Dr. Pizzorno: Well, it's in many ways quite similar to conventional medicine. In order to enter a naturopathic medical school, a student first has to complete a pretty standard pre-med, and it's a four-year graduate school, and upon graduation, they either go into practice or into a residency, and then they have to take the state boards to become licensed.
Now the four-year education is very similar to conventional medicine, and that is the first two years we teach basic medical sciences, and that means things like anatomy, physiology, pathology, biochemistry, etc, and the second two years are focused on diagnosis and treatment. Now, diagnostically, we cover pretty much the same diagnostic procedures as conventional medicine, like radiology and lab taking and physical examination, although we also put in some diagnostic courses that aren't typical of conventional medicine, such as assessment of nutritional status, assessment of environmental toxin load, things of that nature, and then therapeutically is how we are most different from conventional medicine. Well, we study some of the same courses, like we have some courses on emergency drugs and office surgery, we focus most of our attention on herbs and vitamins and diet and lifestyle and hydrotherapy and psychological counseling, basically any therapy we can find that helps make the body stronger.
Mike: You mentioned nutrition as well -- this has been one of the frequent criticisms of more traditional medical schools, that they really don't teach enough nutrition. How much training in nutrition and the relationships between food and health do students receive there?
Dr. Pizzorno: It's substantial. It ranges from specific courses in diet and nutrition, and, last I looked there were like four or five courses of 2-3 units each. But not only do we have the specific courses on nutrition, but we then look at the various diseases, and we get to develop an integrated care protocol for the disease, and nutrition and diet play a huge role in that. So students get literally hundreds of hours of training in how to use diet and nutrition in restoring health and reversing disease.
Mike: Let me get back to the school, and the kind of training that naturopathic physicians receive there. Along the lines of, you mentioned diagnostics, and they are trained in many of the same diagnostic tools as conventional medicine. I just want to point out to listeners how important that is, because a well-trained naturopath is able to diagnose with the same degree of experience as a traditional doctor, and can you speak to that some more?
Dr. Pizzorno: I think that there's a key issue, and that is, when people come to see us, they come to see us because they're sick, and we are responsible for diagnosing the pathology, because at times, they may have pathology that's better treated with conventional medicine, or they may have a pathology that requires some pretty dramatic intervention, or else it will progress and become worse and worse for the patient. So we do diagnose the pathology that the patient has.
I also want to make a point that we're family practice doctors -- we're not specialists. And so if we have a situation where a patient has a condition that does need the assistance of a specialist in diagnosis or in treatment, we would collaborate with conventional medicine practitioners. And 20 years ago it was hard to say that, because conventional medicine was so hostile. Now, they're much less hostile and much more willing to work with us. So, we do make a diagnosis. That means we have thorough training in physical examination, drawing blood and interpreting the results of the blood, taking x-rays, interpreting the x-rays, etcetera.
Mike: But then bringing in the more naturopathic-oriented therapies.
Dr. Pizzorno: Right, so in addition to that, because we're not interested in only finding the pathologies; as a matter of fact, when we find a pathology, and that's important to do, we're much more interested in understanding the physiological dysfunction that the patient is having. So we might run tests that, for example, evaluate how well the liver is detoxifying the chemicals in that person's environment, or we might run tests that measure the level of heavy metals or toxins like herbicides and pesticides the person's built up. Or we might run node tests to look at their intestines to see how well they're digesting their food, or if they're developing inappropriate bacteria in their intestines that are causing a toxic reaction.
One of the side effects of using antibiotics is that they often stimulate the growth of inappropriate bacteria in the intestines, and those bacteria could be very problematic. Most people don't realize that we have in our intestines ten times as many bacterial cells as we have in our body. Those bacterial cells are metabolically active, and sometimes the things they produce are useful for us.
For example, some bacteria like lactobacilli produce B vitamins that may be helpful for us. But other bacteria, such as the clostridium family, when they have protein in the intestines, break down the protein into what is called putrefaction products, and names that come up with things like putrescine, cadaverine, so you can figure out where this was first discovered, and those things are toxic to the body.
So people who have had a lot of antibiotics and haven't had much in the way of foods rich in lactobacilli like healthy yogurt, will build these toxic bacteria, and these toxic bacteria produce these chemicals that poison the body. So we take a very comprehensive approach to our patients, and again, really focus on understanding why that person's sick and how to help them become healthy.
Mike: I have another question for you about the school -- one of the big criticisms of conventional med schools is the influence of pharmaceutical companies, and I'm curious how pharmaceutical companies' information and research are integrated into Bastyr University.
Dr. Pizzorno: Well, we give our students basic training in pharmacology, and the basic drugs, but they don't get detailed by the drug companies. There are some of the natural therapy people who come to see them and sell their products, so I think there is always some risk of that, but because our orientation is much more biochemical, our therapies don't change rapidly. We're not very interested in the latest, greatest drug. For example, vitamin C works the same today as it did 100 years ago. So if a patient needs vitamin C, it doesn't matter whether there's a drug company around or not -- I just give them vitamin C. And the same thing with all the nutrients. There are about 150 nutrients now known to have physiological effects on the human body, and that doesn't change. We may better understand how those nutrients work, but they don't change.
Mike: Oh, okay. Here's an interesting questions: is the demand so high for this education that there's a waiting list to get into these universities, or what's the situation on that?
Dr. Pizzorno: It varies. Somebody who's well-qualified, has done their pre-med, and has good grades and good recommendations should be able to get into one of the naturopathic colleges. Bastyr University has probably the highest standards, it's the most difficult to get into, probably because we've been accredited the longest and have, I think, the most rigorous science program, but all the schools provide a good education, and there's typically enough room for qualified candidates.
Mike: And what is the big trend here -- are there more graduates each year than the previous year?
Dr. Pizzorno: There have been. The enrollment at naturopathic medical schools has pretty much leveled off the past three years. But before that, we had just a huge growth. When we started Bastyr University, in 1978, we had 31 students, and when I left as president of the university in 2000, we had 150 students entering the program, so it increased by a factor of 5 in the 22 years that they had at Bastyr.
You've been reading part three of a five-part interview with Dr. Joseph Pizzorno, the founding president of Bastyr University. Dr. Pizzorno was appointed by President Clinton in December 2000 to the White House Commission on Complementary and Alternative Medicine Policy. President Bush’s administration appointed him to the Medicare Coverage Advisory Committee in February 2003. He is also the co-author of the “Textbook of Natural Medicine” and the “Handbook of Natural Medicine.”