Sustainable Medicine or Ecological Medicine?

I first wrote my manifesto while preparing a vendor’s table for my clinic at the first Sunfest–a fair in New Hampshire that celebrates sustainable living and alternative healthcare.

I was thinking about the correlation between the two, and was inspired to write down some ideas that had been in my head for some time. I came up with a simple document I called the “Ecological Medicine Manifesto” with twenty defining points. Right after I wrote it, I did a search online to find out whether the term “ecological medicine” was in use already, since as far as I knew, I had invented it that evening. To my surprise and delight, I saw that there was actually an ecological medicine movement, spearheaded by the Bioneers and the Science and Environmental Health Network, and a truly wonderful book by the same name—a collection of lectures at the Bioneers conference.

Spurred on by knowing there was a movement behind me, I handed out hundreds of copies of my manifesto at the fair, and spoke to many people about the idea of “Ecological Medicine.” Most were slightly baffled at the term, but liked what I had written.

I spent the winter rewriting parts of it, and thinking about why, after many years of being directly involved in alternative medicine and sustainable living, I had never heard of ecological medicine. Why had the term not caught on in the general public? The time seemed so ripe. I came to the conclusion that the term itself was not self-explanatory enough, and that people assumed “Ecological Medicine” was a type of medicine, such as “Naturopathic Medicine” or a general term such as “natural medicine” and didn’t bother to ask more.

Yet ecological medicine, or sustainable medicine, as I have come to call it, is not a type of medicine, rather, it is a concept against which one can measure all forms of medicine, and say, “Is it sustainable?” “Is it really fulfilling our expectations?”

The problem with the term ecological is that it is harder to say “Is this medical system really ecological?” and have people understand what you are asking. Whereas you can easily say “Is this medical system really sustainable, in every possible way?” and get a direct answer.

Although I felt that the term ecological medicine expressed much that I wanted to express, I found that in my writing on ecological medicine, I wanted to include the aspect of sustainability—in a number of ways. Financial sustainability for practitioners and patients, sustainable harvesting techniques for medicinal herbs—just these two alone are big topics. Then there is the aspect of whether your work as a healer sustains you—can you as a health care worker take care of yourself well enough to actually take good care of your patients as well? And are the models of healthcare we are using actually sustainable—are they self-sustaining, do they grow and change naturally, or do they rely on private or public funding, higher education, and hierarchical power structures to maintain them? To me the term sustainability addresses these socio-economic concerns as well as all the ecological concerns in a way that is more direct and more accessible to the general public than “ecological medicine.”

In the book “Ecological Medicine” Kenny Ausubel explains that they chose the term Ecological Medicine rather than Sustainable Medicine because they believed that the ecosystem doesn’t just need to be sustained where it is, it needs to be restored to its original state of health. I understand and fully agree with their point, given this moment in ecological history, but I don’t think the sustainable agriculture movement would agree that the word “sustainable” means “keeping things as they are.”

Joel Kreisberg at Teleosis Institute has chosen the term Ecologically Sustainable Medicine to describe the movement, which is a nice combination of the two. However, again, I feel it leaves out much of what I would like to leave in the discussion—which are all the other ways that a health care model needs to be sustainable other than just ecologically—such as socially and economically.

There are many forms of sustainable medicine that are already alive and well. To me, the 12-step programs for addictions and free community co-counseling such as Re-evaluation Counseling and Non-Violent Communication are perfect models of highly effective, self-sustaining, relatively non-hierarchical, preventive, community-based healthcare which are free and have no negative environmental impact. By operating in a sustainable manner, they manage to have huge positive impact on people’s emotional and physical health in countries across the globe.

Homeopathy and Community Acupuncture are two other great examples of Sustainable Medicine in action—in that they are generally affordable to practice and to learn, are non-toxic to patients, are pattern-based rather than symptom-based in their view of patients, have high cure rates, use miniscule resources, and have minimal ecological impact.

Yoga and Tai Chi are also inexpensive ways to prevent and treat many of the problems that lead people to seek medical care. Arthritis, depression, fatigue, insomnia, headaches, tendonitis,and high blood pressure are just a few of the problems that can be alleviated by regularly doing yoga, tai chi, chi gung or any number of other practices that include movement, a meditative mindset, and (if done in groups) community.

Although I still have a soft spot in my heart for the term “Ecological Medicine,” the term “Sustainable Medicine” occurred to me as being something a bit broader than Ecological Medicine, and also with far more implicit meaning—something a potentially interested listener could “grok” at first hearing. If the term “Ecological Medicine” has mainly appealed to those who are already essentially, converts, then I say: find something else that works, so that more people can take part in the discussion.

Since I started using the term “sustainable medicine,” I found that people “get it” without my having to define the term first. They can join in the discussion, without having to be taught what the term means in this context. They can do their own thinking when you pose the question “What would sustainable medicine look like?” All forms of medicine can be more or less sustainable, depending on how they are practiced, so it is like a measuring stick, something to strive for. You can also notice people starting to turn the term around in their mind as they think back on their last visit to the hospital, or their last encounter with a physician, and then think about sustainable agriculture, sustainable energy, sustainable living, and they come back and say “Sustainable Medicine! What a concept!”

And so, I have started a Center for Sustainable Medicine, as a way to include sustainability in all its meanings and implications in our conversations about Ecological Medicine, and to draw in people who would not necessarily think to search for the term Ecological Medicine. Through the Center’s website,, I am getting inquiries from medical students interested in learning more affordable and ecologically sustainable ways to better serve rural populations, college professors teaching courses on sustainability and health care, and people simply looking for low cost, non-toxic forms of health care.

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