How to Cure the Sick Health Care System: An Open Letter to President Trump from Leaders in Functional/Integrative/Natural Health and Medicine

Joseph Pizzorno, ND, Editor in Chief

President Trump:

One of the biggest and most important challenges you face is our failing health care system. Although the United States spends far more per capita on health care than the next closest country spends, our outcomes are dismal. Virtually every measure shows that Americans suffer poorer health and more chronic disease than those in most other advanced countries.

Unfortunately, almost all the health care reform initiatives being discussed are merely rearranging the chairs on the Titanic: arguing about who pays, who has control, and how to subtly ration. The problem is not how we make health care available. Rather, the problem is the health care being provided.

The key reasons for this growing crisis are as follows:

1. We have a disease management and symptom relief system, not a health care system.

2. We treat end-stage disease rather than the health of each unique individual.

3. Virtually all the passive determinants of health— nutrition, toxicity, and social—now promote disease.

4. Government, at all levels, has supported competition-preventing regulations and crony capitalism.

The solution to the ailing disease management system is to address the real causes of disease. We have several recommendations to accomplish this:

1. A broader definition of public health that includes such critical concepts as helping and supporting farmers to grow foods with higher nutrient density and working with industry to decrease the   presence of disease-inducing metal and chemical toxins in the air, water, food, packaging materials, health and beauty aids, home and yard chemicals, etc.

2. Primary care that addresses the true causes of disease rather than simply short-term relief of symptoms.

3. Personalized health promotion rather than generic care for disease.

4. A reimbursement and regulatory system that prioritizes health promotion and disease prevention rather than expensive drugs and procedures.

5. Creation of a presidential commission— composed of change agents rather than vested interests—to provide the US Congress with guidance for creation of a real health care system.

Please  be  clear:  We  do  not  want  to  “throw  out  the baby  with  the  bathwater.”  Conventional medicine is miraculous in so many areas. Injury, life-threatening situations, developmental disabilities, overwhelming infection, organ failure—the list of successes is long. Unfortunately, the medical model that works so well for these kinds of conditions has failed for everyday health and chronic disease. We have invested huge resources researching, promoting, and rewarding the end-stage disease treatment model. The time has come to reconsider our priorities.

As widely recognized leaders in functional, integrative, and naturopathic medicine who have dedicated their professional lives to reforming medicine, we present here our suggestions on how to cure our sick health care system. Accompanying this summary letter are articles by each of us supporting our key recommendations. Following are a few select quotes from each article.

Jeffrey Bland, PhD, FACN, cofounder Institute for Functional Medicine

Personalization and Wellness

Presently our health care system focuses almost exclusively on the diagnosis and treatment of disease, and it lacks effective promotion of recovery, restoration of function, and promotion of wellness.

To create a value-based health care system that better manages chronic disease, we need to have a restructuring of care to focus on the genomic, lifestyle, environmental, and social determinants of disease in the individual.

The need to improve health care is much more than changing access to and finances of care, but it requires a significant change from the disease-centric approach to introduce a scientific wellness component to the system.

Dr Jeffery Bland, PhD, CNS, FACN, FACB, is known as the “Father of Functional Medicine,” a medical approach that focuses on the personalized prevention and treatment of chronic diseases. During the past 35 years, Dr Bland has traveled more than 6 million miles teaching more than 100 000 health care practitioners in the United States, Canada, and more than 40 other countries about functional medicine. He has been a university biochemistry professor, a research director at the Linus Pauling Institute of Science and Medicine, the cofounder of the Institute for Functional Medicine in 1991, and the founder/president of the Personalized Lifestyle Medicine Institute. He has authored more than 100 scientific publications and 11 books for the health professional and health consumer. He lives in Seattle, Washington, with his wife Susan, and near his 3 sons and their families while pursuing his hobbies of boating, surfing, scuba diving, and a life-long passion for learning.

Mimi Guarneri, MD, FACC, ABOIM, president, Academy of Integrative Health and Medicine Prevention, Integration, and Collaboration

Although Western medicine excels in the treatment of acute conditions such as heart attack and stroke, it does not empower people toward optimal health through prevention and the management or elimination of chronic disease.

Through interprofessional collaboration, research, and education, we will be able to transform health care to a more economical model that promotes the creation of health, as well as the delivery of evidence-based comprehensive, affordable, and sustainable person-centered care.

We know that the key components of health promotion include mind-body practices, sleep and physical activity, nutrition, achievement of ideal body weight, reduced exposure to toxins, and substance abuse and social connection. Although acute care frequently requires lifesaving interventions and pharmaceutical therapy, chronic disease demands a new model that extends beyond the “ill to the pill approach.”

Dr Mimi Guarneri, MD, FACC, ABOIM, is an integrative cardiologist, president of the Academy of Integrative Health and Medicine, past president of the American Board of Integrative Holistic Medicine, and serves on the Founding Board of American Board of Physician Specialties in Integrative Medicine and is clinical associate professor at University of California, San Diego. She is cofounder and medical director of Guarneri Integrative Health, Inc., at Pacific Pearl in La Jolla, California.  A cofounder of Scripps Center for Integrative Medicine, she served 15 years as medical director. She is board-certified in cardiovascular disease, internal medicine, nuclear cardiology, and integrative holistic medicine.

Joseph Pizzorno, ND, Editor in Chief of Integrative Medicine: A Clinician’s Journal and Stacie J. Stephenson, DC, Chairwoman of Functional Medicine at Cancer Treatment Centers of America The Health Care System and Addressing the Determinants of Health

We do not have a health care system in the United States. We have a disease management and symptom relief system that primarily provides short-term solutions while allowing the underlying real causes to continue unabated. One way to understand what health care is actually being provided is to look at which drugs are most commonly prescribed. Nine of the top 10 only relieve symptoms while allowing the actual causes to     continue unabated.

We will continue to have an ever-more expensive health care until we reprioritize to an actual health care system. This means a system that addresses the real reasons that people are sick.

Virtually all the determinants of health are now instead promoting disease. Our foods are not only depleted of nutrients, but they are now contaminated with herbicides, pesticides, and toxic metals. Health depends on the enzyme machine that we call our body working properly. Inadequate nutrition plus enzyme poisons means not only poorer health and vitality but a heavy burden of degenerative disease.

Dr Joseph Pizzorno, ND, is a world- leading authority on science-based natural medicine, a term he coined in 1978. A licensed naturopathic physician, educator, researcher, clinician, and lecturer, he is founding president of Bastyr University, editor in chief   of   Integrative   Medicine:   A   Clinician’s   Journal, treasurer of Board of Institute for Functional Medicine, cofounder of American Association of Naturopathic Physicians, board member of American Herbal Pharmacopeia, and a member of the science boards of Hecht Foundation, Gateway for Cancer Research, and Bioclinic Naturals. He was appointed by Presidents Clinton and Bush to 2 prestigious commissions advising the US government on how to integrate natural medicine into the health care system. He is recipient of numerous awards and honors and author/coauthor of 12 books, including the best-selling Encyclopedia of Natural Medicine (2 million copies in 6 languages) and the principal textbook in the field, the Textbook of Natural Medicine. His newest books, The Toxin Solution, will be released February 2017 by Harper Collins and another textbook for physicians, Clinical Environmental Medicine, will be released by Elsevier in January 2018.

Dr Stacie Stephenson, DC, CNS, DABAAHP, FAARM, is a recognized physician, lecturer, and national lecturer on nutrition-based medicine, and she was the host of the “Health News with Dr Stacie” radio program. Dr Stephenson is board certified in anti-aging and functional medicine, and she is a board- certified nutrition specialist. She has worked with the Northwestern Health Science University Clinic, Abbot- Northwestern Hospital, and the Macari Clinic for Functional Medicine, where she also served as medical director and chief executive officer. In 2006, Dr Stephenson founded the Carmel Clinic for Functional Medicine—the first clinic to provide hyperbaric oxygen therapy for children with autism. She understands the unique ways in which a person’s health is influenced by lifestyle, diet, environment, family, and beliefs, and she is dedicated to educating men and women on prevention and therapeutic interventions to heal and maintain health. She is chairwoman of functional medicine at Cancer Treatment Centers of America, and she is a member of the Gateway for Cancer Research Board.

Ruth Westreich, President, The Westreich Foundation

Personal Responsibility and Consumer Engagement

We cannot be healthy and thrive as a nation if the only options we have are to wait for disease to occur, and then we treat with pharmaceuticals, devices, and surgery.

We must have access to food and water that supports our body being in natural homeostasis. We must limit the poisons and pesticides where our food is grown. We must NOT be mandated by the state or federal government to inject substances into our bodies or the bodies of our children that we know are harmful and can cause permanent disability or death.

Our young people will not be the young brains that will change the world. And our national debt in health care, Medicare and Medicaid will be our society’s downfall. We are depending on you to speak for us and we are also willing to do our part to change the course of our “disease care” system to one of prevention and true health.

Ruth Westreich is president of The Westreich Foundation. She is a leader of leaders in the integrative/ functional medicine space. She has been active in strategic planning, program development, and execution in the complementary     and alternative medicine field since it was first codified by Congress as a division within the National Institutes of Health. She is working a strategic level to develop collaborations in a system’s-based model as the entry point for integrative/ functional medicine into the health care dialogue at the National level. She has been a major force behind the integrative medicine movement and local and national academic institutions and organizations, including the Academy of Integrative Health and Medicine, Academic Consortium for Integrative Health, Academic Consortium for Integrative Health and Medicine, American Nutrition Association, Bastyr College of Natural Medicine, Samueli Institute, San Diego Hospice and the Institute for Palliative Medicine, Scripps Center for Integrative Medicine, UCSD Center for Integrative Medicine, and UCLArts and Healing.

In This Issue

The focus of this issue is to provide guidance from leaders in functional/integrative/natural health and medicine to President Trump and Congress on how to cure the sick health care system. A brief summary of their recommendations is included in the cover letter on the previous page.

Associate editor, Jeffrey Bland, PhD, continues his thoughtful commentaries on how personalization and improving physiological function are fundamental to improving and restoring health. In this issue, he dives deeply into the foundational concepts of functional medicine and systems biology.

Regular columnist John Weeks provides us a very interesting overview of the history of the integrative medicine movement.  I think the emerging interest    in nonpharmacological approaches to pain control is extremely important. Kudos to Richard J. Kitaeff, ND, LAC, who wrote for the first edition of the Textbook of Natural Medicine in 1985 a chapter  on  nonpharmacological  pain control, which I believe was the first authoritative and comprehensive guidance for clinicians. Finally, congratulations to the NDs for achieving licensure in Pennsylvania!

We present the third of the multipart series on probiotics written by masters of science nutrition graduates of Elizabeth A.  Lipski, PhD:  Keren E.  Dolan, MS; Heather J. Finley, MS, RD; Cathleen M.  Burns, MS, RD; Margaret G.  Gasta,  MS,  RDN;   Crystal Gossard, MS; Emily C. Parker, MS, RD; Jessica M. Pizano, MS; and Christy B. Williamson, MS. This one focuses on disease-specific probiotic strains, associated with cardio metabolic diseases and fatigue syndromes.

Cristiana Paul, MS; and David M. Brady, ND, DC, CCN, DACBN, provide us an article evaluating the bioavailability and metabolic activity of various forms of vitamin B12 and how these interact with B12-related polymorphisms. I think this an excellent example of how genomics will help us better meet the needs of our unique patients.

With the help of associate editor, David Riley, MD, we are receiving a growing number of excellent case reports. This is to me very exciting as no matter how great we believe our philosophy and therapies, the bottom line is our ability to help real patients. This report by William Shaw, PhD, on the effect of glyphosates on neurological disorders and gut microbial disruption is fascinating.

The old adage, “History is written by the victors” (the origin of which is controversial) is certainly true in medicine. This is why the work of the Hecht Foundation is so important. For more than a decade now, the Rogers Prize has been recognizing key pioneers in Canada who courageously advanced this medicine.  However, a biannual award simply does not provide adequate opportunity for the many deserving men and women. To address this challenge, the foundation created the Groundbreaker Award.   In Courage Is   Mandatory for These Groundbreakers, Kristin McCahon presents how the 5 awardees have helped transform medicine. I am honored to have been a member of the international jury of experts that selected the award recipients.

Associate editor, Bill Benda, MD’s BackTalk laments the loss of so many of our cultural icons the past year   and what it means for the future. I must say I agree with him in many ways, though with quite different priorities and perspectives. Although the youths of our generation believed and fought for many great ideals, our actual results have not been what we were hoping for.

Joseph Pizzorno, ND, Editor in Chief drpizzorno@innovisionhm.com http://twitter.com/drpizzorno