Tuesday, November 24, 2009

Gratitude and Naturopathic Medicine

By Sara Thyr, ND

Thanksgiving is many circles of love: A story of one Thanksgiving
Photo by controltheweb via Flickr, under the Creative Commons License.

I have a bumper sticker on my car that says, “What are you grateful for?”

It is one of my favorite questions…. to others as well as myself. I use it often if I can’t sleep at night. It serves to put me in a positive state of mind, reminding me of all of the many blessings and abundance in my life.

Being a naturopathic doctor gives me more to be grateful for each day.

I get to practice cutting edge medicine in a calm and comforting environment. I have the training to diagnose and treat disease, working to uncover root causes of many illnesses like few other practitioners have the opportunity to do. I get to utilize safe and effective medicines, including herbs, nutrients and homeopathy, helping to find the perfect right thing for my patients that will not interfere with other medicines or cause unwanted side effects.

My colleagues are smart, kind and good-humored. Many of them I count among my best friends. I can always rely on them for an insightful opinion and words of wisdom. The years that I volunteered as president of the New Hampshire state association, and more recently on the board of directors of the AANP, have led me to be a part of a greater good. This has also afforded me the opportunity to interact with truly amazing, gifted people. I feel so lucky to be associated with this profession.

I am grateful that naturopathic medicine makes so much sense. That is what struck me when I first learned of it. Treat the whole person, remove obstacles to cure and find and treat the cause of disease…why don’t we do that in our lives more often.

Naturopathic medicine makes me more connected to nature. It brings my attention to making our planet a better and safer place. It creates awareness in me and then those I work with to avoid toxic chemicals in skin care products, cleaning products and in the food we put in our bodies. I am more grateful for pure water and organic food because of my acute awareness that everything we put in our bodies matters.

I am most grateful that my patients get better. That I can give them the tools to improve their health in a dramatic way, when no one else has been able to get to the bottom of their illness. One woman doesn’t need to get a hysterectomy; a young woman has a baby where she’d not been able to have one; another has resolution to very painful digestive problems; a man who came to me can breath without allergy medications, and another is able to wean off his asthma medications as his symptoms have resolved. There are many more stories just like these. It is rewarding to see that they are so happy, healthy, and yes, grateful.

One of my favorite things to do is to speak to prospective students of naturopathic medicine. I can’t imagine a more rewarding profession.

"Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos into order, confusion into clarity.... It turns problems into gifts, failures into success, the unexpected into perfect timing, and mistakes into important events.

Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow. "

-Melodie Beattie

Monday, November 23, 2009

Clinicians and Educators’ Desk Reference

By Marica Prenguber, ND, FABNO

Open book
Photo by Honou, via Flickr, under the Creative Commons License.

Another excellent reference to keep on hand! Developed by the Academic Consortium of Complementary and Alternative Health Care, the Clinicians and Educators’ Desk Reference, is a handy guide to the five licensed complementary and alternative healthcare professions. It has been vetted by experts in each field, and provides information on emerging fields of traditional world medicines, holistic nursing, and holistic and integrative medicine.

The American Massage Therapy Association Council of Schools, the Association of Accredited Naturopathic Medical Colleges, the Association of Chiropractic Colleges, the Council of Colleges of Acupuncture and Oriental Medicine, and the Midwifery Education Accreditation Council were instrumental in the organization and information development. In addition, the American Holistic Nurses Association, the American Holistic Medical Association, the American Medical College of Homeopathy, the Consortium of Academic Health Centers for Integrative Medicine, the International Association of Yoga Therapists and the National Ayurvedic Medical Association also contributed to the content.

Naturopathic input was provided by Paul Mittman, Michael Traub, and Pat Wolfe. Authors wrote to a template which provides key information on the profession, its standards, regulatory status, and more. Each chapter covers one discipline and provides the following information (and much more!) for that discipline: Philosophy, Mission, Goals, Clinical Care, Approach to Patient Care, Scope of Practice, Referral Practices, Education, Schools and Programs, Curriculum Content, Faculty and other Training Information, Accreditation, Regulation and Certification, Regulatory status, and Organizations and Websites.

This reference can be helpful when responding to patient questions regarding other disciplines, as well as when referring patients to those same disciplines. Admittedly I would not call this edge of my seat reading, yet I find that it is a great resource. We know what we do as naturopathic physicians, but what do we know about the details of those other approaches that we find patients also utilizing? Having additional information about those approaches might help us to better select which one is a better fit for referral for our patients. So give it a read – it’s a short 124 pages, and packed with useful information!

Monday, November 16, 2009

Diversity and the Changing Face of Naturopathic Medicine

By Lise Alschuler, ND, FABNO
Vice President, Quality and Education, Emerson Ecologics

final exam
Photo by DC John via Flickr, under the Creative Commons license.

I had the honor and privilege of spending a few days at the Canadian College of Naturopathic Medicine this week. I was invited to the school as part of their naturopathic elder series, which still makes me giggle a little. Perhaps being an ‘elder’ means simply having had enough time in the profession to gain a perspective. It is true that with each passing year, I find myself settling a little further back into the proverbial armchair and surveying the profession. One element that I have been observing for awhile and was beautifully brought forward during my visit to CCNM is diversity. For many years, I have been alternatively disappointed and alarmed and the lack of racial and ethnic diversity in the naturopathic profession. When I was in naturopathic school, I think there were two people of African American descent in the entire school. Even to this day, the faculty at our US schools are overwhelming Caucasian. That is the bad news. The good news is that things are finally changing. Nowhere is that more evident than at CCNM. I was amazed and impressed with the incredible ethnic diversity in both the student body, faculty and administration at CCNM. Certainly the fact that CCNM is located in Toronto, one of the most ethnically diverse cities in the world, has helped to diversify the school. Perhaps against steeper odds, I have been also been impressed with the significant and growing ethnic diversity in the student populations at a couple of our US naturopathic schools. These trends are encouraging.

It only makes sense that the naturopathic profession, as a part of its inexorable emergence, embrace diversity. Our medicine is the amalgamation of healing traditions from around the world. Naturopathic medicine, itself, is color blind. The society within which we practice is increasingly colorful and heterogeneous. Without diminishing the significant accomplishments towards ethnic and racial diversity made by all naturopathic schools, I assert that there is more to accomplish in this regard. Adding more ethnic and racial diversity to the faculty at all schools is of paramount importance. This, in turn, will bring more cultural sensitivity to naturopathic education and will provide critical role models for students of color. We also need more of our doctors of color in leadership positions. Right now, the AANP Board of Directors are all Caucasian. It has been that way for some time. I invite our African American, Asian, Hispanic and Native American NDs to run for the Board, to submit abstracts at our convention and to continue to be a visible and active part of our naturopathic community. I also urge my fellow Caucasians to exemplify cultural and racial sensitivity and inclusiveness. In the meantime, instead of leaning back into my proverbial armchair, I find myself leaning forward, eager for the next, very colorful, generation of naturopathic physicians to infiltrate all aspects of our profession.

Wednesday, November 11, 2009

I Know You Are, But What Am I?

By Bill Benda, MD

Dictionary Uno

Photo by dotjdotsmith via flickr under the Creative Commons License.

There is a lexicon war going on this year, have you noticed? The first shots were fired last February at the Institute of Medicine Summit on Integrative Medicine in Washington, DC, where non-MD practitioners (specifically nurses and social workers) lined up at the microphone during the public commentary sessions to insist on the substitution of “healthcare” for “medicine” in all future language. Then, over the summer, the American Medical Association launched the first wave of its Scope of Practice Partnership, intent upon preventing doctorate-level professions from calling themselves “doctors” and “practicing medicine” and defining exactly what a “physician” is. On the other hand, a few short weeks ago, the US Department of Labor confirmed the legislative validity, among other things, of the official titles “naturopathic physician” and “naturopathic doctor.” So in general it appears people are happy being called “doctor,” unless they don’t want to be, or aren’t legally qualified, or someone else doesn’t want them to be, and that “healthcare” is the politically correct phrase from now on, unless we are talking about naturopathic “medicine” or Traditional Chinese “medicine,” in which case “medicine” doesn’t mean MDs, unless we are talking about the AMA, in which case “medicine” or “doctor” can only mean MDs. Or DOs. Or dentists.

Sheesh. What ever happened to Why Can’t We All Just Get Along? Where has the egalitarian, its-about-the-patient-not-us, change-the-paradigm conversation gone? If we agree that we all want a new definition of healthcare, why are we arguing over old classifications of entitlement? Don’t get me wrong – classifications are essential in the bureaucratic world of reimbursement and such. But doesn’t this war of the words seem a bit childish when so much is at stake in both the national and global arena?

I am, by all traditional criteria, a doctor who practices medicine. And I actively discourage anyone knowing this particular fact before they first get to know me as a person, as I usually will encounter one of two reactions – either an undeserved deference or an equally undeserved dismissal as likely being a jerk (which, by the way, if true is unrelated to my medical degree). In fact I propose that anyone making a restaurant reservation using the title “Dr,” whether medical or naturopathic or veterinarian, should be immediately seated next to the bathroom and then ignored.

The fact is that none of us is actually a doctor, or a nurse, or a naturopath, or an acupuncturist. We are simply human beings who have chosen a particular profession in our desire to help other fellow human beings, which is by definition the antithesis of entitlement. And to fight over a title while denigrating the AMA for its aggressively jealous obsession with that particular idiom is not simply childish; it’s hypocrisy.

And anyone that confused needs to see a doctor.

Friday, November 6, 2009

Charlie Chaplin, Mr. Bean, and Medicine

By Jacob Schor, ND, FABNO

Charlie Chaplin in the Bradbury Building
Photo by Emmyboop via Flickr, under the Creative Commons License.

I've been reading up on what I call the Chaplin Studies over the last few weeks and they've given me a curious platform on which to observe both my daily life and that of my patients. By Chaplin Studies, I'm not referring to some academician by the name of Chaplin. Instead I'm thinking of the studies on laughter and humor's physiologic impact, most of which use a Charlie Chaplin movie, Modern Times, as their experimental control. In recent years though, Chaplin has been supplanted as a laugh inducer with videos of Mr. Bean in order to achieve similar effects. I suppose to be more accurate I should think of these studies as Chaplin, Bean, et al.

However we want to refer to them, there are an elegant group of research papers that was initially triggered initially by Norman Cousin's book on how he cured himself with laughter. Kimata's work an how laughter tempers allergic responses is probably the best known; laughter calms atopic dermatitis, asthma and related illnesses in adults and infants, even to the degree that having nursing mothers watch funny movies improves eczema and night time sleeping in their infants. Hayashi and his group of researchers have taken this a few steps further analyzing which genes are activated by laughter, analyzing thousands of genes before and after laughter provoking videos and no surprise the genes turned on mostly affect immune response, NK Killer Cell activation for the most part.

This isn't what I've been thinking about actually. I've been thinking about the controls they've used in these studies. For the most part in contrast to watching video of Chaplin, Bean et al. used to provoke laughter, the control groups in these studies usually got to watch the weather channel.

That the weather channel is a neutral control has triggered a chain of thought. There was a time that we watched television for entertainment, we would sit down to be amused, engaged but mostly entertained. Of course I may simply be thinking back to my childhood watching cartoons and the Three Stooges. Instead these days many people leave the television on to keep track of the weather, the news, or sports. As if I care what the weather is in Boston today? This does nothing good for us. What of the shows that fall on the opposite side of the spectrum from laughter, shows that my daughter groups under the category, 'Dead Body Shows?' If laughter improves or balances our immune function, what does the casual and constant viewing of shows that portray postmortem examinations? Is this good for us?

These ruminations have colored my observations during the day, as if I am turning a meter towards all experience. Does this make me laugh? Does this make me cry? Does this simply bore me to no end? These experiences are probably reflected in genetic expression and immune function.

Thank goodness for NetFlix and Mr. Chaplin and Mr. Bean I say. They have become my new after work antidote.

Tuesday, November 3, 2009

Where's the "health" in health care reform?

By Sara Thyr, ND

Free woman holding fresh blueberries healthy living stock photo Creative Commons
Photo by D Sharon Pruitt via Flickr under the Creative Commons License.

Back in August, I read an op-ed in The Washington Post by Kathleen Sebelias, our new Secretary of Health and Human Services. It brought this issue that has been nagging in the back of my head to the fore. She really believes that Obama’s plan will improve the health of Americans. But that is impossible. That is not at all what it is designed to do. It appears to me more likely to increase the number of people who have health insurance, which has not been correlated with Americans being free of symptoms and disease.

The problem with that is that in my experience, the insurance companies have no interest in health. Their focus is by and large money.

If you want to improve the health of Americans, you must begin to look more deeply at what is causing them to be ill. Look at what they are eating, what their stress is, what their daily habits are, and assess their exposure to toxins. If we spent even a fraction of the money that currently goes to insurance companies (who’s kneejerk habit is to reject claims, not promote health) on taking the time to actually figure out the underlying causes of symptoms, we would be at least heading in the right direction.

At some point, Americans must realize that they will pay for their own health. Whether or not they want to filter that money through the pockets of insurance executives and the yachts of the owners of big pharma is up to them. But pay they will. I figure they might as well actually get healthy in the process. Something others seem less interested in.

What makes me think Americans are ready to pay for your own healthcare? They already are.

On the board of directors for the American Association of Naturopathic Physicians, we have been having the conversation about DSHEA and the supplement industry in general. Even in the currently unregulated state, it is a multi-billion dollar/year industry. I want my patients to have high quality supplements. But I also want them to have access. The real point is that people are ready to implement changes that are not advocated by their insurer. Not only ready, but happy to pay for it themselves. This is because they want to be well. Not just insured. But actually feel good, live longer, sleep soundly.

If you want to improve the health of people in America, you must work with the people who care most about their health. The two most important groups are the people themselves and the physicians who are caring for them.

When insurers control the amount of time physicians spend, as well as the practice of medicine, the care given is not better. And with all of the overhead and CEO bonuses, it is not cheaper. Mostly, the people are not more well. Most physicians do care about their patients, but have such contraint on their time, they move towards the habitual “here’s your prescription.” The drug may have serious side effects, and rarely does it get to the root of the problem.

Without getting to the root of the problem and supporting the human body, true health is outside our grasp.

If your car’s tired are going flat, is it really ideal to just keep adding air? Sure, that might work to get you to the grocery store and back. But what you really need to do is find the hole. Don’t call your car insurance company. Take it down to the shop and get it fixed. Or buy new tires. Don’t expect someone else to pay for it. They’re your tires.

We spend more than any other nation on health care. If access and money would make us well, we would not rank 25th in the world for infant morbidity and mortality. We would not be lagging behind other nations in overall wellness. Nations who spend a mere fraction of what we do on health care.

As my friend Bill Benda, MD says, this current plan will be short lived. Until we look at increasing health, not increasing insurance coverage, we will be drinking the same old wine out of a new bottle. The public will not tolerate this for very long. The proof of the pudding is in the eating. Are you well or are you not well? Believe me, you care more than anyone about your health issues, not matter how simple or serious.