Monday, September 21, 2009

What Do Naturopathic Residencies and Pygmy Goats Have In Common?

Posted by Marcia Prenguber, ND, FABNO

Just as Lise noted in the previous blog, it has been a several weeks since the conference and, having taken a week’s vacation after the conference, I am still trying to catch up on things. Part of that process is reflecting on the various happenings at the conference, and what we all accomplished during that week.

The top of the list for me is the brand new residency organization – the NPGA! No, it is not the National Pigmy Goat Association, nor the National Propane Gas Association. It is the Naturopathic Post Graduate Association!

Lise Alschuler, Christine Girard and I have a driving passion for post-graduate medical education, and have talked about it for quite some time. So, knowing that there is interest by a number of folks in or associated with the field, and many examples of progress with the increasing number of ND residencies, we decided to move forward and ask for some assistance. How do we address the wide number of needs surrounding naturopathic residencies? The answer? An organization specifically focused on residencies for NDs! The goal of the NPGA is to be a resource to the profession by providing the infrastructure to support the growth of post graduate medical opportunities, to offer information to legislative bodies, to board certification organizations and to the public. The vision of the NPGA is to create universally available naturopathic post-graduate medical education.

The NPGA board is comprised of representatives from various organizations, from private practice, the public, and a representative resident in order to move these goals forward. We will explore a universal application process, residency/resident matching programs. In addition we will look to increase the availability and diversity of residencies as well as expand and diversify funding sources. I admit, pretty big goals. And, I am certain that they can be achieved over time with as dynamic a board as we have in the NPGA. So please join me in celebrating this newly founded board and the naturopathic determination to accomplish these goals!

Monday, September 14, 2009

Feeling That Post-Convention Glow

By Lise Alschuler, ND, FABNO
AANP President

It is several weeks now since our annual AANP Convention in Tacoma. And, yet, I still feel warmed by it. There is something so incredible about a gathering of hundreds of passionate, intelligent and like-minded people who actually like being with each other. I don’t know if it was the genuine joy that I felt and witnessed as people greeted each other, or the reverence with which we listened to some of our speakers and presenters, or simply the act of sharing good food together… but something makes our convention feel good. Really good. And that good feeling lasts. I still have a little glow emanating from me.

All this makes me realize that despite health care’s highly contentious politics, heartbreaking inequities and confused analysis and repair, there are points of calm amidst this storm. The naturopathic community is one of these and is like a hearth fire. The steady flame that we keep alight draws people towards us. People who are embittered with the cold void of depersonalized healthcare seek us out. We warm them up, remind them of our shared humanity, and give them the gift of optimism and possibility. Some stay with us and our collective grows. Others leave as ambassadors to bring guidance and insight to the great, diverse and rugged terrain of health care.

I realize that this may sound a bit grandiose. I mean, really, how could a profession of thousands, in gatherings of hundreds, possibly influence the world around us in this way? I can’t prove that we do. I believe that we do. In the new physics, we know that there are a multitude of fields around us at all times – most of which are in dimensions that we don’t even know exist. Physics also tells us that every thought, every action and every intention impacts these fields and creates change that affects everything else. Following this same logic, collective intention that is manifested as cohesive action (e.g. our naturopathic convention) has major impact on these fields, becoming a force in the universe. The force of naturopathic medicine – directed, resilient and powerful.

We know our world is in great need and I am deeply grateful for the wisdom and love that the naturopathic profession holds forth. I simply cannot imagine this world without it. And, I have every confidence that we will continue to help shape a better future.

All this from the convention!

Wednesday, September 9, 2009

A Different Approach to Practice Building

Jacob Schor, ND, FABNO

The smartest thing we ever did for our practice is bring a dog in as a coworker. Almost five years ago my wife and I succumbed to the pleas of our daughter and the oaths that she would share the added chore and committed ourselves to adopt a 4 day old puppy. She came home to live with us a two months later. Two weeks later she started coming to the office.

We thought this would be temporary plan, only until she was old enough to stay at home with the cat. Were we wrong, so very wrong. Our patients were furious when they showed up and the puppy wasn’t at the door to greet them. In the end, the puppy, now a 95 pound Poppy, became part of the office staff. Our mailman, a fellow in possession of a conservative political belief system that is in no way congruent with the way we see the world, is in love with my dog. He has several hunting dogs at home and aptly describes Poppy as a working dog, a whitecollar working dog. He now carries dog treats in his mailbag and will often take a breather from his route sitting on our floor.

Poppy is a talented assistant and office greeter. She makes people feel comfortable, the kids feel safe and it seems they open up sooner. In our medicine the challenge is to find out what’s really going on, not the numbers on the lab tests, but the challenges of the soul, the traumas to the heart, the fears and the driving hopes. Our experience has been that having a kind and loving dog present in the office has made this easier to achieve.

Thus it comes with no surprise to read about how dogs can trigger oxytocin release in humans. I recently stumbled on an abstract from the journal Hormones and Behaviour that told me a dog’s gaze can trigger oxytocin release in people, as much as a 20 percent increase in blood oxytocin levels. Recall that oxytocin is the hormone that helps us form and cement emotional bonds.

So there is actually science behind what we’re doing. In a scientific manner according to peer reviewed scientific publications, our sweet dog is helping us build trusting relationships with our patients. And our mail man, UPS driver, FedEx lady and everyone else who walks in the door. Our experience is that although work is still work, we do the work in an environment of friendship and trust, what sometimes feels like an oasis in a world that lacks these things. It’s all because of the dog.

Granted, before you all run out to the pound to get your own office dog, keep in mind we were lucky and unknowingly stumbled upon the perfect dog. Poppy is what we call a Hybrid Retriever; her mom was a golden retriever and her dad a Labrador. She has inherited the better characteristics of both breeds. She is intelligent, mellow, affectionate and tolerant of children who want to ride her like a horse (well, most of the time). It’s only after she came home that we learned that our local service dog trainers favor this cross.

Our medicine depends on building relationships. This is Poppy’s job description, it’s what she does every working day. She has helped our practice immensely and helped us do the work we try to.

I know this isn’t the sort of thing you’ll be taught in your business courses. It goes against the entire white coated professional image we were trained to portray in school. Granted we do practice in an unlicensed state and shy away from many ‘medical procedures’ in our office. No need to worry about sterile fields in our practice.

Some of my colleagues will likely be able to enumerate a list reasons why you shouldn’t have a dog join your practice.

In the meantime, it’s a beautiful morning and the dog and I are off to splash in the river and enjoy the day.

Wednesday, September 2, 2009

Ruminations from Tacoma . . .

By Bill Benda, MD

I have always found AANP annual conventions fascinating, although exhausting, most likely because as a non-ND I attend exclusively as Board member, lecturer, and journalist. No alumni reunions or interesting practice enhancement presentations for me, replaced instead by meeting after meeting after presentation after exhibitor appreciation after AANP after HOD after SALT after NMSA after NDI, with a final acronym of zzzzzzzzz.

And still I look forward to it every year. There is something about this particular field of medicine, a certain cultural attitude I resonate with. Probably a déjà vu of my formative years in the 60s and 70s, life relatively unencumbered by social protocol or political correctness. Only it seems I get to exhibit less inhibition this time around; as I am not a native of this tribe, I am a bit more free to travel in and out of the lectures and social gatherings. A bit more lonely as well - a hybrid of participant and observer, collecting thoughts and perspectives rather than disbursing tales of what I’ve been up to since “the last time I saw you.”

The crowd in the conference center seemed a bit more sparse than prior years, fully expected by staff and convention planners in economically challenged times (although the hotel bar appeared to not suffer from inattention). And there were a few novel presentations, such as the “naturopathic approach to global warming” and “here come electronic medical records.” But this is the year that I discovered the real future of naturopathic medicine, unwittingly lured by an innocent request to fill the role of moderator at the annual ZRT Cup, an answer-the-medical-question competition between our seven naturopathic medical colleges for bragging rights, a trophy, and a check for $10,000. I find these students to be a treasure – innocent and worldly, full of desire to change a world that still confuses their (and our) minds and souls. I can easily perceive a distinct difference between them and us, a touch of purity and excitement and energy (in them). I don’t know where they coalesce in the evenings, but it doesn’t appear to be at the bar, at least not before this writer’s curfew. I imagine they are off somewhere strategizing how to fix this global mess we have gotten ourselves into. Or drinking in their rooms. Who knows?

Back to the ZRT cup competition. The early rounds were populated primarily by students participating or awaiting their turn, along with a few institutional mentors. But the competition was hot, with each panelist hungry for the opportunity to elevate their school to the top of a seven-institution academic pyramid. And one by one they rose or fell, with the final round to be between Bastyr and NCNM the following evening.

And what an evening it was. Beautiful room, full bar, and packed standing room only with students and graduate supporters (quite noisy supporters at that). As moderator I had my back to the crowd, but could feel the heat of expectation on my backside. No place for goofs on my part here – there was far more than the $10,000 prize at stake. NCNM won handily, although not so much from superior knowledge as from a somewhat risky strategy that paid off far more than left them stranded: hit the buzzer early, and trust you’ll know or figure out the right answer. A bit of aggressive behavior coupled with confidence bordering on cockiness, which certainly will come in handy when they enter our healthcare system.

Following the night of the ZRT came days of keynotes, and yes, more meetings. The Gala on Saturday night was quite sweet, and thankfully we finally had a band playing music I could dance to. After the final set, its off to the hotel bar, where last calls were called for over a half hour before security showed up to inform the naturopathic crowd that, yes, we are done for the night.

Sunday is the day most conventioneers reserve as a travel-home-hung-over day, but for our young charges it marks the annual Naturopathic Medical Student Association (NMSA) conference. I won’t list the speakers or content for the weary reader, but will emphasize that this fledgling organization already has a seat at the AANP board table, the American Medical Student Association (AMSA), the Naturopathic Coordinating Council (NCC), and the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). If any of you eyeing this diatribe truly wish to invest in the future of your profession, support this organization. Now. With money. And time. And volunteerism in any way possible.