The Circle Game

By Bill Benda, MD, FACEP, FAAEM
2011 Naturopathic Champion Award Winner

Photo by Helen White via Flickr, used under the Creative Commons License.

So. It’s time to find a topic for the next edition of the Physicians Who Listen blog. I know because a week or so ago I received the gracefully worded request from Matthew Santoro, the Communications and Media Associate of the AANP, gently reminding me that Friday is the deadline.

And Friday came and went, bringing to my consciousness the fact that my Integrative Medicine: A Clinician's Journal editorial was also overdue by two weeks, and the Journal of the ACM deadline is only a week or so away, and that my mind is and has been a total blank. It’s not writer’s block—I could blather on for hours about various idiocies inherent to the conventional health-care system or how the emerging theory of basing physician pay on patient satisfaction would be the clinical kiss of death in the Emergency Room.

Nope. I’ve come to the sad conclusion that I really have nothing left to say about the field of integrative/holistic/naturopathic medicine that I haven’t said before, and others’ oft-employed editorial option of describing how the purity of our natural therapies reminds me of the first breath of Spring just isn’t my style. And of course I still do not have the courage to remark on Karen Howard’s leaving or how totally predictable our major conferences have become, as it may hurt some people I still like and admire (but stay tuned).

So I am stuck with nothing to say, and therefore have no choice but to talk about why there is nothing to say. Primarily because this grand experiment of ours is no longer grand or an experiment, at least to me, but simply another chapter in the Big Book of Health-care Tales. Not to sound a discouraging note—this conclusion is simply evidence of an inevitable step in the evolution of all great ideas. First the excitement and purity of discovery (this is so cool and makes so much sense), followed by the heady rise against all odds (from ridicule and ostracization (no, its not a word) to the emergence of Weil, Ornish, NCCAM, IOM reports, and countless billions spent out of pocket), all highly seasoned with the seductive flavor of danger (what if we can’t ever make a living doing this? What if we can’t even find a job?).

But then, with every “victory” comes the inevitable price.

“We can’t prove all of this because the reigning research paradigm was created for reductionistic trials” has become “we must make research a priority because it’s the only way the reigning paradigm will accept us.”

“Should we even consider accepting insurance reimbursement?” has transmogrified into “naturopaths are now on the federal CPT committee!”

Our pioneers are now not only writing even more books but also selling their household products online and hosting daily television shows that remind me of a cross between Oprah and Phil Donahue.

And if I get one more “Dear Bill, this is a personal note to you, and I hope you will join me in an exciting seven-day program to cure you patients and increase your income by 25%,” I’ll have to reach for the Nux Vomica.

It ain’t what it used to be, folks, and I guess that can be considered a good thing in today’s social media/newest/greatest culture. It means we’ve arrived. But it makes me want to leave again, to find whatever the next cutting edge is, the one that will challenge the integrative/holistic/naturopathic model I helped create. To feel the resistance rather than the acquiescence, to worry again that I may not really have a clue as to what I am doing.

I want some new paradigm, fresh idea, brilliant concept - one whose purity will remind me of the first breath of Spring . . .