New Amendment to Hippocratic Oath Stresses Physician Self-Care

By Erik Goldman

WMA LogoIt's been a while since the 2500 year-old Hippocratic Oath underwent a major revision. The last one was in 1964.

But earlier this month, the World Medical Association voted unanimously to amend the venerable declaration to include a statement underscoring the need for physicians to take care of their own health with the same acumen and attention they apply to their patients.

The new clause, authored by a Queenstown New Zealand physician named Sam Hazledine, states: "I will attend to my own health, well-being and abilities in order to provide care of the highest standard."

Hazledine--a physician, entrepreneur, and professional skiier-- says his objective is to draw attention to the reality that burnout, depression, addiction, and physical illness are very common among physicians worldwide, and they are extremely detrimental to the quality and efficacy of patient care.

"This might just seem like small words, but they signify a course-correction for our profession," Hazledine told the New Zealand Herald. "It's not that we have de-prioritised our patients, it's that we have now acknowledged one of the most important components Sam HazledineSam Hazledine, MDto serve them."

The WMA, a sort of "United Nations" of medicine, is comprised of 112 medical organizations worldwide which collectively represent more than 10 million physicians.

At its 68th General Assembly in Chicago, delegates enthusiastically embraced Dr. Hazledine's proposal, and voted to add the self-care clause to the Declaration of Geneva--the modern, secular version of the Hippocratic Oath.

The Oath is used in medical schools worldwide. In some countries it is legally binding, though this is not the case in the US. But for many, if not most physicians, it stands as it has for millennia as the profession's ethical map and compass.

WMA president, Dr. Yoshitake Yokokura says the move reflects the fact that "the life of physicians today is completely different to what it was in 1948 when the original Declaration of Geneva was adopted." That's to say nothing of the vast difference between now and Hippocrates' era!

The revision is a symbolic though important step in empowering clinicians to challenge a sick-care system that is not only abusive to patients but to practitioners as well.






Another Alzheimer's Drug Hits the Rocks

By Erik Goldman

Pharmaceutical fixes for Alzheimer's and other forms of dementia are proving very hard to find. The latest drug failure--Axovant Sciences' once-daily intepirdine--dashes hope in an entire mechanism once thoguht to be important for attenuating dementia.

Remembering Rahmi Oruç Guvenç, PhD

By Erik Goldman

Guvenc 1Dr. Rahmi Oruc Guvenc, demonstrating ancient Turkish healing music at NYU, Sept. 1995The fields of music and healing lost a true luminary last month, with the passing of Turkish music therapist and researcher, Dr. Rahmi Oruç Guvenç.

His death on July 4 from heart failure was reported in the Daily Sabah, a Turkish newspaper. He is survived by his wife and close collaborator, Azize Andrea Guvenç, and his two daughters.

Dr. Guvenç (pronounced “Goovanch”) was born in 1948, in Tavsanli, a small town in western Turkey. He showed an interest in music at an early age, and took up a serious study of Turkish stringed instruments like the Ud, Rebab, Tanbur, as well as the Ney flute, while also studying philosophy at the Istanbul University.

He earned a doctorate in clinical psychology from Cerrahpasa Medical University, with research focused on the healing effects of music, particularly as understood and practiced by the ancient peoples of Turkey and Central Asia.

Turkish classical and religious music, like much Near Eastern music, is based on a system of modes called makams--microtonal scales and specific rules on how to use each tone in creating melodies. These traditions, some of which stretch back thousands of years, also contain many rhythm patterns rarely heard in Western music.

Music & Medicine

Dr. Guvenç’s research showed that musicians and healers once possessed precise knowledge of how musical vibrations, rhythms, and movements affected the human psyche and soma. They were able to utilize this knowledge to facilitate healing. He held that up until the 18th century, there were hospitals and clinics in Ottoman Turkey based entirely on music and movement therapy.

Dr. Guvenç’s life’s work was about rediscovering these practices and making them accessible to modern people. In 1975, he founded TUMATA, an acronym for Türk Müsikisini Araştırma ve Tanıtma Grubu (Group for the Research and Promotion of Turkish Music), which developed the theory and cultivated the practice of these ancient musical healing modalities.

Over the years TUMATA produced many recordings, two of which—Ocean of Remembrance (1995) and Rivers of One (1997) --were released internationally.

In addition to his scientific and performance work, Guvenç was also recognized as a Sufi sheikh, or leader, well-versed in Islamic music and chant, who regularly facilitated sessions in sema—the practice of turning or “whirling,” made famous by the poet Rumi, and the Mevlevi dervishes.

I had the privilege of meeting Oruç Guvenç and members of TUMATA in 1995, during one of their rare visits to the US.

At the time I was a reporter for International Medical News Group, and I’d convinced my editor to let me cover a seminar on Eastern Music Therapy, sponsored by NYU’s Nordoff-Robbins Music Therapy Clinic.

Equal parts lecture, concert, ritual and group participation exercises, the day provided a fascinating entry into a world where the connection between healing and harmony was not just a concept, but a tangible reality to be experienced.

Unexpected & Unforgettable Excursion

For me the day took an even more interesting spin after the formal sessions, when in conversation, I mentioned to Dr. Guvenç that I was a writer for a physician’s publication.

“Oh, I know a medical doctor---a heart surgeon—who’s really interested in these sorts of things,” he said, referring to music, healing, and contemplative practice. “Maybe you would like to meet him someday?” he asked.

“Surely, I would,” I replied.

“Maybe you would like to meet him tonight?” he offered.

Guvenc 2An hour later, I’m the back of a car with a bunch of gleeful Sufi musicians—and their instruments--headed off to some unknown destination in New Jersey, to meet a doctor whose name I had not even been given.

He turned out to be Mehmet Oz, who was not yet the household name he would soon become, but was already exploring the potential of things like biofeedback, Reiki, and music, in the care of people with advanced heart disease.

Dr. Oz and his wife, Lisa, had prepared a huge feast to honor Dr. Guvenç, and graciously opened their home for what proved to be a truly memorable evening of food, music, and intercultural exchange. I am grateful to have been included.

Much has changed in the world since 1995. It’s hard to imagine today even being able to get the visas to bring a group of Sufi-inspired music therapists to a major American university. Throughout the decades and their turmoil, Rahmi Oruç Guvenç, remained committed to nurturing peace and healing through the science of melody and rhythm.

May his memory be a blessing and may he rest in peace.

Amazon - Whole Foods Merger Highlights Healthy Lifestyle Surge

By Erik Goldman, Editor in Chief

Amazon GorillaHealthy living is big business. Very big business.

Which is why the proverbial 800 lb gorilla just reached for the biggest ripest bunch of organic bananas on the tree.

Amazon's surprise move to acquire the Whole Foods grocery chain for well over $13 billion set the business and financial world aflutter last Friday, with predictions and speculations as to the motives and the potential impact of the merger.

Analysts quickly pointed out that the acquisition will instantly transform the online retail giant into a brick-and-mortar behemoth--one that threatens the viability of all other grocery chains including biggies like Walmart and Kroger.

In an insightful piece on the CNBC website, Marcus Lemonis astutely points out that the Amazon - Whole Foods merger will shake the entire business landscape. That's because Amazon is rewriting the basic business playbook. It seems to have intention of becoming profitable. Though many of its business units operate profitably, the company has never turned a net profit and--at least for the foreseeable future--shows no sign of trying to do so.

Growth Over Profit

While most big corporations focus on generating shareholder dividends, and sequestering cash that must be tax-sheltered overseas, Lemonis points out that Amazon's core strategy is focused on growing its size and its reach, rather than pumping up its profit margin.

Simply put, Amazon dominates markets by offering convenience and driving retail prices down. Wall Street's fortune-tellers predict that Whole Foods customers will likely see price reductions in the store aisles once the merger is transacted. In the process, Amazon will put downward price pressure on everyone from from artisanal yogurt producers to herbal medicine makers.

Rather than accumulating cash and issuing dividends, Amazon recirculates its revenue into new conquests---like producing its own original binge-worthy TV serials or marketing its own line of home electronics.

Amazon makes it more and more difficult for its competitors to stay in the game. It's hard compete when you're under pressure to show your shareholders a profit but your main competitor does not.

What's often overlooked in all the financial prognosticating is the fact that this grand drama is being played out in the arena of healthful living.

From Granola to Payola

Given how big the Whole Foods stores have become, its easy to forget that the chain emerged from the once-marginalized "health food" movement. Whole Foods began nearly 40 years ago as a single independent store in Austin, TX, and grew by aggregating (or overtaking) other indie shops.

The products and the values people seek in Whole Foods---organic, fair-trade, allergen-free, grass-fed, locally-grown, non-GMO, drug-free---were once ridiculed or dismissed outrightly by mainstream American culture. Some of them still are.

And yet the "crunchy granola" movement that began with hippies, back-to-the-landers, and advocates of clean living from a variety of religious denominations, has grown to become one of the biggest and most dynamic forces in the US economy.

That's cause for both celebration and concern.

On the one hand, its a very positive sign that so many people are seeking healthy alternatives to highly-processed, toxin-laden conventional foods (whether or not everything in a Whole Foods store is truly an alternative is another question). And down-pressure on premium-price produce could make healthful living more accessible to millions of cash-strapped Americans who currently avoid stores like Whole Foods. Who wouldn't welcome that?

On the other, the rapid commodification of healthy foods and related products could make it all but impossible for smaller manufacturers-- the nurturers of innovation and guardians of the movement's core values--to stay in business. That's a serious potential risk.

The Whole Foods acquisition is not Amazon's only recent foray into holistic living. In March, the company launched its own dietary supplement line.  The Elements brand boasts a quasi-pharma look and feel, and an appeal based on purity, traceabilit, and transparency similar to the core values promoted by practitioner-only nutraceutical brands.

Thing is, Amazon's in-house products sell direct-to-consumer at less than half the price of most practitioner-only products in the same categories. As it has done in practically every other industry, Amazon's offerings will make it harder for practitioner-only nutraceutical companies to justify their higher prices.

It remains to be seen how Amazon's influence affects the healthy living and holistic mediicine movement. But anything that big certainly should not be ignored. One thing is certain: the economy's biggest gorillas are certainly not ignoring us!










In Memoriam: Fredi Kronenberg, PhD

By Erik Goldman

KronenbergHolistic Primary Care honors the memory, and celebrates the life and work of Fredi Kronenberg, PhD, a pioneer in the field of botanical medicine and women's health, who died on April 20.

A Stanford-trained physiologist with a deep love and reverence for the natural world, Dr. Kronenberg found her professional niche in the world of herbal medicine research. Following her post-doctoral research on the physiology of menopause, she became one of the world's experts on the use of herbs to attenuate menopausal symptoms as well as the application of botanical medicines for many other women's health concerns.

Kronenberg was among the exuberant vanguard of researchers and clinicians that spearheaded the integrative medicine movement in the early 1990s. She was the founding director of the Richard and Hinda Rosenthal Center for Complementary & Alternative Medicine, one of the first centers established under the NIH's National Center for Complementary and Alternative Medicine (NCCAM).

Among her many other achievements at Columbia, Kronenberg launched the seminal "Botanical Medicine in Modern Clinical Practice" conference series that ran from 1996-2005. The rosters for these meetings read like a Who's Who of holistic and integrative medicine, and they educated practically an entire generation of physicians, nurses and other health professionals on the use of herbs to prevent and treat a wide range of conditions.

She was also affiliated with the University of Arizona' s Center for Integrative Medicine, and collaborated closely with Dr. Andy Weil and his team on the "Nutrition & Health: State of the Science" conferences.

She also did much ground-breaking research, most notably her studies of Black Cohosh as a remedy for menopausal symptoms, and the role of phytoestrogens in women's health. She maintained a strong interest in traditional Chinese herbal medicine, and did much to build bridges between the Asian and Euro/American herbal traditions.

After Columbia's Rosenthal center shuttered its doors in 2007, Kronenberg continued her work at the Clayman Institute for Gender Research at Stanford.

Kronenberg was a founding editor of the Journal of Alternative & Complementary Medicine, and served as a contributor or board member for several other journals in the field. She was also a beloved member of the American Botanical Council, the nation's leading herbal advocacy organization.

ABC founder/director Mark Blumenthal notes that, "Fredi had been a long-standing and active member of the Board of Trustees of the American Botanical Council for 18 years, since 1999 until her death. During this entire time she was an outspoken and positive influence on the direction and role of ABC. She introduced ABC to many prominent leaders in the CAM community, many of whom have participated in ABC’s nonprofit research and educational mission, publications, and programs."

ABC published an in-depth spotlight on Kronenberg in 2010.

As unpretentious as she was brilliant, Kronenberg never sought the camera or the spotlight. But she was a true leader, and anyone who's been involved in holistic, functional or integrative medicine over the last 30 years has been touched by her work---whether they realize it or not.

Kronenberg was a visionary who led with a quiet grace and a twinkle in her eye. She inspired others with her genuine spirit of inquiry.

In a touching note on, Roy Upton, president of the American Herbal Pharmacopeia, recalled that Kronenberg, "Possessed the straight forward honesty of a New Yorker tempered with an incredible abundance of kindness, playfulness, and love. The last time we were together, she, I, and a mutual friend were skipping arm and arm down the corridor of a phytochemistry conference. Something you just do not see PhDs do (smile), especially in sight of other PhDs (big smile). I was blessed to have known her."

Fredi died in her home, after a long struggle with lung cancer. May her memory and her legacy be a blessing for all who knew her, and for all involved in the noble mission of improving health and wellbeing.