This year marks 20 years that I have been in naturopathic medicine, and as my practice manager has encouraged me to write for our business Facebook site, I’m in a reflective mood. How did I get here and what have been some of the pivotal lessons that have informed who I am today and how I practice natural medicine?
When I started medical school in 1999, I knew nothing of the politics of medicine. Back then, people talked about Complementary and Alternative Medicine, which was definitely not yet main stream, nor was it very "Integrative". I started medical school eager to learn how to help people, and fascinated to discover the inner workings of the human body and mind. About half of my training was parallel to my MD student friends, but some was uniquely naturopathic. We had philosophy courses, botanical medicine, tons of nutrition, psychology, counseling, among others. During my training and residency at Bastyr University in Seattle, I had incredible exposure to working with patients in student clinics for homeless youth, clinics for people with AIDS (back before it was manageable as a chronic disease), and several county health clinics. The experiences reinforced what I was learning in my courses about the power of simple remedies like nutrition and supporting the body’s own self-healing mechanisms. In those settings, no one cared if the vitamin C was buffered or not. We used donated products and focused on teaching people how to stay well and take care of themselves, because they certainly couldn’t afford to see doctors when they could hardly afford quality food. This is lesson #1 - the most important things I can do is to teach people how to take care of themselves, and to be comfortable in their own skin.
Following residency, I was accepted into a prestigious NIH fellowship program in the School of Public Health at the University of Washington. I was thrilled to be training alongside other young MDs, PhDs, and Doctors of Nursing in research methods. We all aspired to run "big important research trials" that would change the healthcare system and care delivery. I was passionate about prevention and public health. For my first research study, I analyzed all the Medicare and Medicaid data in Washington State of a period of years to see if I could find a variable that protected people from second heart attacks. Aspirin maybe? Being lucky enough to be taken to the leading hospital when the first heart attack happened? My hypothesis was that the people who did cardiac rehab, or got diet counseling/nutritionist referral, physical therapy or exercise advice would be the most protected. Guess what I found? There were not even enough occurrences of those preventive services in the statewide databases to measure whether it was making a difference or not! Had I doubted it before, the shortage of health promotion counseling was apalling. That is lesson #2 - attention to a healthy lifestyle and basics such as nutrition, physical activity, and sleep are foundational - and I should never assume people have previously been told how to put advice into action.
The finding of that study - the factor that did protect people from secondary heart attacks - is the third lesson I’ll share about how I formed by early approach to health and medicine. What protected people from a second heart attack was this: following up with their primary care provider within 3 months of the event. While at first that may seem an underwhelming fact, it is significant. It means, firstly, that patient has a relationship with a practitioner that precedes and continues after the isolated health crisis. Specialists have their place, and in my study, most people followed up with one after their heart attack, but it was returning to that primary relationship that made the difference over the subsequent years. This is why I practice today the way I do - with a membership or concierge model of care. I value building a therapeutic relationship with my patients, not just because its nice to take care of people you really know, but because I know that having that primary relationship is protective and preventive.
As many of you know, I’ve been in a new practice location for a few months now and I love it. I’m focusing on quality care, root-cause medicine, and teaching patients how to be well. Of course, I’m still learning and following the latest research and science, and implementing some cutting edge science with IV therapy for cognitive decline and neuroregeneration but comments on that will have to wait for future blog posts! If you haven’t been in to see me in my new space, please come! You can find details and watch a virtual tour at www.drericaoberg.com
Yours in health, Dr O