Natural Medicine and Community Health
Kim Tippens ND, Lac Post-Doctoral Research Fellow Maki Aoki ND Resident Physician
National College of Naturopathic Medicine 049 SW Porter Portland, Oregon 97201
What Is Natural Medicine?
Naturopathic Medicine Alternative Medicine Traditional Medicine Holistic Medicine Complementary and Alternative Medicine (CAM) Chinese Medicine
What is Naturopathic Medicine?
A distinctively natural approach to health and healing that:
Recognizes the integrity of the whole person. Acknowledges that the body has an inherent capacity and tendency to heal. Addresses the cause of disease. Empowers the patient through education.
What is Chinese Medicine?
TCM is, largely based on the philosophical concept that the human body is a small universe with a set of complete and sophisticated interconnected systems that must work in balance to maintain the healthy function of the human body.
Principles of Naturopathic Medicine
Primum no nocere – first do no harm Vis medicatrix naturae – healing power of nature Docere – doctor as teacher Tolle causam – identify and treat the cause Tolle totum – treat the whole person Prevention is the best cure
Naturopathic Doctorate
BASTYR
University
A doctorate of naturopathic medicine (N.D.) requires completion of a four-year postgraduate program with admission requirements comparable to those of conventional medical schools. A degree from one of the accredited naturopathic medical schools trains the graduate to become a primary care physician in general medicine.
Naturopathic Doctorate
Anatomy Physiology Biochemistry Pathology Microbiology Immunology Pharmacology Laboratory diagnosis Clinical and physical diagnosis
Cardiology Neurology Radiology Minor surgery Obstetrics Gynecology Pediatrics Dermatology Other clinical sciences
Naturopathic Doctorate
Clinical nutrition Botanical medicine Homeopathic medicine Naturopathic obstetrics Oriental medicine Physiotherapy Naturopathic manipulative therapy Psychological medicine Minor surgery Hydrotherapy
Chinese/Oriental Medicine
Master of Sciences in Oriental Medicine (MSOM) Master of Sciences in Acupuncture and Oriental Medicine (MSAOM) Master of Sciences Acupuncture (MSA)
Licensed Acupuncturist (LAc)
Clinical Doctorate of Chinese Medicine (DAOM)
Professional Organizations
North American Board of Naturopathic Examiners (NABNE) American Association of Naturopathic Physicians (AANP) State naturopathic organizations (OANP) National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
Role of Natural Medicine in the United States
Primary Care Complementary/ Adjunctive Alternative Integrative Specialization
Education Research Publication
How is natural medicine being used in the community?
Who uses complementary medicine?
Higher education (50% or more college graduates or beyond) Higher Income (more than 50% earn more than $50K) Age group 30-59 has highest utilization
(Barnes et al.,2004)
Use of CAM varies by sex, race, geographic region, health insurance status, use of cigarettes or alcohol, and hospitalization. Socio-demographic characteristics predict use of CAM more strongly than race/ethnicity.
Naturopathic Community Medicine
Current Limitations to access
Insurance coverage for cost of visits & therapies Knowledge of and access to available services
Obstacles to adherence
Cultural Social Socioeconomic
The Role of Natural Medicine in Community Health
Accessible Affordable therapeutics Lifestyle education Portable Cost effective
Historical Role of Natural Medicine in Community Health
Native & Folk Medicine
Shamans Curanderos Oral traditions Use of local and sustainable resources
Historical Role of Natural Medicine in Community Health
Hydrotherapy
Ancient water therapies Therapeutic baths European spa therapy Sanitariums
Historical Role of Natural Medicine in Community Health
Homeopathy
A therapeutic modality used to treat various diseases throughout American and European history An excellent accessible and low cost therapeutic that is highly effective and transportable
Historical Role of Chinese Medicine in Community Health
Acupuncture can be highly effective for several physical ailments Treatments can be given “community style”, lasting 30-60 minutes with patients seated and fully clothed Auricular acupuncture is often used in disaster areas as well as in drug and alcohol detoxification to allay feelings of anxiety, anger, frustration, depression, fatigue and other emotional and physical pain.
International Examples
In various African countries, traditional medicine and therapeutic diets are being used to help people live longer and healthier with HIV/AIDS
Integrative Medicine in Cuba
Cuba has an integrated system of traditional medicine (medicina verde) using herbal and energetic modalities while retaining the important advantages that conventional medicine provides.
Integrative Medicine in Cuba
ACUPUNCTURE IS USED FOR CHRONIC PAIN RELIEF, STRESS, ANESTHESIA FOR SURGERIES, AND TO TREAT AUTOMIMMUNE DISEASES SUCH AS Multiple Sclerosis AND Rheumatoid Arthritis.
And in the United States?
How can this model be applied on a community level, in our society?
How can natural medicine address the health disparities that exist across various socioeconomic groups?
Natural Medicine in the Portland Community
As a member of the Coalition of Community Clinics in Portland, we offer free and low-cost Chinese medicine and naturopathic health care to uninsured and underserved populations of the Portland metropolitan area.
Community Clinics, cont’d
East County Community Clinic: Housed in the Multnomah county health clinic in Gresham. Homestreet Community Clinic: in Hillsboro, hosted by Homestreet inc. in conjunction with other facilities that provide mental health services in Washington county. In Act Clinic: In downtown Portland, this clinic is part of a court-mandated intervention program for drug and/or alcohol related offenders. Provides naturopathic medicine and acupuncture to patients in addictions recovery.
Community Clinics, cont’d
Mount Olivet Community Clinic: Hosted by the Mount Olivet Baptist Church in North Portland. Outside In: A Federally Qualified Health Center in downtown Portland.
Community Clinics, cont’d
Portland Community College-Sylvania Community Clinic: On the PCC Sylvania campus Portland Community College-Workforce Community Clinic: Located at the PCC Workforce Training Center.
Chinese Medicine Community Clinics
Asian Health Service Center (AHSC) Chinese Consolidated Benevolence Association Portland Alternative Health Clinic Immune Enhancement Program.
Other naturopathic options in public health
Public health departments Virginia Garcia Outside In outreach clinics Screening physicals for children enrolled in Headstart programs
How we do this?
Institutional funding and grants Donated supplements Laboratory discounts Fundraising Site donations Student Interns/teaching clinics
Integrative Treatment Plans
Diabetes management in low-income populations
Example:
Diet and exercise plan to optimize weight loss Stress management Specific herbal and/or nutrient supplementation protocols
Who do we serve?
Patients by Ethnicity
Asian/Pacific Islander Black/African American American Indian/Alaskan Native White/Caucasian Hispanic/Latino Other/Unknown
Patient distribution by Ethnicity
Who do we serve?
Insurance Visits
Patient visits by insurance status
Insurance OHP Uninsured
Who do we serve?
Visits by % poverty
Patient visits by poverty level
100% and below 101-150% 151-200% 200% No income reported
Research
What we know…
Natural medicine is widely used in our community Natural medicine is a viable option for low income and uninsured populations in the Portland area.
Research
What we need to know…
Can this practice be sustainable? Details about patient satisfaction Are these treatments comparable in efficacy to usual care? Can this model be duplicated in other states? Can we find governmental support ?
Goals for the Future
Efficacy Cultural Competency Expansion Integration