein, ND
Mesa, AZ

drtimgerstmar

Message 25 of 50 , Dec 24, 2012[-- Image: Frame26 --]



View Source

Hi Colleen,
I think this is a STELLAR idea. Most of us did not have access
to the "elders" in our field in our training or even in our day
to day lives except through this list (thanks again Mona for
starting it!).

Getting the elders lined up to do a 1 hr (?) podcast from the
comfort of their home/office seems very doable. Perhaps (though
not meaning to impose) it could be free to NDs or very low cost
to maximize the number of us who could attend - though I
personally am willing to pay for it, as part of the state
continuing education board I know that people are constantly
citing economic hardship as reasons not to attend.

Maybe aim for 6 (?) bimonthly talks for 2013 - first one in Feb
to give the first presenter a little time to prepare. And if it
goes well, perhaps we could expand it to 12 in 2014? Also if we
could create an archive of these talks on varying
topics/conditions/treatments it could be a wonderful resource
for the future.

Just a few thoughts. And I'm willing to be part of the team that
gets this set up, though I admit to really not knowing much
about webinars.

Best,
Tim Gerstmar, ND
Redmond, WA

Shanon Sidell

Message 26 of 50 , Dec 24, 2012[-- Image: Frame27 --]



View Source

Aloha Mona and all,

I would be happy to contribute by working on setting up the
webinars. I'm doig a similar project for the Hawaii Society of
Naturopathic Physicians.

Isn't technology wonderful?!

Anyone interested in participating as a speaking-contributor,
please email me off-list with topic, and the time frame in 2013
you would be available.

Mahalo and Happy New Year,

Shanon Sidell, ND, LAc
Waikoloa Village, Hawaii
dr.shanon@...

Shani

Message 27 of 50 , Dec 25, 2012[-- Image: Frame28 --]



View Source

Tim et al, I also heartily endorse the idea of regular webinars.
Regular live contact with those most versed in the foundations
of our medicine is likely to make better practitioners of us
all.

The California association has for some time been presenting 4
webinars/year to support our pharmacy CE requirements - they
would be a great resource for the committee arranging this new
series. If we can do this to support our pharm requirements,
then we should certainly be doing it to support our
foundational philosophy and practices!

One important point: let's be professional about this and charge
for these seminars. There are costs to produce and register
people that must be covered, and I would certainly vote to
compensate the presenters as well for their time and efforts.
It's nice to obtain free CE when it's backed by a major
institution (eg, Medscape) or a major donor. But the point of
the proposed series is that it be produced by NDs and for NDs
in a way that no outside party could possibly provide. As such
we must back our own efforts, at least to the point of amply
covering costs.

Blessings,

Shani Fox, ND
Portland, OR

Eric Yarnell

Message 28 of 50 , Dec 25, 2012[-- Image: Frame29 --]



View Source

It feels like I have to write this email about once a quarter.
Oh well, so be it. My bottom line message is: don't worry, be
happy!

I of course am one of those teaching at our schools (Bastyr, but
I also teach a class regularly at SCNM and Boucher and have
guest lectured at NCNM many times and have also visited CCNM).
I was and am also involved with a massive revision of the
curriculum at Bastyr; a similar process has happened at SCNM
and NCNM in the past few years. So I feel I have inside ability
to speak very broadly to these issues directly, and not from
second hand accounts.

First thing that has really changed in the past 50 years: class
sizes are much larger. BU, NCNM and CCNM each routinely admit
over 100 students a year. It is very hard to imagine what this
is like if you were in a class of 50 like me, let alone one
half that size or smaller. Not all the students even know each
other in their class because there have to be multiple sections
of courses, and of course many students never work together in
the clinic. Even Boucher now which has a foundational
commitment to smaller class sizes is doing a second intake each
year.
This is a very, very good thing. A tiny profession like ours can
only achieve so much. We have to grow.

Second thing that has really changed in the past 50 years: the
internet. Access to information has been transformed. The way
learn and use information has thus been transformed.
This is what it is. It is unavoidable, like it or hate it.

Third thing that has really changed in the past 50 years:
evidence-informed practice (EIP). I think the term
"evidence-based medicine" is not quite right, so I prefer to
use EIP. If you want a rationale, humanistic, useful view of
EIP, I suggest you stick to that promoted by Gordon Guyatt and
his group/peers centered around McMaster University in Canada.
They are NOT saying all practice has to be based on clinical
trials. They are completely aware that is both impossible and
idiotic. They are saying there are all kinds of evidence, some
better (ie providing answers closer to the truth) than others,
and that multiple types are always being synthesized in
practice, combined with our "artistic" medical skills (eg
intuition, past personal experience) to come to decisions. They
want to make the process as transparent as possible. The idea is
to muster all the best of everything to come to the best care
for patients. EIP gets warped by ideologues into something it
is not (they use it like a cudgel to try to prove only that
only the tiny area of knowledge of things studied in huge
clinical trials has any value whatsoever).
EIP is also a very good thing in my opinion.

Fourth truly massive change in the past 50 years: it is VASTLY
more expensive to get a naturopathic education.
This is very, very bad but so far, unavoidable.

Ok, that being said, I'll keep babbling along. Hopefully most
people have already fallen asleep and moved on to more
interesting posts.

Implications of the above:

1. Nan, I think you're right, we have larger cohorts who are
less cohesive, but additionally they are faced by more
competition and pressure than ever. And many students are
facing between $150,000-$250,000 debt when they finish. That's
a HUGE burden that cannot be overlooked. People don't really
have the luxury of taking 2-5 years to build a practice (they
think). They're looking at $2,000-$3,000 per month student loan
payments. Of course these can be deferred when people don't have
sufficient income to pay them. But imagine, as you're building
your practice, after a year or so you're doing all right, and
now you suddenly have to pay $2,000 a month on student loan
debt. It's crushing.
New students come to these programs with stars in their eyes. I
am not sure how realistically they are told all this
information. I know they are shown the tables and data about
what all their student loans are going to mean. I also see
students treating it all like some kind of joke, that it's so
much money they might as well just spend more. But it isn't a
joke and we are looking at our own fiscal cliff in naturopathic
medicine. If our students can't afford to be in the profession,
it doesn't matter what they learn.
I would also add that it is hard to make enough money doing
nature cure alone to pay off these bills. Notice I said hard,
not impossible.

2. I have observed thousands of students and the majority are
absolutely as staunchly committed to the ideals of naturopathic
medicine and nature cure as anyone. I would say it is between
75-90% firm commitment. They would have gone to conventional
medical programs otherwise. Of course this commitment is
expressed differently; it doesn't mean everyone rejects all
conventional medicine and will only do hydrotherapy. Really by
far the most common philosophical approach I see among students
is what I think the true heart of naturopathic medicine is,
eclecticism. They will pick and choose among many, many
modalities and philosophies and do what they like and what they
feel is helpful. Various nature cure ideas and modalities are
always among these.

3. Nature cure is not a rock solid perfect tradition that has an
answer for all questions. Honestly, if it were, conventional
medicine never would have arisen. So of course students need to
learn an integrative curriculum. Some people need surgery, some
people need drugs. Many don't who are treated with them. Also,
the good parts of nature cure can also be refined and improved
by further study, practice, and publication/sharing of this
information.
I am more upset by those who seem to treat nature cure as whole,
perfect and entire, a dead/fossilized traditional that can never
improve. Well obviously using such inflammatory language I think
that is wrong. Nature cure like everything is imperfect and can
be improved upon. But this requires a scholarly approach this
is very, very, very sorely lacking in our profession. Where is
our demand for research on nature cure? Where is our commitment
to do that research? I'm not saying we are stuck with clinical
trials either. We could do open trials, publish case series, do
whole-practice trials, or other creative endeavors. But by doing
almost nothing, we get nothing and nature cure doesn't progress
or improve.
For example, does constitutional hydrotherapy really help people
with autoimmune diseases? I think it probably does. I'm sure Dr.
Zeff and other elders with experience would say it does. Great,
that's the empirical basis to do more rigorous work to prove it
is true (or not). Human perception without controls is faulty;
we all see this in our patients and ourselves if we look (read
the great book Why We Make Mistakes and many other books about
memory and perception). If we aren't willing to subject our
practices and beliefs to rigorous scrutiny then we have a much
bigger problem.

Most of my students, at least, hunger for traditional therapies.
They come on my student shift in the clinic to learn to
formulate herbs primarily, as this is sadly little practiced
anymore. I talk to many naturopathic doctors taught over the
past decades and there are also astonishingly few who do
individualized herbal formulas for their patients. To me herbal
formulation is a critical component of nature cure and of
naturopathic medicine, being one of the most individualized
forms of medicine. But its relative dearth does not herald the
end of naturopathic medicine or some deep failure of the
schools. It reflects the fact that not everyone is interested
in this as a doctor (it does take a lot to really learn the
materia medica); they prefer homeopathy or hydrotherapy or
bottles of vitamins or physical medicine or acupuncture or
drugs or whatever. I say BRING ALL COMERS. Let naturopathy be
diverse, heterogeneous, complex, manyfold, ever-changing,
traditional and modern, all of it. I saw let some decide not to
practice, many others will. I say let some belittle nature cure;
fine. They will work with the patients who will not respond to
nature cure. Let others do only nature cure; they will work
with those who eschew conventional medicine. Let some use
drugs; others none. We can and should embrace this diversity.
Diversity is strength.

One other issue: there is no established definition of "nature
cure" as far as I can tell. I suspect many people in fact
harbor very strong support for the core principles most would
agree on but don't call it that. Anyhow, as to Jacob's original
issue about teaching a definition, well, again, I do not think
there is any lack of discussion and work around defining
naturopathic medicine. But it is an amorphous and complex
thing, and if every student were to give the same answer to the
essay, I would be even more appalled and wonder why we were
turning out a bunch of students who can only spew back that
which was spewed at them. I saw let their minds wander and
expand and try to understand in their own way and not just cite
back the very precepts we already know. As to grammar and
spelling mistakes, that is a sign of the times and rampant
throughout the society, not an issue with naturopathic schools.

By the way, hydrotherapy is a required class at Bastyr
University and not an elective (though I think it has a name
that doesn't instantly say hydrotherapy). I am not sure about
the other schools. Hydrotherapy comes up in many other settings
besides the required class. There is a hydrotherapy department
at the clinic and students are taught to perform and use
hydrotherapy techniques.

All the best,

Eric Yarnell, ND
Seattle, WA

thomasballardnd

Message 29 of 50 , Dec 25, 2012[-- Image: Frame30 --]



View Source

Some wonderful things have been written on this topic and it is
a complex issue regarding teaching/state laws/licensing/keeping
our profession intact, etc, etc.

I have a comment not so much on the philosophical side, but on
the more concrete:

I'm blown away with what it appears to me from some contributors
to natchat to be this intricate knowledge of what I'll call for
simplicity sake allopathic medicine and yet reveal they don't
knowing enough about basic naturopathic therapies (ie "I'm
rusty on this, anyone know how to do a oral detox?").

The one that I notice the most often is regarding thyroid
questions. A question comes up and responses not mention a word
about the first and second orders of intervention (1. Prevention
2. Balancing (my shorthand) but instead go into interesting and
intricate detail about thyroid hormone testing and replacement
which I would call the 3rd level (heroic intervention: drugs,
hormones, surgery - therapies that take over function of the
body).

Much of this discussion was about acute medicine (ie antibiotics
vs immune modulators), but I hear discussion all the time about
various drugs and hormones being used for chronic diseases when
it is not clear to me that what i consider core, first line
therapies - nutrition and detoxification - where explored. I
don't want to ascribe thoughts to anyone, but (just like with
infections) it's as if the practitioner is thinking, "well,
this chronic health problem is too serious to muck about with
natural stuff, I need to use real medicine (ie drugs or
hormones) for this."

Maybe I'm wrong. This may just be the function of an internet
discussion where interchange is truncated.

Tom Ballard, RN, ND
Seattle
(Avoiding heroic intervention since 1982)

thomasballardnd

Message 30 of 50 , Dec 25, 2012[-- Image: Frame31 --]



View Source

Some wonderful things have been written on this topic and it is
a complex issue regarding teaching/state laws/licensing/keeping
our profession intact, etc, etc.

I have a comment not so much on the philosophical side, but on
the more concrete:

I'm blown away with what it appears to me from some contributors
to natchat to be this intricate knowledge of what I'll call for
simplicity sake allopathic medicine and yet reveal they don't
knowing enough about basic naturopathic therapies (ie "I'm
rusty on this, anyone know how to do a oral detox?").

The one that I notice the most often is regarding thyroid
questions. A question comes up and responses not mention a word
about the first and second orders of intervention (1. Prevention
2. Balancing (my shorthand) but instead go into interesting and
intricate detail about thyroid hormone testing and replacement
which I would call the 3rd level (heroic intervention: drugs,
hormones, surgery - therapies that take over function of the
body).

Much of this discussion was about acute medicine (ie antibiotics
vs immune modulators), but I hear discussion all the time about
various drugs and hormones being used for chronic diseases when
it is not clear to me that what i consider core, first line
therapies - nutrition and detoxification - where explored. I
don't want to ascribe thoughts to anyone, but (just like with
infections) it's as if the practitioner is thinking, "well,
this chronic health problem is too serious to muck about with
natural stuff, I need to use real medicine (ie drugs or
hormones) for this."

Maybe I'm wrong. This may just be the function of an internet
discussion where interchange is truncated.

Tom Ballard, RN, ND
Seattle
(Avoiding heroic intervention since 1982)

jacob

Message 31 of 50 , Dec 25, 2012[-- Image: Frame32 --]



View Source

Thank you Eric. My tiny peak into the student thinking at NCNM
was just that in comparison to your experience with the
students and it is reassuring to read your thoughts even if
they are coming from someone that I still regard as a young
smart aleck punk. I'm sorry we missed seeing you over the
holiday.

Your reminder of the financial burden that these students
graduate under is a good reminder and should help put our
worries in perspective. We should all feel obligated to help
these inspired young people to get the best education possible
and also to figure out to make a living as quickly as possible.
Is it possible for the schools to turn around and start lowering
tuition rather than increasing it steadily? I don't know that we
can really expect that to happen. Perhaps our focus should be to
helping build the scholarship endowments the schools offer money
to students from?

Jacob Schor
Canmore, Alberta at the moment where it's minus 28 C outside....

Eric Yarnell

Message 32 of 50 , Dec 25, 2012[-- Image: Frame33 --]



View Source

Yes, the scholarship endowment idea is a FANTASTIC one.

Eric Yarnell, ND

Seattle, WA

(well ok I'm in Denver right now and sorry I missed you guys
too)

Mike Whitney

Message 33 of 50 , Dec 25, 2012[-- Image: Frame34 --]



View Source

Hi Eric, Jacob, and All,

Although philosophical tenants are essential, two main issues
face our graduates.  The first is a problem borrowed from the
other medical educations.  The idea that talking business and
healing in the same sentence is unethical.  Business modeling
is not therefore effectively taught in any of our schools or in
medical schools.  Chiropractic schools understand this best and
have access to the business Guru's both on and off campus.


Infrastructure in conventional medicine is guaranteed by both
insurance lists and referral.  We have no such thing.  Cash
practice predominates in mostly unlicensed states.  As such, a
high skill set is required to find a stream of new patients in
a timely manner and do more than effectively offering acute
care.  Without basic communication skills for moving patients
thru treatment choices, retention in the early years suffers in
the extreme.  Meager retention means higher new patient need.
 That brings us to the second major problem.  New patient
acquisition is a function of marketing. Effectively finding
enough new patients to meet a new doctors overhead and pay
themselves a salary given small retention is a huge problem.
 Although around our schools ND IQ in the public eye is
higher, as you distance from the source prospective patients
become progressively unaware of our graduates as a choice.  At
some level this problem is evangelistic in that we need to get
the word out to the people on the street.  Without those skills
taught over the entire curriculum struggle in the early years is
all but certain.

Obviously, lowering tuition, scholarships, paid residencies,
insurance inclusion help but this is not unlike treating the
chief complaint of a cold when the patient is on the verge of
an MI.

All my best,

Mike

Sent from my iPad

Michael W. Whitney NMD DC FABNO

Fellow of the American Board of Naturopathic Oncology

Board of Directors Oncology Association of Naturopathic
Physicians

katie_stage

Message 34 of 50 , Dec 25, 2012[-- Image: Frame35 --]



View Source

Dear all,

The Naturopathic Gathering is alive and well. For those of you
not familiar, it is a student organized conference which brings
the teachings and experiences of our elders to a greater
audience. Although it is student organized, the Gathering is
for physicians as well, and CMEs are offered. It is also
generally quite cheap for a conference and CME opportunity. It
is an incredibly special event that speaks to the heart of our
medicine and has always rejuvenated me as well as offering
clinical pearls. In the coming year the Gathering will be
hosted at SCNM - the date should be announced soon, but I
believe it will be early November.

Happy holidays!

Katie Stage, ND
Past Gathering organizer
and I teach hydrotherapy at SCNM :)
Scottsdale, AZ

[-- Image: Frame36 --]

horsesense2011

Message 35 of 50 , Dec 27, 2012[-- Image: Frame37 --]



View Source

Dr. Yarnell,

Why do you think you have to write regarding this topic about
once a quarter? I am thinking that maybe there is a
dissatisfaction among graduates that may be realized at the end
of school and this is constant. To me, in order to solve issues,
we need to talk more about solutions than the problems.

After graduation, I quickly realized that this is a profession
that eats its young. In order for our profession to grow I
believe that we must have stronger mentorship programs to guide
new graduates. I use equine therapy in my practice, so maybe I
have been hanging out with horses too long, but I believe we
are a herd and must take care of each other. If the herd fails,
we fail, likewise, if the herd succeeds, we succeed. When I was
facing uncertainties after graduation, I reached out to many
NDs, only to have one who answered back. That one person helped
me see my way and not give up. A larger number of admits means
we need better career support and guidance post graduation.

I can see what Anne is talking about. Ultimately, our teaching
clinics need more patients. I can remember being one-among-six
students in an exam room with one patient. You sort of feel
like a middle-child competing for attention. That is no way to
learn. Luckily, I came from a background where I already had
plenty of patient care experience, but I really feel for the
students who have not worked in healthcare before. However, if
you are trying to apply the nature cure concepts and have no
patients to work with, it becomes difficult. I practiced what I
learned on my horses, cats, husband, sister and parents. My
shifts were not the primary exposure to applying nature cure to
patients, and that is a shame. How are our clinics being
marketed?

The talk of a divide in the medicine is disconcerting to me. I
would like to hear your thoughts on it. Evidence-informed
practice can increase validity to what we do and the internet
is an valuable tool for connecting with people. Is the
introduction of insurance the concern? In school I felt a lack
of openness for all the modalities in the profession. Some NDs
express skepticism for certain modalities (i.e. homeopathy).
Here is my altruism again, but divided we fall. Why is it hard
for some people to be open to things which they cannot yet
understand? After all, isn't that how we all learned to add an
subtract?

Happy Trails,
Amy Nelson, ND
www.ridingwithamy.com


Elisa Minerich

Message 36 of 50 , Dec 27, 2012[-- Image: Frame38 --]



View Source

I want to add something to the portion of this conversation
regarding a naturopathic standard of care.  No, we do not have
such a thing at this point in time, but for those of you who
have made comments that our new prescription rights need not
effect the way we practice, you should be aware that a standard
of care may very well be coming.  I suspect that most of you NDs
out there are unaware that the administration at NCNM has
recently made a decision to require doctors in the teaching
clinic to prescribe prescription medication to patients
presenting with certain conditions--meaning that certain
conditions cannot be treated with naturopathic medicine at a
naturopathic teaching clinic.  This is a relatively new
decision and I do not know the specific details (they may still
be working them out) but I understand that this requirement will
be for conditions on the more serious end of the scale (such as
stage III hypertension, uncontrolled diabetes,
pneumonia--again, these are possible examples and I do not know
the specifics).

This new requirement is being created as a legal CYA for the
school and I believe it is in part, though not completely, a
response to the fact that we now have such broad prescription
rights in OR.

Some of you may think this is a good thing and some of you might
think it is horrible.  Either way, you should be aware of it.
 When the institutions associated with our profession start
creating standards such as these, how big of a leap is it to
begin applying the same standard to everyone with an ND degree?

So, this is part of what is soon to be taught in our schools (or
maybe it has already started this year?).  As someone who
attended Bastyr and NCNM I know that both schools have classes
that teach the core of naturopathic philosophy.  What I believe
is more important, however, is what is being taught in the
clinics.  It is one thing to sit in class and philosophize
about naturopathic theory.  It is another entirely to have it
modeled for you by experienced doctors, to see the philosophy
put into practice, and to experience it first-hand.

(Sorry, Jacob, for any grammatical errors I may have made...)

Elisa Minerich, ND

Mount Vernon, WA

Elisa Minerich

Message 37 of 50 , Dec 28, 2012[-- Image: Frame39 --]



View Source

Shoot, correcting myself...should say stage II hypertension, not
stage III.

Elisa Minerich, ND

Mount Vernon, WA

Deborah Phair

Message 38 of 50 , Dec 28, 2012[-- Image: Frame40 --]



View Source

There is one more (of many, perhaps) important components that I
don’t think I have read in any of the posts commenting on this
very critical issue. I need to preface what I am about to type
as hearsay in some much as I am not personally employed by a
naturopathic teaching institution so I do not have first-hand
knowledge of what it is like to teach nor do I have the ear of
students. What I do hear other NDs & recent grads comment about
is 2 additional inter-related issues: the amount of compensation
teachers earn for teaching at ND schools and the (relative) lack
of experience of academic and clinic staff. Again, I can’t speak
for US schools, but at both Canadian schools people are being
paid $100 per classroom hour for teaching. This includes prep
and marking time. I calculate that these people are grossing
about $25 per hour unless they are using old notes from
previous years.



Another comment that I frequently hear is that new grads are
being hired to teach and/or act as supervisors in naturopathic
teaching clinics. Perhaps this is partly because they have few
patients in their private practice and need to augment their
income. Obviously not everyone teaching is a recent grad, but I
know that I would have considerably more to offer now, 15 yrs
out, than I had to offer at 3 or 4 months out. Also, I would
argue that there is a BIG difference, as Elisa stated, between
theorizing about ND strategies that SHOULD work and ND
treatment strategies that DO work, of which only time spent
acquiring clinical skills in practice would allow one to
discern the difference. If our schools are having larger
intakes of students, then presumably their revenues are
increasing – it would be nice to see some of this (presumed)
increased revenue being set aside to pay teaching & clinic
staff more per hour.



My husband is a GP who teaches family practice residents for the
University of BC Faculty of Medicine. As a consequence I get to
interact with many R1 and R2 family practice residents.
Treatment modalities aside, I can say that the skills that
family practice residents learn in their 2 yr residency is
HUGE. It is during their residency when these people learn
to practice medicine (the art of medicine) in a variety of
settings, not just in a family practice setting. FP residents
do obstetrics, psych, orthopedics, geriatrics, pediatrics,
emergency rotations each lasting 1 month in addition to their
6+ months of family practice rotations. There is a considerable
infrastructure in place to train these GPs and the purpose is
for them to learn as much as possible from as many different
docs as possible. Ideally NDs would have access to the same
remuneration for our residents that MD residents have available
so that our doctors in training can also be paid rather than
paying out of pocket when acquiring these invaluable clinical
skills.



I’m not suggesting that NDs should become MDs but I am
suggesting that the manner in which our students are trained as
well as the compensation we pay our teachers & clinic
supervisors needs to be reviewed so that when NDs graduate they
have seen and treated enough pathology so they are confident to
know exactly what treatment works, which treatments “fit” for
their practice style and 1 or 2 (minimally) other Tx options
for back-up should these fail. I also believe that certain ND
manual techniques should be mandatory learning and mandatory to
practice in ND clinics. Examples are hydrotherapy, skeletal
manipulation, visceral manipulation, etc. This email is a
little long-winded, but what I’m trying to say is that if the
people teaching our students are less confident, perhaps
because of their own lack of clinical experience, then those
student will also have weak skills – and if these students are
then hired & teach the next year’s graduates I can see how it
wouldn’t take very many years before specific naturopathic
techniques are no longer being taught.



I would be curious to hear from others.



Deborah Phair B.Sc.(Pharm.), ND, RAc

Prince George, BC



As someone who attended Bastyr and NCNM I know that both schools
have classes that teach the core of naturopathic philosophy.
 What I believe is more important, however, is what is being
taught in the clinics.  It is one thing to sit in class and
philosophize about naturopathic theory.  It is another entirely
to have it modeled for you by experienced doctors, to see the
philosophy put into practice, and to experience it first-hand.

Mona Morstein

Message 39 of 50 , Dec 28, 2012[-- Image: Frame41 --]



View Source

Well, my first initial response is WTF!?

I'm a graduate of NCNM, and I'm sad to say that NCNM is sounding
more awful nearly every post.  Thank Goodness I work at SCNM,
where academic freedom and clinical freedom is the resolute
rule.

Mona Morstein, ND

Mesa, AZ

I suspect that most of you NDs out there are unaware that the
administration at NCNM has recently made a decision to require
doctors in the teaching clinic toprescribe prescription
medication to patients presenting with
certain conditions--meaning that certain conditions cannot be
treated with naturopathic medicine at a naturopathic teaching
clinic. This is a relatively new decision and I do not know the
specific details (they may still be working them out) but I
understand that this requirement will be for conditions on the
more serious end of the scale (such as stage III hypertension,
uncontrolled diabetes, pneumonia--again, these are
possibleexamples and I do not know the specifics).

Mona Morstein

Message 40 of 50 , Dec 28, 2012[-- Image: Frame42 --]



View Source

This is an on-going problem, true, at ND schools--new graduates
teaching and also, sometimes, adjuncts teaching (who are not
always as committed as the full-time faculty).

Also, yes, low pay!

Ideally, of course, experienced docs who had their own clinics
or had a private practice for at least 5 years would be ideal
educators at our schools. Only, how many docs on this list, who
fit that bill and live near a naturopathic medical school, are
willing to teach at the school for the benefits of upcoming
graduates? Very few, of course, and I'm not judgmental about
that. I get it. The time and money to do so does is not enough,
for one thing.

I was upset to hear in a previous post that a newbie grad called
NDs for guidance and 4/5 rejected helping him. That is something
we can not have on our profession. If we cannot teach at the
schools, we need to work hard to teach as we can and help the
new graduates as best we can, especially if they come asking
for some gentle help.

Mona Morstein, ND
Mesa, AZ

whyterose

Message 41 of 50 , Dec 28, 2012[-- Image: Frame43 --]



View Source

Dr. Nelson,

I was surprised by your approach, which marries the reasonable
injunction, “in order to solve issues, we need to talk more
about solutions than the problems.” with the inflammatory
statement, “After graduation, I quickly realized that this is a
profession that eats its young.”  And what defines a profession
that “eats its young” exactly – the fact that mentors do that
readily materialize when you want them to? Compared to a
statistic I saw some time ago that conventional medicine loses
something like 7 graduating classes per year to drugs, alcohol,
and suicides, I would have thought that the naturopathic
profession was doing fairly well in this regard.



My wife and I were both part of the original mentorship program
that was set up at Bastyr. During the four years we were part
of that effort, which became defunct through lack of interest,
the students assigned to me never called and only 1 ever called
my wife. Dr. Yarnell and I both offer mentorship to our Student
Associates at Healing Mountain Publishing as part of that
relationship, an opening that is rarely utilized. When I have
ask students why they do not take advantage of these resources,
they typically answer that they mean to, but that they are too
busy, or too stressed out, to make it happen. Rather than
assuming that the profession is busy engorging itself on its
offspring, perhaps horse sense (or an equally reasonable
hypothesis) would dictate that maybe the pathways for
assistance have atrophied due to lack of use or, worse, through
actual abuse.



When we were considering bringing a new associate into our
practice, I contacted a number of NDs who had mature practices
and had attempted this same feat. It should be said upfront
that any effort to bring an individual into a business –
medical or not – is very challenging, which has little to do
with what profession is doing the hiring. That said, I heard
stories that were very sad, in terms of lawsuits, breach of
contracts, and general misconduct on the part of the new
associate. Again, there are two sides to every story and I have
heard equally distressing stories from new graduates, like
yourself, who were not shown the proper professional courtesy
or respect.



My point is that we are a profession, not a herd or a mob or a
clan. Relationship dynamics between new grads and established
clinicians move in two directions – human directions – which
have repercussion and consequences for future generations of
NDs. Certainly there are challenges that our profession faces,
but I do not think the path to resolving these problems rests
on characterizing the profession as rapacious. A great many
people have made significant sacrifices in order to create the
level of professional opportunities that are now available to
us, demonstrating a level of altruism not typically found in
predatory professions.



You ask, “Why is it hard for some people to be open to things
which they cannot yet understand?” Perhaps if you pondered that
question relative to the experiences of your older peers you
might not be so quick to judge and would be less likely to look
a gift horse in the mouth.





Gary Piscopo, ND, LAc

East Wenatchee,  WA

www.alpinebewell.com





Eric Blake

Message 42 of 50 , Dec 29, 2012[-- Image: Frame44 --]



View Source

This is a very interesting discussion. I see other current
threads - such as the one on the question of dual degrees - as
really overlapping in relevance.

Perhaps we are asking too much of a 4 year program. MDs moved
into standard residencies almost a century ago, realizing the
limitations of the 4 years, and even before that hospital
training and exposure was the norm for quite some time.   The
post graduate training is so important - the case exposure and
responsibility involved makes a potential clinician become a
clinician. We need more of it.

I have been of the opinion for several years that our profession
would benefit by developing in our best licensed states a strong
clinical institutional presence. And I dont mean via the
schools.  Unless the schools wanted to pay clinics to bring on
interns or residents. The osteopaths were shut out of MD
residencies and they built up hospital networks in midwestern
states. Eg in Ohio they built a 12 hospital network.

At our clinic worked to create (2) 2 year residencies a our
clinic, and then ran into some issues for some reason with the
college (NCNM) when we decided not to select any of the
candidates. The school then disqualified us, and we are
debating whether to pursue it any further as the experience
working with the college to create 2 jobs to add to our paltry
40 residencies was unpleasant for us.  One would think they
would be excited to grow the program, and I would hope it isnt
because 'we do a lot of nature cure'  which was brought up as
if it was an issue (ironically I dont think we do 'nature
cure'), and Im not sure why we were continually dissuaded from
making our residencies 2 years.....the candidates we had were
good but it was more of a fit issue with the group (we have 3
docs, are bringing on a nutrtionist and an acupuncturist).

I teach an elective there annually on history, and I always
enjoy the students who are motivated as electives tend to self
select for. And it makes me feel like I am giving back by
helping them to process and to make sense of the chaos that
their chosen profession is. It helps me as well and they have
insights that I learn from too.

When I was more involved teaching there I was once reprimanded
for failing cheating students. The students were then passed
without even consulting me - by the dean who simply overrode my
Fs.  Must keep the assembly line moving and the paying customers
graduating! I watched nonsense become standards - such as the
erroneous idea that standard constitutional hydros are somehow
unsafe in pregnancy.  Or that autoimmune disease was a C/I for
hydros. And the most erroneous of all - that there was no
research on either. I am not surprised to hear that the college
is creating standards based on conventional models.

Well, I'll stop complaining, it is not easy teaching for low pay
in a highly fractured politically volatile environment with ever
changing expectations and a demanding consumer  - and I
appreciate the docs with experience and success who teach at
the college because they want to not because they need to.  The
idea of internet for the basic sciences or as a part of the
program I think is very interesting and I can see Schleich
working to educate the profession on that in his recent
articles.....it would be full circle as that was a Lust idea
early on.

Here is research on naturopathic therapies (ie
hydro/physio/nature cure/whichever tower of babel term you want
to use) in general by the canadian physiotherapy association,
the research supports the use of constitutional hydro as it has
been used based on our naturopathic care standards for over a
century in pregnancy:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031347/

I would hope that this would be the kind of research our
physiotherapy depts would do or would consult before changing
policy...

And here is the European Rheumatology Association (MDs) guide to
nature cure (aka spa therapy) in rheumatological disease:
http://www.researchgate.net/publication/41395608_Spa_therapy_in_rheumatology._Indications_based_on_the_clinical_guidelines_of_the_French_National_Authority_for_health_and_the_European_League_Against_Rheumatism_and_the_results_of_19_randomized_clinical_trials

For more detail see my chapters on hydro and electrotherapy in
the books below available on Amazon or elsevier website
(shameless plug*)

Our interviewed candidates, preceptors, my students in class
impress me as sharp, and I learn from them...so maybe the
patient is getting better in spite of the treatment :)

--

Dr. Eric Blake
Naturopathic Physician and Diplomate of Acupuncture

Anne Van Couvering

Message 43 of 50 , Dec 29, 2012[-- Image: Frame45 --]



View Source

I just wanted to chime back in on this subject.  While I was
certainly unhappy with aspects of my training at NCNM, overall
I got an excellent education, even if I had to do some hunting.
 There are dedicated doctors teaching there, with huge amounts
of experience.  I do think that this is changing, as they get
older, more tired, and disgusted with policies, but I am so
grateful to have had the opportunity to learn from them.

I do think that what we're required to learn is more than what
fits in 4 years.  I did it in four, because the personal &
financial consequences of changing to the five year track were
too huge.  I wanted to do a residency, but with two kids in
college and my husband living across the country because of
work, we  again could not afford it, personally or financially.


I just want anybody who is outraged by the new pharmaceutical
policy at NCNM to reach out.  There are doctors there who
disagree, strongly and vociferously, and they are being
marginalized.  They need your support. NCNM was recently
looking for a new medical director for the clinic - if anyone
was in the mood to apply for that job, they could have some
influence.

As for the lack of response from doctors to students reaching
out - I too have experienced that, but much more in Portland
than in NY.

Drs Piscopo and Yarnell - those sound like amazing
opportunities, I am hugely sorry they didn't work out - I would
have pushed MUCH harder to make it work if there had been a
residency with an emphasis on herbal medicine or nature cure.
 But adding something, no matter how amazing, during the four
years of school is next to impossible - even a three hour class
once a week with Cascade was a major stretch. Although there are
some amazing ones who managed to work or go to births, there
aren't many with that mental fortitude or stamina.

And the trouble with adding time (which would be a logical thing
to do) is that it's $50,000 per year of debt, (providing you can
live on $15,000/yr), they've just taken away the subsidized
loans from grad students,  and our business class tells us to
save $10,000 for start up costs.  (!) And tuition keeps
climbing - and the amount of loans you can take has a cap, so
now you're looking at 9.8% loans, or not eating (I know several
who are taking the latter choice).  I don't know about the other
schools, but this is not a sustainable model - and indeed, the
entering class this year was much smaller than the previous
four years...

And even with all that, I am beyond grateful that I got to go to
NCNM, and that this medicine is out there.  I may not have
learned it all in school, but I know it exists, and I can
continue learning about it.  As huge a field as we play in,
what we learn in school is just enough to get our feet wet and
to not hurt people.  I LOVE being a naturopath, I love and
respect my profession and the dedication and integrity of all
of you. These past four years were the hardest and best of my
life, and I wouldn't trade them for anything. Just watching
patient's faces light up when you tell them there are
alternatives is payment enough.

Anne Van Couvering, ND, LMT

Sag Harbor, NY

[-- Image: Frame46 --]

Nick Kats

Message 44 of 50 , Dec 29, 2012[-- Image: Frame47 --]



View Source

Beautiful..

Thanks Anne,

Nick Kats ND, LAc

Ireland

Tim Murbach, ND

Message 45 of 50 , Dec 29, 2012[-- Image: Frame48 --]



View Source

Hi Mona,

You wrote: I was upset to hear in a previous post that a newbie
grad
called NDs for guidance and 4/5 rejected helping him. That is
something
we can not have on our profession. If we cannot teach at the
schools, we
need to work hard to teach as we can and help the new graduates
as best
we can, especially if they come asking for some gentle help.

I missed the previous post to which you refer; however, I want
to say, I
too have had that experience. After graduating from NCNM in
2005, on
several occasions I contacted previous instructors at NCNM with
clinical
questions relevant to a current patient and had help refused.
For
example, I contacted one instructor with a simple yes or no
answer
question and was told that I would have to pay to attend one of
his
seminars where the topic would be covered in detail. I should
point out
that this experience was not universal as some instructors were
and have
been more than willing to help, but it does illustrate a
problem. This
is one of the main reasons I am so grateful for Naturopathic
Chat. Thank
you, Mona.
--
In Health,
Tim Murbach, ND
Rancho Santa Margarita, CA

James Prego, ND

Message 46 of 50 , Dec 29, 2012[-- Image: Frame49 --]



View Source

no more subsidized loans for grad students?  Thats going to make
it impossible for many people to go to ND school (or any other
grad school) anymore.  Without subsidized loans, I would have
had to make the choice to NOT go to ND school.



That will really change the face of higher education in this
country.

Jim Prego ND

Islip NY

Anne Van Couvering

Message 47 of 50 , Dec 30, 2012[-- Image: Frame50 --]



View Source

The ones they have stopped are the ones where interest is not
accrued until you graduate.  Only $8500 per year of those were
ever possible, but it did make some dent.

Anne

Eric Yarnell

Message 48 of 50 , Dec 30, 2012[-- Image: Frame51 --]



View Source

I am certainly sorry to hear some of your tales. I have to say
that I have unfortunately had to fail at least a couple of
students every year both in the naturopathic program and in the
herbal science undergraduate program, and I have always had the
full support of the administration and never had this
"overridden." I have had students challenge their grades on a
couple of occasions and every time I had all my ducks in row
(copies of tests they failed basically). Anyhow, I am hoping it
is no longer the case at NCNM or anywhere that an F would or
ever could be overridden without proper due process.

Anyway I think you have a very good idea to develop "hospitals"
(though I suspect they would look and feel very different from
conventional hospitals) outside of the existing schools to
provide post-graduate clinical education to most/all graduating
ND students. Who's got several million bucks lying around we can
use to get this ball rolling?!

Eric Yarnell, ND

Seattle, WA

Eric Yarnell

Dec 30, 2012[-- Image: Frame52 --]



View Source

I'll go on record as a full-time faculty member at Bastyr that I
make around $30/hour as an associate professor having taught
there for ten years (I've been in practice for 16 years). There
is no pay for prep time or grading or anything like that, that's
just considered part of running the class. So in reality I
probably make more like $20/hour (though every year I teach a
class it takes that much less time to do so the rate/hour
improves). That's for classroom teaching and clinical
supervising. I believe this is fairly paltry in comparison to
what conventional doctors make in teaching, but I really love
to teach and I am certainly doing better than the vast majority
of humanity so I am not complaining too loudly. I have a lot of
problems with the crap that goes on at Bastyr, but I don't let
that get in the way of my work with students and patients. I
know for sure many experienced doctors look at what they can
make in private practice and laugh at the idea of teaching;
it's a huge drop in pay. I know that I routinely make
$1500-2000 net per month from practicing one day a week in a
private practice (total about ~30 hours patient care and
charting and everything, so that's $50+/hour) with minimal
advertising. I suspect but don't know that some people who
investigate teaching at the various ND institutions who were in
practice change their mind when they find out about the pay.

Eric Yarnell, ND

Seattle, WA

kathygraham1993

Message 50 of 50 , Feb 21[-- Image: Frame53 --]



View Source

I see this post is quite old and that I've come late to the
party. But I'm new, so I have an excuse.

Jacob, you write: “No one came close to Wade Boyle's elegant
differentiation that he once made between naturopathic
herbalism and allopathic herbalism”. I googled and could not
find this info. Could you direct me to where I can read this?

You also lament about how some students focus on the cosmos and
karma when trying to answer how NDs fit into the big picture of
healthcare. I couldn't agree more. It is no wonder why the
science-based medical profession sees NDs as “flakes”.

I have been practicing for 21 years now, and along with all of
the “flaky” things I've suggested and do even now, what I've
found over and over and over again, regarding the best
treatment efficacy, is: diet advice, exercise advice, and
lifestyle advice. For not one essay writer to write about the
correlation between basic lifestyle choices and chronic illness
is disheartening. This is where naturopathic medicine shines the
most, (as well as the act of listening to patients).  IMHO.