Big red circle on my back!

No, it is not a rash or any other dermatological problem!   Rather, it is the "health" product sales target that comes with being a Naturopathic Doctor.  As ND's practice preventive and proactive medicine, it comes with the territory that sales representatives for neutraceutical companies, weight loss products, energetic products etc, etc, want us to sell their products to our patients (or at the very least, let our patients know that these products exist).  Each week I have one or more sales representatives drop by the clinic asking me to meet with them so they can show me their particular product.  And, every single product is the best product in the world!!

How about some forest through the trees to help establish a little perspective?  There are two considerations that need to be kept in mind: First: number needed to treat and, second: rate limiting.

1. Number Needed to Treat:

For example, how many people with high cholesterol given a Statin medication will it take for one of these people to add one healthy year on to their life?  This is called All Cause Mortality and the research with Statins is interesting on this one!  Especially for women.  Or, from a natural perspective, how many people drinking pH balanced water or sleeping on a magnetic mattress does it take to add one healthy year onto one person's life or improve one person's quality of sleep?  The answer of course is based on indication; is "X" product actually indicated for a person?
 
2. Rate Limiting:

Many patients of mine have a gamut of "health machines" and supplements but still suffer from significant health problems.  Unfortunately, the problem here is these machines and supplements, although not usually harmful, do nothing to improve the symptoms that these patients have.  It is like trying to plug up small holes in a dam to save water when the problem is that it hasn't rained in weeks!  This is the concept of rate limiting - something missing that is stopping an important process.

The point is, we have to draw the line somewhere!  If you walk into a health food store and say, "one of everything please!" this is likely to provide some negative interactions and do more harm than good.  I will typically work with people's own supplemental regimen especially if they are part of a multi-level marketing company and have been lead to believe that x or y is necessary for health.  Naturopathic Doctors determine where health products fit into each person's list of priorities and I make suggestions as to particular importance.

So, before you sign on the dotted line with a direct-purchase neutraceutical company, buy that $3000 machine, or start 6 months of a particular treatment, it would be advisable to consult with an ND who has years and years of education in the natural health field.

Your body works and so does nature!

Two things I have been pondering the past few weeks are the disconnect people have with the amazing capabilities of our bodies and also the natural functioning of nature.

New patients at my clinic are instructed to bring all their medications and natural supplements or botanicals on their first visit so I can ensure there are no interactions.  Additionally, I evaluate each item's indication for that particular patient.  It is not rare for some patients to bring in shopping bags full of regimens of vitamins, herbs and specific nutrients intended to assist, upregulate and support nearly every system in the body.  Then, when I explain that the body has an amazingly brilliant, built in capacity to maintain (homeostasis) the optimal functioning of these organ systems and they most likely do not need to take half of their regimen, some patients think I am being almost sacrilegious! Certainly there is an appropriate time, dose and indication for supplementation but will a grocery cart of items, that are not indicated, add any healthy years to someone's life?

My second observation stems from having my own city lawn for the first time (I grew up on a farm).  How did urban society get to such a place of disconnect from nature where people use their lawn mowers to collect all the grass clippings, send this to the landfill site, and then pay a chemical company to put back on their lawns an inferior synthetic fertilizer replica of what they just sent away?!  And then there are all the chemicals and water required to keep that artificial induced carpet of dark green!

It all comes down to education.  Education about what we do directly to our bodies and indirectly through how we treat the world around us.  I believe teaching is the most important aspect of being an ND.  It takes time but is so worth it!

If you follow our Mountain Health Team Facebook we'll show you some interesting ways to utilize those yellow dandelion flowers (Taraxicum officinalis) in the next few weeks.

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!!