Archive for tag: naturopathic medicine

Naturopathic Medical Philosophy

2013-11-20_edwardsHi, everyone!

This week I'll start a series on naturopathic medical philosophy.

Here at NUHS we are fortunate to have Dr. Louise Edwards as the cornerstone instructor for the philosophical portion of our medical education. Dr. Edwards has developed a strong curriculum that incorporates all of the ideas I will be discussing over the next few weeks. With her permission, her words will appear verbatim in this blog where the circumstances are most prudent to do so. This week, I'll begin with the basics, the Naturopathic Model and our primary goal as naturopathic doctors.

The Basics 

Naturopathy is treating suffering (pathos) according to the laws of nature, using natural means.

We, as students and interns, are trained to use the most natural, least invasive methods that are within our scope of practice to help our patients return to a state of health. If higher force interventions are necessary to help our patients heal, then we will refer to a specialist for co-management, just as any other primary care provider would do.

The Naturopathic Model

  1. Health is a constant and natural state of being.
  2. Ill health is an adaptive response to disturbances in the organism.
  3. The universe is ordered and intelligent. Healing is a process that is ordered and predictable.
  4. Removal of disturbing factors (correcting the disturbances in the Determinants of Health) will create the basis for a return to normal health.
  5. Intervention should involve the least force necessary to stimulate the self-healing mechanisms.

Through recognizing and working within the Naturopathic Model, we are able to determine the root cause or "center of gravity" of a patient's divergence from a state of health. With an understanding of the root cause, we can then implement the naturopathic therapeutic order, which I will discuss in coming weeks.

Re-Establish the Basis for Health

Finally, our primary goal as naturopathic doctors is to "re-establish the basis for health." 

We accomplish this through correcting the disturbing factors impacting a patient's healthy state of being.  The patient's disturbing factors can also be described as their "Determinants of Health." Next week, I'll discuss these determinants and how they impact a patient's health, over the short and long term.

Intern Skills - General Physical Exam

This past week was spent finishing and polishing my presentation for Grand Rounds titled "Safely managing prehypertension and stage 1 hypertension with botanicals." This is a subject that is close to my heart if you will since hypertension and strokes are a common occurrence on my father's side of the family.

Hypertension has been called the "silent killer" as a patient may not notice any symptoms until a significant medical event such as a stroke or heart attack occurs. A skilled, thorough doctor performing a routine general physical exam can sometimes uncover masked symptoms, which a patient may not even be cognizant about. A well-performed physical exam can help prevent illness or even prevent an early death.

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At NUHS, we are trained on basic physical exam skills beginning in our second of 10 trimesters. We are taught to fully examine the patient through observation, listening, touch, and measurement. As we progress through the curriculum, we build upon our basic skillset and learn to interpret what we discover. This interpretation is honed under the guidance of our clinicians in the Whole Health Center and satellite offices.

A quick rundown of some of our exam procedures includes:

  • Observing the patient, their demeanor, alertness and responsiveness
  • Observing the patient's skin for hydration, trauma, lesions, or color
  • Measuring height, weight and visual acuity both near and far
  • Taking vital signs: temp, heart rate, breathing rate and blood pressure
  • Examining the head and neck, including lymph nodes and thyroid
  • Testing all cranial nerves
  • Checking the internal components of the eye, as well as the lens and cornea
  • Checking the ear, sinuses, nose, mouth, and throat
  • Listening to the patient's lungs and heart thoroughly
  • Testing muscle strength in the patient's arms, legs, hands, and feet
  • Testing muscle reflexes in both arms and legs on each side
  • Testing patient's sense of joint awareness and planned movements
  • Performing a full abdominal exam, listening for bowel sounds (good)
  • Measuring the size of the liver and spleen through tapping and listening for a change in sound
  • Listening for any abnormal sounds in any major arteries of the body

This seems like a lot to do in one visit, especially if the patient is in a hurry. We have the physical exam presented so often, that by the time we are in clinic, we can perform this exam in 30 minutes or less! This gives plenty of time for the remainder of the patient visit and conversation. The general physical exam is intended as a screening tool to determine if more focused examinations are required for the patient. The physical exam skillset we learn at NUHS helps us to target key systems with quick, accurate examinations. When in practice as primary care doctors, we will rely on this skillset each day with our future patients. These skills will help us save lives.

Two Fellow Interns

This week I'm profiling two naturopathic interns, Heather Bautista and Echaukyei (Chucky) Ndumbi. Today, as the two of them were sitting discussing their future practices and the lives they would improve and save, I decided to set up an impromptu interview.

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Echaukyei (Chucky) Ndumbi and Heather Bautista

Heather Bautista is a native of the Chicago area. After working in the pharmaceutical industry for a number of years, Heather saw how disease was being "treated" and not healed, across the spectrum. She decided to pursue a career that helped others heal through learning proper lifestyle choices and habits. She chose a profession that gets to the root cause of a problem and finds a way, where possible, to remedy that problem to return the person to a basis for health.

When Heather was considering medical school, her experience with the pharmaceutical industry was a strong consideration in her decision to pursue naturopathic medicine as opposed to allopathic. She has a strong desire to help people heal rather than take a course of medications for an indefinite period, many times simply masking a deficiency or illness. When asked what gives her motivation for becoming a naturopathic doctor, Heather mentioned the complete sense of accomplishment and fulfillment that comes with helping another human being truly heal.

Chucky is a native of Cameroon. After his family immigrated to the United States in his early teens, he decided to continue the tradition of becoming a healer, as his family has been in Cameroon for generations. Chucky remembered how healthy his friends and family were as they consumed vegetables, fruits and meats from their farms and lived a healthy, active lifestyle. Chucky came to his decision to pursue naturopathic medicine as it espoused a lifestyle that is crucial to the basis for health as well as being eclectic in preventing, as well as treating, and curing disease, when prevention is not enough.

Chucky chose NUHS based upon the location of our campus to his home in Maryland. Chucky knew he wanted to pursue naturopathic medicine and he said he truthfully could not have prepared himself for the rigors of the basic sciences portion of the curriculum here at NUHS. Essentially, when he visited campus, he fell in love with NUHS. Chucky feels that NUHS is preparing him to become an eclectic naturopathic doctor who will use the proper modality to help his patients heal to the greatest extent possible.

Each of the students who roam the halls of the naturopathic clinic know that when strictly looking at the mathematics of the cost of naturopathic medical school vs. allopathic medical school, the costs are very similar. At the same time, the residencies are not as plentiful, the backing of huge pharmaceutical and medical supply companies is non-existent, and the starting salary of a newly matriculated and licensed naturopathic doctor is a fraction of a new allopathic doctor's. While these are the hard facts as the profession stands today, we are growing as a group.

The success stories are mounting as NDs set up practices throughout the country. We are licensed in 17 states and U.S. territories at the time of this entry's publication. As our numbers are currently around 6,000-7,000 NDs in the USA and Canada, the word is spreading that our medicine works to get to the root cause of illness. Somewhere I've read that about 25,000 practitioners is the critical number to truly have an educated populace who knows of our profession and how we approach medical care. If this is the case, we are doing a pretty good job until now getting out the word about Naturopathic Medicine, in 17 of the 50 states so far.

As Heather and Chucky expressed today, most naturopathic medical students are not here for a huge paycheck. While we all acknowledge that we need to make enough to repay our student loans, pay our bills, live a good life, and save for retirement, our true purpose here is to save lives.

New Classes

This past week we were introduced to two of the more interesting classes I have taken here at NUHS over the past three years. These classes are Minor Surgical Techniques and Environmental Medicine. 

Minor Surgical Techniques is perhaps our best example of medicine's greatest force of intervention, while also following one of the Naturopathic principles of "do no harm." The task of bringing injured tissues together (so that they can heal more completely without complication) while piercing that tissue with a needle and suturing material (some tissue damage in order to help the whole person heal) can help prevent local infection building and possibly invading the circulatory system, where it can infect the person's entire body. 

While many of us will never use the procedures taught in minor surgery, some of our licensed states require that the naturopathic physicians in that state be able to perform all procedures that a primary care doctor would perform in their normal duties. 

Environmental Medicine is a review of the "total load" of today's environment upon the human body. We look at all sources of toxins from our food supply, items of everyday living, air, water and electronic sources. We measure the impact of these sources upon the human body, both in the short term as well as over a lifetime. We research ways of detoxifying the human body from these influences and ways of helping the human body, mind and spirit recover from an overload of toxins. 

These classes roll up many of the concepts we learned in the basic sciences portion of our curriculum from anatomy, inflammatory process, tissue injury and healing, our bodies' built-in filtration systems and just about every process we learned. Now, as I have said before, the concepts are being applied on a daily basis, both in our classes as well as when we see our patients at the Student Clinic.

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In Memory...

Finally, on this Memorial Day weekend, I'm taking the bully pulpit of this blog to honor two of the veterans who have given their lives for our country, our freedoms, our people--not just for their generation, yet for those who follow, both born here and who immigrate here for a better life. These men are my uncles: U.S. Army Private First Class Edward Ammons, who was killed in action in 1945 on Luzon Island in the Philippines during the waning months of World War II after having fought much of the Pacific Campaign; and U.S. Army Private First Class Otto Ammons, who was killed in action in early 1952 near the 38th Parallel during the Korean War. Our family has never forgotten them and I will do my best to ensure that none of our veterans who have given their lives willingly for our country and innate liberties, regardless of the war, action or operation are forgotten.