President’s Corner: Another View of ‘Docere’

As spring arrives with nicer weather and warmer temperatures, I am excited to recognize many changes occurring not only in nature, but in our naturopathic profession as well. We all know that ours is a young and small profession in comparison with our larger medical cousins, but we are rapidly growing and influencing conventional systems around us. While we have a ways to go on topics such as reimbursement parity and Medicaid inclusion our Governmental Affairs committee continues to work diligently to achieve our goals.

On the other hand, over the last few months I have discovered a fascinating new challenge for our young profession. This is a problem that does not require legislative action or argument, but rather education and interaction with our colleagues on the more conventional side of the aisle.

Here, I relate two instances that illustrate this new challenge and suggest we all take them into consideration to move our profession forward. Together we can bridge some big gaps of understanding about naturopathy on a very grassroots and organic level.

The first of my tales is a recent interaction with a gynecologist to whom I referred a patient for a consultation on surgical repair of a severe uterine prolapse and cystocele. The doctor’s notes returned to me had a very condescending and accusatory tone, including mention in several places that the patient should be seeing an internist or other primary care provider (PCP) more qualified than me. After a few days of cooling my jets, I decided much of this probably arose out of the MD’s misunderstanding that I am a trained PCP, as well as her failure to recognize that I sent the patient to her like any other PCP would when presented with something well beyond one’s expertise. I decided to contact the gynecologist.

Upon making the phone call, I introduced myself and made the pretense of the call concern for the patient. I cited numerous errors in what the gynecologist apparently heard from the patient regarding supplements and hormone replacements the patient was currently taking. Upon clearing up these omissions and errors, I was given the opportunity to educate the gynecologist about naturopathic decision-making processes, fill in elements of the patient’s history that had not been discussed, and clearly express my support for the patient’s option to seek a specialist’s opinion. The gynecologist was floored and quickly began asking questions about supplement quality and available options to better educate patients regarding the numerous choices of supplements. The conversation ended with, “Wow, maybe I should be referring patients to you!”

The second example of how our day-to-day interactions can help move our profession forward involves a major surgical center in Seattle. I sent a patient with diabetes to an ophthalmologist, who then referred her on to the surgical center for cataract surgery. The patient needed a pre-surgical physical, but according to their policies, only an MD or ARNP could perform the physical. Needless to say, the patient was irate since I had been her PCP for over five years. The incident was becoming a huge, unnecessary time drain.

Again, I (and my office manager) took a few deep breaths, made about five phone calls to reach the right policy making folks, and had some educational conversations with the surgical group. My office manager found their office manager and I spoke with their medical director about ND education and PCP status with various insurance plans. They admitted their policy seemed grossly out of date and updated it immediately so that our mutual patient made it to surgery on time.

I am sure we all have similar examples in our practices, and I’m sharing my experiences to encourage us to recognize the power we have in ‘Docere’. Not only is it important to maximize patient care, but also for educating the world at large, and the larger health care system in particular. We have the opportunity to move our profession forward significantly. This type of professional teaching works at the ground floor to change uninformed attitudes and opinions about naturopathic medicine and NDs.

I know there are many of you who are already active in doing this daily, so please keep it up! I would encourage you, however, when at any point you feel an issue has become too big, or involves a state agency, hospital, etc. to please bring it to the WANP so we can approach it with you. This is especially important if it involves state policies or is related to legislative activities, as those situations can require very specific messaging and communications.

Let us know your successes and roadblocks. They help inform our ever evolving short and long-term goals at the WANP so that we can best represent you, our members!

Happy spring!

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