Integrative Health Institute

Last week I had the privilege to preceptor with Dr. Walker who is a co-founder and clinic director of the Integrative Health Institute (IHI) on King and Sherbourne downtown Toronto. I believe the model of care established to be one of a kind so far in the Toronto area, if not Ontario. Although there are other multidisciplinary clinics that revolve around a Chiropractic approach or a Medical Doctor's paradigm, the IHI is based on a unique collaborative of patient centered care. The practitioners are able to coordinate appropriate treatments for their patients based on a therapeutic order of intervention and utilizes Registered Massage Therapists, Chiropractors, an Osteopath, Clinical Counselor, and Medical Doctor.

To book an appointment at the Integrative Health Institute call, 416-260-6038 or visit their website at www.integrativehealthinstitute.ca

Who Owns the Podium?

I absolutely love the Olympics. My wife and I personally know several Olympic athletes and know first hand the dedication and perseverance it takes to struggle through many hardships in order to realize their dreams. Additionally, as an exercise physiologist and coach, I have tremendous appreciation for what the human mind and body can do in sports.

Although I certainly realize the necessity for their funding, one thing that slightly taints my experience of watching the games is the irony of the largest sponsors: Coca-Cola and McDonald's. What is problematic, from a public health perspective, is that these sponsors are much more than indirectly associated with the sports (like cigarette brands were to car racing). Rather, the perception portrayed is that they are directly a part of the athletes lives. It would seem that a McDonald's breakfast, lunch and supper contributes to gold medals. The athletes appear to be eating there every day and they even bring their parents! Are Coca-Cola and McDonald's really the meals of champions? Unfortunately, I do realize that the answer is yes for some athletes (along with Kraft Dinner and other nutrient void foods) because Canada's athletes are often not able to afford the quality of foods they would like to purchase. And that is an entirely different topic...

But, it is not the athletes I am worried about since they do enough exercise to negate many of the side effects of a fast food diet (Also, it is highly unlikely their diet constitutes fast food to the degree that we are led to believe by the commercials). Instead, the youth are the real targets here. The movie, "Supersize Me" highlights some of the psychology behind fast food marketing - it's quite amazing.

Check your provincial association for Naturopathic Doctors who work with performance athletes for a thorough investigation of nutritional measures for competition, recovery and rehabilitation.

Beyond Compartmentalization

This semester has the largest spectrum of health philosophies I have encountered yet as a CCNM student. On the one hand, we have courses that teach scientific best practices and algorithms like Emergency Medicine, Primary Care, Radiology and Phlebotomy, and on the other there is the "energetics" of Homeopathy and Traditional Chinese Medicine. It is enough to make anybody's head spin!

Although one way to deal with this disparity is to compartmentalize the information and put up walls between the modalities, I find that selecting and assimilating a patient centered approach from what works from each modality is ideal - best practices first of course. For example, the most important skill I have learned from homeopathic medicine is the art of interviewing. Hands down, there is no better or more thoroughly investigative interview process than in homeopathy. The techniques are so involved that many critics credit the process to the cases of success.

This is a situation that is most likely unique to naturopathic medical school and I believe it will ultimately give ND's a corresponding unique approach to health care.

Quote of the Month

�Some people find fault like there is a reward for it."
Zig Ziglar

Intensity of 3rd Year Practicals

Third year comes with a heightened responsibility & increased level of difficulty in the practical sessions that only the pressure of clinic around the corner could apply. Last week we performed acupuncture on the "difficult" points including inside the orbit of the eye (ST 1), above the inner canthus of the eye (UB 1) as well as beside the carotid (ST 9, LI 17 & 18) and radial arteries (LU 8 & 9). Then, today we did our 1st phlebotomy (blood drawing) on each other.

It is interesting how some people have more anxiety about performing these particular tasks as the doctor and others have more anxiety being in the patient's position. Either way, I think it is a matter of conditioning and not any indication of competency or ability to be successful with certain treatments. Originally, it was protocol at CCNM that every male needed to lie down when having their blood drawn because statistically men were the most prone to passing out. I'm happy to say that I didn't pass out (and even watched my partner insert the needle and change tubes) however, I was kindly asked to lie down - the bigger they are the harder they fall!

Need an Adjustment?

Before beginning university, and before I knew about naturopathic doctors, I originally considered becoming a chiropractor. As I had several sport injuries, I was the patient of quite a few chiropractors across Canada.

This year's manipulation classes finally allow us to complete the final thrust involved in performing a spinal adjustment (or any other joint). Until now we have set the foundation and framework in place by learning: anatomy, physical medicine, orthopedic tests and motion palpations, observed manipulations but did not get to perform the actual adjustment on each other.

The teaching assistant for my practical group sessions is a chiropractic doctor and she busted the myth that it takes a strong male to have good adjustments. Instead, technique is everything! I find getting that perfect adjustment is instant gratification for both practitioner and patient.

I personally know several excellent chiropractic doctors and revere them as musculoskeletal experts much in the same way that a family doctor might revere an orthopedic surgeon. In the future, any difficult musculoskeletal case that I came across, I would not hesitate to refer my patients to them.

What I like about receiving adjustments from a naturopathic doctor (in comparison to other practitioners that can adjust) is that we are well trained in the adjustments that are required for the most common musculoskeletal conditions, take ample of time with each patient, and are not limited to only one form of treatment. Metaphorically, we do not need to hammer something that instead needs a different tool.

A Learning Environment

There are occasions where I am reminded of how privileged I am to be in a learning environment where education rather than egos are encouraged. I was reading a story in a conventional medical email newsletter about how hierarchy is maintained by embarrassing (or worse) the new MD residents. Maybe it is because my school is 80% women but I have to say that I was again impressed by the atmosphere maintained during potentially awkward clinical requirements.

Earlier this week, I completed my first gynecological exam under the supervision of a practicing ND. I was politely interrupted to stop once or twice to perfect my technique and kindly given a reminder when I hesitated or forgot the next step. Maybe it is because most ND's are female that ND students are taught a very thorough, yet patient centered gynecological assessment, where each step is performed with maximal patient comfort in mind. I realize it is not neurosurgery but it is enough to remember the first time through, given the circumstances!

My point was not that we are sheltered, because where safety is concerned the standard is strictly maintained, but that we were presented with the best atmosphere, free from unnecessary attitude in which we could learn a skill.