Be in the know

I always seem to be amazed that it is the end of the day, and the end of another week or month.  Proof that I am in the right profession!  Now it has already been 2 months since my last blog post.

Well, after practicing for 5 months and having my own clinic since January here in Airdrie, I have noticed several common trends in Canadian health care.  Here is one: No news is not necessarily good news.  That is in regards to your blood work and test results anyways.  I frequently hear this from my patients who have had recent blood work performed by their MD.  "Well I haven't heard anything back so all must be ok."  Unfortunately, Medical Doctors are in massive short supply in my area which results in these professionals being severely overworked. 

As such, I have learned to have my patients release a copy of their recent records to me so we can take a look together.  And unfortunately, I often find values that are not just low-normal or high-normal but values that are even flagged by the lab as out of normal ranges.  Most importantly, these abnormal results confirm a clinical suspicion I had regarding the symptoms and presentation of my patient.

So, these labs are your property and do not feel shy to ask to have a copy.  Your MD is within his/her right to ask that you pay a photocopy fee but they cannot prevent you from seeing your results.  Be in the know! 

Up for Air!

This is one of the first days I have had a chance to even think about taking a moment to write something on this blog.  Since beginning negotiations for the purchase of the Healthy Options Centre in October last year, to taking over ownership on January 1st, and transferring all the business necessities while still seeing patients full-time, 2012 has started out at an exceptionally fast pace.  There just does not seem to be enough hours in the day!  Once again, trying to keep some semblance of a balanced life has been very difficult.  With the stress and pressures I feel like I'm in school again but practicing is just a little more fun!

I am really enjoying Airdrie and have been happy with the openness to culturally relevant, evidence based natural therapies.  Most people seem ready for a more naturopathic approach to health care.

Priorities and Paradigms

Since moving back to Calgary I've been without a dentist and I would really like to find one.  It is certainly not that there is any shortage , but I have had so many bad experiences with dentists in the past that I have to admit that I'm overly cautious.   This is one example why networking is so important.  I find that when people can put a face to a name, and then be reassured and in agreement with my approach towards patient care, it makes a big difference towards building a practice. 

However, one obstacle I've encountered on several occasions recently is price.  "You know I'd really like to see a naturopathic doctor but you are so expensive."  And, some ND's certainly are.  However, I believe the priorities of our society and individual paradigms may be more responsible for this perception than actual price (influenced no doubt by socialized heath care - which I'm thankful for in the case of an emergency). 

My wife came home last night after getting her hair cut and styled.  And, she was $110 more beautiful!  Also, several weeks ago I got Canadian Tire to put my winter tires on rims.  That was $167 exchange just for the labour alone.  That is more than the cost of my 1 hour new patient appointment!  I found out that Canadian Tire charges a basic shop rate of $115 per hour and raises this to $125 per hour when there is any electrical work involved.  And this work could be done by a 19 year old mechanic.

Just to clarify, I am very happy for any 19 year old who has worked hard to become a mechanic and I recognize the responsibility of ensuring an automobile is safe on the road.  However, this is not a health care provider.  So, is it unreasonable to expect to pay 25 to 50 percent more per hour for a naturopathic doctor than a mechanic?(1.)  

I believe that since people are accustomed to conventional health care being free in Canada, it requires both a paradigm shift and a change of priorities to get over the inhibition to pay for health care.  However, when conventional medicine has been unsuccessful in helping with a particular health concern we may need to ask, what do we value more: our car, haircut...etc, or health?

Footnote:
(1.) I should add that if someone came to most naturopathic doctors and really could not afford to pay, and that person was not spending $110 at the hair stylist, most would gladly work something out in that case.

Who are Environmentalists?

With the political and environmental controversy surrounding the Keystone pipelines, I realized that the role of environmentalists often seem to be separated from general society.  I heard a CBC radio host exclaim, "I don't know what the environmentalists would think of that" referring to a statement by Keystone.  As if their view would be somehow distinct from the rest of society.

What would happen if society viewed environmental scientists as health care practitioners?  There is plenty of evidence to demonstrate this to be true - our health is directly influenced by our environment.  In fact, even determining the exact role of our genome becomes very difficult because gene expression is changed depending on the environment.

I believe that when society begins to realize that environmental scientists are indeed health care practitioners, and very important ones, there will be major leaps forward in preventive medicine.  

So many choices

On the one hand, waiting for my Alberta license number to arrive could be stressful if I let it bother me.  But, there are just too many exciting opportunities for naturopathic doctors now.  As such, having the time to work through some very important decisions, without seeing patients yet, has been a blessing in disguise.

I believe that we are at the beginning of really being able to help the Canadian public due to an increased demand for integrative medicine.  On that note, I was also very happy to see that CCNM has added another primary care procedures course to the curriculum to further prepare ND's to be excellent primary care providers.  I'm so proud!

Over the past 2 months I have continued to delve deeper into the business side of running a practice and recognize that no matter how many practice management classes we took, nothing can replace a good business mentor as well as doing a lot of researching and using common sense!  All the best to everyone out there starting out - we need to stick together!!

The ND Generalist

One thing I have noticed when talking to potential patients lately is that our society tends to overvalue specialists.  A common question I get is, "what do you specialize in?" and people's reaction to my desire to work in Primary Care is bewilderment.  Yes, I have my interests: sports medicine, gastrointestinal health, etc., but I just enjoy helping people with a diverse set of presenting symptoms.  I find it is exciting and gratifying. 

In actuality, Primary Care is a specialty too.  In fact, an expert generalist can save a person a lot of pain, time and unnecessary referrals.  Of course there is a very important place for specialists, but we need to put a greater value back on general practitioners.

This is one thing I love about naturopathic doctors.  We can use a number of tools in Primary Care that work well and are often safer than a conventional approach. We can utilize botanicals, nutrition and supplements, adjustments of the spine, acupuncture, and counseling all with one patient - if it is necessary.  Possibly the greatest thing about naturopathic doctors is we do not utilize these modalities in isolation but we understand how each fits together to help the patient.

House Calls

Remember back in the good old days when doctors did house calls?  Well, as the provincial elections approach, several politicians are talking about mandating Medical Doctors to do a percentage of house calls.  I have no idea how they will fit house calls into their overpacked schedule but the politicians have recognized that the demand is there. The timing is appropriate in my case as I have been shocked at the leasing prices in Calgary.  There are certainly some beautiful locations to set-up a naturopathic practice, but at $30.00 a square foot per year, the price seems prohibitive right now.  Certainly there are opportunities for new ND's to rent office space in existing practices but it also might be a perfect time to provide patients with a house call service.