Discovering Naturopathy...a Student Perspective

Up for Air!

2012-01-26T13:42:00.001-05:00

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

2011-12-08T20:41:00.001-05:00

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?

2011-11-17T12:47:00.000-05:00

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

2011-10-26T17:53:00.001-04:00

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

2011-10-05T15:49:00.003-04:00

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

2011-10-03T07:45:00.003-04:00

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.

NPLEX Results

2011-09-28T18:58:00.001-04:00

Congratulations to everyone who wrote NPLEX (and Boards) and passed. It was great to get the results sooner than expected and see the right number of capital "P's" on my results page. Thank-God!! I would age another 10 years if I had do all that again...it makes me shiver just to think about it! However, the exams are extremely difficult and failing the first time is not necessarily a reflection of intelligence or your ability to pass. So, if that happened to be you, do not give up.

Well, now there is a mountain of paperwork to complete and decisions to make to begin the process of opening up a practice. I'll keep you updated.

Post Surgery

2011-09-22T16:54:00.000-04:00

Well, I don't intend this blog to be overly personal but I thought that I should update my mothers situation to say that she is recovering well. She believes that her orthopedic surgeon was a perfectionist (which is a good thing!) and that he gave her good instructions before she left the hospital. The silver lining on a horribly painful and frustrating week.

The Canadian Health Care Crisis Just Became Personal

2011-09-19T00:56:00.008-04:00

This week has brought my family up close and personal with Canada’s overburdened and sometimes depersonalized health care system. Last Wednesday my mother broke her leg. My dad took her to the nearest emergency (at the Durham hospital) where she was evaluated and sent home with a partial cast to wait for surgery. The attending MD also prescribed Ibuprofen as my mom mentioned she doesn’t tolerate some Tylenol (most likely due to the codeine). The pharmacist rightfully caught the fact that my mother was scheduled for surgery and Ibuprofen can thin the blood leading to potential bleeding problems in the operating room. After some phone calls, this was worked out and she was re-prescribed Tylenol without codeine.

My mom was then referred to the Grey Bruce Regional Health Centre in Owen Sound (Ontario) for surgery to pin the broken tibia in her right leg. She was told she would be able to get in within the next couple of days.

My family called the hospital on Thursday several times and were told that things were too busy to take my mother in yet but said if she got a letter from the attending MD she could go to London Ontario and wait for her surgery there. However, she chose to wait for an opening in Owen Sound (which is only 30 minutes away) instead of driving 3 hours to London with a partially casted, extremely painful broken leg.

On Friday my family called the Owen Sound hospital and were told that there was no record of my mother requiring surgery and they would need get her information again. By that afternoon, the hospital found her information and mom was booked in for surgery at 10 am Saturday morning. She was instructed not to have any food or water.

On Saturday morning she arrived at the hospital expecting surgery by 10 am. However, after a 9 hour wait, without food, water, or painkillers, she was told that there was a mix-up with her 10 o’clock surgery time and she would be rescheduled. At this point, the swelling around her broken tibia had gone down which allowed the bone to separate and move freely with the slightest movement. This caused her excruciating pain. So, on Saturday night she was put up in the hospital and rescheduled for surgery again the next morning.

Finally, at noon Sunday morning (5 full days after breaking her leg) my mother underwent surgery to get two pins and a plate placed into her leg as well as an unexpected bone graft and muscle repair. What an ordeal.

It is hard to believe that this happens in Canada. I have always stated that conventional medicine is ultimately best suited for acute situations but I’m beginning to have my doubts that this generalization can be applied to all hospitals in Canada. Shame on the Grey Bruce Regional Health Centre.

Transition time

2011-09-16T10:42:00.000-04:00

The last few weeks have seen a tremendous amount of change for my family and I. After writing Board exams, we packed up our apartment in Toronto and took a cross Canada road trip to relocate to Calgary Alberta. This has also been a time of transition from medical student life to business owner.

Over last 4 years, as the title of this blog indicates, I have provided prospective students and advocates a unique inside perspective of life as a student of naturopathic medicine. Although I will never stop learning and always be a student of medicine, I'm not certain this blog title is still appropriate. Anyhow, as the next few months unfold, I will give some updates on the transition from student to practitioner.

Board, Board, Board!

2011-08-12T18:17:00.005-04:00

It has nearly been a week already since taking the Ontario Board certification exams. I should be used to people being intensely analytical and critical about my performance after years of practical sessions and exams, but somehow the Board examiners seemed to have a skill for making my mind go blank. The experience was very, very humbling; in fact, it was somewhat traumatic! The good news is that I'm told many of us will feel this way but ultimately do very well. It is part of the affliction of being a perfectionist!

In Ontario, graduates' skills in physical and clinical diagnosis, instrumentation, Chinese Medicine and acupuncture, and spinal manipulations are all tested in practical exam sessions. There is certainly a lot on the line as a failing grade requires a retake exam next February and an inability to start a practice in the mean time. It is a lot of pressure to say the least. And what is worse is that we do not know our results until October!

In the meantime, I wish everyone of my colleagues all the best with their exam results and with beginning their next chapter in the naturopathic journey, wherever it takes them.

Post NPLEX II

2011-08-05T19:57:00.002-04:00

If I were to make a list of all the things I would loved to have known well while writing the 400 questions on the NPLEX exams, it would be a pretty long list! I feel like each exam question was written by a specialist from a particular field of study and we were required to take our best stab at it with a generalist's training. Well, I guess who better to write the perfect question anyways than a specialist!

Probably one of the unforeseen challenges for me was on the second day after writing the elective TCM and acupuncture exam. During the first 20 or so questions of the afternoon core clinical exam, what happened was when I would see a case where a patient comes in with poor memory, palpitations...etc., etc., I would think, "that's got to be a heart blood deficiency," or whatever TCM diagnosis corresponded to the symptoms. Then, I'd remember that this part of the exam needed a Western diagnosis.

Well, it sure was a mental marathon and, I'd have to say that it was harder than I thought it would be. But, that is the past and it's on to Board exams this weekend. After this weekend, then we can finally celebrate!

Think three weeks of summer left

2011-07-30T14:16:00.000-04:00

That's right, when this is all over, there are still 3 weeks of summer left to enjoy.

All the best to everyone who is writing their NPLEX and Board certification exams next week. We've made it this far so we can do it!

NPLEX & USMLE

2011-07-09T19:23:00.003-04:00

I guess I'm competitive by nature! I think it takes a significant amount of competitiveness just to complete 8 years of school and then continue another 3 months of intensive studying/reviewing to prepare for NPLEX and Boards. So, I recently could not help noticing while I was studying in a Toronto Public Library that a young woman sat down at the same table to study with her laptop and a book, "Step-Up to USMLE Step 2." Now, I just bought this book a week ago.

For those not sure why I would buy this book, naturopathic doctors follow a somewhat similar licensing and board certification track to medical doctors with some variation in the order. The United States Medical Licensing Examination (USMLE) Step 2 is similar to our NPLEX 2 exams and many naturopathic graduates use the USMLE books as a part of their review material.

So, what fascinated me was the simplicity of this particular young woman's study tactics as she read her Step-Up to USMLE Step 2 book and wrote supplemental information from some online medical sources onto the pages (I realize that she will undoubtedly have many medical reference texts at her disposal). Now on the cover of this book it says, "Comprehensive yet concise coverage...Perfect prep tool for Step 2 CK and a head start for the Step 2 CS" (note: CK = Clinical Knowledge and CS = Clinical Skills). Yes, I really like the book because it is very concise; but comprehensive?

Wow, if that is the definition of comprehensive, what do you call the plethora of review notes, manuals and textbooks most ND graduates use to prepare for our exams?! No disrespect intended, I just found it comical in light of some comments by outspoken critics of naturopathic doctors. I realize conventional medicine is no walk in the park either but, if you want a real challenge: try naturopathic medicine!!

Happy Canada Day!

2011-07-01T07:53:00.004-04:00

I've just returned from 5 days in Calgary where I attended the CAND's Health Fusion conference. This year's topic was Environmental Medicine and the speakers were absolutely amazing. The conference was focused on tactics to avoid chemical and heavy metal toxins, how to recognize symptoms of toxic induced loss of tolerance and how to get the body to excrete these toxins when they are absorbed.

I even had the privilege to meet one of the greatest water rights advocates, Maude Barlow (Council of Canadians), who spoke on the last day of the conference. Interestingly, the day after the conference was over, I traveled just east of Calgary to visit family where I found out that they are unable to drink the ground water due to contamination by agriculture.

I have always been a patriotic Canadian but there is now a sense of urgency to protect Canada, our water, agriculture and wildlife for the next generation. We can't take these things for granted!

Well, I must get back to work as I'm also feeling a great sense of urgency to continue studying with only 5 weeks remaining before NPLEX and Board exams.

It's about the Zebras

2011-06-10T15:09:00.003-04:00

As I'm hidden away studying in the air conditioned basement of a Toronto Public Library, I realize that 2 weeks of NPLEX review have already gone by. This means that the Licensing and Board exams are looming that much closer. Will I ever be able to remember all these details? In my office, I could just look it up!

But, after this many years of studying and 12 months of internship, it's now really about the zebras. There is a famous old saying in medicine, "when you hear hoof beats, think horses not zebras." This translates to: when you have a list of signs and symptoms, think of the most likely diagnosis these point to first. Well, this is true in practice but from the advice of practicing ND's I've listened too, not so on these upcoming exams. I do realize that naturopathic medicine is still in the process of demonstrating to the majority of the public (and most conventional physicians) that naturopathic doctors are proficient primary care providers. As such, our licensing boards are going to ensure that we have what it takes to catch those mysterious presentations of diseases. Furthermore, many patients unfortunately only resort to an ND after they have been through an unhelpful ordeal in conventional medicine.

So, I do understand the necessity and therefore should not complain about being sentenced to studying inside during such beautiful weather. However, I can say that I will be very happy on August 7th when this is all over...

The NPLEX II Saga Begins

2011-05-20T12:02:00.002-04:00

Well it is finally here: the final mental marathon required to become a licensed ND. My head already feels like I'm in need of a break after a 6 day NPLEX (Naturopathic Physicians Licensing Examinations) review course. And I haven't even officially started studying yet!

Like any large and difficult task, I think half the battle is overcoming the intimidation and making a plan to break it down into smaller "digestible" components. NPLEX II tests a naturopathic doctor's correct and safe utilization of the following components to prevent and treat disease in every organ system in the body: clinical nutrition, botanical medicine, physical medicine, physical and clinical diagnosis, lab diagnosis and imaging, pharmacology, psychology, emergency medicine, homeopathy, traditional Chinese medicine and acupuncture. It is a tremendous scope of information! So, for the next 10 weeks, new naturopathic graduates in Canada and the US will be reviewing and studying full time in order to be successful on NPLEX II this August. Starting May 30th, I will be following a weekly objective schedule that breaks topics up by organ system and modality. Of course, 8 hours of sleep, daily exercise, phosphatidylcholine and fish oil are just a few extra requirements necessary to survive the NPLEX II saga!

Well, with yet another blog post about survival, I realize that sometimes I take the risk over-informing prospective students. Accordingly, I have periodically considered not disclosing information because some degree of naivety can be beneficial in undertaking a difficult task. As such, in being candid with the extensive, somewhat unrelenting effort it takes to become a naturopathic doctor, my hope is not to discourage anyone from being an ND but to provide an opportunity for proactive students to become informed. However, if for example only one or two of the naturopathic modalities are of interest to you, then maybe making all the extra effort to become a naturopathic doctor is not for you. Keep in mind that there are practitioners who specialize in each of of the modalities that ND's are licensed to practice and maybe you would be better suited as an herbalist or registered dietitian or chiropractor or homeopath or psychologist or an acupuncturist. At least now you can make a better informed choice.

Naturopathic Medicine Week 2011

2011-05-09T11:26:00.000-04:00

May 9th - 15th is Naturopathic Medicine week in Canada. If you are interested in learning the benefits of naturopathic medicine, take a look at these locations across Canada where Naturopathic Doctors will be giving free information seminars.

This is a great opportunity for both prospective students and people who are suffering with health problems to go and get some questions answered. Have a great week!

It's Graduation Time!

2011-04-30T20:15:00.017-04:00

The graduating class of 2011 is done!! It seems absolutely unbelievable...I'm sure the reality of being finished internship will quickly set in as I begin to prepare for NPLEX and board exams, but right now I'm basking in the accomplishment. And what a journey this has been...filled with a lot of ups and downs, the appearance of gray hairs and the skills to help improve health care in Canada.

One thing I was not prepared for this last month was saying goodbye and transferring the care of many patients I have got to know very well over the past year. Although I'm sure their new intern will work as hard as I did, there was a sadness in not continuing along their health journey with them. Well, I do not want to end on a note of sadness as this is a time for celebration. So, congratulations to all the naturopathic medical students in North America who will be graduating this spring. I wish everyone the greatest success.

Real Health Care in Canada

2011-04-17T16:30:00.023-04:00

With only 2 weeks remaining in my clinical internship, and the timing of this federal election, I was paying greater attention to the politics of the profession and the vital role naturopathic doctors have in changing the course of "health care" in Canada. I put, "health care" in quotations because what our politicians have not yet been made aware of is that healthy people are not the ones being taken care of in Canada. Rather, our conventional medical system is in fact a disease care system of medicine.

I realize this is my bias, but I would like to see naturopathic doctors (ND's) be the primary care gate-keepers of the health care system since we have the widest scope of practice of any health care provider (and subsequently the greatest number of therapeutic tools). When necessary, ND's would also know when and which specialist would be best for the patient to be referred to within the conventional and complementary health care systems. I believe this would revolutionize Canada's health care system which is in a state of patient care deterioration and financial crisis.

Most people feel like they are too busy to write or ask their local member of parliament about what health care truly means to them or to let them know about the benefits of naturopathic medicine. But, we can all quite easily talk to our friends, mention our vision for a true health care system on Facebook or Twitter. Many small actions will build into a large movement!

Individual Medicine

2011-03-26T17:50:00.000-04:00

One of the challenges in naturopathic medicine is treating every person individually. This entails pulling together treatment ideas and prescribed changes from a host of resources and, in some respects, I often feel like I am reinventing the wheel with each patient. For the clinician, this is a recipe for a lot of work and at the end of the day, it can be difficult to separate the "office" from home life as the realization of this responsibility sets in.

This is a sharp contrast to conventional medicine which has an established algorithm or standard of care for most medical diagnoses. I can't say for sure, but, when an MD leaves the office, it might possibly be easier for them to believe that they have done all they were trained to do for their patients and no one could expect more of them.

And, the conventional treatment protocols do seem to work for a percentage of the population. However, the majority of patients that come to naturopathic medicine have not been successfully treated with conventional approaches and they are in need of something to address the root of their problems. At times I wish there were more standards of care algorithms for ND's but, then I also hope that as our medicine continues to be supported by science that practitioners never utilize a canned approach.

OSCE time of year again

2011-03-22T12:24:00.003-04:00

I would not ever want to be in the third year's shoes during the OSCE's (Objective Structured Clinical Examination). I can clearly remember my experience last year and seeing the faces of some of the people after their exams, I feel their pain! (My post last year stated that it was almost fun, but even after a year of seeing patients, it would take a lot of adrenalin for it to feel fun).

One of my colleagues in 4th year took it upon herself to organize several mock OSCE's, which we nicknamed the "Moski's", in order to better prepare students for this important test. Now, even the 2nd years do an OSCE that tests their physical and clinical diagnosis skills before they enter 3rd year. I was happy to teach at each event and was impressed with the level of confidence some people have developed.

The OSCE's ensure a standard of safety in Primary Care and as stressful as it is having your every word and move scrutinized, they are a necessity in order to make ND's the best primary care doctors they can be.

CCNM Growing Pains

2011-03-10T20:52:00.014-05:00

The fact that school at the Canadian College of Naturopathic Medicine (CCNM) is very difficult is something I've written about several times before. It has been argued by some students at CCNM (who have other medical degrees) that the diversity of material in the naturopathic program adds an additional challenge on top of the tremendous course load making it one of the most difficult medical programs. Additionally, although CCNM is over 30 years old, it still growing to an ever expanding profession. Furthermore, to accommodate a January enrollment, CCNM has long days of class packed into one of the shortest school years of all the accredited colleges. So, as I've written before, this can be a recipe for exhaustion and burn-out.

At first, the thought of burn-out at a 'holistic' school may seem ironic but it certainly happens. Then, I thought this would change after getting into clinic. But after treating patients for almost a year, I realized that it can still be very easy to take home an exceptional amount of stress. Stress and burn-out is common place in well established schools too. I subscribe to Medscape (which sends me a weekly email about the latest topics in conventional medicine along with blog posts from students and professors) and see there too that conventional medical students also frequently complain about the unrelenting difficulty of their programs. One thing I notice though, is that they do not blame their school.

In contrast, at CCNM, the school administration and curriculum seems to take the brunt of the blame from students; and it may be warranted in some cases. Yes, there are a lot of tedious requirements and it is difficult for the curriculum to address every naturopathic perspective in depth. However, I can't help but wonder if some of the the students have taken the school's willingness to change as a sign of weakness instead of a sign of consideration for the students? And, have some students perceived the never-ending onslaught of rules and requirements as an attempt to needlessly evaluate them instead of an effort to maintain credibility in a growing field? Maybe this will be much in the same way as some people who did not appreciate their parents until leaving the nest. While growing up they had perceptions of endless tasks and rules to adhere too, parents not allowing enough of this activity or that, and not until looking back did they realize their parents actually knew what was really best for them.

I think the naturopathic program should be longer and not streamlined into focused training on one modality. From my experience, being able to use whatever is best and most indicated for patients, not being religiously stuck on one modality, is the ultimate difference a naturopathic doctor can offer. I believe this is an advantage ND's have over any other primary care doctor. The naturopathic profession is growing at a tremendous rate and CCNM grows correspondingly. Ultimately, graduating from CCNM is no easy feat and will be something I remember for the rest of my life...seven weeks to go!

From Green to Transparency

2011-03-02T15:22:00.002-05:00

One of the most powerful agents for change happens each time we buy a product - we vote with our dollars by supporting companies. Over the past year I have noticed an explosion in the number of companies vying for customers by jumping on the "green" bandwagon. The increased awareness and urgency of environmental issues has created public pressure on companies to make more environmentally conscious products. But are they?

Products in the grocery store, clothing manufacturers, many vehicles claiming to have best fuel economy in their class, even Coca cola is coming out with a 30% plant based plastic bottle. My first inspiration for writing this post actually came from watching the Canadian Association of Petroleum Producers TV advertisement that made it sound like they leave no environmental impact at the oil sands in northern Alberta, and yet it doesn't take much searching to find out that the water available to surrounding native populations is not drinkable due to heavy metals and toxic hydrochemicals.

Many companies may claim to be green, but if they were truly transparent we would see that unfortunately money is their prime motivation, not real environmental protection. So, be skeptical! If a product claim doesn't make sense, it is probably not as green as it sounds. Even if what the label or TV commercial says is true, what is the company not telling you? As consumers continue to choose true green products, and these companies become successful, this will raise the bar for those companies who still believe that they can't make a profit without cutting corners.

Quote of the Month

2011-03-01T07:48:00.003-05:00

"Human nature is about the only nature some people experience."

Abigail Charlson

Book Review 11

2011-02-26T23:17:00.005-05:00

Hippocrates' Shadow. Secretes from the house of Medicine by David H. Newman, M.D.

Anyone who is currently, or plans to practice, as a health care provider should read this book. With that said, I would not recommend this book to everyone (even though my caution may inadvertently assist in perpetuating some of the medical secrets and pseudo axioms the author illuminates) as the author boldly presents some issues of huge magnitude with the potential to shake an ardent believers trust in western medicine.

However, for those in the healthcare field, this book exposes the history behind "schools of thought" in medicine and the steps that lead to many common assumptions about the practice of medicine. The author, who practiced as an emergency medicine doctor, runs a clinical research program and teaches at Columbia University, boldly asks if certain segments of medical education is spent teaching material that is incorrect.

The book has a great layout as most chapters begins with an ER room scenario that leads to a discussion. A thought provoking read that is a must for health care providers.

Lasting Impressions

2011-02-16T10:04:00.007-05:00

Over the last few months I have had several patients preemptively express a similar sentiment about the use of supplements. In these particular cases, after the patients’ have told me their concerns and reasons for coming to the clinic, they finish with a caveat that goes something like, “Now I don’t want to be sent home with 10 different supplements to take.”

I can certainly understand the intrigue many practitioners have with supplementation and the excitement that goes along with knowing which vitamin, mineral or co-factor is required for a person’s biochemistry to function optimally - nutrition in the form of supplementation is a very powerful thing. However, this alone is not a legitimate reason to send a patient home with 10 different supplements. As a patient, if taking that many supplements was your desire, it is not necessarily wrong (and I have several patients who have self prescribed more than 10 supplements) but it is not indicated or reasonable for most people.

I wonder if this impression also comes from an early model of naturopathic medicine where naturopaths were associated with a health food store and correspondingly sold supplements. Being confronted with this made me realize that there is a lot of power in a mental association. For example, when you think of agriculture, do you still think of the little red barn? This positive association connects what we eat to a small, caring farm where healthy animals run on open fields and come into a warm little red barn at night. Although this is unfortunately seldom true anymore, the association benefits particular brands that continue to advertise something of the sort.

When you think of a naturopathic doctor, what do you think of? It is interesting how the naturopathic profession still feels the obligation to prove its legitimacy to the conventional medical community as well as the general public despite helping hundreds of thousands of people every year. Although most ND's do not over-prescribe supplements, sometimes naturopathic medicine is growing so fast that not all ND's have embraced the role of a primary care doctor and these particular practitioners choose to practice in a more exclusive and specialized way. This diversity can be a strength and is not necessarily a bad thing.

To help you chose an ND, most naturopathic clinics have a website that explains the practitioner's philosophy and services (I wish MD's had a website to explain their philosophy) so you can see if you are a good fit. Remember that NDs are trained as primary care doctors who follow a therapeutic order and utilize diet, nutrition, herbs, physical medicine, lifestyle counseling and acupuncture individualized to each patient's needs.

NYGH Health & Wellness Fair

2011-02-10T17:07:00.004-05:00

Yesterday I volunteered for our school at the North York General Hospital (NYGH) annual Health and Wellness Fair. With the two establishments being in such a close proximity (directly across the street from each other), it was very interesting to see the range of responses to our booth. Those who came through the fair were mostly employees of the hospital, although an occasional patient stopped by to ask questions.

I was somewhat taken aback by some of the stern looks, harsh comments and being brushed off by a small group of first year Residents. I could not help but wonder if they thought we were a bunch of x-hippies cleaned up to look like business people instead of effective primary care doctors! Over the course of the day, I realized that the naturopathic profession needs to remember how strange and foreign our world of quinoa, medicinal plants, and acupuncture, etc., etc., is to the average person whose medical doctor fixes all their health problems.

It is important to remember that the sample populations we are accustomed to seeing are not necessarily representative of the general consensus of the community. The people that come to the RSNC clinic, or from my experience preceptoring in private practices, have already overcome many obstacles and boundaries to being a patient of naturopathic medicine. If you are reading this blog, you also have already overcome many more barriers - even in terms of awareness - to understanding naturopathic medicine than the general population. As such, there is a great need for the naturopathic profession to be culturally relevant when explaining our perspective of health to the general population and an attempt must be made to try to put ourselves in their position (and try to see things from their perspective).

There were some encouraging moments too at the fair and it was great to initiate awareness of how naturopathic medicine can help many health concerns. I should also consider the fact that we were invited to attend the NYGH Health and Wellness Fair another indication that integrative medicine is not so far into the future.

Village on a Diet

2011-02-06T10:55:00.009-05:00

I wonder if twenty years ago we would have predicted that in 2011 people would be so fascinated with a television show about one of life's most basic physiological processes - losing weight?! Village on a Diet has fascinated me by its simplicity. Yet, despite a basic premise, the solutions for the town of Taylor, British Columbia are a matter of life and death for many of its citizens.

Change is difficult, especially lifestyle changes, and we can see this resistance in many of the people on the show. What makes matters worse is a bombardment of advertising giving people the impression that they need to "ask their doctor" for something they can take that will make their life better, instead of what they need to change.

Although the experts sent into Taylor seem to make up an effective team (despite the "suck-it-up" military style work-outs which may be required to get their weight loss goal in one month), it is very unfortunate that a naturopathic doctor was not part of the group to ensure long term diet and lifestyle changes. This is important because living a longer, healthier life is not quite as simple as "eat less and move more" - although this formula certainly does contribute to weight loss in the short term (and many people have a serious food excess combined with a movement deficiency). What is most important though is addressing the multifaceted root causes of obesity (beyond calories in and calories out).

The show does have many positives, and I have to say, I do love the community approach; that's a first for a weight loss show. Finally, I realize that having a psychologist on the team was a great addition and I hope that her added help is enough to compensate for the physical shock some of the participants undoubtedly endured. I hope this show is an indication that the general population is becoming aware that quick fixes and fad diets are not a long term solution.

Quote of the Month

2011-02-01T06:56:00.004-05:00

"To teach is to learn twice."

Joseph Joubert

The naturopathic Godfather

2011-01-24T20:51:00.010-05:00

Today I met the Godfather of postmodern naturopathic medicine. Dr. Joseph Pizzorno is an elder in the naturopathic community who graduated in the mid 1970's when there was only one naturopathic school in North America. According to him, CAM is popular culture now in comparison to the persecution it suffered when he first started practicing. He is currently the president of Bastyr University and also the author of the Textbook of Natural Medicine.

So today, Dr. Pizzorno gave a presentation to CCNM students and staff about intestinal permeability. As I am not a particular fan of this textbook, I was undecided on whether to attend. However, who can miss the chance to see someone with such a reputation! And, I have to say that the lecture was very educational and, as to be expected from someone with his number of white hairs, some controversial statements were made that only many years of experience could allow him to say.

Maybe the gray hairs creeping up on my head will help me after all!!

Blood, urine & no tears.

2011-01-21T11:29:00.005-05:00

Today I finished my last official shift at the Gamma Dynacare Lab inside the Robert Schad Naturopathic Clinic (CCNM's teaching clinic). Fourth year interns are required to fulfill a mininmum amount of clinical hours in the lab and also obtain a minimum number of patient blood draws, urinalysis and other tests. Additionally, we complete a very thorough one-on-one verbal assignment that assesses our knowledge (learned in lab diagnosis theory classes) of the correct indications for ordering labs. This learning experience was one of my favourite so far at CCNM. It is not often that students get the opportunity to learn in a practical one-on-one teaching environment and I did not take the privilege for granted.

Naturopathic doctors are trained to use lab diagnosis to investigate or support a clinical suspicion. Additionally, many patients are now requesting disease risk assessment tests that can be performed with a "simple" blood test. What is exciting is that many tests are now becoming available at point of care. This means that soon a finger prick (instead of a more invasive blood draw into a vein), saliva or urine will be able to test most hormones and disease risk factors right in your doctors office.

Avocado...who knew?

2011-01-13T18:29:00.005-05:00

It seems I always learn something about food when shopping at my favourite grocery store mcewans. Even though many of the products are beyond a student's budget, I am easily persuaded when it comes to quality foods. We usually go on Saturdays when we are certain to find a few vendors educating the customers about their products and providing samples to excite our taste buds.

Since the store's opening near to our house, I have learned a great deal about olive oils, breads, specialty meats, fine dining food combinations and most recently, avocado oil. When possible, I always pass along cooking information to my patients and have found out that most people realize now that cooking with Extra Virgin olive oil is very counterproductive. Virgin olive oil has a slightly higher burning point than Extra Virgin (harvested at a different time of year and contains different acidity levels) but I hear most naturopathic doctors still recommend grape seed oil as the one of the best cooking oils; and it certainly is. So this is where avocado comes in.

Avocado oil has a burning point of almost 500F (200F degrees higher than most olive oils), just below that of grape seed, and here is what surprised me: it tastes amazing! Furthermore, avocado is among a list of plants that contain beta-sitosterol which naturally lowers cholesterol. Check it out at a health food store near you and ask your naturopathic doctor about more important healthy cooking tips.

That's not a kids meal

2011-01-09T17:00:00.002-05:00

After Christmas my wife and I had the rare opportunity to take our children out for supper with us. On both occasions, at two different popular restaurants, it was quite disappointing at what constituted a, "kids meal." It would seem that kids eating out only enjoy a choice of: mini pizza, breaded mini burger on white bread (no pickle, lettuce, tomato), French Fries with ketchup or a grilled cheese sandwich on white bread. That is not a meal anyone should eat, especially not a child!

I am sure that these restaurants are meeting the demands of their customers which makes me realize the magnitude of this public health issue. Until change happens on a broader scale, be proactive in asking for healthier choices. Skipping the kids entree choices and combining two side dishes at one of the establishments allowed for vegetables and coleslaw which were actually quite tasty. And, sharing a small plate with your child from what you are eating may be the best choice anyways provided your selection is a healthy meal.

Happy New Year!

2011-01-01T23:29:00.003-05:00

I hope 2011 will be a prosperous and healthy year for you.

Thank-you to all of you who have faithfully read this blog over the last 3 years. It is hard to believe that nearly nine years ago I began this educational journey and 3 and a half years ago I signed up to be among the CCNM graduating class of 2011. It is an end and a beginning all at the same time!

Over this next year, I will be transitioning from student to practitioner. Many of my goals for this blog were achieved including being an advocate for naturopathic medicine to the thousands of people who have stopped by for a read. Ultimately though, the greatest reward was when I was told by colleagues that they were inspired to start their own blog after reading this one.

Happy New Year everyone!

Christmas Break

2010-12-17T18:52:00.005-05:00

Christmas is one of my favourite times of year. Unfortunately, it is too often an exhausting, over-commercialized pressure to buy everyone that "perfect gift." So, I try to ignore that extra stress! For me, Christmas provides an opportunity to spend time with family and friends, time to relax and time to reflect on what is really important in life. And, it cannot come soon enough!

I have to admit that I was naive about the energy required to consistently give my best to patients with chronic health care issues. Burn-out can become a reality very quickly if not anticipated and prevented (The age old phrase, "Physician heal thyself" is so important). I realize now that my expectations of being a naturopathic clinician were primarily based on my limited experiences as a patient. As such, I projected much of how I thought being a clinician would be like by attempting to put myself in the health care professional's shoes so-to-speak. But I am just one type of patient and I do not have any chronic debilitating conditions or diseases. Needles to say, I have made some adjustments to the understanding of my job description.

For those of you interested in becoming a naturopathic doctor, as the style of practice varies substantially from one ND to another, do not base your expectations on one particular style of practice or patient group. Although it is impossible to know exactly what to expect, and even what type of practice you want to have, getting as much experience with several different primary health care providers will also help you understand what it will be like to be an ND.

Have a refreshing holiday and Merry Christmas!

Continual Improvement

2010-12-06T11:43:00.008-05:00

The format of the 4^th year internship at CCNM gives the interns more patient interaction compared to some of the other naturopathic medical schools (where the supervising ND does the initial patient intake and the interns only do follow-up visits or work in pairs instead of alone). Although the supervisor does make an appearance during the visit at CCNM, is available for consultation and is ultimately responsible for the patient, there is still a lot of responsibility on the intern to gather the correct information to guide treatment. As such, I remember the anxiety walking into that very first visit. It actually took several months for that apprehension to turn into excitement to see a new patient.

New changes at CCNM are following the format other schools have done to progressively integrate students into clinical patient experience. This experience will help the intern build the confidence required to be ready for that first and subsequent patients. Already, the 1^st years have been doing an observation shift and the 2^nd years sit in on patient visits and have the opportunity take patient vitals. Starting in January, the 3^rd years, under the direction of the 4^th year intern, will have the opportunity to perform physical exams, and help with diagnosis and treatment plans. Although the CCNM academic team met some resistance from the 4^th years in terms of our extra roles and extra responsibilities as mentors, I think the change will ultimately benefit CCNM graduates. Additionally, the patient gets the benefit of a team approach to their health concerns.

Peer mentorship, at the student level, is not well developed at any medical school yet but is an upcoming area of improvement in medical education. Doctor as teacher is one of my favourite naturopathic principles and I believe is exemplified at CCNM in these new changes.

CCNM Christmas Play

2010-11-30T23:35:00.003-05:00

Come out and support the graduating class of 2011 who brings you the original holiday play, Jingle Bell Rock - A CCNM Holiday Tale, on Thursday Dec. 2, 2010 and Friday December 3, 2010. Doors open at 7pm with the play starting promptly at 8:00pm (Location: Canadian College of Naturopathic Medicine). Tickets on sale at CCNM for $10 in advance and $15 at the door. VIP tickets are available for $25, which includes premium seating, wine and cheese during the performance. See you all there for an epic evening of Rock and Roll and Holiday Spirit!

Resisting Burn-Out

2010-11-22T09:15:00.003-05:00

As my posts have slowly dwindled to a monthly endeavor, I feel the need to come clean about the toll this program has taken on my enthusiasm for extracurricular - even naturopathic related - activities. Nearly every day for the last month or so seems to be a struggle to resist burn-out. Unfortunately, it appears as if this is a common theme with this years' graduating class possibly due to several new program requirements. Even within the last week, one of my colleagues started a new club where we have the opportunity to support each other and discuss ways to make positive changes.

I met a transfer student the other day who did one year of naturopathic medicine at Bastyr University and I was surprised to hear that the students there are possibly more stressed-out than at CCNM. I didn't think that was possible! How does the school maintain enrollment? I am sure that Bastyr's campus located within a state park is helpful. The thought of a state park...as great as the Paracelsus Herb garden is, and the Don Valley located across the street from CCNM, they are not a substitute for a state park.

I think Christmas will be my solace and I am certainly looking forward to a couple of weeks of bliss away from the busyness of Toronto.

Here to Stay

2010-11-10T22:53:00.001-05:00

Today I took my family to the Royal Agricultural Winter Fair in Toronto. It was at least 15 years since I was there last, at that time with my siblings and parents. The fair is a celebration of agriculture in Ontario where awards are presented to the finest specimens of farm produce and animals and includes a number of fantastic animal shows. Complementing the food and agricultural theme this year was the “Journey to Your Good Health” educational presentations. Although much of the fair was the same as I remembered it from years ago, I was also aware of increased visibility of natural health products slowly permeating the conventional world and was happy to see a naturopathic doctor answering questions as part of a forum of health professionals.

Remember, we vote with our dollar. So, support those small, local, environmentally conscious agricultural companies when you can - ensure they are here to stay.

Maintaining Mentorship

2010-10-23T15:22:00.013-04:00

Most highly skilled professions have some framework of mentorship set in place to ensure that things which are not easily picked up in the classroom, or from reading a book, are taught in a practical setting. Naturopathic Medicine is no different. Mentorship maintained naturopathic medicine in the United States in the years following the 1910 Flexner Report when naturopathic schools could not afford to operate (the Flexner Report also shut down many "diploma mills" and substandard medical schools which was a positive outcome. Unfortunately though, the recommendations were to only fund schools with a pharmacological and technological focus).

Mentorship at CCNM begins in 1st year as new students are introduced to the teaching clinic with days spent shadowing their supervisor. Second and third year students get more involved with patients each year as clinical supervisors and 4th year interns take mentoring roles. There are certainly times where patients are surprised at the additional students that come into the treatment room and occasionally, the 4th year intern is inadvertently put in the hot-seat with all eyes on her or him. At these times, there is the potential for everyone involved to share an awkward moment.

My love for teaching and background in instructing usually dissolves my concerns about others watching me in clinic. Additionally, I recognize that I am not perfect at this yet and I may say the wrong thing or make a small mistake with someone else watching. However, as the mentor, it can still be an additional source of stress.

I wonder if this change in dynamic is currently making it very difficult for some students to fulfill another type of required mentorship called preceptorship. This is where students spend time with a ND, DC, MD or physiotherapist in their private practice (or hospital). If you are currently a student in naturopathic medicine, here are a few points to consider when being mentored:

1. Firstly, if at all possible, pick a mentor who's style of practice you like. This is very important for preceptoring and will eliminate many unforeseen disharmonies and make for a much more enjoyable day.
2. Recognize your mentor's strengths. Certainly there are times when you may learn how NOT to practice but try to glean the best of what the mentor is offering.
3. Show appreciation. This is so important in order to successfully continue a constructive and receptive attitude towards mentorship and maintain the philosophy of passing down knowledge to the betterment of the profession.

Residency is another type of mentorship offered to naturopathic graduates and I hope to write about this at a later date.

Slow Down!

2010-10-06T10:37:00.013-04:00

Three years ago my wife flew into Toronto from Calgary (while I was finishing my undergraduate degree) and she picked the apartment we would be living at during the next 4 years of school at CCNM. On arriving a month later, I was so impressed with her choice as she selected a location with the beautiful Don Valley literally off our balcony. The Don Valley has hiking trails, mature maple forests and the Don rivers. It could be the most beautiful place except the high traffic brings in unappreciative guests. My wife and I spent many of our first hikes with a garbage bag in hand just attempting to clean up our little area. However, the Don Valley was still my temporary substitute for the wilderness I enjoy.
Recently though, my wilderness substitute seems to be mirroring my cumulative impressions of the largest city in Canada. Even nature seems to be telling me it is time to move on as the Black Swallow Wort (a predator invasive species) has multiplied beyond control choking out the indigenous plant species and my enjoyment of the valley at the same time. Also, the poison ivy proliferated exceptionally well this year and seems to be telling me that my time in the Don Valley is over.

The city of Toronto has many forms of exceptional entertainment including cultural & educational experiences. While living here, I have tried to take in as many of these things as possible. Too often though, I find people are in a rush. What's worse is it is often an angry rush! This was highlighted in recent research that demonstrated the traffic conditions in Toronto are negatively contributing to people's health.

If you are beginning to notice the rush, I want to tell you about the Evergreen Brickworks Slow Food Picnic. This event pairs local producers with Toronto's healthy minded food retailers & restaurants. Chefs cook gourmet food right in front of you to sample in a savory environment of appreciation for good food (Watch for this event next year and be sure to get a ticket). Below is a picture of me representing Mountain Lake Bison Range with Chef Maxine and Dave & Mario of the Healthy Butcher. This event reminded me that it doesn't matter where you are, where there are good people and a good cause, there can be moments of solace even in the largest city in Canada.

Thorough Competency

2010-09-29T11:04:00.007-04:00

Over the last three years of writing this blog and speaking with potential students, I have had many people express their fears about the unknown journey into naturopathic medicine. How difficult is the program? Since you learn so many things, is it possible to be effective at anything? Is it really harder than conventional medical school? Do you learn enough science? Is the art of medicine still taught?

I understand where these questions stem from as I certainly had many of them before entering the program. Although there is absolutely no substitute for experience, and everyone’s experience is different, one of my supervisors recently showed us five categories of competencies expected from naturopathic doctors by the American Association of Accredited Naturopathic Medical Colleges (AANMC). I found it interesting to see AANMC sum up everything we do into 5 areas and I thought I would share them with you.

Here is the Professional Competency Profile of a Naturopathic Doctor:

1. Naturopathic Medical Expert

• Integrate naturopathic philosophy, theory and principles with naturopathic medical knowledge in the care of patients and case management including the assessment, diagnostic and treatment phases.

• Develop, maintain and value a comprehensive knowledge base in naturopathic medicine.

• Conduct an assessment to formulate a naturopathic medical diagnosis.

• Effectively provide and manage patient care.

2. Naturopathic Manager

• Develop and maintain relationships in practice and the community consistent with the philosophy and principles of naturopathic medicine.

• Establish, develop and manage a practice.

• Exhibit strong personal management skills.

3. Naturopathic Professional

• Utilize knowledge of naturopathic history, principles and philosophy to guide professional engagement and development.

• Demonstrate ethics and integrity in professional practice and personal conduct.

• Serve the public through ethical practice, health promotion and disease prevention.

• Ensure professional competence through ongoing self-assessment and professional development.

4. Naturopathic Health Scholar

• Exemplify the principle of doctor as teacher in every patient and public interaction.

• Maintain and enhance professional competence through ongoing learning activities.

• Critically evaluate medical information.

• Educate patients, colleagues, other health-care providers and the public.

• Advance the practice of naturopathic medicine through the development, critical assessment and dissemination of research and information.

5. Naturopathic Health Advocate

• Promote the principles and philosophy of naturopathic medicine in advocating for sustainable, healthy environments and lifestyles for patients and society.

• Reflect a knowledge base that enables effective health advocacy.

• Influence others in accepting naturopathic medicine as an essential element in health promotion and disease prevention.

New Beginnings

2010-09-10T10:33:00.005-04:00

As I came in to the school this week I saw a sea of new faces excitedly awaiting their journey in naturopathic medical school. CCNM is now set to graduate the most students per year of all the accredited naturopathic colleges in North America. I clearly remember how exciting that first month of school was and how it was such a paradigm shift for many people depending on their background. Very soon though, it becomes a lot of stress and an unbelievable amount of work. Even with the added responsibility that comes with treating patients as an intern, I would not trade those 1st year students places for anything!

As the summer comes to a close, it is easy for me to nostalgically look backwards instead of looking forward to the new beginnings I have too. For me, this is the last September I will ever be in school as next year my wife and I will be busy preparing to set up our practice. Also, next Monday the 4th year interns begin a series of new classes (ethics/jurisprudence, practice management, in office procedures) that prepare us to write our final board exams and ultimately for practice. More importantly, the fall brings many new patients to the clinic who either felt better through the warm, sunny months or obligations and distractions delayed them from addressing their health concerns until now.

Choosing the ND Generalist

2010-08-07T17:30:00.004-04:00

Naturopathic Doctors in Canada (and the States where ND’s are a regulated practice) have worked hard to maintain a large scope of practice that includes extensive training in conventional biomedical sciences as well as alternative medical techniques. Until recently I have always wondered why someone would want to give up that freedom for a focused discipline that often requires the same years of post secondary schooling, like a registered dietitian or a chiropractor, when these modalities and corresponding scope of practice are already included within naturopathic medicine.

I realize that there are many good reasons (too many to write about here) why people choose to become a focused health care practitioner, not least of which is a positive personal experience with a certain health care professional or the goal of helping people with specific health concerns. Also, many students may not know their options including the fact that most just do not know what naturopathic doctors are trained to do. Although I am very proud of the ND’s scope of practice, and recognize the privilege to have my training, I now perceive one potential advantage to being a focused specialist... Might the patient’s problems be simpler?

This may not be the case at all but in the last month I have developed a small degree of wishful envy for practitioners who see patients that are presenting with concerns associated with a particular health focus, be it dietary, musculoskeletal problems or emotional issues. It just seems like it might not be as messy! Maybe that is part of the appeal?

In contrast, and without going into specific details, people visiting naturopathic doctors may have anything wrong with them - anything; and it may be somewhat illusive even to conventional medicine. Dr. Bernard Lown, MD writes in his book The Lost Art of Healing; Practicing Compassion in Medicine, “At present, about 25 percent of patients who visit an American doctor are successfully treated. The other 75 percent have problems that scientific medicine finds difficult to resolve. After being shuffled among a bevy of specialists and subjected to costly and invasive technologies, many patients, frustrated, turn away from conventional medicine.”

There is certainly an important place for every practitioner and every patient deserves the opportunity to be treated in the way that is best for them. Coincidentally, I am beginning to understand that with a large scope of practice comes the potential for patients with a greater degree of complicated health problems. This is the challenge of helping these people that puts those brief moments of wishful envy into perspective. Thank God I love reading because I certainly spend a lot of time researching for my patients! And, sometimes simple solutions do work even for the complicated problems.

If you or anyone you know is struggling with a health issue, do not wait until conventional medicine becomes frustrating to see a naturopathic doctor. It is important for ND’s to be able to work with conventional medicine where appropriate to the best benefit of the patient. It doesn’t matter how complicated your case might seem, ND’s will take the time investigate your concerns including asking the right questions and listening to your answers.

Book Review 10

2010-07-28T08:37:00.002-04:00

Confessions of an Rx Drug Pusher by Gwen Olsen.

As more provinces in Canada, and states in the U.S.A., grant naturopathic doctors prescription rights, and after seeing several patients after only 2 months in clinic with side effects from prescription medications, I decided to read another book on the topic of pharmaceutical drugs.

This book is an autobiographical account of how drugs, both pharmaceutical & recreational, have permeated society with nearly a complete disregard to their consequences. As a former pharmaceutical sales rep for 15 years, Gwen Olsen discloses enough inside knowledge about the pharmaceutical industry to put the broad spread dependence on prescription drugs, especially those for depression and other mental illness, into serious question. The book is very well referenced with an abundance of evidence including heart wrenching patient cases and scientific research.

As an autobiography, the author openly recounts the horrific events in her life, including messy family dysfunction and mental illnesses, that gave her a first hand experience on the receiving end of many of the medications she was trained to believe would help people. Her ultimate conversion to a traditional view of wholistic medicine, and occasional moments of over disclosure, may give some ardent Big Pharma believers an illegitimate excuse to discard the authors' perspective based on character weakness. However, the book still stands on its own as another beacon of light uncovering the damaged path left by years of unabated over prescribing and the lack of public safety with regards to medications.

Another book outlining some of the corruption in the pharmaceutical drug industry is, The Truth About Drug Companies by Marcia Angell, MD. This book, in contrast, is written from a MD's perspective in completely unemotional prose by the former editor in chief of the New England Journal of Medicine.

Schooled by an MD!

2010-07-14T19:20:00.008-04:00

I recently watched a debate on the effectiveness, safety and merits of complementary medicine. The panel included a medical doctor and a scientific sceptic on the con side, and two naturopathic doctors for the pro side. It was apparent to me early into the debate that the conventional medical community has a serious lack of understanding of what ND's actually do. ND's know what MD's do, and for the most part are familiar with the conventional medical school of thought, but so much of the time MD's really misunderstand what naturopathic doctors do.

There are some explanations for this. Certainly, there are some naturopathic doctors who muddy the waters and represent the profession in a way not typical of the profession as a whole. But, what makes naturopathic medicine most complicated is that the scope of practice is so large that some ND's may have an entirely talk-therapy based practice and on the other end of the extreme, some ND's may do primarily a sports medicine based practice.

One interesting point made by one of the naturopathic doctors was that, currently (because of the relatively few ND's by comparison), the largest population of doctors that practice natural medicines and therapies are actually medical doctors. This hit home when Dr. Lawrence Palevsky, MD came up from New York and gave a guest lecture on Pediatrics at CCNM earlier this week. It was fascinating to hear his perspective on the antecedents to conventional medical thought and its methodology for the treatment of childhood diseases. It was almost shocking to hear a Medical Doctor use every naturopathic tactic possible to avoid prescriptions of antibiotics, acetaminophen (Tylenol) and even present an informed choice on vaccines. I was reminded of the necessity of childhood fevers and shown, in tremendous detail, the great harm in handing out fever suppressing drugs like candy - and I learned this from a medical doctor! There is hope for much more integration of conventional and naturopathic medicine in the near future.

2010-07-01T08:08:00.001-04:00

“Eat food. Not too much. Mostly plants."
Michael Pollan - In Defense of Food

The [CCNM] Hour

2010-06-19T22:38:00.008-04:00

As an ND intern, I have the privilege to spend an hour visit with my patients. Initially, I thought this would allow ample time to ask all the pertinent questions, perform a relevant physical exam and ensure the proper care was provided for the patient by the end of the visit. Although this may be true in some straight forward cases, I have found that patients often see us as a last resort and have an extensive story and medical history to share. Furthermore, I think patients find some therapeutic value in just being able to freely tell me their story, in full, without me limiting their responses or cutting them off to one or two concerns per visit.

As such, I have already listened to (while carefully charting) some extremely complicated cases and the hour flies by before unearthing all the potential contributing factors to the person's current state. And, I still need to remember to at least take the person's blood pressure! However, when I review the patients case, I recognize the tremendous value of the information I gathered to point me towards treatment options and areas where I need to research. Furthermore, I have realized that most patients with complicated cases (that have stumped other health professionals) do not expect me to have an exact solution by the end of one hour. Although that would be nice, my assurance that a health improvement - at the very least - in the near future is possible is more important.

Meet the New Naturopathic Interns

2010-06-07T21:32:00.008-04:00

Come on down to the Canadian College of Naturopathic Medicine (click for directions) on Monday June 14th at noon to meet the new interns. After 4 years of university and 3 years of naturopathic medical education, we are now entering our 12 month internship and are accepting patients. CCNM has one of the largest naturopathic teaching clinics in North America which has over 26, 000 patients visits per year.

During the event there will be an opportunity for everyone to learn more about naturopathic medicine through several short presentations including:

1) Brief intro to naturopathic medicine
2) Overview of services offered at RSNC
3) Pediatrics overview
4) Sports medicine overview
5) Adjunctive Cancer Care

Also, there are information tables and interns will be available to answer your questions.

The first clinical impression

2010-06-03T16:47:00.003-04:00

Keeping in mind that my first impressions of clinic are highly influenced by the kinds of health care issues the patients I have seen thus far have presented with, my first thoughts traveling home after my clinic shifts were much more melancholy than I was expecting. Some people are really in need of a significant amount of help. Another realization I have been continually reminded of is the critical state of our current health care system and the luxury naturopathic doctors have to spend sufficient time with their patients. We have the time to ask the detailed questions and actually listen to the answer (I truly believe that most family doctors do not prefer to spend so little time with their patients but are forced to do so in order to survive under the provincial health care billing system).

So far, my aspirations of the valiant hero who swoops in with the naturopathic coup de grace and instantly changes the person's health future have been shifted, I believe positively, to recognize that pacing myself will be critical. This is a learning process - it is called a "practice" for a reason! Even if I do have all the answers in a particular case, delivering those answers in a way in which patients will comply is an art in of itself. There are so many new realities now in clinic and it is a very steep learning curve. As such, the first couple of weeks have been somewhat overwhelming.

However, we do have a great amount of support at the teaching clinic. Each intern has at least 4 different supervisors, and is therefore exposed to 4 different styles of practice and patient case management. Additionally, we have a variety of health professionals available for consultation on site at the clinic including Laboratory Technicians, ND's, Chiropractors and a Psychologist. So, there is help when we need it.

This was just a first impression and is subject to change!

Quote of the Month

2010-06-01T09:32:00.003-04:00

“If you are traveling down a path without obstacles, it probably doesn't lead anywhere."

~Unknown Author

NPLEX Nastalgia

2010-05-20T14:34:00.000-04:00

As Dr. Anderson's Naturopathic Physicians Licensing Examinations (NPLEX) prep course wrapped up here at CCNM for the 2nd year students, I clearly remembered last summer and a small part of me wished I could do it all again. Even though some of the same material was tested in my undergraduate, after 2 months of extensively studying the basic medical sciences, last summer was the 1st time I really felt like I knew what I was taking about!

In fact, last summer's studying was the highlight of my naturopathic journey until I entered clinic this May. I was my own boss, I could build up my weaker areas and dig deep into the areas that interested me the most.

Some words for the wise. If you are writing NPLEX 1 this summer (I write NPLEX 2 after graduation in August 2011), remember that no matter which one of the accredited schools you are in, the curriculum only sets a foundation to learn from. The exams are much, much more detailed and require extensive self study. The areas of anatomy, microbiology, immunology, food metabolism and pathophysiology are foundational to naturopathic primary care doctors and are one of the things that separate the accredited schools from the unaccredited schools.

Since the NPLEX format changed in August of 2009, there has been a heavy weighting on pathophysiology. Therefore a good pathophys textbook is a necessity. As a visual learner, another one of my favorite books is, "Metabolism at a Glance" by J.G. Salway (third ed). I also took Dr. Anderson's (systems based and focused more on Nutritional Biochemistry) & Dr. Grossman's (focused more on Anatomy & Microbiology) courses and enjoyed both. However, they are intended to remind you of the breadth of information required to know and indicate areas where you need extra studying. Furthermore, keep in mind that these review courses can not teach at the depth of knowledge required to pass NPLEX 1.

Just 3 study tips:

1. If possible with your school's schedule, take at least 2 weeks off after your final exams before starting to study for NPLEX 1.
2. Slowly build up to 8 hours of studying per day and take Sundays off to rest your brain (try for a minimum of 6 weeks of studying).
3. Take the day before the exam off completely. The NPLEX is a mental marathon, and like any athlete who has peaked for a performance, you need to rest the day before.

All the best!

A New Leaf

2010-05-10T22:46:00.008-04:00

Today we completed the first of two days of clinic orientation. While biking to school this morning, the routine was so familiar, and our final exam marathon still so fresh in my mind, that I did not feel ready to be back at school. However, after the morning introductions, I realized that although the setting was the same, everything was different now. We are not only students, we are now health care providers. In fact, we were informed that 44% of the patients that visit the clinic here at CCNM reported that their ND intern was their primary health care provider. What a phenomenal responsibility!

We are turing over a brand new leaf in our journey. I understand that we are forever students and our next step is a 12 month long internship with 1035 clinical hours, case management documents, competency checks, more assignments, and still a few required classes. Even so, our focus has now shifted from excelling in class and passing exams to getting people to feel better. And, they do! We were shown some encouraging data that CCNM is accumulating, which reinforces what we all have known to be true: naturopathic medicine helps many people.

Quote of the Month

2010-05-01T07:43:00.002-04:00

“We are indeed much more than what we eat, but what we eat can nevertheless help us to be much more than what we are."

Adelle Davis

One Last Push!

2010-04-24T21:29:00.009-04:00

Six final exams down and 5 to go! The full-time 4-year naturopathic program at CCNM is not for the faint of heart and may not be advisable for anybody intending to keep one foot in the 'real world' and the other in naturopathic school (note: more part-time options are becoming available).

Focused curiosity is everything! Nearly every day I made a short list of things that were 'interesting' to me and I researched them. Also, I found that I had no choice but to live, breath, eat, talk, sleep, and dream naturopathic medicine for the last 3 years in order to keep the vast breadth of knowledge I learned applicable and current in my memory. This meant that my wife (and family and friends when I saw them) have had to put up with about three-quarters of the conversations ending up being something about medicine.

As a male, I will never be able to fully appreciate the experience of having a baby. Although, I have been at my wife's side twice (most recently two weeks ago) so I do have a better idea than some. As such, I am going to make a small leap here and say that I feel that there is just one last push remaining in this school year, with all the effort, the pain and eventually joy that accompanies the experience. Thank God for the joy!

Calm before the final storm

2010-04-08T22:02:00.007-04:00

There is only a week and a half to go before the final exams of 3rd year. This will be the last set of final exams we will write. Sure, after graduation next year there will be licensing exams and provincial exams, which may be very difficult, but this is a huge mile stone. Beginning on April 19, our grand finale is 11 exams in 9 days.

I'm hoping to begin to live more of a balanced life once clinic starts in May. These past 3 years have been a tremendous sacrifice for my family and sadly my health to some degree as exercise was too often put low on the priority list. I really do understand now that becoming a ND is a calling and not just a profession.

Recently, I was talking with a prospective student who was debating between conventional medical school and naturopathic medicine. She told me her opinion of the strengths of each but explained that she had heard that naturopathic medical training was more difficult than conventional because of the additional types of medicine we learn. As such, she was concerned about the intensity of the program. Although I am unable to directly compare from personal experience, I can be fairly certain that if a person believes naturopathic medicine will be easier than conventional medicine, they may take a serious blow to their perceived academic ability. This is why I believe the "calling" has kept me going. If it was "just a profession" I would have stuck to my day job!

Quote of the Month

2010-04-01T07:14:00.001-04:00

“Wellness is not a race but a journey."
~Unknown

TCM and Acupuncture Progress

2010-03-31T19:47:00.005-04:00

As would be expected before entry into clinic, completing 3rd year means completing quite a few practical exams. Still remaining is our emergency medicine practical, in-office procedures practical, manipulation (chiropractic) practical, and the one that I am studying daily for, the Asian medicine acupuncture practical.

I did not know until recently that not all the accredited Naturopathy schools offer Traditional Chinese Medicine (TCM) and Acupuncture as part of the curriculum. Well, CCNM has a very intensive TCM and acupuncture program. Just to give you an indication, here is how the final exam will happen. First, we are presented with a case and need to determine a correct TCM diagnosis based on symptoms as well as pulse and tongue diagnosis. Then, we are required to select points that correspond appropriately to the case. We are required to know the actions and indications for about 225 of the approximately 400 total acupuncture points we have learned. Finally, we are required to locate and correctly needle 5 indicated points (within half a fingernail width of their specific location on the body) all within a 15 minute time frame. I would have never thought this was possible when I started in first year!

OSCE Follow-up

2010-03-24T18:55:00.009-04:00

What an experience! If it wasn't for the nearly crippling anticipatory anxiety, I could almost say it was fun - the kind of exhilaration that happens during an important performance. Being sequestered in a meeting room for an hour, in a group of nine, prior to the official start of the exams did not help. However, I heard many other groups used much better coping tactics than mine did and they were able to laugh off some of the tension. I will never forget the walk down the stairs to the clinic. Our group walked in silence and I felt like I was in the movie Gladiator right at the scene where they were waiting to get rushed out into the Colosseum.

However, once I entered the first room and began talking to the patient, things began to flow more naturally. All the hours of preparation and studying pathologies, redflags for life threatening conditions and physical exams was integrated into somewhat of a smooth patient experience.

The OSCE's at CCNM consist of 3 patient visits that are each 18 minutes long. Then following each case we have 5 minutes to write up how the case would be appropriately managed and answer questions on our understanding of the patient's condition. Although 18 minutes is certainly not enough time to investigate the root cause of many diseases, it is sufficient time to rule out whether the patient has an emergency situation. As the first principle in our oath is, "First do no harm," having the ability to quickly evaluate the severity of a patient's symptoms and provide a medical diagnosis (Primary Care responsibility) and management plan is essential to every ND's training.

OSCE Time

2010-03-16T22:22:00.005-04:00

Next week, the third year class will undergo the Objective Structured Clinical Examinations (OSCE). Passing the OSCE's are another one of those checks we require before entering into clinic in May...a really, really big check!

These exams were implemented 3 years ago as part of the continued progress towards ensuring ND's are ready for the field of being a Primary Care Doctor. The exams are the summation of all of our Primary Care knowledge up to this point and also tests our ability to clearly and effectively interact with patients. Although I am certainly under a lot of pressure right now, I can say that I'm proud that Primary Care is taken so seriously.

More on this topic after I pass!

The Learning Curve

2010-03-07T13:46:00.006-05:00

As most of my colleagues in 3rd year at CCNM will be simultaneously pounding out the last details of their Relevant Clinical Inquiry Assignment (RCIA) due tomorrow morning, I have paused for a moment to reflect on the journey. Maybe I'm pacing myself, or still recovering from burn-out, but I just needed to take a moment and see the forest through the trees.

At this point in 3rd year, the focus is about checking off mandatory requirements before clinic in May. Number of clinic observation hours complete- check; number of patients - check; case management file - check; preceptorship hours - check; Gynecological practical exam - check; Male Genitourinary and DRE exams - check; RCIA - check. Check, check, check...It took a lot of planning ahead and coordination to get those checks while still managing to study and go to classes and I have certainly gained a tremendous amount of experience in the process.

Looking back, last year I needed to believe that 3rd year would be easier. Now it wasn't really easier, especially this final semester, but the learning curve was different. When I talk to my second year colleagues, I realize that the learning curve in second year is the steepest and sets a high standard of work ethic that just makes third year more manageable. Third year fills in the details and is the clinically relevant stepping stone that is required before we begin our internship in May. It is more practical and if I can relax enough to admit it, it is more fun! And, on that note, I have school work to get back to.

Quote of the Month

2010-03-01T07:00:00.007-05:00

“Practice does not make perfect, or necessarily improvement, but rather practice makes permanent. Only perfect practice results in perfection."
~A Wise Coach

Integrative Health Institute

2010-02-22T08:05:00.001-05:00

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?

2010-02-17T19:41:00.008-05:00

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

2010-02-12T14:38:00.007-05:00

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

2010-02-01T07:32:00.007-05:00

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

Intensity of 3rd Year Practicals

2010-01-25T19:57:00.005-05:00

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?

2010-01-15T18:38:00.010-05:00

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

2010-01-07T22:16:00.005-05:00

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.

Quote of the Month

2010-01-01T07:54:00.000-05:00

"Negative feelings are like stray cats. The more you feed them, the more they hang around."
Joyce Rupp

Merry Christmas

2009-12-25T08:56:00.001-05:00

Merry Christmas to everyone!

I hope you are able to spend some time relaxing with friends and family and are too busy having fun to be on the computer and reading this on Christmas day - I typed this ahead of time and scheduled the post for Christmas morning!

Thank-you to those who have been checking in regularly and providing excellent feedback.

Have a safe and fun holiday.

Christmas- A Needed Break

2009-12-22T11:55:00.008-05:00

Maybe it was because it was the 9th exam in a week, or the accumulation of a 2 1/2 year mental marathon, but I was humbled by the difficulty of the questions on our final Botanical Medicine exam yesterday. I absolutely love Bot Med and it is never just about passing the course for me, so after the exam, I actually pulled out my notes and looked up the questions that I could remember.

I do need to put the books down for a while and celebrate because myself, and everyone of my colleagues, deserves to take a break and look at how far we have come. It doesn't seem real yet but, we have just finished the last set of Christmas final exams we will write for this program, since next year at this time we will be interns.

It is only 4 months now until clinic starts...where has the time gone?

Have a safe and healthy Christmas holiday everyone.

Virtual Substitutes

2009-12-08T20:19:00.005-05:00

The phrase, "Now that is a day at the Park" brings a lot of things to mind. For me, spending the day in front of a coloured, flashing box in the living room was not very high on the list. Yet, with Christmas approaching, and toy marketing fever beginning to peak, parents are lead to believe that the Fisher Price Smart Fit Park constitutes a day in the park. I don't mean to pick on Fisher Price particularly, as there are certainly other companies and some Fisher Price toys are valuable.

Unfortunately, I find a belief in Toronto that indoors is safer and cleaner than the outdoors. Neither are true and indoors is most likely contaminated with many times the level of toxic substances (carpets, laminate floors, glues, paints, plastics, air fresheners, cleaners...) than the outdoors.

This brings to mind an evening tobogganing with my son last year. Several other parents from the neighborhood came with their children and I heard one ask, "how many years have we lived here and never used this hill?" Simple, healthy, inexpensive pleasures right on our doorstep but too often traded for a virtual substitute.

When buying gifts this Christmas, evaluate the consequences your purchases will have on others. I believe that with some intention, we can all make better choices.

Quote of the Month

2009-12-01T07:53:00.002-05:00

“Adopt the pace of nature: her secret is patience"

Ralph Waldo Emerson

Formula has Risks

2009-11-13T14:57:00.006-05:00

The slogan , "Breast is Best" over the last several years has formula companies comparatively recommending their product as a close second. Why anybody would choose to start their child on second best is interesting (I certainly understand those who are physically unable to breast feed). As Naturopathic Doctors promote patient education, informed choice in cases like this is what is important. I was surprised to learn in Maternal/Newborn Care today that most Medical schools have no training (zero hours) in their curriculum on breastfeeding. What was possibly even more surprising was the statistics on the percent of mothers who breastfed in Canada. In some provinces, only 65% of mothers attempted to initiate breastfeeding and only 20% exclusively breastfed until their child was 1 month old (BC is doing something right here as it's rates are substantially higher than this).

Research negating the benefits of breast feeding may include babies who have ever breastfed (even for a week) instead of comparing those who exclusively breastfed with those who were bottle fed. However, the evidence is now confirming what advocates have maintained for years that bottle feeding has risks. There is a growing body of research demonstrating increased rates of asthma, obesity, type 1 diabetes and even ulcerative colitis.

Note: Here in Toronto, as a result of the recent H1N1 pandemonium, the public breastfeeding support clinics were taken over as flu screening or vaccination clinics leaving new mothers who would access those clinics without any support. Certainly a situation without a perfect solution.

Stone Tree Clinic

2009-11-03T11:04:00.011-05:00

As the start of clinic is quickly approaching, and graduation is just over a year away, I am beginning to seriously plan where and how I will practice. We have been very fortunate at CCNM to be able to hear perspectives from successful naturopathic businesses. Today, Dan Clements who operates Stone Tree Clinic in Collingwood Ontario with Dr. Tara Gignac, ND spoke to our class about the business model, operations and philosophy of their clinic.

I realized the importance of being exposed to a variety of practice models which will ultimately shape what my practice will look like and how well it will serve the public. As I have already said before, I could not agree more with the idea that the profession as a whole is stronger, and we are able to help more people, when naturopaths are able to be successful in their practice. I really appreciated Dan's encouragement and acknowledgement of our skills as primary care practitioners as well as the skills he highlighted that set us apart from any other health care provider.

What was most inspiring to me was that the Stone Tree Clinic operating model allowed for a balance in life, time for family, keeping healthy and options like taking a working sabbatical in South America to bring health care to the less fortunate.

Visit, stonetreeclinic.com to see a different approach to health care.

For those interested Dan's blog specifically about practice management visit, alternativehealthpractice.com

Quote of the Month

2009-11-01T08:08:00.000-05:00

“We make our world significant by the courage of our questions and the depth of our answers.

Carl Sagan

Canadian Thanksgiving

2009-10-12T18:41:00.015-04:00

The pace of third year took me by surprise and Thanksgiving weekend could not have come at a better time. Next Monday, the midterm exams begin and the third year class has been so busy, with assignments and preparation for practicals, that it seems like we only have a week to prepare.

A walk through the forest this weekend calmed my mind (reminded me of the many things we have to be thankful for in this beautiful country) and rejuvenated my motivation to study for the upcoming botanical medicine midterm - known for being one of the hardest courses in third year. I found photography a great way to trick myself into studying!

Salidogo odora (Goldenrod)

This herb grows abundantly in open meadows and fields. The leaf is usually picked in the fall and can be made into a tincture or tea. Common uses are as a renal tonic, diuretic and carminitive.

Maple Forest Trail

Although third year is much busier than I had hoped for, clinic (internship) is only 7 months away. There is light at the end of the trail!

The Business Side

2009-10-06T11:18:00.000-04:00

I have a huge interest in the business side of naturopathy. I think that if an ND can be successful in their business then they are able to help more people, positively impact their community, pay their share of taxes to this great country and donate to the charities they like. So when our business professor invited Dr. Eli Camp to speak about building a practice, I was sure to attend. Dr. Camp (a graduate of Southwest College of Naturopathic Medicine) provided us with an overview of the extensive planning and work it takes to set up a business. She instilled that this is not something we want to try to figure out after graduation as there is so much to know about what happens on the business side of being an ND.

The course was filled with plenty of tools and tips from her business experience.

Check out Dr. Camp's business website: www.biznaturally.com

Quote of the Month

2009-10-01T18:30:00.001-04:00

“All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self evident.”

Arthur Schopenhaur (1788-1860)

The Disappearing Male

2009-09-29T20:54:00.007-04:00

Silicon in hair products to make our hair shine, vinyl toys for our children to chew on, phthalates to make colognes last all day, flame retardants in our pillows... the list goes on. In fact there are thousands of chemicals sold that end up inside our house and almost none of them have been tested for long-term safety.

CCNM was priveledged to have Rick Smith (who is the Executive Director of Environmental Defence and author of, Slow Death by Rubber Duck) speak on the effects of common chemicals. As he made clear, pollution is not something out there like big smoke stacks, but right inside us: we are polluted!
The Canadian Government's recent 180 turn on the hormone disruptor Bisphenol-A (BPA) is an indication that, with public pressure, changing the influence of the chemical giants is possible. Removing BPA from baby bottles is an excellent start, but the problem is much bigger. The problem is about a regulatory system that failed, about 85% of chemicals that have never been tested, and about the unknown (since it will take decades to see the effects of this toxic legacy).

The CBC documentary, The Disappearing Male, showed that baby boys are the first ones to be effected by chemical hormone disruptors. Even in adulthood, male reproductive problems can be linked to petroleum byproducts. However, consumers have great power and vote everyday with what they purchase.

Check out toxicnation.ca for information on how to go toxic free. Naturopathic doctors are very educated in this area and can work with you towards removing the pollution from your body and providing you with resourceful ways to minimize your exposure.

Book Review 9

2009-09-07T11:00:00.007-04:00

The Truth About the Drug Companies by Marcia Angell, M.D.

This is one of the most powerful books outlining some of the major problems in the pharmaceutical drug industry. It is written in factual, unemotional prose by the former editor in chief of the New England Journal of Medicine. As a medical doctor, she supports the appropriate use of pharmaceuticals but is outraged at many unethical practices of the industry including: how extensive marketing is used to deceive people into believing new "me-too" drugs are superior to old ones, how doctors are given kick-backs, lures and bribes to sell drugs, how people are told that drugs are extremely expensive to pay for innovative research and development, and how clinical trials are biased and rigged by the drug companies who support the research.

Although some time in the book is spent on the unnecessary creation of drug markets, unlike other good books on this topic, the author does not allocate much space to side effects and harm many drugs can do, nor the potential for inappropriate drug dependence (especially with psychological drugs) - no conspiracy theories contained! Instead, the book, which is numerically tedious at times, highlights in great detail the outlandish "marketing" costs of industry. The author's point is supported by undeniable cases of corruption directly from within the industry. One of the main points of the book is drugs that work could be sold at a fraction of the cost and the pharmaceutical industry should be re-focused back to finding truly life saving drugs instead of creating and marketing dubious "me-too" drugs.

This issue is now directly important to naturopathic doctors in Canada as British Columbia's ND's have prescribing rights and more provinces will be on board in the future (some States in the US have also granted prescribing writes several years ago).

The Truth About Drug Companies

Quote of the Month

2009-09-01T11:53:00.000-04:00

"Look deep into nature, and then you will understand everything better."

Albert Einstein

Celebrating halfway from the top

2009-08-17T10:33:00.018-04:00

To celebrate the completion of the first 2 years of Naturopathic school and NPLEX 1, some friends and I decided to climb Mount Temple which is the highest peak in the Alberta Rockies (11,000 feet). The day had many memorable moments including seeing a grizzly bear relatively close as we hiked above Larch Valley. Then, in the face of continual discouragement from teams returning, we were the first of only 2 teams to climb to the summit on what ended up being one of the most difficult and amazing adventures I have done in a day so far. Thirty-five to 50 cm of fresh snow took its toll on even the most fit mountaineers. Thanks to my brother and friends who maintained a positive attitude throughout the entire day, we worked as a team and completed our goal. Enjoy the pictures below:

Southwest Face of Mount Temple
with Sentinal Pass on the left

Navigating the Rocks

Open Slopes

Summit in Sight

Looking Down
Looking Up!

We Made it!

Quote of the Month

2009-08-01T12:08:00.002-04:00

“It is more important to know what sort of person has a disease then to know what sort of disease a person has."

Hippocrates

Paracelsus Herb Garden

2009-07-30T19:47:00.012-04:00

I have always appreciated this little getaway at CCNM as a place to clear my mind and enjoy Botanical medicine from a practical perspective. Although the school is surrounded by busy streets, this offers more than some consolation! I took these pictures on a study break today. Only 5 days until NPLEX. All the best to everyone who is writing it.

View from across the yard.

One Entrance

Goldfish with the wetland plants.
Garden Path
Monarch and Echinacea
Blazing Star, Lavender & Calendula

Not all Green plastics are Created Equal

2009-07-29T19:37:00.004-04:00

With the longest recorded strike by Toronto city workers coming to a close, city services will hopefully resume soon. Although city run daycamps and daycares were shut down and the Center Island Ferry did not run, it was the garbage accumulation that got noticed.

Maybe now is a good time to take a serious look at our throw away society and cut down and look for alternatives. As such bioplastics have received a lot of attention lately. As with anything, not all products are created equal and some companies have their bottom line as a priority rather than actually contributing to the solution. Businesses looking to implement bioplastics need to be aware of how different composition of bioplastics actually breakdown, if at all.

For example, "while a material can be labeled biodegradable (referring to the process whereby microorganisms cause decomposition and assimilation), it may not necessarily be compostable, the process by which material biodegrades to produce carbon dioxide, water and humus..." Take a look at the article, The Truth About Bioplastics by Fiona Wagner for more details.

Book Review 8

2009-07-06T22:34:00.004-04:00

The Secret History of the War on Cancer by Devra Davis

With the 7th annual, 8th annual, 10th annual (depending on the city) weekend walk to end breast cancer, the topic of this book is currently quite counter to the popular culture. However, Dr. Devra Davis is one of a growing number of writers and health experts to point out that there needs to be a refocus in our effort in regards to cancer research. The breast cancer campaigns have due concern since the Generation X women are twice as likely to develop breast cancer as their mothers were. Interestingly, Dr. Davis states that the aging population does not explain this increased rate nor the increase in childhood cancers.

This book is a thoroughly detailed account of the History of contemporary thoughts on scientific direction and public policy surrounding cancer. Dr. Davis shows what happened to derail programs intended to reduce cancer and how so much effort is spent on treating cancer ($100 billion a year is spent in direct cancer treatment costs) and finding a cure, instead of preventing it in the first place. For example, more than 80,000 chemicals are in use and complete toxicity tests are available on fewer than 1000.

Our society has been led to believe by cancer researchers that science will find a cure and money is wisely spent toward this effort. Unfortunately, the public is not made aware that cancers are highly preventable diseases. This is certainly an important and sensitive issue to all of us.

For more information: www.devradavis.com

Quote of the Month

2009-07-02T07:00:00.000-04:00

“DNA isn't destiny - it's history. Your genetic code doesn't determine your life. Sure it shapes it - but exactly how it shapes it will be dramatically different depending on your parents, your environment and your choices.”

Sharon Moalem
(Author: Survival of the Sickest)

Happy Canada Day!!

2009-07-01T00:01:00.000-04:00

Garbage In Garbage Out.

2009-06-26T08:31:00.006-04:00

Toronto city workers are currently on strike. This affects many city services but most prominently in the news is the issue of garbage pick-up. Reports came in that people began dumping their garbage in rivers and parks after only one day of the strike!

Certainly baby diapers in an apartment without air conditioning makes for a very uncomfortable situation. However, now is the perfect time to recognize how many other things we purchase that are just thrown out. We will not need a list because we can see it. This "garbage crisis" puts us in an uncomfortable situation that forces us to stop our current out of site out of mind philosophy.

Annie Leonard does a really great job of comically getting our attention on this fun animation, www.storyofstuff.com. When people positively change their buying habits, ecological and healthy change will happen.

HBBH Business Workshop

2009-06-14T17:23:00.007-04:00

Naturopathic Doctors (ND's) face unique business challenges after graduation including the fact that, in Canada, Naturopathic Medicine is not covered by the Provincial Government's health care system. This means that in order for ND's to do what they were trained to do, they are required to become an entrepreneur. The latest statistics show that about 20% of ND graduates do not work in the field. What is really sad is when an excellent, caring doctor has to close up their practice.

I cannot imagine trying to begin a practice without knowing what I learned this weekend (and this is only the 1st of 4 seminars). Health of Business, Business of Health (HBBH) is taught by Andre Belanger and Dr. Dickson Thom. These 2 men are very passionate about helping ND's succeed in their business and ultimately want to ensure that ND's are able to help others. Planning and preparation is key. Don't wait until you graduate to take these courses.

New NPLEX study website

2009-06-10T08:16:00.009-04:00

New this year is for ND students is, ND Online Learning Center (NDOLC).

Before I was aware of the NDOLC, I paid for both NPLEX 1 prep courses offered. As I am detail oriented, I value classroom learning for providing me with the big picture. Additionally, I bought the Healing Mountain study manual. As such, I think that my bases are covered and am not going to purchase this new online learning package. However, if you are currently using NDOLC, it would be great to hear your comments. "Written by ND's for ND's" and the $50.00 price tag does seem enticing.

New Journal for Naturopathic Medicine

2009-06-08T18:53:00.004-04:00

The first publication of the International Journal of Naturopathic Medicine was just launched this June. The Journal's site states that subscribers will, "Receive an environmentally-friendly print journal and have access to state-of-the-art practice and research in the field of naturopathic medicine..." I'm familiar with at least 5 of the names on the Editorial Board (Faculty of CCNM or guest speakers in my classes) and am certain that the journal will be of the highest quality.

An arena for peer reviewed research will most certainly benefit the continued advancement of naturopathic medicine.

Note: Subscriptions are $149.00/year or 2 years for $129/year.

Naturopathic Movies 11

2009-06-04T12:00:00.003-04:00

FOOD INC.

This movie premiers on June 12 and from the looks of things, it will be a tremendous paradigm shift in the way many people view food. The timing is interesting for many reasons, one of which is that stocks in agriculture and agricultural loans are reaching an all-time high. Furthermore, people are becoming aware that their food selections do affect the availability of better food choices in the grocery store or local farmers market.

To view the trailer, visit: www.foodincmovie.com.

UPDATE:

After seeing this movie, it met my expectations and I highly recommend it!

Naturopathy in Hawaii

2009-05-23T17:53:00.014-04:00

My family and I just returned from the beautiful island of Maui where I had the privilege to preceptor with a Naturopath there. Naturopathic medicine is regulated in the state of Hawaii and the people are very receptive to preventative and complimentary medicine.

On the beach we were talking to some amazing volunteers who were protecting the coral reefs, "for the future generations" by educating the tourists and providing coral friendly sunscreen for free (most sunscreens are petroleum based and toxic to the coral). Everywhere we went in Maui, we noticed the themes of beauty, health and peace and were very sad to leave.

NPLEX Preparation

2009-05-08T19:14:00.004-04:00

Naturopathic students have 2 sets of licensing exams to write called NPLEX (Naturopathic Physicians Licensing Examinations). The first one is written after completing second year and includes the Basic Sciences: Anatomy, Physiology, Pathology, Immunology, Microbiology and Biochemistry. Then, after completing the 4 year program, the final NPLEX is for the clinical sciences.

This week, I am taking the first NPLEX prep course with many of my colleagues taught by Dr. Paul Anderson, ND from Bastyr University. The amount of information we need to know is phenomenal but exciting at the same time. Most students study full-time for the two months prior to the August 4th exam date and I plan to do the same. No rest for the dedicated!!

Naturopathic Medicine Week

2009-04-27T16:40:00.002-04:00

Next week is Naturopathic Medicine Week in Canada (May 2-10).

Check out your local Chapters/Indigo, Coles or favorite health food stores during this week for Naturopathic Doctors giving presentations. Click here for a list of free seminar locations across Canada. This is a great opportunity to learn what naturopathy can do for you and to ask questions.

It's been a year!

2009-04-23T14:40:00.008-04:00

Although I did not have the time to post nearly as much as I would have liked, I was still surprised at the interest in this site. After one year, there were between 250-400 visitors per month and people asked some very good questions.

It was an exciting year for Naturopathic Medicine in Canada. Nova Scotia was the first province east of Ontario to provide legislation for ND's, Ontario is transitioning Naturopathic Medicine under the Regulated Health Professions Act, and of course the recent approval for prescribing rights in British Columbia.

Hopefully third year will allow for a little more time to publish as the second year pace was absolutely crazy. It seems like CCNM crams a 5 year program into 4 years!. Actually, CCNM's program is longer than the "standard" 4 year length. Analogous to university, the first 3 years consist of 2 semesters for a total of 8 months of school per year (what is not analogous to university is that the days are 8-10 hours spent just in class). Finally, the 4th year internship is a full 12 month rotation from May to May.

With one week of final exams to go, I survived 2nd year-barely! Next on the agenda... is more studying. Naturopathic students who completed 2nd year write the basic science board exams in August.