The idea that “the first is the last and the last the first” was a value in my liberal Protestant upbringing. It likely had some noblesse oblige in it too. The concept can be challenged as an entrapping promise that good will come of waiting. Regardless, in some the call to work with the least-cared-for becomes a guiding mission. Self-preservation of the integrative field may be another motivator of such a mission. A past head of the NIH agency that researches integrative practices has challenged the main body of clinical research as un-generalizable due to the research being on upper income, well-educated, white, female patients. For a multitude of reasons, Integrative Medicine for the Underserved (IM4US) has emerged as the leading edge of the movement for integrative health.
I sometimes refer to my 1983-1993 years with the re-emergence of the naturopathic profession – amidst the broader social-medical movement that birthed integrative health – as my boot-camp. Given the decade duration of the commitment, it was more of an extended Marine Corp stint. The work was hard, ground won celebrated, compensation scarce, friendships fierce, and mission central. The pole star was the naturopathic profession’s commitment to “treat disease by restoring health.” The constellations that guided the voyage were a set of principles and something educators Jared Zeff, ND and Pamela Snider, ND would articulate as the “naturopathic therapeutic order.” So when the Association of Accredited Naturopathic Medical Colleges (AANMC) recently posted an updated version of the profession’s therapeutic order, I thought it a good time to re-visit the engine room of that field’s transformational work.
The George family name has been linked symbiotically to the growth of integrative health and medicine in the United States for 20 years. When a group of philanthropists met with a set of integrative academics at the Miraval Resort in 1999 and then again in 2001 in what would become the immensely influential Bravewell Collaborative, Penny and Bill George had their hands on the wheel. At Allina Health inpatient-outpatient integrative health program in their home city of Minneapolis they intentionally spawned methods and data that would guide others through $30-million pouring on the coal. The action of the Georges and the George Family Foundation intentionally reverberated nationally. Where they choose to invest is always of interest and their strategy as a family foundation has caught the attention of the national philanthropic community.
The polarization between reductive biomedical science and a whole person integrative model obscures deeper differences relative to human nature. The top-down, fix-it mode of the former is grounded in a fundamental belief that people (a.k.a. “patients”) either do not want to change or simply can’t. Meantime, the time-consuming, get-in-there-and-partner focus of lifestyle-oriented integrative practitioners assumes that the presenting human being arrives with seeds of change seeking ground for germination and growth. A recent Harris poll on perceptions of self-care among conventional medical doctors and their patients that was funded by the Samueli Foundation and led by its integrative health director Wayne Jonas, MD describes the chasm that has opened between the two parties. The patient is seeking an integrative model for self care amidst the present predication of medical delivery on the skeptical view of human nature.