Lise Alschuler, ND, FABNO draws similarities between the integrative healthcare community and hyperthyroidism.

by Lise Alschuler, ND, FABNO

As the Inauguration of President-Elect Barack Obama approaches, the complementary and integrative healthcare community seems to have entered into a universal state of hyperthyroidism.  Consider the symptoms of hyperthyroidism in an individual:  nervousness, irritability, palpitations, rapid heart rate, increased sweating, tremor, shortness of breath with exertion, sleep disturbances and changes in vision. 

Leaning towards a metaphorical description of these symptoms, could we not be describing the very state of our integrative healthcare community as we approach the new presidency?  There is a hunger, bordering on lustful need, for radical transformation of our healthcare system.  Integrative practitioners across the country are in a feverish pitch of agitation, excitement, and anxiety in our effort to help shape healthcare in our country.  Some of us are even losing sleep over this as we summarize healthcare reform submissions from community groups around the country to the Daschle healthcare team, or send in our resumes for positions in the federal administration, or set up community groups, or engage in support of healthcare reform legislation. 

Our change in vision for what is possible for healthcare in this country has created a collective, almost desperate, sense of anticipation. The feverish pitch of hope, need and enthusiasm for the new administration and the implications for healthcare extends far beyond the borders of this country.  In the same way that hyperthyroidism alters basal metabolism, the combined ground swell of determined hope has, I believe, altered our very metabolism for change. 

Hyperthyroidism can be proceeded by a hypothyroid state, in which basal metabolism is sluggish.  In many ways, this describes the state of the integrative healthcare community over the past several years.  The integrative healthcare community has, over the past 8 years, created some new legislative and policy initiatives and experienced bursts of new collaborations. Overall, however, I would assert that our underlying state has been one of complacency, perhaps even of defeat.  The broad sweeping and well-thought out recommendations from the White House Commission on CAM that was completed under Clinton was left half implemented.  Political strife and insufficient funding to NIH NCCAM alienated and disenfranchised the majority of integrative healthcare practitioners.  At the same time, the last many years has witnessed a distinct increase in direct anti-CAM policies by the AMA, such as its Standard of Practices Policies document, its support for state legislative initiatives restricting medicine to licensed medical doctors, as well as its funding for defeating legislative initiatives for naturopathic physicians, psychologists and nurse practitioners seeking licensure and scope to practice primary care.  All of this characterized a period, which could be compared to a hypothyroid-like state of lethargy for the integrative movement as a whole.  

Nonetheless, as is the case in the human body, within a state of hypothyroidism lay the seeds for the opposite state.  Some individuals with autoimmune hypothyroidism can convert, or intersperse hyperthyroid states into their overall presentation.  Interesting, the underlying mechanism of auto-antibodies is the same, but the targets change. So too, are we, as a collective body of integrative practitioners, now changing from a hypothyroid way of being to a hyperthyroid state.  For our community, the auto-antibodies are, and have been, essentially of two types:  the demands of our patients and the costs of our healthcare.  Up to now, antibodies have attacked the master gland of healthcare rendering it incapable of meeting the needs of its greater body.  The resultant deficit of health, chaotic and dysfunctional delivery of healthcare, and the neglect of too many in need is obvious. 

Now, however, with the promises of thoughtful healthcare reform from the incoming administration, these same antibodies are attacking different targets within our healthcare body and beginning to stimulate different results.  The beginnings of a hyperthyroid state, if not storm, are coalescing.  The impatience for coordinated change that is sustainable, relevant and integrative has reached feverish pitch.  Our hearts have begun to beat faster in unison as we call upon our incoming administration to expand the focus of healthcare to prevention, integrated treatment and health promotion. I believe that this is exactly where we, as the integrative community, need to be right now.  At the same time, as we know, untreated hyperthyroidism can lead to tachycardia, electrolyte disturbances, swelling and even death.  To avert this catastrophic end, medications are required – often helped, incidentally with complementary treatments such as acupuncture, herbal and nutritional strategies, and behavioral and psychological interventions.

Fortunately, medicine exists for managing our collective state of hyperthyroidism around healthcare reform.  Placement of qualified integrative healthcare providers in decision-making positions in the healthcare administration is one effective medicine.  Development and implementation of healthcare reform that moves into healthcare transformation, inclusive of federal initiatives that increase access to, coordination with, and research for integrative healthcare practices, is curative.  The only necessary pre-condition to this treatment is the collective and unified willingness on the part of the integrated healthcare community to participate in the conversation and support the effort.


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