Embracing your inner lifelong student will help keep you and your practice on point, and foster a healthier community.
The oft-quoted assertion from 16th century English philosopher Sir Francis Bacon, “Knowledge is power,” is and should be a lively undercurrent of any practice. Medical research in multifarious disciplines continues at a rapid clip, and health care, as well as disease care, evolve just as swiftly.
Stagnation is anathema to any health-centric practitioner. With the demands of a growing and thriving practice interwoven by the demands of home life, it may be challenging to fit in hours of engaging in new learning modalities.
Dorene Petersen, president and founder of the American College of Healthcare Sciences (ACHS) in Oregon, asserted, “Seeking out new knowledge and expertise to remain vital members of the evolving health care community is very important to staying current.” She pointed out that many licensing and membership entities (such as the Oregon Board of Naturopathic Medicine) require professionals to regularly provide proof of continuing education credits in order to maintain their licenses or memberships. “This helps ensure all health professionals, including natural practitioners, are staying informed of developing research trends, policies and practices to best serve their communities.”
Although in many states, ongoing professional development is often mandatory to maintain licenses and/or certifications, Beth Howlett, MAcOM, LAc, director of communications, Adjunct Faculty, OCOM (Oregon College of Oriental Medicine) said she believes “it is also essential for practitioners to renew their understanding of the complex field of patient-centered care, evidence-based medicine and the evolving landscape of health care delivery. There is always something new to learn—from best practices to new technologies to new integrative and functional medicine approaches to disease, any natural practitioner should expect to be a lifelong student.”
A common characteristic of natural practitioners, observed Cheryl K. Burdette, ND, Progressive Medical Centers of Georgia and Texas, is the compassion, curiosity and constant seeking for new and better answers to heal and empower patients. Yet, being educated about the latest progressive therapies while also keeping up with evidence-based research seems to be at odds with one another. “In order to ensure patients are getting the best treatment, but are not serving as guinea pigs it is imperative that natural practitioners keep their heads in the science,” she stated. “The natural practitioner should attend a variety of events to keep a balanced perspective.”
Ryan Cliche, executive director of the Washington, D.C.-based American Association of Naturopathic Physicians (AANP), suggested that as the natural health field and available treatments continue to rapidly evolve, it’s the responsibility of practitioners to remain apprised of these developments and implement them when appropriate. “By doing so, they are better positioned to safeguard their patients and provide the best care possible. It also leads to increased public confidence in the practitioners as individual professionals and our profession as a whole.”
Rapidly Evolving Areas
Within the ever-expanding realm of health care practice, the natural approaches to wellness also contain several areas of increased invigoration. In Petersen’s viewpoint, aromatherapy is a modality that is accelerating in knowledge and practical application. Knowledge regarding the impact of engaged olfactory and limbic systems through the therapeutic value of essential oils is evolving quickly. “As more of the public becomes aware of the benefits of aromatherapy for general wellness support, the need for high-quality, organic essential oils as well as educated aromatherapists will continue to expand,” she predicted.
Another area Petersen sees as a quickly evolving modality is holistic nutrition, a response to what she called the “three biggest killers in the U.S.—diabetes, obesity and heart disease,” which are largely related to dietary habit. “This is leading to more job opportunities in the holistic nutrition field for holistic nutritionists, wellness coaches and community educators, to name a few,” she noted.
Gut health, specifically, how the individual microbiome environment impacts wellness and disease risk, is gaining tremendous attention, according to Dr. Burdette, and this has amplified the notion of “who we are treating.” She explained, “our bodies are 90 percent bacterial DNA, and only 10 percent human DNA. Bugs in the gut will be the first ones to metabolize any treatment we take in or food we consume. This explains why two people can eat the same thing but gain weight differently. Different flora in the gut will determine what is absorbed from the diet. Different flora can change medications and their metabolites. Our knowledge is rapidly evolving in this area, making clinicians mindful that it is not just the patient you treat, but their microbiome as well.”
Cliche said he views the evolving focus on the genome as tremendous opportunities for individualized, whole care.” One area is an evolving focus on the genome, giving rise to nutritional genomics and personalized medicine and health. Health care professionals who have a focus on providing individualized care are well positioned to take advantage of this.”
The Affordable Care Act, pointed out Howlett, has impacted opportunities for natural interventions, with many states and plans providing coverage for such modalities as acupuncture, for example. “Due to the prevalence of social media, everyone and especially celebrity utilization is driving awareness and interest in trying acupuncture, especially for things such as fertility, stress management and pain.”
Meanwhile, within the practice environment proper, Howlett pointed to increased and rapid sophistication of health technology, such as record keeping, patient engagement and patient-centric care, are evolving “in a way that is both exciting and overwhelming,” she shared.
Beyond this should also be the constant awareness of other specialists and practitioners, said Jacob Teitelbaum MD, author of the smart phone app Cures A-Z, which means that practitioners from a wide array of backgrounds need to be able to know what the others are doing. For example, he elucidated, in standard medicine, if an internal medicine physician was not aware of cardiology, endocrinology, hepatology and many other specialties, the patient he or she is treating could suffer from complications or early fatality. “In the same way, to properly help the people they are serving, natural practitioners need to know when other branches of the healing arts are needed to help their clients,” he said.
No doubt your client/patient population is becoming a bit more savvy; they want more than what their allopathic physicians can provide. Consumers en masse are seeking preventative approaches to remain in a decent state of health and to thwart lifestyle-related dire events and disease. They are desirous of staying out of hospitals and surgical units.
This is evidenced by the continuously compounding growth of dietary supplement sales, as well as the better-for-you foods and beverages that are more plentiful. Yoga and other forms of mind-body exercise and alignment are not just trendy, but are adopted as part of healthier living.
“Here in Oregon, specifically, we are seeing a growing interest in natural, local and sustainable products, including foods, body care products, herbs and supplements,” Petersen attested.”As with any demand, there will be a need for health professionals who can provide the public with research-based information and safe and effective practices for using these products in a wellness routine.”
Acupuncture, Howlett’s specialty, is trending due to media exposure and a growing evidence base. Case in point: the November 28, 2015 edition of the Asbury Park Press, the Gannett-owned regional newspaper covering the New Jersey Shore, carried a feature about a new acupuncture business, the Zen Den. In Gannett feature fashion, the reporter told the story of a patient who suffered from rheumatoid arthritis, and that acupuncture “gave me my life back.”
Howlett elaborated, “I think mindfulness interventions from breathing exercises to adult coloring books are trending because they are approachable, portable and effective in promoting wellness. Nutrition has always been a core part of natural medicine and scientific advances in understanding of metabolic disease processes and impacts, epigenetic factors, and general public interest in healthy school lunches, GMO (genetically modified organism)-free, local food and sustainability also drive interest in nutrition topics.”
The concept of the microbiome, as mentioned, is what Dr. Burdette believes is also trending; as more health media report about it. For instance, she offered, people who have psoriasis have different bacteria than those who don’t. “Conditions often thought to be genetic might actually be bacteria’s influence on our genetics which is much easier to treat. It is likely that we will soon realize that vegetables like broccoli have benefit not only because of what they do to us, but how they improve our microbiomes. The saying, ‘You are what you eat,’ may soon be, ‘You are what your microbiome eats, metabolizes and leaves for you.’”
Life in and of itself, for practitioners, tends to fall into a routine; much of that routine is characterized by appointments, both in the office and in personal lives. Beyond the annual recertifications, etc., it may be easy to become educationally stagnant as the daily grind repeats itself for many months. In other words, you may find yourself feeling a bit behind in keeping up with what’s new, attractive and applicable for your practice.
There are certain things you can do without the fear of having to overhaul your life. Petersen advised to continue exploring various modalities as the CAM industry is richly diverse. “There are plenty of things to learn and get excited about!” she exclaimed. If a practitioner were to feel uninspired or stagnant, research a new modality you have yet to explore—holistic nutrition, aromatherapy, acupuncture, homeopathy, massage and herbal medicine, among others, as they all truly are complementary. “There’s always new research and information coming to light, and the best way to stay excited about your work as a holistic practitioner is to dive into something new.”
Numerous continuing education events Howlett said she attends bring together old friends, and establishes new referral and peer-to-peer opportunities for both personal and professional growth. Also, she suggested, understand your own unique learning style—for example, if you are a tactile learner, choose hands-on classes. This is also a reason to join professional associations to stay abreast of trends and opportunities. Networking and building your own natural medicine network are terrific payoffs as well.
When you have regular pockets of time, Dr. Burdette advised to stay current about peer-reviewed medical literature by reading and “embracing” the research. There are thousands of evidence-based studies that deal with natural therapies. Natural practitioners, she declared, share a responsibility to read and understand the research and speak the language of standard care in order to exert influence for movement in a more wholesome direction.
And, be a part of the movement,” she stated. “This means being active on boards that are supporting research and data collection.”
For example, Dr. Burdette is active on the Brassica Scientific Advisory Board (SAB), the company that makes truebroc brand glucoraphanin from broccoli. Brassica supports research-based initiatives about broccoli-derived compounds. Natural ingredients are often dismissed from study not because they are not useful for human wellness, she emphasized, but because they are not profitable. “By aligning my passion with a group that is investigating compounds, we can collect data and create evidence—even in the absence of pocketbooks that are like those of pharmaceutical companies. Being active on this board connects me to hundreds of doctors and subject matter experts who have extensive experience working with and studying broccoli compounds. Our collaboration helps to educate patients who want to use natural agents.”
And, closer to home, why not have regular dinner meetings with other natural practitioners in your area, such as acupuncturists, nutritionists, energy workers, physicians, etc., Dr. Teitelbaum offered. “Pick a topic for discussion of how each different specialty would approach it to help people, so you can learn when to refer to each other. In addition to being excellent for getting the best results for the people you treat, it is also one of the most powerful ways available to build your practice.”
Promoting Unity in the Community
As Dr. Teitelbaum suggested, the idea of professional yet informal get-togethers is a way of becoming educated about related practices, challenges, issues and successes. Yet it’s also a way of building a stronger united “face” in your shared community. Of course, you can add your local health food retailers to this as well. Work referral programs, and allow for talks in their stores.
Community also has a larger—but no less important than local—connotation, and the larger can have positive influence on the local. “Join your professional associations at the state and national level,” suggested Howlett. “These memberships often come with reduced or even free continuing education opportunities. For working across disciplines, join a local chamber of commerce and/or community association and/or support groups if you are looking to build locally. If the intent is to create referrals and advocacy networks, join non-profit groups such as a Pain Society of Oregon or the Rethinking Psychiatry group. It is often possible to subscribe to newsletters and Twitter or Facebook feeds for these groups to stay connected and engaged.”
Petersen said she encourages all ACHS graduates to explore the holistic health community by getting involved with other modalities and attending conferences and events. There are many professional organizations that provide excellent resources through their memberships and that host conferences and events. For example, an aromatherapist could branch out by attending a nutrition, herbal medicine, a massage and/or yoga conference. “Building a network is important for individual practitioners and our holistic health community at large, but it’s up to all of us to build connections and community,” she opined.
Dr. Burdette agreed, adding that joining boards and physician discussion groups allows for comparing outcomes and sharing “clinical pearls. These clinical observations, when joined together, are what eventually become studies to move the entire community and society to action.”
She added that without a collection of the group’s work, outcomes are considered to be anecdotal, which doesn’t carry serious weight and lack a certain authority. She noted that Progressive Medical hosts regular grand rounds in which its clinicians and others from the community gather to discuss what is working and areas where support is needed, and this provides a strong team-based approach to individualized patient care.
“Overall,” summarized Dr. Teitelbaum, “scientific research in this area is growing rapidly, as is the public’s interest. Continuing education, therefore, is important to stay abreast of this information.”
Healthy Take Aways
■ The area of holistic nutrition is growing, and seems to be a sound modality for those concerned about cardiovascular disease, obesity and diabetes.
■ Microbiome is experiencing robust growth in research and understanding; by addressing an individual’s unique microbiome, care protocols may be more successful to achieve wellness.
■ The mass media is also reporting more favorably about a number of complementary wellness approaches, which many consumers are finding intriguing, as they are fatiguing of the typical allopathic approach.
■ The Affordable Care Act has and will continue to provide more opportunities for patients to receive natural, CAM-based treatment.
■ Understand your own learning style and select educational opportunities that suit. Subscribe to journals outside your specialty but may be linked or related, to generate a stronger sense of patient care intuition based on the newfound knowledge.
■ Create unity among the CAM and related wellness experts in your community—including working closely with health food store owners and staff.
■ Join a professional services board and become active; this helps generate much keener networking abilities and strengthens the relationships you have.
For More Information:
■ American Association of Naturopathic Physicians, (202) 237-8150, www.naturopathic.org
■ American College of Healthcare Sciences, (800) 487-8839, www.achs.edu
■ Cheryl Burdette, ND, www.progressivemedicalcenter.com
■ Oregon College of Oriental Medicine, (503) 253-3443, www.ocom.edu
■ Jacob Teitelbaum, MD, (410) 573-5389