Evolution of the Dietary Supplement Industry: An Interview with Erik Goldman
Throughout his 30-plus year career in medical writing and editing, Erik Goldman has acted as a bridge between the conventional and natural medicine community. What began as a personal interest in psychology, religion, ecology, and indigenous healing traditions eventually led, through his work in the medical journal industry, to the discovery that most conventionally-trained physicians lack scientifically-sound education about holistic practices. Fueled by this observation, Goldman merged his holistic interests with his medical science and editing background to found Holistic Primary Care – News for Health and Healing in October 2000. Today the publication and its website, Holisticprimarycare.net, reaches an audience of approximately 100,000 physicians nationwide and provides healthcare professionals with a credible source of scientifically-sound information on natural medicine and holistic healthcare.
Klaire Labs® recently had an opportunity to interview Goldman about how the healthcare industry has evolved over the course of his career, how this evolution is impacting dietary supplements in terms of quality and access, and where he believes dietary supplements and holistic care are headed in our country.
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Interview by Keegan Sheridan, ND
Klaire Labs: How do you see our healthcare system evolving as it relates to the acceptance and integration of natural medicine?
Goldman: There are some very important watershed projects happening at major conventional medical centers that I believe will have significant influence on the future evolution of this entire field. The research that’s happening at the Cleveland Clinic Center for Functional Medicine, under the guidance of Drs. Pat Hanaway and Mark Hyman, will be very important. They’re assessing clinical-and economic outcomes-in patients with a number of common chronic diseases who are treated by functional medicine practitioners using functional medicine-style clinical logic and clinical interventions, and comparing these to similar patients with similar diseases who go through conventional care in other parts of the Cleveland Clinic system. So this will be some real proof-of-concept data. And, if the data show that functional medicine can deliver what many of us believe it can, then this will be a major step forward for the movement.
I’m also keeping an eye on the new medical school that Susan and Henry Samueli are funding at the University of California, Irvine. That’s a big deal-an entirely new training program built from the ground up, and based on natural medicine principles.
Klaire Labs: You mention the Cleveland Clinic and UC, Irvine. They certainly aren’t the first to launch an integrated hospital center. Is there something different about these centers as compared to other hospital-based systems launched in years past that sets them up for success?
Goldman: In the past, a lot of hospital systems jumped on the “alternative medicine” trend and built out these “integrative” centers that were well-intentioned but not necessarily well-conceived. The hospital administrators viewed them as a way of attracting younger, healthier people into their networks but there was never really any true buy-in to the core principles. Many of these centers were founded on philanthropy, or they were the pet project of a particular administrator. But they were ultimately not able to pull their own weight economically, and a number of very prominent ones have closed in the last few years-the Continuum Center at Beth Israel here in NYC, the University of Arizona’s pace-setting program. Some really nice centers were shut down after a larger administrative change in the hospital system (and there’s a lot of that going on these days).
So, the history of natural/holistic medicine at major medical centers has been mixed. Overall, though, I think a lot of administrators are realizing that this is where the ball is headed, and they need to take it more seriously. So we’ll see what happens in the future.
Klaire Labs: How has the dietary supplement industry evolved over this same period, in the face of this more integrated approach to medicine?
Goldman: I’ve been tracking the supplement industry for about 20 years now, and there’s no question that over the last two decades, it has become vastly bigger, more diverse, and more sophisticated. It is now a very complex ecosystem with many different types of products…not just simple vitamins, supplements, and herbs. We now have probiotics, prebiotics, various types of omega-3s and other fatty acids, very specific amino acids, enzymes, etc. We have a whole new range of CBD (cannabidiol) and cannabis-derived or cannabis-related products in the supplement space.
The knowledge base for how to use these products has also grown. And while there’s still not nearly enough really good research on the clinical use of supplements, there is more research than many people realize.
Klaire Labs: We know consumers are asking their doctors for a wide range of dietary supplement products. Is the conventional community ready to accept dietary supplements into their practices and protocols to meet patient demands?
Goldman: There’s no question that the medical community has become more open to the use of supplements. We still occasionally hear the old party line that “it’s all just expensive urine.” But by and large most doctors and nurses-even those who are conventionally trained and practicing in conventional settings-recognize and tacitly (if not wholeheartedly) agree that supplements can play a positive role in promoting health and alleviating disease. I believe certain categories-especially probiotics and omega-3s, and probably vitamin D-have benefitted quite a lot from practitioner buy-in.
The surveys conducted by my company since 2010 have showed steady rises in the number of practitioners-including mainstreamers-who recommend supplements, dispense supplements, and discuss supplements with patients. It is no longer “alternative” for a doctor to have these discussions. Our data show that many mainstream practitioners are recommending supplements, though they don’t necessarily wave a flag that says “I’m alternative” or “holistic.” These things have just migrated into the scope of basic mainstream primary care. And I think that’s a very positive trend.
Klaire Labs: So the conventional community is awakening to the power of natural medicines, like dietary supplements, and the industry is expanding as a result. Is all the growth good and is it happening in the correct way?
Goldman: The diversity and rapid growth of the industry have positive and negative aspects: on the one hand there are vastly more options for both consumers and practitioners. But we’ve definitely hit a point where there are too many choices. There are a lot of “me-too” products out there, and while I think most of the really big and high-profile companies are very serious about their quality control, there are a lot of other companies that are not. You don’t have to look too far to find questionable products, poorly made products, sham products, or products that really stretch the definition of “natural” or “healthy” to the breaking point.
My sense is that many practitioners, like many ordinary people, are overwhelmed by the plethora of supplements out there. They struggle to figure out which ones are really what they say they are, which ones are best, and which ones offer good value.
Klaire Labs: You mention “big and high-profile companies.” Nestlé’s recent acquisition of Atrium Innovations, a company that holds some of the most prominent dietary supplement brands like Douglas Laboratories®, Pure Encapsulations®...