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Developing Confidence with Seth Braun

In today’s show we talk with Seth Braun about confidence, specifically confidence for clinicians. We focus less on what confidence is and more on how you can work to develop it.

You might be thinking what does confidence have to do with medicine? The answer is everything. The confidence that you as a clinician have in the room with a patient may make the difference between both the success or failure of your own practice and the success of your patient as you work with them toward health.

This past summer when I was precepting for a second time with Dr. Coward, a long time ND, we had a good conversation around success. What was it that he saw, that he observed, in the ND’s who had made it that was different than those that didn’t make it? After a lot of thought he said it was two main things: 1. Having a certain modality, body system, or condition that you specialize in, and 2. Confidence.

This is the first podcast in a series that I’ll be doing on confidence because it is so important to success, and one of my goals with this podcast is to make you, the practitioner, more successful. As you succeed, our profession grows, there are healthier people in the world, and so on. Everybody wins.

According to Seth there are 3 levels of confidence:
1. The basic definition – Confidence – a combination of the latin roots Con and Fidelus, meaning to be faithful to. Being faithful to that which you want to be good at. This means showing up, working hard, practicing in a way that you resonate with. This part isn’t usually the problem for Naturopath’s, or others in the holistic healing community.
2. Generating resourceful states – it’s based on the idea that you are what you think. Taking time in the morning to be grateful for what it is that you have, so you are meeting others from a positive place, from a place of abundance.
3. Authenticity – Learning how to take the mask off.

We touch on resistance to change and how it is a normal part of growth. We also talk about the idea of persistence vs. pivoting and when to change course if something seems like it isn’t working.

Press play to learn more, and check out Seth’s coaching site here, and book Indestructible Success

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 more expensive. The people walking down the street in the future admiring it for what it is, but not knowing what stood before or the hard work it took to make it make it livable and cast its long shadows across the sidewalk of Wallingford Avenue.

Change is happening in naturopathic medicine. The number of ND practitioners continues to grow. Schools are expanding. Scopes are expanding. ND’s in Washington can now accept Medicaid. Seemingly every year another state gains licensure. But overall we’re still fighting to get out of the shadow of the American Medical Monolith, not yet big enough to cast our own.

The relationship between naturopathy and evidenced-based medicine is part of that change.

In today’s podcast we talk with Dr. Joshua Goldenberg, ND, a researcher, clinician, and entrepreneur about naturopathy and evidenced-based medicine.

While a naturopathic medical student, Dr. Goldenberg did a research study on attitudes toward evidenced-based medicine within the profession. Listen to the podcast to hear more about:

  • What evidenced-based medicine really means
  • What has driven a change in attitudes inside and outside the profession
  • Problems with the “evidence”
  • And much more….

We also get to know Dr. Goldenberg a little better, and hear more about his current venture, Dr. Journal Club, where he evaluates relevant research in weekly short video clips (and more). Check it out here.

Naturopathic Medicine Week 2014 – Info and Resources

“I must do something” always solves more problems than “Something must be done.” – Author Unknown

Here we are in the middle of Naturopathic Medicine Week 2014. For the second year in a row a naturopathic awareness week has been established in what is going to be an annual event. The Senate has again passed a bill making this week official. The bill is filled with goodies about why we are needed (eg.. 75% of healthcare costs are due to preventable chronic illness – a staggering number) and worth a read.

I talk with Mike Jawer, from the  AANP about the origins of this week, the bill that passed congress, resources for practitioners and advocates and more. Apologies for the quality – I recorded it today through my crappy computer microphone during a lunch break at the the clinic.

Here are some of the resources and happenings so far:
AANP Resources – Including how to talk to the media, how to write a press release, and much more. Check out this link. Really. You’ll find something there you can use.
The bill that passed the senate
Arizona declares state Naturopathic Medicine Week

Bastyr is putting out a series of pretty infographics (you can see new ones as they come out and share on Facebook by typing in #nmw2014 into the search box).

nm_licensenm_principles

Bastyr California had their state senator come visit

bastyr_ca

Tree Planting at NCNM

ncnm_tree_plant

Free images to share and use (courtesy AANP):

NaturopathicMedicineWeek NMwk_small

Look for more updates at #NMW2014 on Facebook and Twitter.

 

Nine Months

It’s hard to believe, but in nine months I’m going to graduate from Bastyr with my doctorate in Naturopathic Medicine. Some of you know this journey well having done it before me. Maybe you are just starting out and it’s hard to even see when you won’t be a student; what all of the sacrifice and hard work is for. For me, the end is starting to get clear and I can taste it.

That taste though is bittersweet. Thinking about not having class anymore and finding a place to settle down hit the palate first with a nice sweet start. Leaving the good friends that I have made and this hub of progressive medicine give that finish a bitter aftertaste.

The ND Update has been quiet as I’ve enjoyed my last summer in the pac NW, but it’s time to fire it up again as this fall quarter starts, the days get shorter, and this long summer extends into October. This is the second day of Naturopathic Medicine Awareness Week 2014. I’m going to be talking to Mike Jawer from the AANP tomorrow and do a podcast on some of the festivities that are planned. Look for that in a few days. Here’s a link to the AANP Page that has lots of resources. Check it out http://www.naturopathic.org/naturopathicmedicineweek . #NMW2014

Dr. Coward…. If you’ve been following this show for a while then you know how highly I think of Dr. Steven Coward of Asheville Natural Health and Homeopathy. He is a solo practioner and NETS 6 figures seeing patients for only 25 hours or so per week. He takes Wednesday off every week. He doesn’t advertise much or nickel and dime his patients, his practice stays full, and his patients get better. It’s the best of everything. Check out the podcasts I’ve done with him here and here.

Well, I spent another week precepting with him a couple weeks ago while I was in North Carolina. We had a lot of good discussions, but the one I want to share a couple points from was from what it takes to be successful. He has seen ND’s come into his practice and into the state and not make it. What did it take to be successful? His two main points

  • Confidence
  • Some specialty – either in some body system (eg.. cardiovascular conditions, g/i conditions), age group (pediactrics, elderly), or by modality (physical medicine, homeopathy, etc).

I’m going to explore these topics more in the future because it’s so important for our success.

Other guests have mentioned the speciality part using various names like niche. What it comes down to is that people need a way to assocaite what you do with something. It’s a memory thing. If you just say you do natural medicine, you live it, and know it well. But for that person that doesn’t know naturopathic medicine they have nothing to make that connection with unless you give it to them. Do other things on top of that specialty, but have something that potential patient can make that connection to.

Other things:
Ebola has been in the news a lot recently. One of our own, Dr. Paul Herscu, wrote a fantastic post on ebola including potential natural treatments:
http://paulherscuepidemics.blogspot.com/2014/09/ebolavirus-2014-outbreak.html
Well worth the time to read through the whole thing.

 

Maryland Naturopathic Licensure with Dr. Kristaps Paddock

I was so close, so close, to calling this post “How The East Was Won”. That was feeling the that I was getting from this win for naturopathic medicine, but that would have been a bit presumptuous. There is still plenty of work to do on the east coast. This is a sign though of big change. The fact that Maryland has passed a bill licensing naturopathic doctors in the home state of the NIH and John’s Hopkins University is huge. The fact it only took 4 years is even more remarkable.

In this podcast we talk with Dr. Kristaps Paddock who is the president of the Maryland Naturopathic Doctors Association about the bill that was passed. We talk about the specifics of the law including what naturopathic physicians can and can not do. We also talk about the process of getting the bill passed. It’s a great conversation.

Press play to learn more about:

  • The right that only ND’s and MD’s have now in Maryland
  • The scope of the Maryland naturopathic licensure law
  • What physical medicine is allowed and isn’t allowed with the new bill
  • The potential for a pharmaceutical formulary in Maryland
  • Finding allies and building relationships to help create change
  • Why a good lobbyist is essential for a licensure effort
  • Finding a sponsor for a bill
  • The importance of lobby days in education and building relationships
  • How to best educate others about naturopathic medicine
  • Negotiating with any opposition when trying to get a bill passed
  • Dealing with the medical society in your state licensure effort
  • Forming work groups to educate others on naturopathic medicine
  • What it took to reach the tipping point
  • Getting the support of the state Department of Mental Health and Hygiene
  • Working with the smaller medical organizations
  • The importance of being well rehearsed and professional
  • and much more….

Resources:

  • Dr. Paddock – If you are working on a licensure effort or are thinking of practicing in Maryland Dr. Paddock has told me he welcomes your questions and encourages you to reach out. His email is paddock (at)) drpaddock.com . Replace the (at)) with @ when sending the email.
  • Endurance: Shackleton’s Incredible Voyage by: Alfred Lansing
  • Leadership from a Dancing Guy

The Healing Power of Nature with Dr. Kurt Beil

In today’s podcast we talk with Dr. Kurt Beil ND, LAc, MPH about the healing power of nature. Intuitively, nature is something that we know is good for us, especially as people practicing or interested in CAM. Most of us feel this on some deep level, but what is science showing about the effects that exposure to nature or elements of nature (like plants) have on us? How can this help our patients heal faster or become more resilient to stress?

Dr. Beil has done research on this topic himself. He is also well versed on the studies that have been done on the healing power of nature and natural environments. We talk about both in this podcast. Press play to learn more about:

  • What biophilia is and why you probably have it
  • How having a view of nature increased healing rates in a hospital setting
  • Why having a fish tank in your office may improve healing
  • The differences in how men and women respond to their environment
  • How moving to an area with more nature improved mental health in a large English study
  • When to “prescribe nature” to a patient – how it can improve healing rates
  • And much more…..

Resources:
1984 Science article on faster healing from having a view of nature while in a hospital
Dr. Beil’s 2013 study on stress levels after exposure to natural or urban environments
Article on the English study of mental health and natural environments

Leadership, Entrepreneurship, and Sharepractice with Dr. Brandeis

In this podcast we talk with Dr. Andrew Brandeis, ND about leadership, running your own business, and about his current venture Sharepractice. Dr. Brandeis graduated from Bastyr University in 2008. While at Bastyr he started the student newspaper The Beet, as well as co-founding the website Medfinds. He co-founded Sharepractice last year and has raised over a million dollars in venture capital to back the app. He spoke with me from his home in San Francisco.

Press play to learn more about:

  • Getting other people to buy into your vision
  • Why you need more than just an idea to be successful
  • Why the people you surround yourself with is important
  • The importance of mentors
  • Finding a good mentor
  • How to let someone go
  • Why no is good
  • How Sharepractice can help you be a better clinician
  • The importance of balancing work and play
  • How to deal with rejections
  • Setting work/life boundaries
  • And much more….

One of my favorite parts of this interview is when we talked about how to fire someone, how to let someone go. No, it’s not because I’m a masochist, it’s because of the fresh perspective Dr. Brandeis offers. He advises that the moment you think of letting someone go is when you should. Things will never get better and it will just get harder over time to make the decision. Pay the employee for two weeks or a month after you let them go and offer to make them introductions to other companies that may be a better fit. Support them in finding a new job. Sometimes the chemistry just isn’t there with an employee and it doesn’t mean that they are a bad person, they just aren’t a good fit for your team. Sure, they will be without a job temporarily, but in the end they’ll have the opportunity to work for someone who is the right fit for them. You both with be happier in the end.

Resources mentioned:
Winning by Jack Welch
Blink by Malcom Gladwell
The Lean Start-Up
The Four Hour Workweek

The DCFli – Frequently asked questions and 2014 Wrap-Up

In this weeks episode we talk with Mike Jawer, the federal legislative and government affairs director for the AANP, about the DC FLI. If you’re not sure what the DC FLI is don’t worry, we’ll answer that question for you. Already know what it is? Cool, we talk about how things went this year including our ask to be included in medicare.
Press play to learn more about:

  • What the DC FLI is
  • Why your participation matters
  • How it works
  • What it costs
  • Progress that has been made
  • Our asks from 2014 including inclusion in medicare

The DC FLI is short for DC Federal Legislative Initiative. It’s a yearly event to increase awareness of naturopathic medicine in Washington, DC and work for the interests of naturopathic medicine on the federal level.

The way this takes shape is that one weekend, usually this has been in April sometime, students and practitioners meet for a conference where there is training and speakers on Saturday and Sunday. Monday is lobby day. On Sunday you are given a packet with the senators and congressmen you’ll meet with on Monday. It’s usually their healthcare aids that you meet with, but occasionally the senator or congressman will be part of the meeting. We have an ask or asks every year which we tell them about. This is how the political process works. Last year our ask was for the passage of national naturopathic medicine awareness week and the resolution passed. As Mike talks about in the podcast, without all of the meetings that the DC FLI attendees had on that Monday the resolution wouldn’t have passed. The awareness week was a one time thing, so our ask this year was for it to be passed again. Another ask we had was to be included in medicare. This is a big ask, but at the same time not so big. If patients could see naturopathic doctors who are trained in preventive medicine than it could save the system overall lots of money. The majority of chronic disease is preventable and naturopathic physicians are trained in how to support the patient to implement those things that prevent illness (diet and lifestyle).

If having a conversation with a congressmen or their aid sounds intimidating that’s normal, but in my experience the meetings have been mostly positive. I’ve been to the DC FLI 3 out of the last 4 years and there was only one visit where the person I met with didn’t seem to have any interest. Healthcare costs are out of control in this country and when the congressmen or their aid sits and talks with a trained professional that has a solution to these costs (by preventing the disease in the first place) you’ll have their ear. They have likely heard of naturopathic medicine before and their job is to represent you.

From my own personal experience the weekend is incredibly fulfilling. You have a chance to meet colleagues from other schools and practitioners that have made the trip to lobby. We are always well received and it seems that every year our message is being heard more clearly and we’re growing. We had a couple congressmen speak at the Monday evening reception and that was the first time that has happened. If you’re on the fence about going, do it. If it’s not for you than that’s OK, but at least you tried and you helped further the cause of naturopathic medicine. If you’re not directly involved in naturopathic medicine you can help support the lobbying effort by donating to the naturopathic medical school of your choice. Every year students from all of the school fundraise, to help pay for the cost of the trip.

Here’s a link to Mike’s summary of 2014 on the AANP website.

And as always, if you like what you hear sign up on itunes, and our mailing list for the latest show updates.

Medical School Student Loans – Repayment options and more…

In this episode learn everything you need to know about paying back your medical school, or other types of, student loans. Listen as Danette Wells, the Financial Aid director at Bastyr University, brings a ton of clarity to a confusing topic. We talk about:

  • The latest student loan news
  • The best repayment option for you
  • The five different repayment options
  • What consolidation is and if it’s right for you
  • What a loan servicer is and why you don’t get to choose yours
  • What happens to the multiple types of loans (grad plus, stafford subsidized, stafford unsubsidized) once you graduate
  • What an exit interview is and what you have to do for it – hint “the answer is b”

Danette kindly offers advice to all students with loan questions, not just those at Bastyr, so give her an email if your questions aren’t answered after listening.

The latest news was about the pay as you earn plan. It isn’t law yet that the new regulations are in effect, right now they are just recommendations. It looks like that naturopathic medical students will be eligible for this option though. Check with Danette to see if this is right for you.

The repayment options we discuss are:
1. Standard Repayment
2. Graduated Repayment – pay just interest for the first 2 years, interest and principle for the next 2, and than standard repayment after.
3. Income contingent – 20% of discretionary income
4. Income based – 15% of discretionary income over 25 years
5. Pay as you earn – 10% of discretionary income over 20 years

Danette gives more clarity on the podcast to what each of those mean and what the bast options are, but basically the first two are not based on income and the last 3 are.

With the income based plans there is yearly paperwork that has to be filled out in order for the government to know what you have to pay back for the following year. If your income is $17,000 or less, at least for a single filer, that repayment will be $0. This will be the case for a lot of new grads.

The student loan rate now (June 2014) is lower than it was a couple of years ago. It has just recently dropped and will be going up soon (I think). When you graduate there will be a weighted average of the interest rates from each chunk of money you get and you’ll be paying on that weighted average.

At the end of the payment term for the income based loan repayment plan (25 years) and the pay as you earn repayment plan (20 years) the rest of the loan amount is forgiven. You will be taxed though on the amount forgiven the following year. You’ll be issued a 1099 and then will be responsible for taxes on that chunk of money. To prepare for this Danette advises setting up an automatic transfer of $50 to a savings account monthly and using that money for the taxes when that time comes.

Creating a successful practice with Dr. Coward

In this episode we talk to Dr. Steven Coward ND of Asheville Natural Health and Homeopathy. I met Dr. Coward through a preceptorship I did in the Fall of 2013 and he’s the real deal. He works only four days per week and has a net income of around six figures. In this podcast he tells us how he does it.
Learn more about:

  • Bringing in your first patient
  • Why it’s important to practice in an area you like
  • The essentials of starting a practice
  • How much money to budget when starting a practice
  • Why a bigger practice isn’t necessarily better
  • Keeping overhead low to maximize profit
  • Using billboards for name recognition and visibility
  • How to make money in your first month of practice
  • and much more…

This is one of my favorite shows. Enjoy.

One of the tips that Dr. Coward gives is to have some street visibility, especially when starting out. His first clinic location was right next to the health food store in Asheville. He had a good sign that people were being exposed to, even if it wasn’t conscious. When he would meet people and tell them what he did they would recognize the name and it worked well to increase familiarity with his practice. If you don’t have a clinic location in a very visible place he suggests getting a billboard for the same effect.

Another important thing that Dr. Coward did was keep his overhead extremely low, so that he always made money. What this meant was getting a simple clinic space early on and having some modest savings for his initial supplies. Even now he has a simple clinic setup, but that allows for more money to be put into his pocket and less paid out to the landlord.

As always, if you liked this podcast subscribe on iTunes or the new mailing list for updates when new shows come out.