Natural Medicine and Community Health

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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
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What Is Natural Medicine?

• Naturopathic Medicine
• Alternative Medicine
• Traditional Medicine
• Holistic Medicine
• Complementary and Alternative Medicine (CAM)
• Chinese Medicine

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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.

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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.

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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

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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.

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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

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Naturopathic Doctorate

• Clinical nutrition
• Botanical medicine
• Homeopathic medicine
• Naturopathic obstetrics
• Oriental medicine
• Physiotherapy
• Naturopathic manipulative therapy
• Psychological medicine
• Minor surgery
• Hydrotherapy

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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)

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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)

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Role of Natural Medicine in the United States

• Primary Care
• Complementary/
• Adjunctive
• Alternative
• Integrative
• Specialization

• Education
• Research
• Publication

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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.

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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

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The Role of Natural Medicine in Community Health

• Accessible
• Affordable therapeutics
• Lifestyle education
• Portable
• Cost effective

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Historical Role of Natural Medicine in Community
Health

• Native Folk Medicine
• Shamans
• Curanderos
• Oral traditions
• Use of local and
• sustainable
• resources

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Historical Role of Natural Medicine in Community
Health

• Hydrotherapy
• Ancient water therapies
• Therapeutic baths
• European spa therapy
• Sanitariums

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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

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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.

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International Examples

• In various African countries, traditional
  medicine and therapeutic diets are being used to
  help people live longer and healthier with
  HIV/AIDS

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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.

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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.

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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?

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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 under-served populations of the
  Portland metropolitan area.

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Community Clinics, contd

• 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.

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Community Clinics, contd

• Mount Olivet Community Clinic Hosted by the
  Mount Olivet Baptist Church in North Portland.
• Outside In A Federally Qualified Health Center
  in downtown Portland.

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Community Clinics, contd

• Portland Community College-Sylvania Community
  Clinic On the PCC Sylvania campus
• Portland Community College-Workforce Community
  Clinic Located at the PCC Workforce Training
  Center.

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Chinese Medicine Community Clinics

• Asian Health Service Center (AHSC)
• Chinese Consolidated Benevolence Association
• Portland Alternative Health Clinic
• Immune Enhancement Program.

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Other naturopathic options in public health

• Public health departments
• Virginia Garcia
• Outside In outreach clinics
• Screening physicals for children enrolled in
  Headstart programs

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How we do this?

• Institutional funding and grants
• Donated supplements
• Laboratory discounts
• Fundraising
• Site donations
• Student Interns/teaching clinics

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Integrative Treatment Plans

• Example Diabetes management in low-income
  populations

• Diet and exercise plan to optimize weight loss
• Stress management
• Specific herbal and/or nutrient supplementation
  protocols

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Who do we serve?

• Patient distribution by Ethnicity

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Who do we serve?

• Patient visits by insurance status

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Who do we serve?

• Patient visits by poverty level

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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.

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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 ?

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Goals for the Future

• Efficacy
• Cultural Competency
• Expansion
• Integration