From the Executive Director: A View from the Mountain Top

So how does our profession look from 30,000 feet?

Well, I can’t answer that, but having just returned from this year’s AANP convention in Keystone, Colorado, I can give you the 9300-foot perspective. Overall, I came off the mountain very encouraged about the state of our profession in 2013. I also came away with an increased appreciation for our moist, oxygen-rich air in Seattle – altitude effects are real!

It’s quite apparent there has been a shift in culture within and around the AANP, and there’s a spirit of involvement and cooperation that is very palpable. The passion of members is evident and progress is being made on many fronts – most notably this year with recognition of our profession by the state of Colorado!

While technically not a ‘licensing law’, the new registration act for Colorado NDs is a significant and solid start and the culmination of many years of work by our colleagues there. Congratulations to the CAND!

At this year’s pre-convention State Leadership Summit, the focus was on four key areas: 1) increasing teamwork within the profession; 2) implementing section 2706, the non-discrimination clause of the Affordable Care Act; 3) licensing new states; and 4) defining the role of NDs in the larger healthcare system. About 50 participants from around the country spent a full day considering and discussing these issues and constructing some novel ideas about how to best proceed. One result of the workshop was a resolution from the House of Delegates to create a task force focused on improving communications and integrated functionality throughout the organization.

Another highlight from this year’s convention was the State Alliance meeting. After an initial presentation that focused on Colorado’s path to success, the licensed and unlicensed states met separately. This allowed a more in-depth focus on the different needs of each group and I was very impressed by the discussion we had about legislative goals and strategic considerations. Everyone recognized the importance of building relationships and the need to thoroughly understand a state’s political environment in order to be effective. While all of our states are politically unique, we were also able to identify our commonalities and share lessons learned through experience, as well as identify areas for potential collaboration going forward.

Another topic of discussion was how to increase membership and participation in both our state and national associations. This is a perennial challenge for any profession, but especially important for a small profession with large aspirations like ours. Here are some of my observations on increasing our membership:

A mature, or maturing profession, needs and is reflected in its associations. As much as the primary focus of naturopathic practice may be on the doctor-patient relationship, we also exist collectively in the public sphere. Our ability to participate in the larger system is dependent and often determined by our public voice and presence. As Dr. Bastyr said, “Naturopathic medicine is one part science, one part art and one part politics.” The need for this ‘doctor-society relationship’ was clearly evident to those at the conference – as well as the understanding that increased membership fuels our capabilities. How to encourage more of our colleagues to support our associations is the question.

In order to grow, we need both state and federal representation. State involvement is primary. This is where healthcare law is made. The Affordable Care Act notwithstanding, states are charged by the US constitution with legislating and administering laws governing healthcare, licensing and reimbursement policies. From that perspective, it seems obvious that all NDs should support their state associations. As able and responsive as the AANP is and can become, a national association will never replace active involvement by the doctors in the state and local districts where they live. This is just politics 101, but it is crucial that our doctors recognize it as such.

Beyond our own states, however, is the larger context where our profession is bringing a new paradigm to healthcare.

Nationally, naturopathy impacts the whole country – and beyond! In this time of emerging healthcare reform – and who knows when and what it will finally look like – it is imperative that naturopathic medicine have a national presence.

The AANP is well positioned, well organized and well led to do this and so it is important for our doctors to support the national association, too. Please join both your state association and the AANP!

As self-evident as this may seem, our memberships aren’t necessarily reflective of this awareness. While the percentage of ND members tends to be higher than that of other healthcare professions, the majority of our doctors are still not becoming active members. There are multiple reasons for this, and I’d like to highlight just a few. Hopefully, we can put these issues on the table and call on our collective creativity to find solutions to optimize our membership and actualize even more of our potential – as individuals and as a profession.

While acknowledging and celebrating all the positive growth underway, the current relationship of all of our associations is still inherently competitive – and not terribly efficient. States compete with the AANP, and even with one another for resources to fuel their operations and carry out their separate missions. These complications occur in three primary areas: 1) membership; 2) continuing education; and 3) corporate sponsorship.

Too often, I’ve heard doctors tell me that they are supporting either their state or the AANP – most often citing the cost of joining both. Survey results from a few years ago indicated there were at least 100 NDs in Washington who belonged to the AANP but not the WANP. That’s substantial – for either organization. Is dual membership an option? If so, how do we implement it without cutting into the budget of one or both of our organizations?

The situation is similar with continuing education, an area that’s exploded with course offerings from our state associations and private organizations. CE is one of the primary revenue sources for most states and the flood of options has cut into revenue. This is particularly true when the AANP convention is held in one of our larger states that has its own educational offerings.

Corporate sponsorship is another significant source of revenue that is increasingly challenging to obtain. This pie is only going to get smaller as more state associations seek funding for their own operations. From a fundraising perspective, the most common form of rejection for a state to hear is “We already support your national organization.” Clearly, we’ve got to find a more effective and sustainable way to fund all of our organizations.

A few more questions.

As much as we need local political action and organization in each state, is it really necessary for every state to create their own unique infrastructure? Is a single national organization with a more formal definition of state affiliates worth considering? Do we need fifty websites and fifty search engines? Are fifty press kits and fifty sets of bylaws beneficial? Do we need 50 states offering their own conferences and courting sponsors from the same pool of companies that all other organizations pursue?

How can we address these issues, make it appealing for more of our colleagues to participate, optimize funding for all of our needs and find the best economy of scale for a profession of our size? If you have any ideas, please let me know.

Our profession is doing well. We’re riding quite a wave of vitality right now and I hope my questions don’t come across as a wet blanket. Looking ahead, these are some of the areas where our awareness and creativity need to be directed. In the mean time, support your state – support the AANP, and let’s celebrate a positive new environment that we’ve collectively created while we also look to the future and find the best ways to support the evolution of naturopathic medicine!

In health,

Bob May

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