Being a Good 'Medical Consumer'

Liability in the Naturopathic world is very different from the malpractice system that allopathic providers operate under. This stems from a radically different philosophical approach to health, the low risk experienced by patients, and a radically different type of healing interaction than most people are accustomed to.

In Allopathic Medicine, patients are diagnosed, treated with medications and surgery, and maintained in that state indefinitely – 'under' a physicians care. There is a clear differential in power, with the physician having authority over the patient – and the expectation that the patient does as directed. Because of this, an elaborate system of liability protection and malpractice has been created. Physicians, because they are human, have oversights and make mistakes. But because they are the sole authority in the therapeutic relationship – they also assume all responsibility. Since errors will always occur; allopathic physicians would be unable to practice if they were actually held responsible for their decisions. The two systems that have developed to address this are standards of care – community standards created by physicians of how patients under certain conditions should be treated and applied to all – and a medical malpractice system that essentially pays for any mistakes just as car insurance covers accidents in driving.

The Naturopathic community functions very differently. Our primary form of liability protection is based on a relationship between the patient and physician. Naturopathic physicians spend considerable time creating a relationship of trust, as evidenced by the length of their visits, accessibility of care, and the personal nature of their interactions. Naturopathic physicians are teachers. They don't tell their patients what to do, they instead educate their patients with respect to their options and support them with their decisions. The responsibility for health lies with the patient who is advised and supported by the physician with the ultimate aim being independence and self sufficiency.

Although most Allopathic providers do not disclose issues of liability or standards of care – the basis of much of the care provided has more to do with standards protecting the physicians liability than the best interest of the patient. But Naturopathic physicians actively promote medical consumerism... educating patients about different philosophies of care, stressing their rights and role in their own care, providing basic education about health issues, and generally equipping patients with respect to their rights as consumers.

For this reason Naturopathic Physicians do not frequently encounter liability issues, have different requirements for malpractice, jurisprudence and standards of care that vary from state to state based on regulations and laws. All Naturopathic physicians who have graduated from accredited universities have lines of authority under which they practice.

In a practical world, liability issues are consistent with professional demeanor and social standards. The best way to address concerns about a provider is the same way you would address any person -air your concerns directly. Lawsuits, liability and other legal misunderstandings are often quickly settled with basic information and communication. When patients go instead to others to air their complaints or use public forums – they engage in slanderous behavior, that is essentially professional gossip. Just as gossip is damaging to the reputations of individuals in the world, professional gossip is much more serious because it doesn't just hurt feelings... it damages a person's professional reputation and therefore their livelihood.

So how do patients protect themselves? In the state of Idaho anyone can call legally call themselves a Naturopathic Physician and practice. Licensure is NOT required. This is a buyer beware state – but physicians who have graduated from accredited schools are easily identified and will usually make a point of discussing their education. Secondly look for basic characteristics that identify a good physician – do they promote education, do they spend adequate time with you to establish a relationship and answer questions, and are they accessible at odd times or in case of emergency? Lastly evaluate your own appropriateness for this style of healthcare. Do you take responsibility for your own care, do you want to be more educated about your health, do you want to learn to be a good medical consumer and become more self sufficient? If you want to know who a physician is, ask for patient referrals and ask the questions that concern you the most.

How do Naturopathic Physicians protect themselves? Naturopathic Physicians protect themselves by following professional and ethical standards; creating relationships with their patients; and conducting themselves with integrity. Our biggest challenge is practicing in a community where there is a huge discrepancy between different providers who may call themselves by the same titles. While the term Naturopathic Physician in Washington State refers to a physician who has graduated from an accredited university with a doctoral degree in medicine and is formally trained as a primary healthcare provider; in Idaho anyone can practice and call themselves a Naturopathic Physician - no training required. 

In summation, genuine safety in healthcare varies markedly between the various healing professions based on the risks to the patients. Rules for protecting oneself from a poor outcome follow the boundaries of common sense and social standards. Shop around, ask questions, and be a good consumer. Communicate with your provider. And if you encounter challenges, follow professional and ethical standards. These simple tips protect the therapeutic relationship that is essential for genuine healing.

The right to make decisions about your own health care is a tenuous one. There are many people who support the concept of a medical monopoly, denying patients the right to choose their own care.... there has never been a time where this choice is more at risk. Consumers who access and support medical alternatives promote that right for all people. But the success of the system is dependent on NOT falling into the constraints that insurance, malpractice, professional associations, and legislation has imposed on our ability to make choices about our own care. In my humble opinion and with respect to my faith; maintaining exceptional and professional Naturopathic care is the way I choose to protect the rights of my patients.

Boise Classes: Global Care Home Room

Global Care Home Room is a series of monthly classes to help our Boise patients understand how to use and get the most from our GC program. The program is a repeating 6 part series designed to highlight different aspects of Global Care.

Global Care is based on a radically different paradigm of care that that requires a skill set most of us have never had the opportunity to consider or develop. But the process of learning to utilize this program is part of the reason Global Care is so sucessful.... rather than teaching a set of home remedies without context or understanding; Global Care teaches a thought process that can be applied to any situation utilizing any resources available. This makes the GC 'student' self sufficient and able to promote healing under any circumstances utilizing whatever resources are available.

This month, our class focused on Mentorship. While most people are accustomed to walking into a physician's office and simply doing what they are told - a more effective healing relationship is based on creating a rapport... knowing and trusting the person you seek medical advice from is a foreign concept for most of us. In Global care it is fundamental to the process. Relationship allows you to seek information, consult as equals about various conditions, and make the decisions that direct you towards better health.

One of the primary ways this benefits a patient is walking through an illness or therapy WITH a professional who teaches and interprets the unfolding circumstances as they occur.  This provides invaluable clues to what is unique about you, how you respond, how you cope... these are clues that most providers never see. But this level of practical teaching creates a level of healthcare that allows more significant and complex illnesses to be understood and addressed.

While most people access healthcare seeking to solve acute problems, Global Care takes this a step further and promotes lasting health through education, empowerment, equipping and support. Home Room Classes are designed to help you get the most from your experience by educating you about the program and resources available to you. Below is a list of the schedule. These classes are available to GC clients only and can be registered for through Eventbrite.

Class 1 Basics: Scheduling, contact, classes, blog

Class 2 Mentorship: Relationship, preparing for visits, plan
Class 3 Empowerment: Health Notebook, records, medical consumerism
Class 4 Equip: Home Pharmacy, Classes, skills and tools
Class 5 Individuality: treating the patient, underlying principles
Class 6 Self Sufficiency: Becoming a healer, self care, care for others

Blessings and Cautions of the Age of Internet

While the Internet has put a tremendous amount of knowledge at our fingertips; it also has brought many significant problems. This seems especially true in the field of healthcare where desperate moms pour over contradictory healthcare information in the midnight hours seeking advice from this unlikely source....

There is much to be learned online. But since anyone can publish anything.... it can also be a source of misinformation or dangerous advice. Un-opinionated people rarely feel the need to stand on a soap box and share their views. I am no exception! If you are looking for balanced accurate information; the Internet is NOT a good place to start.

My sister posted a vaccine question on Facebook....and there was NO gray area, very little factual information in the responses, and a lot of very opinionated people saying that the solution was black OR white... but ignoring the fact that vaccines ARE gray area! There is no doubt that vaccines are an essential health tool in the third world; and in areas of crowding, poverty and lack of healthcare access. And although there are clearly risks - the benefits are significant and indisputable. But is the risk and benefit the SAME for my well nourished kids, living in the suburbs, enjoying excellent health? Absolutely NOT. The risk of vaccines to my kids is significantly greater because the threat of them dying from these diseases is significantly less. And although I have taught Vaccine Classes ( a genuinely factual and as balanced as I can make it approach) for 25 years; I have yet to find a single book or Internet article that doesn't take sides. And while the debate rages on... the reality is that vaccine risk vs vaccine benifit is individualized and based on family history, health history, risks and benifits best considered by an educated physician and caring parents.

The point about Internet Medical Advice is that it is generic. Accurate or not, the real question is: do you have the knowledge and background to be discerning? Can you see this wealth of information, sift through what is wrong and what does not apply, and be left with information that is genuinely useful? My opinion is that people with a knowledge of the subject searching for a deeper understanding actually do well. But in general I notice that people who use the Internet to start an investigation about healthcare (this is different than researching a diagnosed condition) and use the Internet as a do-it-yourself guide often do not do well.

The second issue about the Internet is your own personal temperament. Some people do NOT do well with excessive details or constant warnings about the worst case scenarios or most dramatic cases. Some people do better when information unfolds at a reasonable pace and is relevant- which is NOT what happens online. The number of neurotic and panicked people that call and require being 'talked down' after reading incorrect, dramatic, or unnecessary Internet information reaches epidemic proportions at times, like now, when we are in the heart of the 'sick' season. Enough so that I am prompted to step up on the soap box and address it on my blog!

And lastly, while I have based my practice on patient responsibility and education:  providing educational opportunities; and easy and affordable access to information around the clock for my patients.... allowing the Internet to augment rather that BE an exclusive source of information... I still receive the calls of panic.

In conclusion, I feel that the Internet is a source of both good and bad information. Patients who have a basic knowledge of a topic can often find additional useful information. Most information will support a bias that either contradicts or allies with your own ideas, so must be read with discernment. And some people sensitive to dramatic information or unable to filter out excessive unnecessary information can actually be harmed by Internet Surfing. Your best bet is to see the Internet for what it is, a collection of opinions by genuine humans who like you have biases, passions, and blindspots. While I don't recommend it as a substitute for professional advice; I recognize that not everyone enjoys the type of access to information my patients enjoy.

Cleanse, Homeopathic Series, and other Classes

Its time for Classes! Please take a look at what we have coming up and register today! This article will help you know what classes are offered and how to register. Please note that we will be teaching in both Idaho and Colorado, and repeating most classes in both locations. Click on the class name to link to its registration page.

Colorado Classes
Introduction to Naturopathic Medicine Saturday January 26, 2:30-4:30. Free Class.
Cleanse Class Colorado Tuesday January 29,  9:15 - 10:45 AM Detox Class, 11:00 - 12:20 Allergy Elimination Challenge and 6:30-8:30 PM maintenance and follow up. Global Care only.
Introduction to Homeopathy January 30, 6:30-8:30
Acute Homeopathic Prescribing  Thursday (Jan 31) and Friday (Feb 1) 6:30-8:30

Boise Classes (see Eventbrite for complete list)
Introduction to Homeopathy February 6
February Home Room February 11, GC Only
Intermediate Homeopathy: Acute Prescribing February 6 and 13
Spring Conference: Healing with Homeopathy March 15 and 16

Registration: all classes require preregistration online to attend. The Eventbrite program is how we track the class participants to prepare class materials, notify you of cancellations or other changes, and collect fees if required. Information regarding dates, time, location, class descriptions, pre-requisites and registration deadlines are all located online. Even if the class is free, registration is how you inform us of your intent to attend.

Boise Classes: are generally offered twice, in the day and nights/weekends at our quarterly conferences. 

Getting the most from our classes. The foundation of all of our classes is the philosophical principles of Naturopathic Medicine. Although we may discuss specific conditions or supplements... it is the underlying thought process that differentiates us from other systems of healthcare. Reinforcing these principles takes time - they are different from the way most people think of allopathic or natural medicine. Because of this we encourage you to take all our classes several times. Our Global Care Package is set up to support this value.
  
Plan to take notes and if possible discuss what you have learned with a friend to help you review the material. Keep class notes in your Health Notebook for reference. The best way to learn the material is to see it demonstrated, hear it taught, and then try it out. 

Who should attend? Classes attendance is expected as the foundation of our Global Care Package. But prospective clients, friends and other people interested in Naturopathic Medicine will benefit from attending. Classes are an inexpensive way to become acquainted with our philosophy and learn practical tools.

FAQ

I am not sure what category to register under?
Global Care Members have a separate registration since all class fees are prepaid in their monthly fee. All other choose the General Admission option and are generally charged a fee which can be paid on the Eventbrite website at the time of registration.

Can I register at the door?
Registering at the door prevents us from getting an accurate head count, purchasing/printing enough materials, and sometimes classes are canceled because of a lack of attendance only to have more people show up at the door.... Please register in advance.

Can I bring my Children?
We LOVE children. As long as your kids are not disturbing others, they are welcome. Bring quiet toys or books to keep them happy.

My friend can't attend. Can I just bring her the hand outs?
Since Naturopathic Medicine functions under a completely different set of philosophical guidelines, care is not based on conditions but on the individuality of the patient. The tools whether they are drugs, herbs, dietary changes or surgery are based on the individual and not a condition. This is such a different way of thinking that it takes most people several years to master. HOW we use modalities and medications is what makes us different.... because this cannot be conveyed by sharing hand-outs, and in the past has created a great deal more harm than help; we ask that you master the skills of Naturopathic thinking before sharing material of any kind.