Virtually every corner of the medical industry houses an entangling drama between mission and money. There is the service, the need to make a living, and then the way making a living can transform into a production orientation dominated by the impulse to make more money. For integrative health and medicine, the drama is intense, whether in integrative centers owned by large institutions or solo practices in the community. The mission-money challenges get “curiouser and curiouser” for the licensed integrative practice fields that are not fully swept up into the thundering $3.3 trillion river of cash that annually rips through the dominant medical industry. An edginess sets in when, as the sick joke has it, you have just enough recognition to get into debt, but not enough to get out of it yet. So it is always interesting to explore new data on income and practice methods such as were recently published by the Association of Accredited Naturopathic Medical Colleges in it’s 2020 Graduate Success and Compensation Study.
The most gripping moment for me was quite private after my spouse suggested that we don our COVID masks and join some 5000 others at City Hall on day 6 of Seattle’s demonstrations against police violence against black people, and for massive systemic change. We were sitting on the curb during a break in the action. We were quite aware of how little we know and understand, even with the mentoring of a 24-year-old daughter who is hypersensitive to race issues. We leaned in close to each other as the mixed crowd of humans, nearer our daughter’s age than to our own, milled about. The course of our conversation led us to try to imagine needing to have had “the conversation” 15 or 20 years ago with our now 28 year old son, were we black, and he a young black man coming of age. That being his ritual welcome into adulthood.
News feeds for the natural products and integrative health practitioner fields have in recent weeks included a drumbeat of alerts on actions of the Food and Trade Commission (FTC) on what the agency considers inappropriate claims relative to COVID-19. A major natural health organization blasted the FTC’s efforts as practitioner gagging and censorship and is mounting a campaign to stop the activity. Others in these fields point to bullseyes some practitioners and companies have painted on their foreheads via gross over claims (“this mushroom will cure your COVID”) that laser-guide FTC’s actions. At a sober center amidst a tangle of issues – state/federal jurisdiction, free speech, provider-patient relationship, and the peculiar institution of in-office sales of natural products – sit Laura Farr and Rob Kachko, ND. They are the executive director and president, respectively, of the American Association of Naturopathic Physicians (AANP). Among the multiple questions is whether naturopathic doctors and others in integrative medicine are “canaries in the coal mine” of a new, potentially widening push by the FTC and other federal and state agencies into the regulation of integrative and functional medicine practitioner offices.
The polarization in US medicine has never been so front and center as it is with COVID-19. Natural agents are off the table. Despite early clarity that the state of the host matters big time in susceptibility to the virus, natural strategies focusing on host susceptibility are routinely denigrated and dismissed. So it was remarkable that within the course of 24 hours in late April, two colleagues independently sent news of a formal medical center protocol associated with a medical school that includes multiple natural agents. These are inlaid with conventional measures into a series of stages that the institution’s medical staff is following. Who are these people and how did this come to be? I was able to reach the primary author of the institution’s Critical Care COVID-19 Protocol, a South Africa educated internist, Paul Marik, MD, FCCP, FCCM. Marik is a professor of medicine and chief of pulmonary and critical care medicine at Eastern Virginia Medical School (EVMS) who has previously stirred controversy for unorthodox approaches. The non-conventional reasoning that drove the COVID-19 protocol Marik calls “uncommon common sense.”