Progress in Puerto Rico

By Efraín Rodríguez Malavé, ND
2012 AANP Physician of the Year
San Juan, Puerto Rico

This year, the AANP honored me with the 2012 Physician of the Year Award in recognition of all the work that I have done in raising awareness about naturopathic medicine and establishing the profession as legitimate and regulated. Though my journey has been long, it has been very productive.

I fell in love with the profession of naturopathic medicine in 1982. I decided to leave my home of Puerto Rico, in the East Caribbean, and attend school in Portland, Oregon, in the western part of the US, to get my ND degree. In 1984, I was sitting in a meeting at NCNM where Dr. Jim Sensenig was discussing the need to organize an association to promote and develop our profession. At the conclusion of the meeting, he asked me, “After you finish your degree are you going back to Puerto Rico to help us expand our profession?” I answered, “Yes, I will. That is my country. It is where I was born, where my family and friends live. And I’ll go back and help them with their health.” I graduated and returned home to Puerto Rico in 1986.

As soon as I arrived home, I started taking steps to regulate the profession. Eleven years after my return, our dream was realized and our law that regulates naturopathic doctors was passed. Since then, NDs on the island have been able to practice without fear of being prosecuted by MDs. Our scope of practice is broad but not full. Next year, we will be working and lobbying to clarify the language of our regulation, so it will allow us to practice to the full extent of our naturopathic medical training.

We have also recently been working on health insurance coverage. And lastly, but certainly not the least, we are working on getting the naturopathic program at Universidad del Turabo accredited by the CNME. The program met the CNME eligibility requirements in April and is moving through the self-study program and will hopefully be up for candidacy in 2013.

Autumn at AANP

By Michael Cronin, ND
AANP President

It is fall and we are right on schedule with our calendar and planning process. The annual planning for the 2013 work plan and budget has us at the stage of surveying our members in preparation for updating and editing the work plan at our next Board meeting. The Board planning process also includes reviewing and refining the AANP strategic objectives and Ends statements. Through this discussion our CEO, Jud Richland, will identify AANP’s priorities and put together a draft work plan and budget. The Board will work through the details of his draft and approve the final work plan and budget in December 2012.

The naturopathic profession continues to grow macroscopically with an increase in the number practicing NDs, rising student enrollment, and more patients visiting naturopathic physicians. This past weekend the ND program at National University of Health Sciences in Illinois became the 8^th fully accredited program in North America. Congratulations NUHS! Bastyr California began its San Diego program in September. An ND program in Puerto Rico is seeking candidacy for accreditation to become the 9^th accredited program.  We also see progress in California with an expansion of the naturopathic physician’s scope of practice which now includes IV therapy.

Gaining licensure in more states is our most urgent need. The largest impediment to our growth is that only 4 states (Minnesota, Idaho, Kansas and North Dakota) have been licensed since California in 2003.  Our opposition is more organized. The closer a bill gets to passage the more back room lobbying occurs to hold bills. Our state legislative efforts must be better prepared, have excellent lobbyists, have stronger media coverage and have more positive testimony and lobbying from patients wanting naturopathic care.

We recognize the important contribution that testimony from conventional physicians familiar and supportive of naturopathic medicine and doctors has to counter the claims of our opposition.  Our legislative efforts need relevant evidence and scientific data demonstrating our history of safety and effectiveness.

Our 2013 plan will improve AANP’s support in all these areas so that the tools needed to grow our profession are available for our membership to leverage.

Bastyr University California Opens

By Michael Cronin, ND
AANP President

I had the pleasure of representing the AANP at the Bastyr University California celebration and grand opening on Friday, September 14.  It was a sunny day with over 400 guests, 51 very enthusiastic students and an equally inspired team of faculty, staff and administration.  The campus is located in the Scripps Ranch area of San Diego. The opening of this campus is the 8th in North America with 6 in the US and 2 in Canada.  The California campus occupies a two story building designed and built out for the needs of the college. Click here for a photo album.

The onset and timing of the Bastyr move to California was instigated by a recruitment effort by the California Naturopathic Doctors Association (CNDA) officers. The CNDA wanted an in-state college to support the continued growth and evolution of naturopathic medicine in California.

The 3 living founders of Bastyr, Shelia Quinn and Drs. Joe Pizzorno and Les Griffin, cut the ribbon to open the campus. Daniel K. Church, PhD, President of Bastyr, greeted the crowd with great enthusiasm. He acknowledged that the move was undertaken with an awareness of the risks and excitement about the opportunities that growth brings. Dr. Church described the appointment of an advisory board from area NDs, integrative MDs and interested public members. He described this campus as having the opportunity to partner with local institutions including Scripps Center for Integrative Medicine and the University of California at San Diego. Dr. Church was pleased to announce that the Washington campus has an incoming class of 105 students. 

Moira Fitzpatrick, PhD, ND, FICPP, CHT, was appointed vice president of the San Diego campus not long ago. Dr. Fitzpatrick was on the Bastyr Board of Trustees and was asked by Dr. Church, to lead the program. She described one focus of this new campus was to become active in evolving Naturopathic medicine in global health. Tabatha Parker, ND, of Naturopathic Doctors International, has been hired as faculty and to support the growth of naturopathic medicine in global health.

From a personal perspective, the opening evoked a strong sense of pride in our community and in our colleges. Bright, wholesome and inspired people are brought together by these institutions to affect real and lasting change in how we care for our fellow humans. It is an affirmation that this is a good thing we do.

P.S. During the celebration, news that SB 1446 passed was released. SB 1446 clarifies that nutritional IM and IV therapy is within the scope of practice for NDs. Congratulations to CNDA!

Honey Update 2012

Jacob Schor ND, FABNO
2013 Conference Speaker Selection Chair
denvernaturopathic.com

It has become something of a tradition at this time of year that, as we approach the Jewish New Year, I take a few moments to use PubMed, the search engine for the medical journals stored at the National Library of Medicine, to review new publications on honey.  It’s a bit of a distortion of the more traditional Jewish custom that we have of dipping apple slices in honey and wishing each other a “Happy New Year.”

This process has become more difficult each year as there has been a rapid increase in the research publications on the medicinal effects of honey. A quick search tells me that in the last 12 months, 592 medical journal articles have been published that contain the word honey. How can I expect to keep up?

Well it’s actually simple enough, PubMed allows me to place limitations on the search.  Thus if I limit my search to list only randomized, placebo controlled clinical trials using humans as subject, the number of citations drops to a manageable six papers. I delete several of the papers, one authored by a researcher by the name of “Honey” or that mention honey only in passing.  We are down to only three. Papers worthy of mention.

I can work with that:

Last November the journal Wound Repair and Regeneration published the results of a clinical trial by Betina Lund-Nielsen and colleagues from Copenhagen.  They compared two types of bandages for the treatment of malignant wounds in cancer patients, standard silver-coated bandages and honey-coated bandages.  Patients were randomly selected to either be treated with the honey coated or the silver-coated bandages.  Sixty-nine patients took part in the study.

On average the wounds of those using the honey bandages decreased in size by 15 cm² and the wounds of those using silver bandages decreased by 8 cm².

Patients in either group whose wounds reduced in size lived considerably longer, a median survival time of 387 days compared with 134 days in patients with no wound reduction. [1]

In February 2012 German researchers Biglari et al reported in the journal Spinal Cord on the effect of honey on chronic pressure ulcers.  This was a prospective observational study.  Twenty patients who had chronic spinal cord injuries and who had developed pressure ulcers were treated with Medi-Honey.  After 1 week of treatment all ulcers were void of bacterial growth. Overall 18 patients (90%) showed complete wound healing after a period of 4 weeks, and the resulting scars were soft and elastic. No negative effects were noted from the treatment using Medihoney. [2]

In April 2012 the journal Phytotherapy Research published a report by the opthamologist M Cernak and colleagues from the Slovak Medical University in Antolska, Slovakia.

Endophthalmitis is a rare but serious complication of eye surgery. Typically topical fluoroquinolones are used before and after surgery to prevent these infections. The problem is that many bacteria are becoming resistant to antibiotics, even to these heavy duty ones.  This study compared a solution that was one-quarter honey and three quarters water against a standard antibiotic.  In this study 101 patients were randomized to use either honey (n = 49) or ofloxacin (n = 52) treatment. In both groups, eye drops were administered five times a day for a week before and 5 days after eye surgery. After surgery and treatment, no significant difference in antibacterial effect was found between groups. In other words, the honey worked as well as the antibiotics.  [3] 

Best wishes for a sweet New Year to all of you.

Some of our past yearly ‘Honey Updates’ are worth reading as they contain recipes that you might find interesting.

The first one, well that is still preserved on our website, from 2005 has a nice recipe for baklava made with honey and nuts: http://denvernaturopathic.com/news/honeybaklava.html

Other past honey newsletters:

2006: http://denvernaturopathic.com/news/honeyupdate06.html

2007: This newsletter contains Rena’s Honey Cake recipe: http://denvernaturopathic.com/2007HoneyUpdate.htm

2008:  lost track of that one

2009: http://denvernaturopathic.com/HoneyUpdate2009.html

2010:  so much for consistency

2011: http://denvernaturopathic.com/HoneyReview2011.htm

References:

[1] The effect of honey-coated bandages compared with silver-coated bandages on treatment of malignant wounds-a randomized study.

Lund-Nielsen B, Adamsen L, Kolmos HJ, Rørth M, Tolver A, Gottrup F.

Wound Repair Regen. 2011 Nov;19(6):664-70. doi: 10.1111/j.1524-475X.2011.00735.x. PMID: 22092836

[2] Use of Medihoney as a non-surgical therapy for chronic pressure ulcers in patients with spinal cord injury.

Biglari B, vd Linden PH, Simon A, Aytac S, Gerner HJ, Moghaddam A.

Spinal Cord. 2012 Feb;50(2):165-9. doi: 10.1038/sc.2011.87. PMID: 21931331

[3] Honey prophylaxis reduces the risk of endophthalmitis during perioperative period of eye surgery.

Cernak M, Majtanova N, Cernak A, Majtan J.

Phytother Res. 2012 Apr;26(4):613-6. doi: 10.1002/ptr.3606.

PMID: 22508360 

Why I Hate AANP Conferences

By Jacob Schor, ND, FABNO
2013 AANP Conference Speaker Selection Committee Chair

It’s such a relief that the AANP conference is over. I can finally stop pretending that I was looking forward to it. Or enjoying it!

Nothing personal. I enjoyed seeing many of you there in person, but honestly who among us would choose to spend a week hermetically sealed in an air conditioned hotel sitting in windowless lecture rooms? Are our schools graduating a new kind of naturopathic physician? Ones that like fancy hotels and that don’t need nature? If you take nature out of naturopathy, you don’t have much left.

I return home from AANP conferences dreading the arrival of our credit card bill; we spend more on a conference than we would ever consider for a vacation.

Why do we do these conferences? Because the MDs do, isn’t a good enough excuse. Because the AANP makes money off them? Well I’m not yet sure that the AANP breaks even. Because we need continuing education? That’s a joke these days as we can find all the CE we need online.

Most of the year my weekdays are spent sitting indoors at a desk with a changing array of patients sitting with me. The last thing I want to do when I take off time from work is sit somewhere else.

Why am I again chairing the conference speaker committee? It’s because like everyone in our profession I believe that the future can be better than the present—especially when it comes to our conferences. I think we can recreate our conferences and turn them into a different experience, an experience that is more congruent with whom we are both as people and a profession.

Next year is OUR chance to do it differently. As many of you already know, the conference is going to be held in Keystone Colorado in July, a week after the Fourth of July. This is a beautiful time of year to be in the Colorado Mountains. The wildflowers should be in bloom, most of the snow melted, and the mountain meadows moist and lush.

This is a location that you should be happy to visit, glad to come early to and stay on after the conference is over. In fact we are hoping to create excuses so that you do exactly that. We want you to bring your families. We want to meet those children of yours in person, not just look at their photos on your computer in the back of lecture rooms. In fact, I plan to bring my dog. We want to merge recreation with education and have you leave the conference rejuvenated. We have ambitious plans but can’t make them happen without all of you. We need your help.

This year’s Call for Abstracts is out. We need your creative ideas of things you can do, things you can teach, things that will further your colleagues’ knowledge and their ability to help patients. Submit these ideas as abstracts. Our good AANP president, Michael Cronin, has told me it is time we left behind the long marathon lectures of the past. He is eager to hear submissions that are shorter, particularly 30-minute lectures. Think short, sweet and if possible outdoors. Also think about long and slow lectures, the kind that you can stretch over an hour or two-hour hike. Maybe what you want to teach will only work with a small group of people. We will consider it! Perhaps you may get to repeat it a few times. Leave behind the old formats. We don’t have to repeat what was done in the past.

I may not be a big fan of our current conferences but I think we can make them a whole lot better. Let’s make this happen.