Naturopathic Doctors as Part of the Health Care Team

While many naturopathic doctors work in private, solo practices, there is increasing demand for NDs as vital members of the health care delivery team. Interprofessional healthcare occurs when different disciplines collaborate to collectively provide patient care. Patients benefit by having the right expert advice, at the right intervention point. Improved cross-profession communication also decreases care delays, medication interactions, and promotes team members working together for optimal patient care. Naturopathic doctors are an integral part of interprofessional healthcare delivery in many types of patient care settings. We speak with several naturopathic doctors in various interprofessional healthcare settings to learn how they work to uncover the root cause of illness, coordinate care with numerous professionals, and ultimately educate and empower patients toward wellness.

One of the NDs we interviewed is Dr. Arvin Jenab, a naturopathic doctor at the Susan Samueli Center for Integrative Medicine (SSCIM) at the University of California-Irvine Health. He serves as  Medical Director of Naturopathic Medicine and the Director of the Naturopathic Residency Program. He works directly with medical residents and patients and is actively involved in research and education. Dr. Jenab develops new programs to increase access to integrative medicine by underserved communities across Orange County, California.

Interprofessional healthcare benefits patients and doctors alike – the days of one doctor treating one condition are behind us – we have moved into an era where patients need a village of doctors and doctors need a team of colleagues!  Interprofessional healthcare results in team-based, patient-centered, compassionate care. Patients feel heard and more extensive efforts and resources go into determining the cause of illness and developing the most effective treatment plan. With the complexity of chronic diseases and overwhelming number of influences that impact health, it is increasingly important to create opportunities for interprofessional healthcare whereby both patients and doctors can engage in meaningful exchanges aimed at changing the context of health.”

Arvin Jenab, ND

Graduate, Canadian College of Naturopathic Medicine

Uncovering the Root Cause

Naturopathic medicine is grounded in recognizing the power of identifying the root cause and limiting suppression of symptoms to only when necessary for patient safety or comfort. This is why initial visits with naturopathic doctors are likely to last between 60-90 minutes. Topics such as nutrition, digestive health, family history, stress, sleep, and mental health will be addressed regardless of the issue presented with the understanding that the body functions as a complete system, and that each of these pieces are components and contributors to overall health.

Dr. Sunita Iyer is the Clinic Director and Founder of Eastside Natural Medicine, PLLC where she and her colleagues see primarily perinatal and pediatric patients, offering midwifery care, mental health care, acupuncture, lactation management, minor surgery, and primary care for all ages. Dr. Iyer’s specialties are the Five Ps: preconception, pregnancy, postpartum, parenting, and pediatrics.

“When patients have each part of their body addressed by a separate health care provider, there is a presumption that health and well-being happen in isolated systems.  We know this isn’t true. When working as an integrated and interdisciplinary team, we can better understand our roles, contributions, and limitations to communicate more effectively about the person we are treating rather than the systems. Patients know that we are all working toward their health together, and that when something isn’t working, we will all problem solve together.”

Sunita Iyer, ND, LM

Adjunct Faculty and Graduate, Bastyr University

Dr. Tegan Moore is the Executive Medical Director and Co-Founder of WHEELHOUSE Center for Health and Wellbeing. Her practice sees a variety of patients from pediatrics to oncology who are looking for a team-based approach and personalized healing solutions for chronic illness. Dr. Moore’s team works together to provide a one-stop-shop for genomic and microbiome analysis, personalized nutrition and lifestyle interventions, acupuncture, and cognitive/behavioral health.

“Naturopathic doctors are trained to search out and address imbalances in the body that cause symptom patterns—a method of doctoring that often requires unique treatment strategies catered to the needs of the patient. This approach to treatment often stands in contrast to allopathic protocol-based treatment plans and can act to augment care plans and improve health outcomes.”

Tegan Moore, ND

Graduate, University of Bridgeport School of Naturopathic Medicine

Many times, conversations with patients reveal symptoms or health issues that may have not otherwise been addressed, and can serve as a first line of defense against chronic disease, greatly reducing the need for future healthcare intervention.

Dr. Lisa Taulbee is a primary care provider who specializes in women’s health and gynecology. She works for ZoomCare, which is an on-demand interprofessional health care clinic system with specialists who are available to see patients without referrals seven days a week.

“Patients often require multiple approaches and therapies to best manage health conditions.  All the providers on a patient’s care team are able to provide input in regards to their own specific areas of expertise, including naturopathic doctors.  Natural therapies can augment conventional therapies and even prevent the need for conventional therapies that may have adverse risks associated.”

Lisa Taulbee, ND

Graduate, National University of Natural Medicine

Dr. Jacob Wolf serves as a naturopathic provider at Lake Health Integrative Medicine, a practice which consists of osteopathic physicians, medical doctors, and chiropractors.

“With current heavy reliance on opioids and polypharmacy, a growing number of patients are looking for non-drug alternatives that an ND can offer.”

Jacob Wolf, ND, LAc, Dipl. OM

Graduate, Southwest College of Naturopathic Medicine

Furthermore, “NDs are investigative diagnosticians. They take the time to gather a fair amount of information including labs and imaging, analyze and interpret based on defining and guiding principles of naturopathic medicine, develop hypotheses, and follow through with sometimes complex treatment strategies.  Our uniqueness is our systems-based approach to health and disease, and our consideration of the mental and emotional factors that influence patients’ health,” adds Dr. Jenab.

Dr. Dawn Siglain specializes in autoimmune, pulmonary, and renal health at Inner Source Health in New York City. She also is trained as a Reiki instructor and acupuncturist.  Dr. Siglain describes a visit at Inner Source as unlike any other doctor appointment, with an in-house variety of providers for women’s health, pediatrics, mental health, chronic pain, neurodegenerative disease, cardiovascular health and metabolic syndromes, Chinese Medicine, Lotus Physical Therapy, Pelvic Floor Therapy, and massage therapy.

“Naturopathic medicine extends beyond what labs may reveal about a current physical state.  Using a preventative eye, I assess labs with a narrower reference range which allows for detection of imbalance in the body before symptoms of discomfort may arise.”

Dawn Siglain, ND, LAc

Graduate, University of Bridgeport School of Naturopathic Medicine

Doctor as Teacher

The first step to treatment is providing patient education with medical professional insight. Naturopathic doctors take the time to explain how factors could be contributing to illness so that the whole person is treated, not just the symptoms. In doing so, naturopathic doctors may collaborate with other medical professionals to provide the most comprehensive care available. Most importantly, the patient is involved and given options in each step of the process.

Dr. Dan Rubin is a board-certified naturopathic oncologist, founding president of the Oncology Association of Naturopathic Physicians, and Medical Director at Naturopathic Specialists, LLC., where many of his oncology patients are sent to him on referral from medical doctors. His team of interprofessional healthcare providers sees patients for pain management, diet and nutrition, IV therapy, and more.

“As part of an interdisciplinary team, each physician is presented with the same patient, but each physician, given their specialty, is going to see the patient a little bit differently. NDs are very attuned to identifying the cause of illness rather than just addressing the symptoms.  This focus on asking “Why did you become ill?” rather than jumping straight to “do this to get better,” helps to facilitate patient education and draw attention to the patient’s accountability in maintaining their own health.  It’s that vital step that makes personalized medicine and care possible.”

Dan Rubin, ND, FABNO

Graduate, Southwest College of Naturopathic Medicine

Dr. Heather Bautista is a naturopathic provider at Edward-Elmhurst Integrative Medicine Clinic. She works alongside medical providers to offer holistic patient care.

Simply put, interprofessional healthcare gives patients options. Being in an outpatient hospital setting, I often get statements like ‘I don’t want to go on medication’ or ‘I don’t want to be on this certain medication’ followed by ‘What can I take instead?’  It is not about replacing a medication with a supplement, but giving the patient options of what they can do at home with their lifestyle, food choices, possibly looking into environmental exposures, stress levels, detoxification pathways, etc.”

Heather Bautista, ND, CNS, LDN

Graduate, National University of Health Sciences

If the patient desires care outside the specialties or training of one health care provider the naturopathic doctor will make referrals to another.

Dr. Erica Joseph is a naturopathic oncologist at Seattle Integrative Oncology. In this busy practice, naturopathic doctors offer patients additional care in addressing symptoms and side effects from their treatments – a service that other providers do not have time to offer.

“Within the realm of oncology, each practitioner has a very specific role that they play and the different modalities can be quite separate, from radiologists who provide imaging, to surgeons who perform biopsies or curative surgeries, on to medical oncologists or radiation oncologists who provide their respective treatments. As a naturopathic doctor, I work with patients through each of these different stepping stones and help them to have a cohesive and optimal health care plan. By having the option to see multiple providers, patients gain more knowledge about their health and are given more options for treating their health conditions.”

Erica J. Joseph, ND, LAc, FABNO

Graduate, Bastyr University

Many times, naturopathic doctors can work with patients to incorporate lifestyle changes such as exercise, diet, nutrition, and stress management that provide a more natural approach to healing and longevity.

“From a family medicine perspective, the interdisciplinary model is priceless. Being able to see a child, and also take care of the parents, and even grandparents, provides insight not only into the symptoms in that moment; we gain a critical view of all of the social dimensions of health which often supersede the healthcare encounter in terms of effects upon a child’s or family’s health,” Dr. Iyer adds.

Interprofessional Feedback

Naturopathic doctors share the feedback that they have received about their naturopathic approach from their interprofessional team members.

Intrigued by whole-person approach

Dr. Jenab states, “My colleagues are intrigued and interested in learning more about the naturopathic approach to patient care.  Specific feedback is that we are thorough, hold a lot of information in context, are effective at engaging patients, and create a therapeutic space that encourages patients to speak openly about their health including their emotions, thoughts, and beliefs.”

Open to new approaches

As a licensed naturopathic doctor who practices in a pre-licensed state, I am always surprised by the positive feedback I get. My day-to-day interaction in my practice is with osteopathic physicians, medical doctors, and chiropractors who fully understand and appreciate the training of naturopathic doctors and value my approach to patient care. Other colleagues outside of my practice have occasionally been skeptical of treatment or diagnostic techniques that I have used, but have been open to trying new approaches,” says Dr. Wolf.

Surprised by extent of patient care

Dr. Iyer provides a different context on feedback she’s received. “I have a lot of friends who are other healthcare providers: nurse practitioners, surgeons, dentists, and physical therapists.  When they heard that I am a naturopathic physician and midwife, they hesitated.  They aren’t sure what that means.  Do I run wild in the countryside with scissors? Am I anti-vaccine? Am I anti-medicine altogether?  The way I describe my approach is as ‘natural-lite.’  Which isn’t to say that I don’t find natural therapies incredibly powerful or effective in my practice.  What I mean is that my approach is very much a marriage of methods.  All are welcome. Over time, I subject both natural and conventional therapeutics to scrutiny.  I don’t think one side is ‘better’ than the other.  I don’t think that there are sides.  We live, as do our patients, in a system. For our patients to be healthy but also well-resourced, we must work within the system to get their needs met.  Other providers are surprised that the naturopathic approach and the holistic approach involves the larger healthcare context of our patients, and not just using herbs or supplements to treat symptoms.”

Patient Success Stories

Naturopathic doctors share success stories of interprofessional patient care.

Cancer

“As a cancer specialist, I see the benefits of interprofessional healthcare firsthand. I really believe that ‘it takes a village’ when it comes to the treatment of a person with cancer.  If a patient only sees one physician, there’s realistically only so much care that they can receive. By involving medical, surgical, radiation, and naturopathic oncologists, the care they receive is more rounded and the patient is well-supported; it’s a team effort to provide the best care possible. I also believe the principle that ‘iron sharpens iron.’ The interactions and experience that I’ve had with my multidisciplinary colleagues over the years has made me a better physician, and enhanced the care that I provide by expanding my own knowledgebase.”

Dan Rubin, ND, FABNO

Graduate, Southwest College of Naturopathic Medicine

Breast Cancer and Hypothyroid

“I am treating a patient with metastatic breast cancer who has been on a trial drug for about two years. During this time, she has had multiple joint pain, severe fatigue, as well as insomnia. We had been attributing her fatigue to treatment side effect, however upon deeper investigation we found that she was hypothyroid, likely due to the variety of treatments she has received. By improving her thyroid function, she has regained significant energy as well as improved sleep. She was also starting to develop elevated liver enzymes due to her treatment and although she has been responding well, there was concern she might not be able to continue. Working together with her medical oncologist, we were able to come up with a plan to stabilize her liver enzymes which has allowed her to continue treatment. Additionally, I provided her acupuncture, which has greatly improved her pain level and daily functioning.”

Erica J. Joseph, ND, LAc, FABNO

Graduate, Bastyr University

Lower Back Pain

“A patient came to me for acute low back pain on referral from a neurologist. His symptoms were initially concerning for a potentially emergent condition, cauda equina syndrome, but there was no evidence on MRI. Since a surgical treatment was not an option, he was referred for acupuncture. I used a combination acupuncture techniques and targeted supplements to resolve the majority of symptoms including peri-anal numbness, thigh and groin pain, and low back pain. However, he still had a “stuck” feeling in his right sacro-iliac joint when moving from seated to standing. He began a series of biweekly manipulation sessions. Additionally, he began treatment with a massage therapist available in our practice. He now has complete resolution of symptoms and is back to full function.”

Jacob Wolf, ND, LAc, Dipl. OM

Graduate, Southwest College of Naturopathic Medicine

Women’s Health

“A 39-year-old female patient presented initially for an evaluation of acute abdominal pain. She was ultimately diagnosed with NSAID-induced gastritis.  After questioning the patient, she revealed that her high NSAID use was due to severe dysmenorrhea from stage 4 endometriosis.  She had previously desired to preserve her fertility and declined contraceptive options and hysterectomy for treatment.  We initiated numerous natural therapies to help control her pain as well as counseling her on all options, including surgery.  Her pain was so severe and limiting her life to such a degree that ultimately, she made the decision to move forward with hysterectomy.  I referred her to a surgeon I frequently work with who was able to perform the surgery. Though it was not natural therapies that ultimately resolved her issue, I believe that having the time to try multiple options as well as counsel her on the risks associated with surgery and answer her questions as well as address her fears, she was able to make the decision that freed her from the excruciating pain she had been dealing with for decades.”

Lisa Taulbee, ND

Graduate, National University of Natural Medicine

Weight Loss

With hopes of making a full recovery after a work-related back injury, my patient considered the advice of his physical therapist to start exercising and lose weight and was referred to me to help with this lifestyle change. After four months, he lost 84 pounds. This patient has started intermittent fasting with continued weight loss.

Heather Bautista, ND, CNS, LDN

Graduate, National University of Health Sciences

Pregnancy and Birth

“One of my favorite stories is of a new mother that was in the care of a midwife at my clinic. During her care, she came to me for management of her thyroid with medication, lifestyle, and nutrition, which was very different than what her prior primary care physician was able to offer.  Given the nature of my working relationship with her midwife, we were able to jointly manage her care plan, labs, and follow up.  In the course of her pregnancy, she required a TDaP vaccine, which she was then able to walk right upstairs and receive with our team.  After her baby was born, she was having lactation difficulties.  I was able to step in to help with some botanical lactation support, she was able to see our acupuncturist for milk supply augmentation, and was able to connect with our mental health counselor and psychiatric nurse practitioner to assist with her postpartum anxiety and depression.  I was able to work with both her mental health team members to offer nutritional and supplemental support, and to ensure that her treatments were synergistic, not overlapping, and certainly not antagonistic and causing harm.  Most importantly, she was able receive all of this care in one place. She came in with her baby and was able to move between appointments seamlessly, with each of us shifting rooms to accommodate her while she breastfed or pumped.  While there are so many stories like hers, what we have created in our clinic in terms of interdisciplinary and integrated care that holds families is an incredible experience for us as providers, and for the families that we care for.”

Sunita Iyer, ND, LM

Adjunct Faculty and Graduate, Bastyr University

Psoriasis

“A recent success was the complete remission of an intractable case of psoriasis that presented in the ear canals and genitals and produced chronic and constant itching and irritation that was very distressing to the patient. The team approach included naturopathic internal medicine techniques including specialized genomic analysis of the patient’s inherited gene single-nucleotide polymorphisms that were potential contributors to immune dysregulation, genomic analysis of the patient’s microbiome to address inflammation that could be contributing to the immune activation, personalized nutrition offered by our skilled nutritionist as well as process cognition sessions with our hypnotherapist to support anxiety and improve the patient’s stress management skills. I am happy to report that the patient’s skin lesions healed within six weeks after treatment began and they are still symptom free to this day!”

Tegan Moore, ND

Graduate, University of Bridgeport School of Naturopathic Medicine

Mental Health

“I had a patient suffering from mental health concerns which were severely impacting his personal and work life.  He wanted only all-natural treatment; however, he was taking medications to keep his mood stable.  He had an appointment with his prescribing physician, but told me that he wasn’t going.  I strongly advised him that it was in his best interest to go to the appointment, explain his desires to his medical doctor and continue taking the medication as prescribed.  For him, naturopathic medicine could only work in conjunction with conventional medicine.  With the patient’s consent, I reached out to his psychiatrist and sent him my recommendation plan for this patient’s naturopathic appointment. It was so important in this case to have continuity of care including clear communication with his prescribing physician.  We were both concerned for the patient’s well-being.  In addition, this patient needed the support of naturopathic medicine combined with allopathic care to achieve his optimal state of mental wellness.”

Dawn Siglain, ND, LAc

Graduate, University of Bridgeport School of Naturopathic Medicine

Continuous Learning and Excellence in Patient Care

Naturopathic medicine serves as a key component to interprofessional patient care. With the collaboration of health care professionals, naturopathic doctors serve as a teacher and guide in navigating patients through their healthcare options. Furthermore, interprofessional care encourages open-mindedness and continued education between providers to establish the best care possible for each unique patient.

I consider myself an idealist and hold a personal vision for an integrated model of care where the naturopathic paradigm helps to inform the overall team approach. Although many integrative health settings currently offer naturopathic care as a ‘supportive’ or ‘complementary’ modality, it is my hope that the heightened interest in holistic and functional approaches to healing makes room for naturopaths to act more often as the central hub in integrated clinical settings.”

Tegan Moore, ND

Graduate, University of Bridgeport School of Naturopathic Medicine

In the words of Dr. Rubin, “In the end it’s all about the medicine and supporting the patient in a positive way. Having a community of health care providers, each with their own perspective and experience, looking at one person and weighing in on what options they have while supporting and enhancing treatment is a wonderful standard of care to aspire to.  In my opinion that’s how medicine should be delivered and exactly the care I would want to receive.”

Click here to find a naturopathic doctor near you in the United States or Canada.

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Naturopathic Approaches to IBS

With a prevalence of 10-20% worldwide, irritable bowel syndrome (IBS) is an exceedingly common digestive disorder characterized by abdominal pain and distension, changes in bowel habits (constipation, diarrhea, or both), and is usually a long-term affliction.1 In order for a diagnosis to be made, the symptoms must be present for at least six months, occurring at least once per week.2

What Causes IBS Symptoms?

IBS is part of a category of digestive disorders known as functional gastrointestinal disorders (FGDI), which means that a clear pathology cannot necessarily be determined, even though the patient may be quite ill. It is a syndrome with a certain constellation of symptoms common to sufferers, but a diagnosable, named disease cannot be determined, e.g. celiac disease, inflammatory bowel diseases such as Crohn’s or ulcerative colitis.  Because of this, IBS has historically been considered a “disease of exclusion”, meaning that an organic cause cannot be found through lab work or imaging, and that the diagnosis is made after all other causes have been ruled out.

Conventional medical care may be inadequate for these patients because a definitive cause cannot be determined. A handful of drugs are currently on the market to help alleviate symptoms, but they do not address the root cause in the way that naturopathic medicine can. 3, 4

“Most patients who visit my practice have tried eliminating foods from their diets, seen many providers, performed numerous GI tests and still don’t have answers for why they don’t feel well. IBS generally does not start over night. I try to determine what has brought the patient to this point. I like to consider myself trained as a detective as well as a naturopathic doctor to understand why this person has developed IBS. An initial patient visit should be extensive. I cover a thorough timeline of health history, evaluate past health records, document treatments tried and understand who my patient is as a person. It’s my goal to think outside of the box for events that could have led to the development of IBS. Once I have an understanding of the most likely reason for their distress, I systematically start there, while working through other possibilities.”

Crane Holmes, ND

Graduate, National University of Natural Medicine

Mechanisms

Until more conclusive diagnostic testing can be developed, common features, aside from symptoms, have been observed in IBS patients which give insight into the underlying cause of the syndrome. Understanding the mechanisms behind a health concern is an ND’s first step toward effective treatment and hopefully, cure.

  • Low grade inflammation of the gut has been implicated in IBS, not to be confused with irritable bowel diseases. Inflammatory cells of the intestinal lining have been detected in IBS patients, and they have an increase in inflammatory markers called cytokines in both the blood and lining of the colon. 5
  • Histamine, which we typically think of for allergic reaction is also produced in the gut and is thought to contribute to the “visceral hypersensitivity” of IBS patients. 6
  • Post-infection IBS is the development of IBS in the aftermath of an intestinal infection that can last long after the infection itself resolves. This is thought to create abnormal gastrointestinal motility and increased contractility of the smooth muscle, perhaps due to inflammatory processes.7

“IBS is a disorder with a complex set of triggers, none of which would be individually sufficient to produce symptoms, but may do so when combined. Food sensitivities, unbalanced flora, and improper fermentation can set up a condition in the gut that then only takes a trigger, like emotional or physical stress or a dose of sensitive food, to cause reactions and symptoms. Natural treatment is based on the concept of ‘The Four Rs’: Remove, Replace, Re-inoculate, and Restore.”

Wm. Thor Conner, ND

Graduate, National University of Health Sciences

IBS Triggers

  • Food sensitives/intolerance – When it comes to IBS, food plays a central role in that many people with IBS note significant association between the foods they eat and the appearance or exacerbation of their symptoms.  Inflammation of the gut lining may be a common result of food sensitives/intolerance, which may trigger IBS.
  • Dysbiosis – A characteristic of IBS appears to be a reduction in the diversity of the gut microbiome. One study showed that those patients with the most severe symptoms had fewer different strains of gut flora than of those with milder cases or healthy control. 8
  • Stress – The gut-brain connection appears to be particularly important in the development of IBS, and many cases of IBS began with a traumatic life event. 9
  • Hormones – Because women tend to develop IBS more often than men, female sex hormones are thought to play a role. In fact, estrogen dysregulation has been shown to create an immune response in the gut, contributing to the symptomology. 10

NDs share IBS patient success stories

“I have a 28-year-old female patient who is in a master’s program and enjoys spending time working outside raising animals. She had a history of IBS associated with heavy, painful menses but otherwise normal GI health. After foreign travel, increased stress and some general illnesses, she developed urgent IBS-d. This urgent diarrhea greatly affected her daily life, making tending animals and leaving the house for school difficult. She had tried multiple food eliminations, herbal teas, probiotics and other supportive therapies she could find online without much improvement. Her main strategy was to avoid eating which could prolong her day away from a restroom until she was home at night.

Homeopathic podophyllum provided immediate relief for the explosive, urgent diarrhea which allowed her to feel more comfortable leaving the house. Further work revealed issues with GI dysbiosis and pancreatic insufficiency. After a few different herbal and pharmaceutical treatments to correct the dysbiosis, discovering the right pancreatic enzyme and focusing on stress reduction/sleep improvement, one year later she is having one-two non-urgent, well-formed stools per day while maintaining a healthy diet.”

Crane Holmes, ND

Graduate, National University of Natural Medicine

“A 38-year-old male patient presented with symptoms of IBS which included abdominal pain and distension. These symptoms were relieved with bowel movements that were urgent, frequent, and loose. He had been experiencing these symptoms for six months, and his quality of life was slowly deteriorating. He stopped going to restaurants with his family, as he felt extreme anxiety at the thought of being unable to control his pain and bowel movements. He traveled for work frequently, and would not eat meals with his colleagues, surviving on ginger ale, nut bars and Imodium. When he came to see me, his anxiety was heightened as his wife was asking for a separation. After gathering a full history, completing a physical exam and ruling out other causes, the assessment of IBS was made. I recommended dietary changes, botanicals and supplements to control his anxiety and GI symptoms, and counseling was provided to help him grieve the end of his relationship. After three months, his symptoms were better controlled, and while he was still struggling with the divorce, his quality of life had improved, he had started his own business, was relying less on Imodium. He was able to travel and control his IBS and anxiety with botanicals and supplements. Today, he is in a new relationship, and although his IBS symptoms flared up briefly when he started dating, he enjoys his life, eats a variety of foods, and travels without anxiety. This case really helped me understand the gut-brain axis and its influence on the balance of health.”

Poonam Patel, BSc, ND

Graduate, Canadian College of Naturopathic Medicine

“A female in her mid-40s presented with a six-month history of abdominal pain, loose stools and nausea.  Her symptoms started around the same time that the she had undergone significant stress with work and family. She was diagnosed with IBS-D and recommended to take Imodium as needed for the loose stool and to reduce stress. She did this, however the symptoms never really resolved which brought her in to see me. I gave her a gut healing protocol with glutamine, herbs and digestive enzymes which helped a little, but also did not resolve her symptoms. It became clear that her symptoms were worse with some meals so we investigated food intolerances and found that she reacted to wheat, dairy and eggs. She eliminated these from her diet and her symptoms improved slightly more, but not completely. At this I ordered a small intestinal bacterial overgrowth (SIBO) breath test, which was positive. Of note, the only risk factor she had for SIBO was stress.  I treated her SIBO and all her GI symptoms resolved. While she still had mild reactions to wheat, dairy and tomatoes, she was able to tolerate them much better after SIBO treatment.

Depending on the study, somewhere between around 60-80% of patients with IBS test positive for SIBO. This may be what is causing all their digestive symptoms and, in my opinion, is important to consider when determining treatment approaches. If SIBO is present, it is the first thing I work. If SIBO is missed, you won’t generally get very far with the IBS treatment until it is addressed.”

Lela Altman, ND, LAc

Graduate, Bastyr University

“I had a patient that had been treated for years for IBS exclusively with medications, to little effect. She had what she called ‘unpredictable’ gas and stool urgency, with many loose bowel movements a day, constant cramping, and bloating after meals. She also suffered from headaches and depression, insomnia and fatigue, and had different medications for each. She was told she would have to deal with the symptoms, and that they would likely get worse as time went on. She called me in what she saw as a last-ditch attempt to get some relief. She was on a diet of mostly processed foods; particularly wheat-based. I convinced her to do a basic elimination for two weeks, focusing on eliminating wheat and increasing vegetables. We also addressed the daily stress she was under and gave her some good ways to deal with it in a healthy way.

She left hopeful for the first time in years. A month later she reported having had solid bowel movements consistently through the weeks, and significant improvement in gas and bloating. She was sleeping better and hadn’t had a headache since the second week. She even found the energy to start an exercise routine. She had seen the immediate effect from removing offending foods, and using enzymes and probiotics, and found it was worth the effort. At six months she was thriving for the first time in decades and had become a vocal advocate for gut health. She even led a meditation group for her stress-filled office in an effort to improve her surroundings.”

Wm. Thor Conner, ND

Graduate, National University of Health Sciences

Due to the complexities of IBS and the intricacies of the workings of the human digestive tract, a single treatment is unlikely to be fully beneficial for managing IBS symptoms effectively. Using a multi-pronged approach that takes advantage of the various approaches available is more likely to result in adequate symptomatic control and management of the condition long term.

For questions about how naturopathic doctors treat patients with conditions like IBS, click here to find an ND near you in the United States or Canada. The Gastroenterology Association of Naturopathic Physicians (GastroANP) is also a great resource!

Learn More About Becoming a Naturopathic Doctor

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Dr. Cory Szybala – NUNM

Laying the groundwork to become an ND

Born and raised in the Midwest, Cory Szybala, ND was always interested in healthcare but did not have much exposure to it outside of the conventional model. After earning a bachelor’s degree in biochemistry from Indiana University, working as a nursing assistant at a local hospital, and shadowing a number of different providers in the area, he decided to relocate to Portland, Oregon to pursue research.

https://aanmc.org/videos/webinar/food-as-medicine-szybala/”After working with so many amazing practitioners in multiple disciplines of medicine, I felt there was a ‘gap’ in what I consider true primary care medicine. It wasn’t until I moved to the West Coast that I heard about naturopathic medicine, and once I did, I felt as though I had found true primary care medicine – medicine that works on a preventative, holistic, and integrative level.”

NUNM as a springboard

While living in Portland, Dr. Szybala visited the National University of Natural Medicine (NUNM) campus, shadowed students, and spoke with administrators before deciding to enroll in the naturopathic medical program. “Each school has its very own unique personality and I felt like NUNM fit mine. Not only did I graduate with the information and skills necessary to help patients, but I was also able to make lasting friendships with colleagues, professors, advocates of the medicine, and more.”

As a student, Dr. Szybala was a member of the acclaimed Food as Medicine Everyday series, and the Naturopathic Medical Student Association (NMSA). His experience working with NMSA allowed him to stay up to date with state licensure and scope initiatives, which helped him gauge where he wanted to set up his future practice.

Finding fulfillment as an ND

“Since graduating I have worked as a consultant, a researcher, adjunct faculty member, as part of a team dedicated to sharing the knowledge of healthier food choices through the Food as Medicine Institute (FAMI), a public speaker, and now private practice owner. The wealth of knowledge that you learn while going through naturopathic school and thereafter is more powerful than you think.”

Dr. Szybala enjoys providing an individualized holistic/integrative approach to each of his patients. “I am passionate about discovering the reason(s) behind a particular issue and working with a patient to come up with the best solution(s) for them. To be able to truly deliver primary care to those who need it is not only rewarding but absolutely necessary.”

Dr. Szybala and his wife – Mollie Parker Szybala, ND operate Sun Valley Natural Medicine in Ketchum, Idaho. They each work part-time at the clinic while pursuing other interests. Their work outside the clinic has helped establish themselves in the community, and has doubled as a marketing outlet.

The Szybalas enjoy spending time in nature, hiking, skiing, and attending young professional outings.

Advice for aspiring NDs

Dr. Szybala encourages prospective students to shadow multiple NDs, and to experience different models of practice, business, and naturopathic specialties. “The flexibility is one of the most appealing parts of the naturopathic profession.” It’s up to you to determine how you want to use your degree. What career path will you take?

Join Dr. Szybala for a free webinar – Food as Medicine

“During my time shadowing, preceptoring, working with FAMI, and now working in my own practice, I have seen food be a huge factor in the health and well-being of my patients. It is often a first-line defense, as well as a great way to empower your patients to take their health back into their own hands.” Dr. Szybala’s webinar will cover how to use food as medicine in a naturopathic family practice, what to consider when prescribing a healthy diet or lifestyle, how to prepare your clients for success, how to troubleshoot, and when to follow-up. Click here to watch the Food as Medicine webinar.

Learn more about Dr. Szybala:

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2019 Year in Review

A Year of Academics, Scholarship and Community Outreach

Each and every year, the field of naturopathic medical education advances significantly. We are proud to recap the advances our seven accredited naturopathic medical schools made in academics, scholarship and community outreach during 2019. Looking ahead, there is a lot to be excited for as well!

Click the tabs above to read messages from each of the schools.

A Year of Inclusion and Equity

Bastyr University
Campuses in San Diego, California & Seattle, Washington

As Bastyr University concludes its 41st year, we reflect on some of the milestones and achievements that have furthered our mission to create a more healthful world for all:

Diversity, Equity and Inclusion Training. Bastyr welcomed Dr. Kortet Mensah as the inaugural Associate Vice President for Diversity, Equity and Inclusion (DEI). Starting in fall quarter of 2019, all faculty, staff and students at the Kenmore campus participated in DEI trainings, which included community-based conversations about levels of oppression, factors that contribute to and derail oppression, and strategies to advance inclusive diversity and equity at Bastyr and beyond. DEI training at Bastyr University California will begin in winter quarter of 2020.

Health Equity Speaker Series. The Center for Social Justice and Diversity also launched a Health Equity Speaker Series this fall, with its first topic titled “What is Health? The Need for Health Equity.” Students who helped facilitate this event are a part of the Center’s Student Leadership Certificate Program, designed to support students in developing skills in the areas of professional leadership, social justice, and cultural humility. The one-year program complements existing degree programs through its focus on practical and engaged leadership skills

Support for Susan G. Komen. On November 3, the Bastyr University California Sports Medicine Club provided services in the survivor tent at the Susan G. Komen Race for the Cure. Students practiced physical medicine modalities such as light massage and stretching, taping, icing, trigger point therapy and cupping. In addition, ND students and residents provided health screenings in the main event area for the 9,000 participants. Students enjoyed giving back to the local community and educating participants about Bastyr University Clinic’s integrative oncology services.

2019 marked 100 years of licensure in the United States — a milestone achieved through the tireless efforts of many individuals. Our 141 newest ND graduates join this great community and look forward to bringing more innovations in naturopathic medicine into the new decade!

To learn more about Bastyr, click here.

A Year of Commitment and Excellence

Boucher Institute of Naturopathic Medicine
Vancouver, British Columbia, Canada

The Boucher Institute would like to once again congratulate its students for outperforming the average NPLEX results by a healthy margin. We credit the ability and commitment of our faculty that continue to be second to none in terms of preparing our students to become excellent, compassionate doctors.  BINM would also like to congratulate the school’s team of students who once again, came first at the NMSA cup competition in Portland, OR last August.

Our academic team will be expanding in order to support the school’s growth and new programs. Additionally, we have invested in developing new and exciting fundraising sources to benefit students and ensure that our tuition costs remain as steady as possible over the longer term.

New programs are being built to ensure continued graduate success and employment opportunities for BINM graduates. Our core program will continue to teach our students the benefits of practicing collaborative medicine, and we are in process of creating relationships with other higher education institutions to broaden student opportunities in areas like research and recruitment. Boucher graduates are grounded in the roots of the naturopathic medicine and its supporting science, because it represents the soundest form of sustainable medicine. We look forward to what will be an exciting 2020.

To learn more about BINM, click here.

A Year of Research and Innovation

Canadian College of Naturopathic Medicine
Toronto, Ontario, Canada

For CCNM, 2019 can be characterized by the terrific strides the College has made in research and innovation. Our efforts this year focused on a few key areas.

The microbiome. More than just a buzzword, the microbiome plays a significant role in maintaining our health and preventing disease. CCNM embarked in a landmark study to explore the interplay between our environment and the microbiome in mothers and newborns; particularly, how exposure to pharmaceutical drugs and environmental toxins affect health outcomes during pregnancy.

Lab testing. CCNM launched a high-quality, evidence-informed webinar series in September to examine the value of laboratory testing in clinical practice, and support NDs and other health-care practitioners in diagnostic decision-making. The first two webinars are on the topics of hematology, kidney and urinalysis.

Student scholarship. Now in its second year, the Student Innovation Fund is a grant competition that nurtures student-led research at CCNM. This year’s winners are currently assessing the impact of naturopathic care being provided to patients with fibromyalgia at the Robert Schad Naturopathic Clinic, CCNM’s academic medical centre.

It’s no surprise that CCNM is considered a hub of naturopathic research. We look forward to even more discovery in 2020!

To learn more about CCNM, click here.

A Year of New Opportunities

National University of Health Sciences
Chicago, Illinois

National University of Health Sciences continues to expand its Clinical Clerkship program for naturopathic medicine students. Throughout 2019, NUHS added three new clinical opportunities. These internships at the Aurora Clinic, Salvation Army Clinic in Chicago and the Center for Integral Health in Lombard have unique patient populations that can help students prepare for various types of practice and provide hands-on, real-world experience for our student clinicians. They also have the added benefit of being located in the Chicago area near campus.

As part of a homeopathic rotation at the Center for Integral Health in Lombard, students are able to work alongside Timothy Fior, MD, who is also a lecturer in Clinical Sciences at NUHS and Lisa Krebs, ND, an NUHS alumnae. “Students will come away with the confidence and skills to accurately use this important modality in practice,” Dr. Krebs said.

At the NUHS Whole Health Center in Aurora, NUHS has added a ND faculty clinician who will attend shifts at the clinic each week with ND interns. NUHS also added an ND faculty clinician to supervise students at the Salvation Army clinic in Chicago. This supervision allows interns to provide more naturopathic modalities at the clinic such as basic bloodwork and constitutional hydrotherapy treatments.

Faculty members look forward to working with students as they continue to take advantage of these opportunities in 2020. For more information about clinical internship opportunities visit the NUHS website.

To learn more about NUHS, click here.

A Year of New Leadership and Advancement

National University of Natural Medicine
Portland, Oregon

NUNM welcomed our new president Dr. Christine Girard, a 1997 NUNM graduate who is already building on NUNM’s history of thinking and healing holistically. She’s excited about NUNM’s role in the intersection between naturopathic medicine and public health, and recently shared an update in AANMC’s November newsletter.

Through our 2019 acquisition of IPSL Institute for Global Learning, we have expanded the opportunities for students to participate in service-learning programs as part of their education. We also now offer two international master’s programs, giving current and future students greater opportunities to become advocates for social justice. We’re very excited for what this new partnership has in store for 2020!

Next year, we look forward to our students continuing to bring integrative health care to our local communities through programs at our academic health centers. NUNM’s new shared clinical rotations allow students studying in both the ND and Chinese medicine programs to mix the two approaches in practice, providing patients with more integrative tracks to health. Our newest sites, opening in 2020, will be located in residential facilities in the Portland metro area where access to holistic care is less available. This model of integration has proven to be effective at maintaining patients’ engagement with their care regimens, and we’re excited to enhance patient outcomes and student learning through these new sites!

To learn more about NUNM, click here.

A Year of Transformation and Innovation

Southwest College of Naturopathic Medicine
Phoenix, Arizona

In Fall of 2019, SCNM announced plans to launch two 100% online Master of Science in Nutrition degrees – the Master of Science in Clinical Nutrition (MSCN) and the Master of Science in Nutrition Business Leadership (MSNBL). Both programs will seat their first class in April of 2020. The MSCN will educate and inspire the next generation of leaders and practitioners in the field of clinical nutrition and the MSNBL will educate and inspire current and future leaders to grow the global natural products industry. Both programs will equip graduates with evidence-based and sustainable practices that safely, ethically, and effectively enhance the health and well-being of the people and communities they serve.

Additionally, SCNM is in the early building stages of The Ric Scalzo Institute for Botanical Research. This state-of-the-art molecular biology and phytochemistry laboratory will work in collaboration with the natural products industry and other academic institutions to develop new products and improve existing botanical therapeutics through scientific exploration grounded in herbalism’s rich tradition. Scheduled to open in 2020, the Institute will conduct analytical testing, cellular and molecular biology assays, and metabolomic testing. Furthermore, the Ric Scalzo Institute for Botanical Research will expand research opportunities for students.

To learn more about SCNM, click here.

A Year of Change and Celebration

University of Bridgeport School of Naturopathic Medicine
Bridgeport, Connecticut

In October, the College of Health Sciences hosted more than 150 statewide experts and healthcare leaders for its inaugural symposium, Building Bridges: Implementing Healthcare Solutions to Prevent Opioid Addiction and Chronic Pain in Connecticut.

In March 2019 the University of Bridgeport announced that the School of Naturopathic Medicine will be closing its doors, based on a wide variety of factors, including a restructure of the University. The students enrolled as of the spring semester will complete the teach-out, with the last class graduating in May 2022.  In the meantime, however, we are celebrating every success and appreciating all the little things that are often taken for granted. Each event, including the Back to School Barbeque, Philosophy Day, and the Thanksgiving Pot Luck takes on new meaning.  We have had so many folks reaching out and helping us to champion our profession and the level of achievement that we have reached in the last few years.

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NUNM in a Complex and Changing World

Clean water. Healthy food. Sustainability. Access to health care. Social justice. These issues have become part of the realities of our everyday lives and can no longer be ignored or passed on to someone else. The planet is a smaller place. The world is more connected than ever. We can no longer separate the health of the planet from the health of the individual.

At NUNM we think and act “wholistically.” Whole person. Whole community. Whole world. That’s why we offer our students unique opportunities to act at each level of the macrocosm.

Like all naturopathic medical schools, we provide care to underserved patient populations in order to make a difference in our local community. We have community clinics throughout the Portland-metro area in accessible places like multi-unit housing centers, churches, and community centers. We do it differently by providing clinical training opportunities in the profession’s only Tier Four Patient-Centered Primary Care Home naturopathic teaching clinic.

Do we embrace the principles of naturopathic medicine? Absolutely. We seek the “and,” not the “or.” Our new president, Christine Girard, ND, MPH, knows we can do both nature cure and primary care. She’s done it. We are disruptive innovators. Our Director of Helfgott Research Institute, Ryan Bradley, ND, MPH, knows. He’s written about it in Medicina. His article, “Naturopathy as a Model of Prevention-Oriented, Patient-Centered Primary Care: A Disruptive Innovation in Health Care,” speaks to how naturopathic medicine can both disrupt and run parallel to  conventional medicine, securing its future.

We research what we do on the community level. Our most recently published community-based research project was the Food as Medicine Everyday (FAME) research project published in the Journal of Alternative and Complementary Medicine in 2019 (Tippens KM, Erlandsen A, Hanes D, et al. Impact of a Short-Term Naturopathic Whole-Foods Based Nutrition Education Intervention on Dietary Behavior and Diabetes Risk Markers: A Pilot Study, J Altern Complement Med. 2019 Feb;25(2):234-240.). The FAME project evaluated a multi-site, community-delivered, nutrition education intervention on eating behaviors and cardiometabolic risk factors including weight and inflammation.

And speaking of Food as Medicine, everyday, since 2014 we have partnered with the Coffee Creek Correctional Facility, providing incarcerated women with basic nutrition education and equipping them with tools to overcome the many obstacles to healthy eating. Talk about doing good work in our local community.

Do we work internationally? Yeah, we sure do.

NUNM is the pioneering site for an international longitudinal cohort study focused on student health. The International Cohort on Lifestyle Determinants of Health (INCLD Health) is a longitudinal cohort designed to measure students’ dietary and other self-care behavior, as well as stress and wellness, to learn the trajectory of student quality of life and health over the course of their education. Online data collection, remote blood-spot sample collection, and 16S RNA microbiota sequencing are among the innovations in INCLD Health. NUNM is actively recruiting students, with Endeavor College of Natural Health (Brisbane, Australia) and Canadian College of Naturopathic Medicine (Toronto, Canada) aiming to recruit in 2020. INCLD Health provides students with an opportunity to experience research first-hand through active participation, as well as help grow the structure for future research.

In fact, we’ve recently expanded our global reach. Dr. Girard speaks often of her interest in the area of intersection between naturopathic medicine and public health both locally and globally.

We continue to position ourselves in the global community. Having recently acquired IPSL: The Institute for Global Learning, we have expanded the opportunities for NUNM students to participate in service-learning programs as part of their degree. In addition, we now offer two international master’s programs: Master’s in Community Organizing and Social Activism and Master’s in International Development and Service. These international programs offer students more opportunities to explore the world and to become change leaders and advocates for social justice.

Christine Girard, ND, MPH

President, National University of Natural Medicine

So, do you want to change the world? Yeah, so do we. Come join the changemakers. NUNM.

Learn More About Becoming a Naturopathic Doctor

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