Naturopathic Medicine Week -Treat the Whole person

In honor of Naturopathic Medicine Week, I am trying to post a little bit every day about Naturopathic Medicine… what we do, how we do it, and who we are!

Today during shift, I was reminded how important it is for us as doctors to look at the whole patient and treat the whole person not just their symptom or their disease. I mean hello people, a person is not just a cough or fatigue, there is more to that story. In fact, treating the whole person is one of six Naturopathic Medicine Principles.

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6 Principles of Naturopathic Medicine

How does this look one might ask?

Let’s say a person has stomach pain. There are billion things that stomach pain could be ranging from really acute, scary things to other things that are much more benign. All medical doctors (in theory) should be able to ascertain the type of pain and obtain a history about the symptom, do a physical exam, and ideally diagnose the patient with the disease or condition. But sometimes, often times more than we would like to admit, the pain is just pain and we do not have a great medical explanation behind it.

Now many doctors (including Naturopathic doctors) would just treat the symptom so the person has relief and hope that it resolves on its own. BUT!!! and this is a big but here folks… that does not treat the underlying problem. A Naturopathic doctor is charged with the goal to not only fix symptoms and figure out the condition, but to try to help correct the underlying reason that the person had the symptom or condition in the first place. This often means stepping away from the focus on a symptom and looking at the whole person…

  • What do they eat?
  • How do they sleep?
  • What are their stressors? How do they deal with them?
  • Do they have other symptoms?
  • What is their lifestyle and environment like?

The Naturopathic Physician is allowed the time to look at these underlying lifestyle issues that often cannot be addressed during a quick visit. This allows us to help the person heal themselves and hopefully avoid having to continue treating the symptom over time.

Homework Assignment!!

I am ‘assigning’ homework for anyone who is interested in supporting Naturopathic medicine, learning more about it, or wanting to do something Preventive for your health…

Take a picture of yourself with something that you would consider preventive health. This could be eating an apple, going on a walk, taking a nap, laughing with friends, getting a check up at the doctors, drinking tea, or more… take that picture and post it to your blog or social media with the caption “Naturopathic Medicine Week” or hashtag “#naturopathicmedicineweek” and “#nmwNUNM2017”. If you do not participate in social media, but want to participate comment in the comments below your Preventive Health picture. 🙂

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Working the Med Tent at the Portland Marathon! #NatMedWeek2017 #NaturopathicMedicineWeek #nmwNUNM2017

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Nicaragua Medical Mission – Healthcare Part 2

This is part 2 of my series on healthcare in Nicaragua covering a typical day in the clinic.

Typical Daily Clinic Schedule

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Several patients waiting to be seen

The clinic I worked in was open from 7:30 AM to 4:30 PM. We would arrive around 7:00 AM to anywhere from 20-30 patient’s waiting in the waiting area outside. Prior to the clinic being open one of the doctors or one of the medical missionaries (myself included) would give a short devotional to the patients outside.

Nicaragua is a primarily Christian country with 40% of the population Catholic and 40% protestant. While this would typically never happen at a clinic in the US, the devotional time allowed the patients to reflect on something during their wait period prior to being seen and also they saw that the physicians in the clinic cared enough to take the time to prepare something to say and pray with them. It was a sweet moment to see all the staff members and patients together as one in prayer.

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The doctor giving a devotional to patients waiting to be seen at the clinic

After that the clinic would open. Patients file in one by one, first going to the front desk and paying their 3 Cordoba (26 Cordoba = $1 dollar), which covered the whole medical visit including most treatment. Then they would go to the front desk where a nurse and/or medical missionary (like myself) would take their vitals and ask them basic intake questions about their current symptoms, allergies, medications, etc. Then they would either go get their blood drawn in the lab (an exam as they called it), meet with one of the doctors at their desk for a consult or lab result interpretation, or in some instances go into a treatment room and receive an ultrasound, EKG, or further examination.

Most of the patient visits involved very little examination outside of heart, lungs, vitals, and HEENT (head, eyes, ears, nose, throat). Sometimes an abdominal exam was performed. Sensitive exams (gyn exams, prostate exams, etc.) were only done on special days when outside doctors were visiting the clinic, generalists typically do not perform these exams in Nicaragua.

More on types of diseases seen and treatment administered in Part 4 of the series. After the patient discussed their symptoms with the doctor, they received a piece of paper with medications and doses on it. The patient would then head outside of the clinic over to the pharmacy window where the pharmacist or medical student or whoever was working the window that day would count out the correct number of pills and provide the patient with a bag of medications for no extra charge.

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Where I counted pills as a pharmacist

At around 12:00 PM, the clinic closed for 1 hour for lunch, kind of like doctor’s offices in the USA. All of the staff members would crowd around a tiny table in the middle of the clinic and eat and talk together. It was a nice moment in the middle of the day to slow down and check in with one another. After lunch was over, it was back to business, but typically slower in the afternoon. Around 4:00 PM we cleaned up the clinic, but did not mop or sanitize things, because they have a cleaning lady (janitor) who would pick up after everyone was gone.

The clinic saw between 70-100 patients per day of various ages, genders, and states of health.

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Entering into the clinic through triage

The overall clinic operations on a day-to-day basis was similar to a small rural clinic in the USA. Some differences were that all of the staff… doctors, cleaning staff, nurses, etc would sit together around the same table and eat during lunch. No one was working during this time, checking their emails, or reading. It was refreshing to disconnect. Also, there was less emphasis placed on exams and more on what the patient had to say. It was more personal. Similar to the US, the visits were rather short, 15 minutes tops (unlike a typical patient visit with a Naturopathic physician).