Many practitioners feel homeopathy can seem to be too complicated to take on, but it doesn’t have to be. Dr. Steven King, ND breaks down homeopathy with tips on taking a good case and how he approaches case/patient analysis using Rajan Sankaran’s sensation method.

This episode is the conclusion of the interview that was posted last week in which Dr. King talks about lessons he’s learned from over 30 years of being a Naturopathic Doctor.

Highlights of the interview:

In homeopathy the basic goal is to get to the depth of a person; to find out how they interact with a view the world. There are 2 parts to this process. The first is taking the case and the second is analyzing the information.

When taking a case start with open ended questions. Let the person speak, and listen to what they say. Look for words that are out of place and/or images that are charged or dramatic. Observe when the person moves with their whole body and hands. This is when they are speaking from their depth. When they are done speaking ask “what else”? Eventually when they don’t have anything else to say go back to those “charged” moments and say “tell me more about that”. If there aren’t any charged moments or times when they are moving from their depth, one technique is to say “tell me everything about your chief complaint (ie.. migraines)”. Ask about feelings associated with the chief complaint.

In Sankaran’s sensation method there are 3 basic sensations, each associated with a different kingdom. These kingdoms and associated sensations are: animal, mineral, and plant. The sensation of the animal kingdom is survival. Themes include strength vs. weakness and victim vs. aggressor. An example of language that a patient may use when they need a remedy in this kingdom includes “I’m at his mercy. There is nothing I can do, he has power over me” when describing stress from a bad boss. The mineral kingdom is associated with a person’s own substance/capacity. Language used here includes “I don’t have enough energy to do my job”, or “I don’t have enough money to be content”. Notice how they both refer to a feeling of lack of something. The 3rd kingdom is the plant kingdom which relates to a sensation of a particular interference or interruption that the patient experiences. Language a patient may use includes “I get so indignant, he comes in and interrupts me” or “I’ve got a flow going and he comes in and breaks it.”

In this podcast Dr. King goes into much more depth then I do here and presents a case so you can get an idea of how this would play out in a real patient visit. Press play to hear the interview.

I first heard about Dr. Steven King and his practice, Ravenna Homeopathic Clinic, while seeing a patient as a student clinician at Bastyr. The patient mentioned their daughter had received a homeopathic remedy from Dr. King that cured her allergies. She thought that it might have just been the sheer presence of the doctor, and not the homeopathy that did the curing. I was intrigued and sought out Dr. King for an interview. After a few emails and phone calls over a period of about a month we had a date and time for the interview set. I showed up to his office on an unseasonably warm evening in Seattle with my recorder and after a wait while he finished with his last patient, we shook hands, exchanged greetings, and went into his office where the interview took place.

We both thought the interview would only be an hour, but it was such a good conversation that it went for 2 hours. The second part of the interview, which will be posted next week, deals with his approach to homeopathy. Look for it next week.

In this podcast we talk about lessons and stories from Dr. King’s 30+ years of experience. Dr. King graduated from NCNM in 1982, and has been in practice in the Seattle area with his wife since that time.

Some of my favorite parts of the interview:

I learned that NCNM used to send people to Wichita, Kansas for the first two years of the basic sciences naturopathic (ND) curriculum. They were sent to Newman College (now Newman University) and were taught by nuns!

Lessons on the art of observation: trust your gut, watch for congruence when people are talking. Look for where a person is engaged and where they are not engaged.

Business Lessons: It’s possible to invest too much money upfront. This puts a huge psychological pressure on what you do. Be thoughtful about debt accumulation. There is a big difference between being a business person and being a doctor. As a business person you need systems setup to track money and set up accounts.

On hiring: Be extremely thoughtful about who you hire (receptionist/assistant). They have to have both attention to details AND a personability/ability to interact with patients. The receptionist is the center of practice – the face and sometimes the heart. It’s important to have someone that represents it well. When starting your practice do everything, so you know what the receptionist needs to do when he/she is eventually hired.

When interviewing he says: Tell me about a difficult situation in your life and how they resolved it. Looking at their eyes and face can tell you a lot. Also, have them alphabetize a group of papers.

Lessons on being a doctor: Never pretend that you know something you don’t. Learn to be truthful and to set yourself aside (your need to be special, etc…). You must learn to focus on someone else besides yourself.

This is just the highlights of a great interview. I’ve listened to it about 5 times now and always come away having learned something. Press play at the top of this post to hear the entire interview.

Btw… This is my first post since graduating from Bastyr. I passed boards and am now fully licensed in the state of Washington as a ND, and am starting a practice in North Carolina where there isn’t licensure yet. Boards are tough, but manageable. Same story with student loans. There are some good repayment plans available where you’ll likely pay little or nothing your first year(s) out. I’ll talk about my experience with those in an upcoming episode.

You may also like

Naturopathy and EBM with Dr. Goldenberg

Change happens. As I type this, the quiet morning is being pierced by the rhythmic banging of a piece of heavy machinery destroying the last remains of the office building across the street. I won’t be here to see what rises from the pile of concrete and rebar, but it’s sure to be taller and … Continue reading Naturopathy and EBM with Dr. Goldenberg →

Starting a medical practice sounds like a daunting task to many people. Doing it an unlicensed state sounds even harder. It may even bring up thoughts of getting a visit from the friendly local medical police and getting handcuffed in the middle of a patient visit.

The reality is that starting a medical practice as a naturopath in a state without licensure isn’t that difficult and has many advantages. For one, there is lots less competition. This is huge. Many states with millions of people have one or two naturopathic doctors. Some don’t have any. You have a chance of being a rockstar from the get go.

We talk about this idea as well as many others in this conversation with Dr. Christie Fleetwood, ND. She gives us tips from her experience practicing for 8 years in Virginia, an unlicensed state at the time (and still unlicensed as of this posting in June 2015). The only thing that made her leave was her husband accepting a job offer he couldn’t refuse.

Press play to hear more including:

• The advantages of being a cash based practice
• How to chart in an unlicensed state
• Just how well you can do your first year out of ND school in an unlicensed state
• Making referrals to doctors that don’t know what a naturopath is
• How practicing in an unlicensed state can give you a better work/life balance
• Clients vs. Patients
• The importance of Docere
• Getting malpractice insurance for cheap
• What state to hold your license in when practicing in an unlicensed state
• The best type of advertising
• The importance of going where your heart will sing
• Natural Awakenings – is it worth your advertising dollars
• Advertising in a restaurant to gain business

And much more…..Press play to hear the entire conversation.

This podcast is a continuation of last week’s podcast. It’s the second of this series on mastering the medical literature. If you haven’t listened to last week’s episode start here.

The guy answering my questions if the awesome Dr. Goldenberg, ND. If you want to learn about some of the latest natural medicine research on May 27 he’s doing a webinar through the WANP.

The last episode we talked through the abstract of this article. It was interactive. You read the article, while Dr. Goldenberg answers my (and hopefully your) questions. This episode picks up where the last one left off and we talk through the full text of the article. Listen (and read along) to learn more about:

• The best way to read a piece of research
• What a multicentered trial is and why it’s important
• The danger of unmasking
• What subgroups are and why they are important
• How to spot bias
• If niacin really is a helpful treatment for cardiovascular disease
• And much more….

It really is a good use of your time and fun in a nerdy kind of way. And face it, if you’re a doctor you have at least a little bit of nerd in you. My goal was to create an interactive piece that we could all benefit from and I think we did it. Pour yourself a drink, download the article, press play, and stay tuned for our next episode with Dr. Christine Fleetwood, ND on how to be successful in an unlicensed state.

Are you intimidated by reading a medical research article? Do you start reading, get to a number you don’t understand, and then put an article down? Or maybe can you get an idea of what an article is talking about, but don’t get certain sections sometimes? If you can answer yes to any of the above then this series is for you, for us.

This podcast series is a special one. It’s interactive. You download the full text version of this study on Niacin (the full text is free). While you read the study, Dr. Joshua Goldenberg, ND answers my questions – lots of them, enough to fill two podcasts. We go section by section figuring out what each thing means, and what to look for. When it’s over you’re going to be better at reading medical literature. That was my goal when I came up with this idea for a podcast and I think we reached it.

If you’re wondering who Dr. Goldenberg is then I’ll start by telling you he’s the most qualified person in our profession to be doing this series on reading, interpreting, and evaluating the medical literature. He teaches the class at Bastyr called Critical Evaluation of the Medical Literature, he’s published a number of journal articles including a metanalysis for the Cochrane Review, he’s done research himself while a student, and he runs the website Dr. Journal Club. Whew. We’ve spoken before on naturopathy and evidenced based medicine and got his take on this debated topic.

A quick blurb about the Dr. Journal Club – Dr. Journal Club is a project he started where he reviews some of the most relevant pieces of research in short videos and for any clinician is worth checking out.

Like I said before, this is part 1 of this 2 part series on mastering the medical literature. In Part 1 we dive into the abstract. As questions came up for me (and where I think they would for you) we talked about them. This meant spending a lot of time in the abstract because they mention some statistical things like p value and confidence intervals there first. In part 2, which will be posted next week, we talk through the heart of the article. A lot of what we talk about in this podcast will help you read and interpret the rest of the article, so start with this podcast.

Things we talk about here in part 1 include:

• If the abstract is enough
• Why peer review is important
• What a p value is
• What confidence intervals are and what they mean
• Hard outcomes – what they are and why they are important to you clinically

Look for more when part two of Mastering the Medical Literature – Niacin comes out next week.

Starting a practice can seem like a daunting task, especially for someone without any business experience or skills. Most of you didn’t get into your profession to be a business person, you just wanted to help people. Now that you’re close to graduating or already graduated, you’re faced with the task of either getting a job, residency, or working for yourself (starting your own gig). Working for yourself, starting your own practice, can be intimidating, but the freedom and opportunity that it brings offer its own rewards.  In this hour with Dan Clements we dispel the myth that starting a practice has to be a hard thing.

Dan Clements knows practice building. Together with his wife Tara Gignac, a Naturopathic Physician, they have built a successful practice in Ontario, Canada. They have also co-authored a couple of books on starting a successful practice including The Practitioner’s Journey, the required reading for our business class at Bastyr. Dan has some great insights on what it takes to start and build a successful practice.

In this hour we dive into starting a practice, tangible steps to take to get your practice off the ground, social media, buying a practice and much more.

Press play to learn more about

• The skills you need to start a practice
• Taking small steps toward a big goal
• Building a referral network the easy way
• The advantages of buying a practice
• How to find practices for sale that may not be listed
• Why doing all forms of social media is a bad thing
• The power of the 15 minute intro visit
• Online booking
• And much more

Resources:
7 Books Every Practitioner Should Read
5 More Books Every Practitioner Should Read
How to find a practice for sale
Website Building
Weebly
Squarespace

Cell phone use is increasing worldwide. We are told that the radiation they emit is safe, but is it really? We have now been using cell phones for over 30 years, and data is accumulating that the radiation they emit, although non-ionizing, has definite biological effects. A couple of Natural Medicine Journal articles on the topic caught my eye. Both worth a read and both written by Dr. Jennifer Brusewitz, today’s guest.

The first article goes into research on the effect of EMF (the type of radiation emitted by cell phones) on glucose metabolism in the brain. The researchers found that 50 minutes of cell phone use increased glucose metabolism on the side of the brain that the phone was being used on, relative to the other side of the brain. This goes directly against the claim by the Federal Communications Commission, and cell phone makers, that there are no physiological effects of EMF emitted from cell phones.

The second article goes into research on the long term use of cell phones and cancer risk. The article is a review of a case/control study where 593 participants with malignant brain tumors were matched with 1,368 controls. The analysis showed a statistically significant association between cell phone use and malignant brain tumors, with those exposed for the longest amount of time (25+ years) at the highest risk.

We turn to Dr. Jennifer Brusewitz, the author of the articles and a Naturopathic Physician practicing in Portland, OR to get more information about this topic. In addition to being an author for the  Natural Medicine Journal, she works at the National College of Naturopathic Medicine clinic as a shift supervisor.

Press play to learn about:

• The link between cancer risk and cell phone use
• How to minimize risk and exposure
• The correlation between amount of time used and cancer risk
• The most effective way to eliminate EMF exposure from your phone
• And more….

Together with regular physical activity and not smoking, our analyses suggest that over 80% of coronary heart disease, 70% of stroke, and 90% of type 2 diabetes can be avoided by healthy food choices that are consistent with the traditional mediterranean diet – Quote in a review of the Mediterranean diet by Walter Willett, MD of Harvard.

Let that sink in for a second. These are the basics folks and they work.

What exactly is the Mediterranean diet and why are we still talking about it? Remember the 5/2 or the (fill in the blank) diet? Probably not too well. Dietary trends come and go, but the Mediterranean diet has had staying power. These questions will all be answered when you hit play at the bottom of this page.

We speak with Kelly Morrow, MS, RD to answer these questions. Kelly is a registered dietician, and core faculty member in the Department of Nutrition and Exercise Science at Bastyr University.  At the Bastyr clinic she supervises nutrition shifts, in addition to having a private practice. Her past includes a stint working at Evergreen Hospital and a Community Health center. She gives a great overview of the diet and resources to help you get to know the diet better.

Press play to learn more about:

• What foods are included in the diet and what aren’t
• What the deal is with alcohol – is it really recommended as part of the plan?
• Why it’s not just about the diet, but the other things too
• Motivating patients to change
• The idea of generalized to personalized
• Resources to learn more about the Mediterranean diet
• Easy to follow recipes for your patients
• And more….

Resources:

• Old Ways Foundation – Research, Recipes, and Historical Information
• Bastyr Nutrition Pinterest Page – Pretty page with lots of recipes

Studies Mentioned:

• Primary Prevention of Cardiovascular Disease with a Mediterranean Diet – New England Journal of Medicine – Full text
• Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH-AARP Diet and Health Study – Archives of Internal Medicine – Abstract

One of the challenges and great rewards of naturopathic medicine is the different modalities that we can use to help heal patients. Physical medicine, herbal medicine, homeopathy, vitamins, minerals, and more. One quote from an elder is that we “do what works”. I like that. What about the basics though? Diet, exercise, stress management, self-talk, relationships – those fundamental things, those things that usually have to be in place for the rest to work. It’s easy to lose sight of these as appointment times grow shorter from the pressure to maximize patient loads, and as new and practicing ND’s struggle to pay back large student loans, and experience low rates of insurance reimbursement. The fundamentals will always be there though, codified in the eternal truths of health and in our very own therapeutic order of naturopathic medicine. This is a podcast about the basics, a show on how to assess and treat patients using these fundamentals of health.

Long ago Dr. Charley Cropley decided that the fundamentals were all that he was going to work on with his patients. He doesn’t use any supplements or drugs and his patients get better. Dr. Charley Cropley was Colorado’s first naturopathic physician (Yes, the original), starting his practice there in 1979. He’s been voted Boulder, Colorado’s top alternative healthcare practitioner multiple times, and he’s a wealth of information on the basics.
He works with patients on nutrition, exercise, their thinking, and their relationships, and he’s been doing this for over 30 years. He’ll probably say some things you won’t agree with and that’s good (You’re not a true naturopathic physician if you agree with everything your colleague says) , but I guarantee you’ll learn something from this hour that will let you treat your patients more effectively.

Press play to learn more about:

• The one thing that everyone is trying to do in life
• How we are the authors of our own health
• Illness as an expression of the Vis
• Medicines as diluting personal power
• The ways of eating, moving and resting, thinking, and communicating.
• How to assess and treat in these areas
• The idea of not treating patient, teaching the patient
• The power of your relationship with your patients
• Helping patients discover the roots of their health issues themselves
• Doctoring as a dance
• Self-mastery as a skill – bringing our actions into harmony with wisdom

Resources mentioned:
The Mucusless Diet Healing System
Food Is Your Best Medicine

You’re almost a doctor now or maybe you’re already done. You’ve got a unique set of skills that only a few thousand people alive can claim to share. Stop and think about that for a second. What are your options now? Residency, start a practice, work for someone else. All of those have their pluses and minuses… How about a 4th option; traveling to exotic locations while working as a doctor?

It’s possible and other ND’s have done it and are doing it now.

In this episode of The ND Update we talk with Dr. Alison Chen about her time in Thailand working and traveling as a naturopathic physician. Dr. Chen Graduated from CCNM in 2013 and has been traveling since she passed boards. I first heard about her when she wrote this extensive post on how she had been traveling and working as an ND. In this podcast we go into further detail about her experiences. Press play to learn more about:

• When to start planning your trip overseas
• Why going overseas without a job lined up may be your best option
• What services work best when practicing overseas
• How much money to set aside when making the jump
• The best spots in Thailand to find work
• Work visa’s and whether or not you need one
• How to price your services
• The best times of the year to find work at resorts
• Patient management
• Traveling with partners and/or kids
• Doing this all with just a backpack
• What to put in your backpack
• How you can live in Thailand for $1,000 USD per month

After the recording was over and I had a chance to relisten I followed up with Alison on some questions I had:

What prep did you need to do stateside before you left?.. Vaccinations?

No vaccinations; I got a 6 month tourist visa but you can get a 1 month on arrival (read more below). Make sure your passport is up-to-date (ie. 6 months and a few pages empty). I photocopied all my important documents.

Visa application – how does that work?

There is a 3 month and 6 month tourist visa that you can purchase ahead of time (http://www.thaiembdc.org/dcdp/?q=Type_of_Visa). This wasn’t made clear to me so I’ll explain it to you the best I can.

With both the 3 and 6 month, you are allowed entry for 2 months without leaving the country, but at the 2 month mark you must go to a consulate (within thailand) and pay to extend your tourist visa for the last month (maybe $60-100). With the 3 month you have 1 entry, which means if you leave Thailand before the 3 months then you lose the rest of the time. So, if you plan on traveling to other countries before the 3 months is up but then stay for a longer duration after, you can ‘wave’ your visa. I.e. tell immigration as you are entering that you don’t want to use your 3 month visa yet and they will give you the automatic 1 month upon arrival visa instead (free) and you can use the 3 month visa later.
Similarly, the 6 month visa is a 3 month but double entry. So you can stay 2 month, extend for 1 month but then you must leave the country and re-enter for another 2 months with a 1 month extension at the consulate.

The tourist visas take a few weeks to send in and receive at the standard rate, but you can also pay for a 1 day visa at a $100 extra fee (I think).

If you get the 1 month on arrival visa (free) you can stay the whole month but then must leave the country to re-enter. Many of the airports are picky about having a return ticket. If you don’t have one, I’ve seen people just photoshop their original ticket and get away with it… lol.

At the one month mark, many people do a ‘visa run’, however as I was leaving Thailand there was a pretty strick policy going around to dissuade visa runs and people living long term in Thailand. In any case, Chiang Rai (in the North) have a very easy access to Myanmar and the islands have an easy (and cheap) flight to Kuala Lumpur. There are services that do 1 day visa runs to talk to some expats to find out about them. Most are around $40 there and back.

Or you can just make a trip to Cambodia, Vietnam, Philipeans, Indonesia, Kuala Lumpur, etc for a nice trip. I would definitely recommend Indonesia (Bali, Gili islands), Cambodia (Ankor Watt). I wrote about some of my travel spots on my website too.

Credit Card/Debit/Money – Can you use the same card you use stateside?

As long as you have a debit card with the ‘plus’ symbol then the atms work. You can only take out $300 (equivalent in thai bhat) at a time so you may want to bring USD (to exchange) and Bhat with you. There’s a hefty fine to use the ATM ($5) then also with your own bank ($5). So it does add up. I was able to find a Canadian bank account that waived the fees from their side. Most banks will if you speak with a financial planner and get a little chummy with them ;).

In Thailand… how do you get access your money once you’re there?

I just used my debit card. And I charged cash for my patients.

Do you have a part of Thailand you recommend people fly into?

You have have to fly into Bangkok. Note that there are 2 airports: 1 international (BKK- Sunvarnabhumi), 1 domestic/ within Asia (DMK- Don Mueng). There are free shuttle buses from one airport to the other, it takes about 45-75 min pending on traffic.

The domestic flights are cheap and will almost always go through Bangkok (DMK). So you may have to buy 2 separate flights if you want to travel from 2 areas within Thailand (other than Bangkok). I recommend Nok Air and AirAsia as the cheapest. Nok Air will allow you 1 carry on bag which can add up in cost with AirAsia as they charge per flight.

When you’re done watch this video interview Dr. Chen did with another ND who has traveled and worked, Dr. Adam Friedman. Really, watch it. You’ll learn a ton. See you in Thailand.