Our vision for the millennium : a thriving homeopathic profession
- Judyth reichenberg-ullman, nd, dhanp and robert ullman, nd, dhanp
The climate for alternative medicine in the United States is more favorable now than ever before, at least since the late 1800's when homeopathy had its heyday. There is a growing demand for alternative health care practitioners that is becoming recognized by health care plans and HMO's. We have been practicing as naturopathic physicians specializing in homeopathy for 15 years, and studying homeopathy for 20 years. We've been very involved in homeopathic politics for about 10 years. Add to this the fact that Judyth just turned 50 and faced the challenge of breast cancer. Most recently, the IFH, with which we have been very closely involved for eight years, is in the process of dissolving. All of these factors have inspired us to think a lot about where homeopathy in America has come and where we are going.
As most of you are well aware, homeopathy thrived in the mid- 1800's until around 1910, the time of the Flexner Report. The decline and near demise of homeopathy in this country resulted in part from the Flexner Report, opposition from allopathic physicians, and the proliferation of pharmaceuticals. At least as important, however, were deteriorating and inconsistent standards in homeopathic training as well as infighting among the homeopaths themselves. We hope that we can learn from the mistakes of our well-meaning predecessors.
This is a time of great possibility for the homeopathic community. Homeopathy has the opportunity to spread dramatically over the next 50 years and to assume the place that it deserves in the arena of American health care. We believe that a number of things need to happen for this to occur. Our intention, in this article, is to point out the areas on which most homeopaths agree, and then to propose questions for the community to tackle. We invite the homeopathic community as a whole to bring forth the greatest possibilities for this wonderful method of healing to live long and prosper.
The Current Status of Homeopathy as We Perceive It Homeopathy is on a positive growth curve as far as the number of practitioners, individuals benefiting from homeopathy, homeopathic pharmaceutical sales, and media coverage. The level of homeopathic training, overall, has improved dramatically. This is true not only of some of the formal homeopathic training programs, but also of the advanced seminars, often with teachers from outside the United States. In our experience teaching students in the IFH Professional Course, we have marveled at how much the students knew after just a year or two of intensive extended weekends, compared to what we learned about homeopathy in our naturopathic medical schools. However, the training is inconsistent. NANHE, the accreditation body for homeopathic education, is making commendable efforts to set high standards for homeopathic training. The more homeopathy becomes popular and in demand, the more schools, of varying levels and standards, will inevitably arise.
A multiplicity of professions are represented by homeopaths today, some with medical training and some without. In fact, the very definition of homeopathy is up for debate.
A multiplicity of professions are represented by homeopaths today, some with medical training and some without. In fact, the very definition of homeopathy is up for debate. Some say it is medicine, others disagree and say that it is not. Licensed practitioners may feel that the practice of homeopathy necessitates the ability to diagnose and treat. Some unlicensed practitioners respond that they would not choose to have a medical license even if they could, and that they would prefer to leave the diagnosis to those licensed to do so and just do homeopathy. The legality of practice for homeopaths is also variable. Licensed practitioners may or may not have homeopathy included in their scope of practice. This may vary from state to state, as was tested in court in North Carolina in the case of George Guess, M.D. Legal challenges have also been mounted in the past year to two unlicensed practitioners, one of whom was practicing in Connecticut, a state where both homeopathy and naturopathic medicine are licensed.
A rather fierce debate continues about where we as a community should put our efforts to train homeopaths. There are licensed medical professionals who believe they are the only ones who should practice homeopathy. Some members of our community argue that we must expend our efforts to train those who already hold medical licenses, for example, medical doctors and nurse practitioners. Others feel that the future of homeopathy lies in creating some type of certification for unlicensed practitioners which would allow them to practice within the law, but not as medical practitioners. Still others believe in a two- or multi-tiered system of homeopaths, with differing amounts and types of training.
The organizations representing the various groups of homeopaths find themselves in agreement on a few issues and in disagreement on many, as was evident at a joint meeting in January, 1998 in Washington, D.C. Although we could agree that more well-trained homeopaths were needed and on the goal of some form of cooperation, we agreed to disagree on most issues. The astute suggestion was made that we need to take the case of the homeopathic community, as we do with our patients, in order for healing to occur. What was clear was that homeopaths are a diverse group of independent thinkers with a strong dedication to their beliefs, and that individual and group needs still take priority over the needs of the community as a whole.
On the positive side, homeopathic training in this country is varied, accessible, and often quite advanced. On the other hand, standards are inconsistent, practitioners spend large amounts of money on courses which still may not give them the ability to practice legally, and very little clinical training or supervision is available.
...Homeopathic training in this country is varied, accessible, and often quite advanced. On the other hand, standards are inconsistent, practitioners spend large amounts of money on courses which still may not give them the ability to practice legally, and very little clinical training or supervision is available.
The acceptance of homeopathy among the mainstream health care community and the public is growing, but slowly. We have considerable contact and exposure with conventional medicine. Our experience has been that most medical practitioners are unwilling to embrace homeopathy based on current research, and that patients generally seek out homeopathic care despite the opinions of their physicians. We, ourselves, participate in a statewide health maintenance organization in which we are specialists. Patients can only see us upon referral from their primary care practitioner. Although our patients usually can convince their physicians to refer to us, the idea comes from the patients and rarely the referring physicians.
There is considerable financial disparity among individual practitioners as well as organizations. Perhaps this is natural-survival of the fittest, so to speak. However some of the organizations that have been very supportive of homeopathy are suffering. The IFH is on the verge of dissolving and the HCC (Homeopathic Community Council) lacks sufficient funds to make adequate grants. Either the work of these organizations is no longer needed by the community or we have not found the optimal way to tap into the resources of the homeopathic and greater community. Even the homeopathic pharmacies have had to tighten their belts, despite a tremendous rise in sales over the past few years. Many individual homeopaths find it difficult to sustain a practice viable enough to support themselves and their families and to finance continuing homeopathic education.
Lastly, although public understanding of homeopathy is on the rise, there is considerable confusion about just what homeopathy is and is not. The average American may know that homeopathy is a kind of alternative medicine but can probably not differentiate it from herbs, nutrition, or other modalities. This dilemma is exacerbated by the fact that it takes time to explain homeopathy. While it may take five minutes or less for someone to grasp acupuncture, it can take half an hour to even begin to explain the philosophy, much less the subtleties, of homeopathy. Having been interviewed on many talk radio shows, we appreciate the difficulty of conveying even a rudimentary idea of homeopathy in a short period of time.
A Recent Historical Comparison with Naturopathic Medicine
We recently had the good fortune to attend the national conference of the American Association of Naturopathic Physicians (AANP) in Portland. Attended by approximately 500 physicians and students, we found it quite inspiring and, in many ways, it provided a model that the homeopathic community might wish to emulate. Since the National College of Naturopathic Medicine began on a very small scale in 1956, and especially since Bastyr University began in 1978, naturopathic medicine has grown phenomenally. Over the past twenty years, the profession has developed a strong, well-represented national organization, despite significant challenges from opponents. Naturopathic medicine is currently licensed in about ten states and there will be legislation introduced in 1999 for licensure in Idaho, Massachusetts, Rhode Island, California, and Texas.
Naturopathic physicians are well-represented on the Internet, are achieving a national media presence thanks to a rapid media response team, have an effective political action network, and are authoring and contributing to a remarkable number of books in the field of natural medicine. Many health care provider groups and HMO's are contacting the AANP to recruit providers. Hospitals and conventional doctors are seeking out opportunities to co-manage cases with naturopaths. Major corporations are brainstorming with Bastyr concerning wellness programs for their employees. Bastyr has received tremendous media attention for their AIDS grant from the National Institutes of Health.
Naturopathic education is also mushrooming. There have been two new schools established in the past eight years: the Southwest College in Phoenix and, this year, a school at the University of Bridgeport in Connecticut. Enrollment in the naturopathic schools is growing so quickly that extra classrooms have been established. As of next year, the number of naturopathic graduates in this country will actually double.
Despite this growth, homeopathy has achieved relatively little recognition among naturopathic physicians. The Homeopathic Academy of Naturopathic Physicians has granted board certification (DHANP) to under 50 physicians. At the convention in Portland, distinguished by five days of very impressive presentations, one entire day was devoted to the treatment of cancer and another to mental illness. There was only one presentation on homeopathy, a talk by Judyth on the homeopathic treatment of schizophrenia, given to a room full of curious and interested doctors and students.
As we listened carefully to the impressive accomplishments of the naturopathic physicians over the past twenty years, we were filled with respect for those who have worked so hard and with a renewed loyalty and dedication to our naturopathic colleagues. But the question kept resounding in our minds: where has the homeopathic community come in the same twenty years, and by 2018, where will we have come?
What Can We Agree Upon?
We wish to suggest some goals for the homeopathic community that we believe many homeopaths can agree upon:
• Well-trained practitioners of classical homeopathy throughout the United States.
• Skilled and experienced teachers of homeopathy from the U.S. and abroad.
• High-level homeopathic training programs spread throughout the country.
• Accessible, affordable, high quality clinical supervision.
• The ability for trained homeopaths to practice legally.
• Widespread public education and media coverage.
• Some type of standardization of training, practice, and ethics.
• Financial prosperity for homeopathic practitioners, organizations, pharmacies, instructors, and programs.
• Cooperation among homeopathic practitioners.
• The establishment of an inclusive homeopathic profession. (Although this goal is dear to our hearts, we acknowledge that it is not universally supported.)
Questions for the Homeopathic Community to Address
1. Is homeopathy medicine?
2. Is non-classical homeopathy included in the definition of homeopathy?
3. Is it important that all homeopaths practice legally?
4. Do we need a stand-alone homeopathic profession? If so, is licensure a goal worth pursuing?
5. Do we need accredited degree programs in homeopathy? If so, what would be the most desirable degree?
6. What is the best way to establish clinical training, supervision, and peer support?
7. Should homeopathy continue to be an alternative modality or do we want to see homeopathy go mainstream?
8. Is third party reimbursement important or even desirable for homeopaths?
9. Is there a need for homeopaths, licensed or not, to join together in some form of cooperative effort?
10. Do we need one organization or trade association that represents the needs of all homeopaths?
11. How should homeopathic standards of education be determined?
12. Should homeopaths be subject to ethical standards? If so, how should they be enforced?
13. How do we best support homeopathic vendors (pharmacies, publishers, etc.) and organizations?
14. What is the most effective way to educate the public about homeopathy?
15. What is our shared vision for homeopathy 10, 20, 50, and 100 years for now?
What will it take for all of us to work together as a team? Hopefully not a crisis that threatens our ability to practice the healing art that we cherish.
The Future of Homeopathy is in Our Hands Our love and dedication to homeopathy is a binding force that, we hope, can surmount any differences that may exist. How can we join together to pass on the homeopathic legacy of Hahnemann and of past and present masters in the most thoughtful and effective way possible? What will it take for all of us to work together as a team? Hopefully not a crisis that threatens our ability to practice the healing art that we cherish. The future is in our hands, as well as in the hands of those that follow us. How will we co-create a vibrant and flourishing path for the generations of homeopaths to follow?
Judyth Reichenberg-Ullman, ND, DHANP and Robert Ullman, ND, DHANP feel very fortunate to being doing what they love: helping others with homeopathy, teaching, and writing about their experiences. Co-authors of Ritalin-Free Kids, The Patient's Guide to Homeopathic Medicine, Homeopathic Self-Care, and Prozac-Free, they practice at The Northwest Center for Homeopathic Medicine in Edmonds, WA. The past year has brought Judyth in Bob much more in touch with the need to enhance their vital forces by embracing life beyond homeopathy.
The climate for alternative medicine in the United States is more favorable now than ever before, at least since the late 1800's when homeopathy had its heyday. There is a growing demand for alternative health care practitioners that is becoming recognized by health care plans and HMO's. We have been practicing as naturopathic physicians specializing in homeopathy for 15 years, and studying homeopathy for 20 years. We've been very involved in homeopathic politics for about 10 years. Add to this the fact that Judyth just turned 50 and faced the challenge of breast cancer. Most recently, the IFH, with which we have been very closely involved for eight years, is in the process of dissolving. All of these factors have inspired us to think a lot about where homeopathy in America has come and where we are going.
This is a time of great possibility for the homeopathic community. Homeopathy has the opportunity to spread dramatically over the next 50 years and to assume the place that it deserves in the arena of American health care. We believe that a number of things need to happen for this to occur. Our intention, in this article, is to point out the areas on which most homeopaths agree, and then to propose questions for the community to tackle. We invite the homeopathic community as a whole to bring forth the greatest possibilities for this wonderful method of healing to live long and prosper.
The Current Status of Homeopathy as We Perceive It Homeopathy is on a positive growth curve as far as the number of practitioners, individuals benefiting from homeopathy, homeopathic pharmaceutical sales, and media coverage. The level of homeopathic training, overall, has improved dramatically. This is true not only of some of the formal homeopathic training programs, but also of the advanced seminars, often with teachers from outside the United States. In our experience teaching students in the IFH Professional Course, we have marveled at how much the students knew after just a year or two of intensive extended weekends, compared to what we learned about homeopathy in our naturopathic medical schools. However, the training is inconsistent. NANHE, the accreditation body for homeopathic education, is making commendable efforts to set high standards for homeopathic training. The more homeopathy becomes popular and in demand, the more schools, of varying levels and standards, will inevitably arise.
A multiplicity of professions are represented by homeopaths today, some with medical training and some without. In fact, the very definition of homeopathy is up for debate.
A multiplicity of professions are represented by homeopaths today, some with medical training and some without. In fact, the very definition of homeopathy is up for debate. Some say it is medicine, others disagree and say that it is not. Licensed practitioners may feel that the practice of homeopathy necessitates the ability to diagnose and treat. Some unlicensed practitioners respond that they would not choose to have a medical license even if they could, and that they would prefer to leave the diagnosis to those licensed to do so and just do homeopathy. The legality of practice for homeopaths is also variable. Licensed practitioners may or may not have homeopathy included in their scope of practice. This may vary from state to state, as was tested in court in North Carolina in the case of George Guess, M.D. Legal challenges have also been mounted in the past year to two unlicensed practitioners, one of whom was practicing in Connecticut, a state where both homeopathy and naturopathic medicine are licensed.
A rather fierce debate continues about where we as a community should put our efforts to train homeopaths. There are licensed medical professionals who believe they are the only ones who should practice homeopathy. Some members of our community argue that we must expend our efforts to train those who already hold medical licenses, for example, medical doctors and nurse practitioners. Others feel that the future of homeopathy lies in creating some type of certification for unlicensed practitioners which would allow them to practice within the law, but not as medical practitioners. Still others believe in a two- or multi-tiered system of homeopaths, with differing amounts and types of training.
The organizations representing the various groups of homeopaths find themselves in agreement on a few issues and in disagreement on many, as was evident at a joint meeting in January, 1998 in Washington, D.C. Although we could agree that more well-trained homeopaths were needed and on the goal of some form of cooperation, we agreed to disagree on most issues. The astute suggestion was made that we need to take the case of the homeopathic community, as we do with our patients, in order for healing to occur. What was clear was that homeopaths are a diverse group of independent thinkers with a strong dedication to their beliefs, and that individual and group needs still take priority over the needs of the community as a whole.
On the positive side, homeopathic training in this country is varied, accessible, and often quite advanced. On the other hand, standards are inconsistent, practitioners spend large amounts of money on courses which still may not give them the ability to practice legally, and very little clinical training or supervision is available.
...Homeopathic training in this country is varied, accessible, and often quite advanced. On the other hand, standards are inconsistent, practitioners spend large amounts of money on courses which still may not give them the ability to practice legally, and very little clinical training or supervision is available.
The acceptance of homeopathy among the mainstream health care community and the public is growing, but slowly. We have considerable contact and exposure with conventional medicine. Our experience has been that most medical practitioners are unwilling to embrace homeopathy based on current research, and that patients generally seek out homeopathic care despite the opinions of their physicians. We, ourselves, participate in a statewide health maintenance organization in which we are specialists. Patients can only see us upon referral from their primary care practitioner. Although our patients usually can convince their physicians to refer to us, the idea comes from the patients and rarely the referring physicians.
There is considerable financial disparity among individual practitioners as well as organizations. Perhaps this is natural-survival of the fittest, so to speak. However some of the organizations that have been very supportive of homeopathy are suffering. The IFH is on the verge of dissolving and the HCC (Homeopathic Community Council) lacks sufficient funds to make adequate grants. Either the work of these organizations is no longer needed by the community or we have not found the optimal way to tap into the resources of the homeopathic and greater community. Even the homeopathic pharmacies have had to tighten their belts, despite a tremendous rise in sales over the past few years. Many individual homeopaths find it difficult to sustain a practice viable enough to support themselves and their families and to finance continuing homeopathic education.
Lastly, although public understanding of homeopathy is on the rise, there is considerable confusion about just what homeopathy is and is not. The average American may know that homeopathy is a kind of alternative medicine but can probably not differentiate it from herbs, nutrition, or other modalities. This dilemma is exacerbated by the fact that it takes time to explain homeopathy. While it may take five minutes or less for someone to grasp acupuncture, it can take half an hour to even begin to explain the philosophy, much less the subtleties, of homeopathy. Having been interviewed on many talk radio shows, we appreciate the difficulty of conveying even a rudimentary idea of homeopathy in a short period of time.
A Recent Historical Comparison with Naturopathic Medicine
We recently had the good fortune to attend the national conference of the American Association of Naturopathic Physicians (AANP) in Portland. Attended by approximately 500 physicians and students, we found it quite inspiring and, in many ways, it provided a model that the homeopathic community might wish to emulate. Since the National College of Naturopathic Medicine began on a very small scale in 1956, and especially since Bastyr University began in 1978, naturopathic medicine has grown phenomenally. Over the past twenty years, the profession has developed a strong, well-represented national organization, despite significant challenges from opponents. Naturopathic medicine is currently licensed in about ten states and there will be legislation introduced in 1999 for licensure in Idaho, Massachusetts, Rhode Island, California, and Texas.
Naturopathic physicians are well-represented on the Internet, are achieving a national media presence thanks to a rapid media response team, have an effective political action network, and are authoring and contributing to a remarkable number of books in the field of natural medicine. Many health care provider groups and HMO's are contacting the AANP to recruit providers. Hospitals and conventional doctors are seeking out opportunities to co-manage cases with naturopaths. Major corporations are brainstorming with Bastyr concerning wellness programs for their employees. Bastyr has received tremendous media attention for their AIDS grant from the National Institutes of Health.
Naturopathic education is also mushrooming. There have been two new schools established in the past eight years: the Southwest College in Phoenix and, this year, a school at the University of Bridgeport in Connecticut. Enrollment in the naturopathic schools is growing so quickly that extra classrooms have been established. As of next year, the number of naturopathic graduates in this country will actually double.
Despite this growth, homeopathy has achieved relatively little recognition among naturopathic physicians. The Homeopathic Academy of Naturopathic Physicians has granted board certification (DHANP) to under 50 physicians. At the convention in Portland, distinguished by five days of very impressive presentations, one entire day was devoted to the treatment of cancer and another to mental illness. There was only one presentation on homeopathy, a talk by Judyth on the homeopathic treatment of schizophrenia, given to a room full of curious and interested doctors and students.
As we listened carefully to the impressive accomplishments of the naturopathic physicians over the past twenty years, we were filled with respect for those who have worked so hard and with a renewed loyalty and dedication to our naturopathic colleagues. But the question kept resounding in our minds: where has the homeopathic community come in the same twenty years, and by 2018, where will we have come?
What Can We Agree Upon?
We wish to suggest some goals for the homeopathic community that we believe many homeopaths can agree upon:
• Well-trained practitioners of classical homeopathy throughout the United States.
• Skilled and experienced teachers of homeopathy from the U.S. and abroad.
• High-level homeopathic training programs spread throughout the country.
• Accessible, affordable, high quality clinical supervision.
• The ability for trained homeopaths to practice legally.
• Widespread public education and media coverage.
• Some type of standardization of training, practice, and ethics.
• Financial prosperity for homeopathic practitioners, organizations, pharmacies, instructors, and programs.
• Cooperation among homeopathic practitioners.
• The establishment of an inclusive homeopathic profession. (Although this goal is dear to our hearts, we acknowledge that it is not universally supported.)
Questions for the Homeopathic Community to Address
1. Is homeopathy medicine?
2. Is non-classical homeopathy included in the definition of homeopathy?
3. Is it important that all homeopaths practice legally?
4. Do we need a stand-alone homeopathic profession? If so, is licensure a goal worth pursuing?
5. Do we need accredited degree programs in homeopathy? If so, what would be the most desirable degree?
6. What is the best way to establish clinical training, supervision, and peer support?
7. Should homeopathy continue to be an alternative modality or do we want to see homeopathy go mainstream?
8. Is third party reimbursement important or even desirable for homeopaths?
9. Is there a need for homeopaths, licensed or not, to join together in some form of cooperative effort?
10. Do we need one organization or trade association that represents the needs of all homeopaths?
11. How should homeopathic standards of education be determined?
12. Should homeopaths be subject to ethical standards? If so, how should they be enforced?
13. How do we best support homeopathic vendors (pharmacies, publishers, etc.) and organizations?
14. What is the most effective way to educate the public about homeopathy?
15. What is our shared vision for homeopathy 10, 20, 50, and 100 years for now?
What will it take for all of us to work together as a team? Hopefully not a crisis that threatens our ability to practice the healing art that we cherish.
The Future of Homeopathy is in Our Hands Our love and dedication to homeopathy is a binding force that, we hope, can surmount any differences that may exist. How can we join together to pass on the homeopathic legacy of Hahnemann and of past and present masters in the most thoughtful and effective way possible? What will it take for all of us to work together as a team? Hopefully not a crisis that threatens our ability to practice the healing art that we cherish. The future is in our hands, as well as in the hands of those that follow us. How will we co-create a vibrant and flourishing path for the generations of homeopaths to follow?
Judyth Reichenberg-Ullman, ND, DHANP and Robert Ullman, ND, DHANP feel very fortunate to being doing what they love: helping others with homeopathy, teaching, and writing about their experiences. Co-authors of Ritalin-Free Kids, The Patient's Guide to Homeopathic Medicine, Homeopathic Self-Care, and Prozac-Free, they practice at The Northwest Center for Homeopathic Medicine in Edmonds, WA. The past year has brought Judyth in Bob much more in touch with the need to enhance their vital forces by embracing life beyond homeopathy.
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