NYGH Health & Wellness Fair

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

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

"To teach is to learn twice." 

Joseph Joubert

The naturopathic Godfather

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.

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?

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

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!

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

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

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.