Southwest College of Naturopathic Medicine: Dr. Paul Mittman, CEO

by HCE Exchange on November 18, 2011

Since 1993, the Southwest College of Naturopathic Medicine and Health Sciences (SCNM) in Tempe, Ariz., has been training medical students of all backgrounds to apply nature to medicine.

Currently, the college enrolls 373 students in the doctor of naturopathic medicine program. This discipline is a four-year doctoral program that requires a bachelor degree and a pre-med background to be considered for admission. Over 900 naturopathic doctors have graduated from the program since the institution’s founding.

The college has more than 70 full-time and adjunct faculty who bring vast expertise and experience to the students. Many faculty are world-renowned and leaders in their fields, including Dr. Yong Deng, M.D. (China), L.Ac, department of acupuncture and oriental medicine chair, author of  “Encyclopedia of Chinese and U.S. Patent Herbal Medicines,” and director of the International Association of Integrated Medicine (IAIM); Richard Laherty, Ph.D., department of medical sciences chair and recipient of an NIH Individual Postdoctoral Research Service Award; and Matthew Baral, N.D., department of pediatrics chair, who serves as the pediatric contributing editor to the “Natural Medicine Journal” and the “International Journal of Naturopathic Medicine” and is the founding and current president of the Pediatric Association of Naturopathic Physicians.

Reaching out and giving back

Nearly 30,000 patients are treated each year through the college’s patient-care services. These services are split between the medical center located on the college campus in Tempe and eight community clinics with whom SCNM either collaborates or solely staffs.

The outreach clinics began in the mid-1990s. The Arthur M. Hamilton Elementary School Clinic in Phoenix, Ariz., exemplifies these community partnerships. Started eight years ago, the college worked with the school to raise funds to break ground for a clinic that is now opened five days a week and serves not just the Hamilton students, but also the entire Murphy School District.

“These are children who have the misfortune of being born into poverty and a lot of them are children of undocumented parents, so they don’t have access to routine care,” Dr. Paul Mittman, chief executive officer of SCNM, said.

SCNM also works in a women’s shelter, an HIV clinic, a mobile medical center, a community health center, and two drug and alcohol rehab facilities.

SCNM doctors are trained in both patient examination and assessment and are qualified to write prescriptions and conduct routine office procedures along with a range of alternative therapies such as acupuncture, clinical nutrition, manipulation, homeopathy, and botanical medicine. They also work closely with other practitioners and medical facilities to insure that patients get the best care.

Explaining naturopathic medicine

The term “naturopathic medicine” sounds strange and almost cultish to the uninitiated, but Mittman is quick to explain the common sense behind this medical discipline.

“If you picture a doctor who combines the best of western and alternative therapies, you would be talking about a naturopathic doctor,” Mittman said. “So, on the one hand, you use the foundation in the biomedical sciences to understand people and health and then illness and combine that with conventional and alternative therapies.”

Naturopathic doctors still look at a patient’s medical history and still conduct physical examinations, along with routine lab work and imaging studies, but these commonplace procedures aid them in looking a little deeper into the patient’s potential medical issues.

“All of this helps us to form a very in-depth history of the patient that then helps us to  understand the diagnosis and to look deeply to see what other factors might be underlying the diagnosis,” Mittman said.

For example, a doctor sees 10 patients who suffer from migraines. The doctor gives the diagnosis, “headache-migraine.” Conventionally, Mittman explained, the treatment follows an algorithm whereby the doctor will start with a solution that is designed to mitigate the pain. If the migraines persist, the doctor will then prescribe medication to hopefully prevent the migraines.

However, Mittman asked, what if you looked more closely at those 10 individuals and found that several of the patients are women who experience migraines at the same time each month?

That could indicate a hormonal component is involved. Or maybe, after a closer examination of the patients, you find that certain foods trigger the migraines for certain patients. Removing these foods from their diets just might remove the migraines.

Another patient has migraines and cervical pains. You find that the headache started after this patient was involved in a vehicular accident, a possible culprit behind the migraines.

“Just looking to individualize the diagnosis and also paying particular attention to those lifestyle factors that could affect a person’s health, their diet, has an impact on the diagnosis,” Mittman said. “Are they eating a diet that promotes inflammation or regulation of inflammation? Most inflammatory mediators, including prostaglandins, originate as fats, so depending on what kind of fats a person eats, the more likely they’ll have inflammation or more or less inflammation.”

Saturated fats or trans-fats can affect inflammation in one direction, while mono-unsaturated fats and other essential fatty acids can push it in the other direction.

“Rather than relying solely on drugs that can block the process further downstream, the COX 2 inhibiter, then why not make sure the body has more substrate that’s going to promote a regulation in inflammation rather than promoting inflammation in the first place?” Mittman asked. “So combining diet with other therapeutic life changes (exercise, stress management) is the core of what we do.”

Training the students

In the fall of 2010, 80 students enrolled at SCNM, giving the institution its largest incoming class in SCNM history. In 2009, the college purchased property that is adjacent to its Tempe campus. On that property was a building that SCNM has now converted into a brand-new medical center.

The new building combines some innovative features not only for SCNM’s specialization, but also for medical education in general.

“When we designed the center we included feedback from patients, students, and our faculty,” Mittman said. “So, we feel that it has a real patient-centered feel to it. We incorporated some technologies that are real assets to our patients and the students who are learning.”

SCNM opened the center with electronic health records (EHRs) already in place. With few exceptions, there are no paper charts, giving doctors immediate access to patient records. SCNM is also about to streamline its referral process both in the center and for doctors outside of the facility.

“Our students are being trained right off the bat in this system,” Mittman said. “They’re not going to have to unlearn charting on paper, as they move into the technology that’s going to become the standard in healthcare.”

On staff, the new center has not just naturopathic doctors, but also medical doctors, acupuncturists, chiropractors, psychologists, massage therapists, and biofeedback technicians. This helps to create an integrated atmosphere of internal communication among that group, and it also helps with referring out patients who might require diagnostics.

The medical center also has six classrooms built onto it where students will conduct chart and case preview and review. Each classroom has wireless technology that enables them to access the school’s digital collections and subscriptions. The classrooms also have a digital-closed circuitry monitor system. From any classroom, students can view each of the exam rooms (but only if patients fill out a consent form allowing themselves to be observed). Students can observe physicians or other students, and doctors can watch students.

“From a learning standpoint, it really enhances the process,” Mittman said.

The school also introduced a new curriculum in 2010 for first-year medical students that will require them to begin practicing physical exams on their first day. This program will have students start by working with each other, then with standardized patients and finally with regular patients. Students will also start working with physicians in the field as early as possible.

In 2002, SCNM became the first naturopathic medical school to put all of their class material online, giving students the ability to access notes. With Welch Allyn, Southwest pioneered an arrangement in which each student would receive a full diagnostic set upon entering the program.

A long-term passion

Mittman has been CEO of SCNM since 1999. His passion for naturopathic studies is contagious, as is his passion for the power individuals have to change themselves.

“When patients are empowered to understand their illness and to make therapeutic life changes, whether it’s diet, exercise, stress management, or biofeedback, remarkable things happen,” Mittman said.

As one of the leaders in one of the most progressive areas of study, Mittman said SCNM is always looking to the future, ready to move and embrace innovations that can improve their practices, while letting go of practices that don’t work. Mittman emphasized how important it is to “not get stuck in the past.”

He noted that SCNM is the first naturopathic medical school in North America to take the leap into EHRs, and the 2010 curriculum revision, a roll-out that will take four years to complete, is the most significant curriculum revision in naturopathic studies in 30 years.

“We took the biomedical sciences and blended them into one Human Biology block oriented by the various organ systems,” Mittman said. “Rather than having it be discipline-oriented, having it system-oriented means that when students are covering the cardiovascular system, they have a team-taught course, covering it in anatomy,  physiology, biochemistry, etc. It is coordinated, so that’s it happening all at the same time rather than being split among several courses.”

As Southwest moves into the future, Mittman said the institution is looking to address several questions, including how to grow the school both numerically and physically, how to increase their capacity to have an impact on health and healthcare today and in the future, and how to diversify revenue sources.

“We’re looking at how to do all of that in a way where we don’t end up as a school with a host of competing programs competing for limited dollar,” he added. “What are the types of programs that are going to need the most as we move forward?”

SCNM is also looking at adding health education, wellness, nutrition, and post-graduate programs.

“How do you get a school that’s operated in a certain way to be more efficient? How do you break out of that and change, but not undo the culture of the institution?

More than a medical issue

“In the United States 80 percent of the $2.5 trillion we spend on health care goes to treat preventable conditions and chronic diseases that have their roots in the way we live our lives,” Mittman said. “If we want to have a healthy society and not bankrupt our country, we have to address our healthcare issues at their root causes.”

Mittman firmly believes that’s where naturopathic medicine comes in.

“A future where we successfully tackle these daunting challenges is one that I believe will include naturopathic medicine,” he said.

SCNM, he said, values goodness, both to our bodies and to others, above all else. The college requires students to do community service and encourages senior executives to serve on boards and to participate in the community in as many different ways possible.

“If there’s something that’s missing deep down inside, I think people are limited in how healthy they can be,” he said. “If you believe in the idea of holism, you have to think of health as more than just a medical matter.”

It is Mittman’s wish that the medical community would unite, bringing all forms of medicine together.

“How wonderful it would be when you would have physicians and practitioners who come from different backgrounds who work together in as seamless a way as possible for the benefit of each patient.”

-by Pete Fernbaugh

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{ 1 comment… read it below or add one }

Sergio Decena October 4, 2012 at 12:31 am

I atually live in Tx. I am interested in what is Naturapathic medicine I have a medical deegre from UCE, one of our university in Dominican Republic. I have been practicing since 1989 as a GP end trauma medecine.
What must I do to engage into your naturophatic medical program?

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