An Open Letter to Naturopathic Doctors
By James Maskell
Dear Naturopathic Doctor,
When Benedict Lust was first laying out the principles of Naturopathic Medicine one hundred years ago, I’m sure he would be thrilled to see the landscape of today. Detoxification has breached into the mainstream, state licensure has momentum (even if New York remains hopelessly regressive), tens of thousands of doctors have been trained in a lifestyle-first, root-cause approach and, dare I say it, being healthy is becoming “cool.”
There is a new movement brewing that I think has the potential to thrust Naturopathic principles into the previously hardest-to-reach parts of medicine. Our allopathic hospitals, specialty medical groups and even Flexner-inspired health systems are starting to visualize a new way to overcome the truly epic foe of lifestyle-driven chronic illness.
The only reason they have to move in this direction is the scale of the problem facing us. Pick your poison:
- 86% of healthcare cost for chronic diseases
- Millennials’ health far worse than previous generations
- Health spending to reach $47 trillion
On the front lines, Naturopathic Doctors are quietly and effectively making an impact one by one, but it’s clear current efforts are not sufficient to solve the problem. What if there was a more scalable solution based on the same principles?
The incredible news is: There is, and group medical visits are quickly emerging as a scalable, profitable and transformational solution to lifestyle-driven chronic disease that can reach even the most vulnerable members of society.
In some ways, this is a returning to tradition; many early NDs practiced in sanatoriums in a group format. Patients would come to learn how to eat, sleep, decrease stress, take mud baths and do hydrotherapy.
Whether it’s “integrative group visits” empowering the poorest areas of Massachusetts under the stewardship of Dr. Jeffrey Geller, or “Functioning for Life” at the Cleveland Clinic or even TribeRx for Chronic Pain from your very own Dr. Robert Kachko, the momentum is undeniable.
All these groups are completely in alignment with the principles of Naturopathic Medicine:
1. First Do No Harm
Sitting in a circle is the least-costly, least-invasive invention out there and a perfect foundation for the naturopathic therapeutic order.
2. Healing Power of Nature
Groups that take advantage of MBSR, mediation and group acupuncture activate inner healing mechanisms at almost zero cost. You went to school to reconnect with nature and help others do the same. Now, you are held hostage by your desk and your EHR.
3. Identify and Treat the Cause
Loneliness is a bigger driver of all-cause mortality than smoking, nutrition, exercise or alcohol and this modality uniquely solves for loneliness, introducing people who want to get healthy to each other. Group medical visits are a timely treatment for diseases with biopsychosocial causes.
4. Doctor as Teacher
This model allows for the most efficient teaching structure for in person care and is a core benefit of the group model. Many doctors have chosen this model because it allows space and time to teach. Beyond efficiency, the group creates a way patients can learn from each other, which often lands better than doctor to patient.
5. Treat the Whole Person
If Lust were alive today, he would see not only humans as whole people, but people in context of their community. Truly whole-person healing.
Groups are the perfect structure for activating the foundations of healthy behaviors, from stress reduction to healthy sleep, nutrition and exercise. The accountability and vulnerability of peer groups is unreachable with one-on-one care. As we move from prevention thinking to resilience, this is an ideal structure.
I have been entrenched in this world for the last 15 years; I’ve met hundreds of NDs, taught at AANP, SCNM and UB, and helped dozens of NDs evolve their practices to direct primary care, packages and modern models of payment.
I know many of you feel the profession is divided. Some embrace the success of functional medicine, some find it an affront to the profession you know and love. Some want to be primary care practitioners, some prefer to be chronic disease reversal specialists. Some want to prescribe medication, others want to get patients off all medication. Some vaccinate. Some don’t.
Could this finally be a catalyst for unification?
The emerging data and clinical success of group visits when infused with lifestyle principles and delivered in a series that solves loneliness is strong enough to create a sea change in medicine. The fact that it makes what was previously slow, inefficient and hard to scale now scalable, profitable and truly effective for facilitating behavior change forms the backbone of my assertion. The phone calls I am taking from health systems ready to activate these groups back those feelings up.
There is one simple truth I need to share:
The Naturopathic Revolution is Upon Us.
But it’s not going to be called Naturopathic Medicine.
It could never be, you don’t let other people use your word. There’s not enough of you.
The title doesn’t matter. But the principles do and they are arriving fast. The momentum is unstoppable.
The current state of play is that you, the ND, live with the pressure of a system that makes the doctor responsible for the outcomes. The group format creates community and fosters self-responsibility, creating far more touch points for people to solve their problems together. More than an expert, they need to see a peer having success. Are we robbing them of this opportunity by treating solely alone?
As Lust predicted, every chronic condition humans experience is being reversed and improved by these groups visits, from autoimmune disease to cardiology, trauma to pre-term births.
I see an opportunity for NDs to lead this next era, overseeing dieticians, health coaches and peer focused groups with the skill set, education and mindset to steward this next era. This opportunity resides in private practice and in health systems. Taking insurance and for cash.
My question is: Are you ready to come together and lead?
My next book The Community Cure : Transforming Health Outcomes Together comes out January 14th and will be available for free for 5 days on Amazon. Learn more about our 5-Day Group Visit Challenge, starting Monday, December 9th, and register for the challenge here.