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Practitioner Roundtable

Practitioner Roundtable Practitioner Roundtable
Longevity By Nature
 
EuroMedica

Participants:

Jeff Anshel, OD, FAAO, Author of Smart Medicine for Your Eyes (Second Edition), Kapaa, HI, https://cvconsulting.com/

Dr. Nicole Avena, Princeton, NJ, www.drnicoleavena.com

Michael Edson, MS, LAc, New Paltz, NY, www.naturaleyecare.com

Marc Grossman OD, LAc, New Paltz, NY, www.naturaleyecare.com

Jason Napuli, DC, Adjunct professor at Logan University and Chief of Chiropractic and Complementary & Integrative Health; VA Residency Program Director, VA St. Louis Health Care System, St. Louis, MO, www.logan.edu/faculty/jason-napuli-dc/

Jodi Perrin, DC, ND, Instructor of Naturopathic Medicine – Clinical Sciences, National University of Health Sciences, jperrin@nuhs.edu

Dr. Elizabeth Livengood, Owner, Livengood Health, Mesa, AZ, www.livengoodhealth.com

Holly Lucille, ND, RN, ONC, Los Angeles, CA, www.drhollylucille.com

Dr. Rosia Parrish, Boulder, CO, Naturopathic Wellness Center of Boulder (Virtual Practice Only), www.nawellness-boulder.com

Jacob Teitelbaum, MD, Kailua Kona, HI, www.vitality101.com

Since Natural Practitioner’s (NP) inception, the field of complementary and integrative health (CIH) has grown. Here, NP talks with a panel of practitioners about trends they are noticing, technology news, patient- and self-care, as well as the future of CIH.

NP: Are there any health issues that you are seeing a rise in? Why do you think this is the case?

Napuli: There are many health issues that continue to rise in the United States and specifically within the veteran population. Newly separated veterans report chronic physical conditions, with lower back pain being at the top, and chronic mental health conditions such as PTSD (post-traumatic stress disorder), anxiety and depression. As we begin to see these conditions increase, we have to find ways to improve quality of life and overall function.

For members serving in the military, there are many positive effects that military service has on well-being. The intensity and duration of service, along with the transition to civilian life, has the potential to correlate negatively on veterans’ well-being. There is a growing trend to improve well-being practice and further exploration of our veterans physical and mental well-being.

In 2016, the Department of Veterans Affairs began to adopt the Whole Health approach as a transformational way to improve the quality of our veterans’ [lives] and change the system from what is wrong with you to what matters most. The Whole Health paradigm places the patient (veteran) at the center of the circle and its focus is on finding ways to improve the quality of life. There are three arms to Whole Health—Pathway, Well Being and Clinical Care. Pathway is the opportunity to surround the veteran with a health coach who will establish goals and complete a personal health inventory. Once a veteran engages in this health care focus, they can explore well-being or self-promotional activities such as movement therapies, nutritional support and mindfulness. Those who do not respond well to well-being activities may not be ready to embrace the self-management and independent lifestyle. These veterans explore the clinical side for a course of treatment that is geared toward improving their function so that they can gain independence from passive interventions and begin to live a life that is full of self-management strategies and overall improvement in their ability to manage their chronic conditions and be in control of their life and health care.

Avena: Obesity has been on the rise for years, but it has only gotten worse for Americans, especially children. Type 2 diabetes is developing at a younger and younger age. Americans have moved toward convenient foods and diets that include immense amounts of processed sugar and fats. We as a nation are simply addicted to sugar, and it shows in our health and diagnosis statistics and outcomes.

Anshel: On the assumption that you are talking about eye health, the answer is yes. There have been increases in just about all significant eye concerns, including glaucoma, macular degeneration, cataracts, dry eyes and diabetic retinopathy. This is due largely to the aging of our general population—since life expectancy is, for the most part, still increasing, most of these diseases occur later in life. Some lifestyle factors are also at play, though. For example, the condition of “dry eye” is due to increased computer use.

Perrin: I am seeing a rise in various endocrine disorders, such as hypothyroidism, hormonal dysregulation and diabetes. I think it is likely due to a combination of poor diet, high stress, sedentary lifestyles and the abundance of endocrine disrupters in the environment.

Grossman: Macular degeneration and cataracts. Poor nutrition and [an] increase in electromagnetic fields.

Livengood: I’m seeing an interesting rise in hyperlipidemia as people are declining excessive statin use and others are enjoying benefits of long-term keto and carnivore diets. They experience weight loss, reduced blood sugar and increased energy, but their LDL numbers, including subparticles, are extremely high in some cases. We’ve known for years that cholesterol alone is a coin toss in terms of predictive value for cardiac events. However, I am closely following the research and other lab markers and imaging on my patients to ensure their safety and best outcomes in this uncharted territory.

Lucille: I think long viral syndrome is certainly something that has gotten my attention. I think one thing that the COVID pandemic helped is for people to understand that there are indeed long viral syndromes.

Edson: Yes, these would include autoimmune diseases and dementia related brain disorders, including Alzheimer’s disease. There are a number of underlying contributing factors, including lack of farm to table food people are eating, becoming more sedentary, chronic stress, exposure to environmental toxins, and the fact that people are simply living longer.

Parrish: Stats used to indicate that one in eight couples faced fertility challenges, but recent reports from the CDC (Centers For Disease Control and Prevention) and WHO (World Health Organization) show that the numbers are increasing to as high as one in five couples. There are several factors contributing to the prevalence of infertility:

1. Advanced age: Many individuals are choosing to become parents at an older age, which has its advantages such as financial stability and more time with children. However, there are downsides to delayed parenthood, including decreased egg quantity and quality. This can reduce the chances of successful fertility and pregnancy, increase the risk of pregnancy loss, and raise the likelihood of genetic disorders. Aging also impacts men’s fertility, with older males experiencing a decrease in sperm quality.

2. Lifestyle factors: Various lifestyle choices can have a significant impact on fertility. Factors, such as diet, smoking, alcohol consumption, drug use and a sedentary lifestyle can disrupt hormone levels and interfere with reproductive processes.

3. Environmental factors: Environmental toxins play a substantial role in infertility. Exposure to pesticides, air pollutants and endocrine-disrupting substances can affect fertility. It is crucial to consider environmental factors such as proximity to golf courses, fracking sites, farms and the quality of air and water. Additionally, the presence of plastics in daily life can contribute to hormonal imbalances, as plastics contain bisphenols and phthalates that mimic and interfere with hormones.

4. Medical conditions: Several medical conditions contribute to the rising incidence of infertility. Hormonal imbalances like polycystic ovary syndrome (PCOS), endometriosis, fibroids, ovarian cysts, inflammatory diseases, autoimmune conditions, infections, thyroid disorders and insulin-related conditions (including diabetes) all play a role in fertility challenges.

5. Stress and mental health: Stress and mental health have a profound impact on fertility. Neurotransmitters and hormones involved in stress, such as cortisol and DHEA, are vital for fertility. Major grief, trauma or other stressors can disrupt these hormonal balances and interfere with menstrual cycles, ovulation and sperm production.

Teitelbaum: We are seeing a dramatic rise in chronic fatigue syndrome and fibromyalgia in the form of “long COVID.” Ten percent of people with COVID have developed post viral chronic fatigue syndrome and fibromyalgia. This translates to 17 million Americans. Sadly, they are being marginalized as well. Incorrectly being told that there is no effective treatment, and often having it be implied that they’re simply crazy, because the doctor doesn’t know what’s wrong with them.

NP: What trends are you noticing in the field of complementary and integrative health?

Napuli: Complementary and integrative health continues to expand both within VA and across the United States. As the evidence based grows for non-pharmacological and non-traditional health care potions, larger health care systems are beginning to adopt these modalities as interventions. When we consider CIH modalities that have the best evidence, we consider the following modalities as rising to the level of inclusion. Acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/QiGong and yoga. Of note, chiropractic is considered mainstream, with its own evidence base related to spinal manipulation, and not considered complementary and integrative health. Chiropractic care spinal manipulation and physical therapy, along with the promotion of self-management strategies such as exercise, nutrition and wellbeing, are considered conventional medicine approaches to first line treatments for acute and chronic pain conditions. Once these have been trialed as a first line approach, the need for CIH modalities can be determined based upon patient response or lack thereof. It is important to remember that CIH modalities are “complementary” or “in addition to” conventional approaches and should not be considered as “stand alone.”

Avena: I have seen more people move toward integrative medicine as a whole over the past 10 years. Alongside Western medicine, integrative components and therapies have research-backed results, which give people promise. One noticeable trend is the turn towards whole-system treatment, including mental health prioritization. Treatments including hypnotherapy and meditation teachings to decrease stress and improve mental stability have grown, leading to better overall well-being and health.

Anshel: Many people are hoping to, if not circumvent, then to at least augment their treatments with “natural” approaches. Unfortunately, these usually only enter into the equation for most when a disease has already manifested and the time for prevention has passed. Diseases are easier to manage with integrative practices prior to expression rather than “after the fact.”

Perrin: Since my practice has more of a focus on women’s health, the trends I see in the field might be a bit narrow. I do see an increased number of women seeking alternative care for cervical dysplasia and HPV. A lot of women are looking to avoid the potential risks associated with traditional dysplasia treatments, have had multiple failed procedures, or were told to watch and wait, and wanted to take a more proactive approach to resolve the dysplasia instead of allowing for the potential for it to progress to a more advanced stage.

Grossman: More people are interested in integrative medicine approaches.

Livengood: I’m pleased to see wide acceptance of regenerative procedures in both natural and conventional practices. Patients are more informed and seeking services such as PRP injections. I also see practices becoming more specialized in areas, such as regen, aesthetics, hormones, etc. Integrative primary care is hard to find and a full-service family practice is even harder to find.

Lucille: I think the NMN, rapamycin, longevity stuff is trending pretty hard right now.

Edson: There is a growing field of doctors and other health professionals that are practicing functional medicine, which does take a more holistic approach to health and healing, starting with analyzing and treating gut flora imbalances.

Parrish: Several trends have emerged in recent years, primarily that there has been an increased interest, popularity and acceptance of natural medicine, including naturopathic medicine (my field!), acupuncture, herbal medicine, yoga and meditation, and others. Many use it to fill in the gaps of conventional medical care, but others use natural medicine entirely as an alternative.

I also think there’s been a focus on treating the whole person and making sure that the mind, body and spirit is treated. In naturopathic medicine, I’m always looking at interconnection in the body and how some systems of the body are related and impact each other. A holistic well-being focus for my patients is really important.

There have also been some awesome leaps with research and evidence of natural and integrative medicine, which include improvements in research on safety, efficacy, mechanisms of action, and integration of functional and natural medicine into the conventional medical system. Although I don’t think we’ll ever get to the point that I’d like with natural medicine research, the amount of evidence based medicine that is out there now is the best we’ve ever had.

I also see a trend in integration of natural medicine into conventional medicine to offer holistic health services alongside traditional medical treatments. This improves patient outcomes and provides a personalized approach to care that is not new in natural medicine, but has begun to transform the patient’s experience post-pandemic. We are seeing this with everything from fertility [to] cancer, to long COVID and more. Medical integration is profound for patient outcomes.

Lastly, a trend that many wish would go away but is not, is technology in health care, with apps, wearable devices and online resources for accessing information, tracking health data and engaging in virtual consultations or telemedicine. I’ve seen a boom in this recently, with the advent of more fertility trackers and online resources that have increased accessibility of knowledge and democratized access to knowledge and previously restricted resources.

Teitelbaum: The physicians are not buying into the divisiveness that natural options are always correct and medications always wrong. Rather, they are using science, instead of the industry propaganda fed to most physicians. Basically, they’re using the best and safest of everything that is available. I suspect the term coined by the late Dr. Hugh Riordan, calling this “comprehensive medicine,” is becoming more apt.

NP: Who or what was your inspiration for wanting to become a natural practitioner?

Napuli: My inspiration for becoming a natural practitioner began with my experiences as an emergency medical technician and paramedic in New York City. Seeing firsthand trauma and the effects of that, I knew then that it was my desire to explore nontraditional options for health that were geared toward a proactive approach rather than entirely reactive. By addressing health and well-being from the beginning, you aim to find ways to improve your quality of life and mitigate many of the chronic conditions that [we] are seeing in our population.

Avena: I am always based in science and had an interest in the nutrition component of health. Over the years I have spent doing research, I had found that there is a lot of unnecessary suffering happening, and many of the diseases and ailments that people commonly face are rooted in their lifestyles. Helping people to realize that they have more control over their health than they think has become very important to me.

Anshel: I opened a practice in a holistic healing center near San Diego, CA in the late 1970s. I worked with many other integrative practitioners, all of whom had nutrition as a part of their practices. I realized that the “eyes are a part of the body”—anything that affects the various tissues or organ systems in the body also affects the eye. Few studies had been done at that time that would look into nutritional support for better eye health, so the early results were mostly observational. Eventually, though, the field opened up—and even now, we are still uncovering new aspects of nutritional support that can be applied directly to eye health.

Perrin: I have been practicing chiropractic since 2004, and a few years into practice, I worked with a patient that mentioned that they were seeing a naturopath for some of their health conditions. I had never heard of naturopathy and did some research on the profession. What I read about the profession resonated with me, but at that time I wasn’t in a position to pursue a degree in naturopathic medicine. After a few more years in practice, I was finding patients just didn’t hold their adjustments as well as they used to. They would be good for a week or so and then be back with the same complaints, month after month. I wanted to see patients get better, and naturopathic medicine seemed to be the piece that was missing for me. In 2011, I finally decided to take the steps necessary to pursue a naturopathic degree and enrolled in National University of Health Science in Lombard, IL. Looking back with what I know now, I realize it is the disturbed determinants of health that were not being addressed in those patients. They needed more than just adjustments to overcome the disturbance in their body.

Grossman: I follow the philosophy of looking for the underlying causes of medical conditions.

Livengood: My interest in natural medicine stemmed, ironically, from my first job as a pathology aid at Desert Samaritan (now Banner Desert). The pathologist often had a lifestyle or nutritional explanation for why the surgical specimens ended up on his dissection table. Raising my children confirmed to me how important a healthy day-to-day lifestyle is for prevention and treatment of health problems.

Lucille: I think it was my parents and not wanting to do what I saw them as pharmacists do, just the old “here take this” approach. I wanted to know more about the incredible healing our bodies had inherently and that is what motivated me. It took me to the American Holistic Nursing Association, as my undergrad was in nursing, and that led me to naturopathic medicine!

Edson: To help empower patients to learn to be part of their own health and healing, and to be able to offer support in the endeavor.

Parrish: My inspiration for becoming a natural practitioner stems from witnessing the transformative power of natural medicine in my own family. Seeing family members overcome chronic illnesses through natural approaches ignited my curiosity and belief in the body’s innate ability to heal itself. I was fortunate to have ongoing mentors who were natural medicine practitioners, guiding me on this path and instilling in me a deep appreciation for the holistic and individualized approach to health. This, coupled with my belief that pharmaceuticals and surgery are not always the ideal solutions for everyone, fueled my desire to seek out alternative methods for promoting well-being and healing.

Teitelbaum: I came down with post viral chronic fatigue syndrome in 1975. It knocked me out of medical school and left me homeless. My professors were totally unable to help me, and then started to imply that I was just a “depressed med student.”

But it was as if the universe put a “holistic homeless medical school” sign on my park bench when I was homeless. I didn’t even know there was such a thing as holistic medicine. But numerous holistic practitioners came by my park bench and taught me how to recover. I was able to return to medical school, and being a science geek explored the literature supporting holistic medicine. I was shocked at just how much science there was behind it, and how it was being ignored.

NP: What do you do to stay healthy and de-stress?

Napuli: There are many things that one can do to stay healthy and de-stress. First and foremost, it is finding the balance between your daily activities, whether that is work, family, self, religion and serving your country. By finding the balance, you ensure that you are able to mitigate stress and know that you give your best in that moment. Being able to transition from one to the other is important to reduce stress and anxiety, but also [to] have fulfillment in your daily life. Finding time for relaxation, mindfulness and movement therapies are important to well-being and balance. Finding time to be focused and intentional also contributes to balance and fulfillment.

Avena: I love to be with my family and spend time outdoors. We go on walks and travel often to detach and experience new places, and I think that’s the best way to relax! I also love the beach. I like to workout at the gym with my friends a few days each week, and the other days I lift weights at home and walk my dog, Monty.

Anshel: After 45 years, I’ve retired recently from private practice and have relocated to Hawaii to be near my new granddaughter. However, I am still working with many companies and professionals to promote the inclusion of nutrition into the private practices, as well as writing consumer-based books to educate the public on the importance of regular eye examinations.

Perrin: I will admit this is a work in progress. Balancing a healthy work-life balance between a full-time teaching position and private practice is challenging, but I love what I do. I also try to eat well, manage stress appropriately, stay physically active and sleep well. Spending time with my family and playing with my pets are a big part of my R&R and stress management. I also love flower gardening in the summer, and any type of craft project I can get my hands on brings me joy.

Grossman: Meditate and exercise daily.

Livengood: Practicing medicine is a work of heart, but running the business can be all-consuming. I make sure to get adequate sleep and have recently started Reverse Dieting with a personal nutritionist. I also take targeted supplements. Making time for things that restore my energy is hard to find, but I do squeeze in walks, meditation, reading and massage therapy.

Lucille: It is a lifetime job. I believe in movement and food as medicine, and I work very hard to adjust those two things as my age and situation in life changes. I play music and have a band and it is a lovely way to de-stress and have a lot of joy. My garden is another key point in this, as well my family. Edson: Exercise regularly (particularly taking regular hikes in the woods), meditate and practice QiGong.

Parrish: I do a lot to stay healthy and de-stress:

• I eat a balanced diet that includes fruit, veggies, whole grains, protein including meat, fish and legumes, and healthy fats including avocado, bone broth, nut butters and seeds, and more. I do avoid processed foods, most sugar and fast food. Staying hydrated is also important and I drink morning smoothies with multiple powders in it (currently, Glut shield, SBI protect, greens powder, collagen powder, Immunoberry liquid, dairy free milk and frozen fruit including mango). I sometimes make savory detox smoothies as well including matcha tea, green powder, cilantro, kale, parsley, ginger, curcumin, water and more. It isn’t for everyone!

• Prioritizing regular exercise is of utmost importance to me. However, since transitioning to a virtual clinic, I have faced challenges in maintaining an active lifestyle. Balancing my responsibilities as a mother of two young kids makes it even more difficult to prioritize exercise. I am eager to explore effective strategies and techniques to cultivate discipline and incorporate physical activity into my routine, despite the sedentary nature of virtual practice. Movement that I do love is dance, yoga, barre, Pilates, jogging, HIIT and more.

Being outside: Spending at least 30 minutes outside each day, even if it’s just a walk around the block, is really important. Exposure to nature has been shown to improve mood, reduce anxiety and promote overall well-being.

Honoring sleep: Prioritizing getting sufficient and restful sleep each night. Creating a relaxing bedtime routine, and ensure your sleep environment is comfortable, quiet and dark. Avoid electronic devices before bed and limit caffeine intake, especially in the evening.

Hydration: Drinking at least half your weight in ounces of water each day, and consider adding electrolytes to help maintain hydration levels.

Hydrotherapy: Taking Epsom salt baths, swimming, or using a sauna to promote relaxation, reduce inflammation and support detoxification.

Stress management techniques: I love exploring stress management techniques, including deep breathing exercises, meditation, yoga, reading relaxation books, mindfulness practices or journaling. Engaging in activities that you enjoy, such as hobbies, reading, listening to music, or spending time in nature, can also help reduce stress.

Social support: I have a lot of friends and try to cultivate and maintain strong connections with them as much as possible. I am even someone who loves talking on the phone!

For health care, regular checkups, dental appointments, pap and pelvic exams, lab work and more, are all appropriate for preventative care. Taking supplements, botanical medicine [and] homeopathy, are also important for my health care stay healthy routine.

Teitelbaum: Only do things that feel good and say no to things that don’t. To me this is another way of saying that I stay authentic.

NP: Overall, how can practitioners better serve and help their patients?

Napuli: Practitioners today can serve their patients best by asking the simple question. What matters most? What is your mission, aspiration and purpose? By setting a goal and understanding the patient better, you can ensure that your intervention and recommendations are patient-centered and supported through the doctor-patient relationship. Being able to transition from doctor centered to person centered is important for the success of the doctor-patient relationship and also considered evidence based. Creating independence and promoting self-management strategies is an increasingly popular trend and supported by the evidence. Increasing patients’ dependency on passive care entirely rather than goal setting and creating opportunity for self-management strategies is something that is not supported by the evidence nor person centered. Understanding that health care can be transformative and proactive rather than reactive and dependent is important for the success of not only the person, but professional autonomy and cultural authority.

Avena: I think educating practitioners on the impact of environment in disease is crucial. Environment includes everything from social circle to food to toxins in soap!

Anshel: Most optometric students don’t realize the important role of nutrition in eye health, so it’s often a “start from scratch” process. Not every doctor is open to making use of all this information—as a result, they might feel “overwhelmed” with the details involved when it comes to learning about nutrition. That is why I started the Ocular Wellness and Nutrition Society (OWNS). It is a full source of nutrition education designed to help eyecare practitioners learn about the best options for treating their patients. While I am no longer the president, I am still an advisor for them.

Perrin: The best thing a practitioner can do is stay current with the information available so that they can offer the best care possible for their patients. They should be striving to learn something new every day because one day that information might be the key that can help a patient overcome their health challenges and live a better life.

Grossman: My creating a team approach and working together with other integrative medical professionals to help create treatment protocols.

Livengood: Practitioners need to listen to their patients, even if it seems they are venting or discussing intangibles such as their mental health. Even if we can’t solve all these issues, patients usually just need to feel heard. The No. 1 complaint I hear about other providers is patients feeling dismissed or rushed.

Lucille: Do their own work, walk their talk and continue to be a better listener.

Edson: Listen to what they have to say, and offer advice based on where the patients is at that moment in terms of what they are able to hear.

Parrish: Practitioners can enhance their ability to serve and support their patients by embracing a patient-centered approach that prioritizes effective communication and establishes clear policies and procedures. Actively listening to patients, demonstrating empathy, and fostering a safe and nonjudgmental environment for open expression of concerns and questions are crucial aspects of patient care. Additionally, here are other ways to improve patient care:

Recognizing patient experience: Even if lab results appear normal, it is essential to validate and address the patient’s symptoms and concerns. Taking their experiences seriously and seeking appropriate interventions can lead to more comprehensive care.

Trusting the patient’s intuition: Patients are often attuned to their own bodies and can sense when something is not right. When a patient expresses a need to seek further assistance or return for follow-up, it is important to trust their instincts and support their decisions.

Continual education and staying updated: Health care is a rapidly evolving field, and practitioners should strive to stay informed about the latest research, treatments and technologies. This ongoing education enables them to offer the most current and effective care options to their patients. CEs, conferences, webinars, books and other resources, are really important to stay on the pulse of medicine.

• Collaborating with other health care professionals

Teitelbaum: Again, realize that most of what we are being fed is corporate propaganda. Both in the general and “scientific” media. And sadly, I have found that physicians are no better at distinguishing propaganda from science than anybody else. The pharmaceutical propaganda simply says that it is “evidence-based,” when it really isn’t.

So basically, practitioners have to look at the studies themselves. The study conclusion will tell you who paid for the study. But you have to tear the data apart to see what the science really says. Then you need to do an analysis of the probable benefit, versus the safety and cost. Then you need to see for yourself what works.

NP: What does the future hold for the field complementary and integrative health?

Napuli: The field of CIH and Whole Health will continue to expand. Understanding the evidence related to this and one’s ability to navigate the integrative health care setting are important. The continuation of building evidence that continues to support this, along with the cultural transformation from what is wrong with you to what matters most, are necessary for providers to be person centered rather than doctor centered.

Avena: I think it is only growing. People are realizing the impact of everyday life on health and are being educated on the prevention (not just treatment) of lifestyle disease. Research emerges monthly regarding alternative practices and therapies.

Anshel: As long as consumers need health care, there will be a need for alternatives. Remember, in the U.S., we don’t have a “health care” system—instead, we have “disease management.”

Perrin: I see complementary and integrative health fields growing and becoming more “mainstream” rather than an alternative as more people learn there is a better way besides relying on drugs and surgeries that don’t address the underly cause and don’t lead to optimized health.

Grossman: I feel complementary and integrative medicine is the medicine for the 21st century.

Livengood: Billions of dollars are spent on complementary medicine and this is expected to grow as people seek alternatives to the conventional disease-care model. However, consumers rely heavily on certification labels, reviews, referrals and social media. Despite being “alternative,” we still have to rely on current methods of patient education in order to reach our target audience. This can be a painful growth curve for some of us who remember using the Yellow Pages. Keeping up to date with the latest certifications can also be quite expensive.

Lucille: I think it is bright, but not without its obstacles. The more traction and interest the field gets from consumers, I feel the more pharma and insurance companies get worried and then seem to try and message against this system of medicine. But we should remember, there is value in all systems of medicine and a place and time for everything!

Edson: The public is demanding better information with the understanding that traditional medicine has its limitations in terms of prevention and healing, so hopefully this will drive the traditional medicine community to be more open to incorporating complementary medicine the their practices.

Parrish: Complementary and integrative health approaches are likely to become more integrated with conventional health care systems. There is a growing recognition of the value of combining complementary modalities with evidence-based medicine to provide more comprehensive and personalized care. The field is likely to embrace a more personalized approach to health care, utilizing tools such as genomic testing, advanced diagnostics and individualized treatment plans. This personalized medicine approach can enhance treatment outcomes by tailoring therapies to patients’ specific needs and genetic profiles.

Teitelbaum: Our toolkit for helping people with things that standard medicine cannot continues to grow.

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