This morning I spoke to a group of physicians and dietitians at Swedish Hospital Issaquah, and I left in tears. I managed to save my tears for the car thank god, and with a few hours behind me to process I am now grateful that I am still sensitive enough to feel the meaning in what was said. Here is what I let get to me: though I have been in private practice as a Primary Care Provider for over eight years, and though I volunteer many hours per week to help improve my own skills and the political standing of my profession, I still crumbled when I heard two MDs essentially write off Naturopathic Medicine as little more than a Placebo Effect.
It should not surprise me, since I have had many similar interactions in the past. But in this day and age, when healthcare quality is getting so much publicity, doesn’t it seem to be time for us to all work towards the common goal of patient health? I am a critical thinker, and a rational person, if anything erring on the side of too critical. There are many things that naturopaths do in practice (need we mention injecting someone with his or her own urine?) that I consider absurd, unsafe and irrational. But to write off an entire profession based on the lack of research or lack of a clear understanding of how it works to me seems wasteful.
Let me be very clear that my practice is in no way based on the Placebo Effect. There is no way any physician can survive in an ethical manner if there are not quality results coming out of a practice. Here are four things I tell my patients, and you can be the judge:
• My goal is for you to not come back. What this means is that if I do my job correctly, you will be well after a few visits and you will come back only as needed.
• More testing does not necessarily add up to better medicine. I often talk my patients out of unnecessary testing, including many of the tests that other naturopaths order at the first visit.
• More supplements does not equate to better health. AND I SELL SUPPLEMENTS. But I often am the one talking my patients out of taking more supplements, and encouraging them to let food be their medicine.
• Naturopaths work up a ladder of intervention, but also refer and consult when necessary. It does not behoove me to continue to see a patient who does not improve or only improves temporarily; I will consult via phone or send the patient for a consult in order to enhance a patient’s care. There are SO MANY WONDERFUL SPECIALISTS out there (who are comfortable enough with their own skills that they are enthusiastic about sharing management with another qualfied practitioner), and I am grateful for those who are willing to co-manage and share their expertise. This always ensures that a workup is complete, that the best person for the job is performing that job, and that the patient receives the most comprehensive, safe and effective care possible.
SO is naturopathic medicine all placebo? I’m sure on occasion this could be true, but not more than in any other profession. Do people get better faster when they feel they are being truly listened to? Yes absolutely, and I do think that at times this is why many patients prefer a naturopathic physician. This morning one of the more vocal critics was an Allergist who reported that so many patients complain of food allergies, but when his testing comes up negative (as he reported it so often does), he really thinks it is all in their heads. What I was too shaken to do was to thank him for behaving this way, because many of those patients walk through my door, are listened to, and are able to make changes and take action to actually improve their health and see symptoms resolve.
If that is the placebo effect, then I am all for it.