B Fruitfull

Acid Reflux causes and Treatment

Global Health Webinar

Global Health Webinar


I am going to welcome our speaker today
with us here at the AANMC we have Dr. Sean Hesler who received his medical
training from the Southwest College of Naturopathic Medicine in Tempe Arizona
he received he’s the recipient of the 2018 American Association of
Naturopathic Physicians President’s Award and the 2011 SCNM Alumni Award for
community service for his commitment to global and community health throughout
his career alongside his wife Dr. Sarah Preston Hesler he co-founded Mama Baby
Haiti birth center in 2010 Dr. Shawn currently serves as executive director
for Naturopaths Without Borders a not-for-profit organization operating in
Haiti Mexico Thailand and Phoenix in addition to sharing lessons on global
health at universities and conferences around the US Dr. Sean teaches
medical students and professionals and seminars and Naturopaths Without Borders
sites he’s also adjunct faculty at AT Still
University and really uses the tools of root cause to stimulate healing and life
shifts in his patients Dr. Hesler specializes in cognitive
enhancement genomic medicine biohacking mental emotional conditions and pain
through physical and mental emotional therapies so I am super psyched to have
you with us today Dr. Sean I’m gonna turn it over to you and make my face go
away but I’ll be here for questions we’ll take questions and answers in
about a half an hour so for those of you on the call thanks so much and thanks
for joining us thank you so much for having me I’m really excited so as that
wonderful intro said I’m the executive director of Naturopaths Without Borders I
also have taught at SCNM I teach outside of SCNM and I kind of have a
traveling roadshow of nutrition and paint classes with some other with some
other doctors that I’m really happy to team up with so I just got back from
weekend teaching at Bastyr University California are those students but my
focus really for my whole career is global health and it’s what I most love
talking about so let me tell you a little bit about my
story I I went to the University of Hawaii at Manoa for my undergraduate
degree I had already I was dead set on becoming a chiropractor I was a
chiropractic patient in high school after a sports injury that I sustained
to my back my PA actually referred me to a chiropractor when I wasn’t getting
better after two weeks to get me back in the field and my family is very
skeptical but you know they’re like well we really trust our PA he’s been
amazing and so I started seeing a chiropractor and I’ve always had this
very analytic brain I want to know how things work I don’t know why they work
and so I started shadowing with chiropractor and learning the different
variety of techniques even beyond what what he did he could speak to the whole
field of chiropractic and from then I did a I did a high school project and I
was really excited to to interview him and ask him all these questions my last
question was what do you think about the other systems of holistic medicine like
you think the acupuncture works these other things because I didn’t grow up
with any of that I grew up in a conventional household and he said yeah
he’s like I think it all works I don’t do it I focus on what I do but you know
go out and explore and so I did so I met Dr. Ryan Firchau who is an SCNM
2002 grad when I went to college and kind of the rest is history so one of
the things that shifted me from wanting to be a chiropractor who also got an
acupuncture license who also got additional nutrition training and a
homeopathy degree was that the ND really puts all these things together and so
the parallel to this is what I wanted to do as a as a career as a focus which
patients I wanted to see I knew that I did not want to only do private practice
and not to mean chiropractors but you know in my mind at the time you don’t
want to crack backs all day you know 5-10 minutes a piece and so aside from
this I had also started developing interests in global health and an
understanding my position of privilege within the
world and the layers upon which upon which that existed and so I started
looking into doing service work and then eventually I read a book called
Mountains Beyond Mountains which has spurred so many careers in global health
and community health it’s about basically biography of dr. Paul Farmer
and his organization Partners in Health and they do amazing work all over the
world and it was fascinating to read his story I’ve read several of his books as
well which are much heavier than academic and that was kind of what
tilted me toward I want to be a complete physician I need to be able to prescribe
I need to be able to do all of these therapies together and to practice
sustainable medicine and so I you know the ND was was the clear the clear
choice so my first global health experience was in between graduating
undergrad and before SCNM it was with moderate aha day which is kind of an eco
resort where the jungle meets the sea and trickle in Mexico which is about an
hour and a half north of Puerto Vallarta and that funds at the time funded a
sliding scale clinic in town for people who couldn’t afford medical care I was
with a very holistic MD who had learned acupuncture before she went to MD
school was learning homeopathy and was just she’s one of my inspirations in
life and so I you know I had the bug and I I’ve really run with it so one of the
reasons why I chose a SCNM was because it had at that time the only chapter of
Naturopaths Without Borders which fascinated me because they were doing
local work they were looking to do more international work is this you know
fledgling student group run by some really amazing people I think I I had
read on a SCNM’s website like an interview with the co-founder Tamara Torres who
is still an awesome part of my career and I’m better for knowing her
and so I started doing NBW from my first quarter actually thirteen years ago this
month was my first rocky winter actually the first rocky point trip in
Mexico of naturopathic orders so this is actually a picture from that first trip
it was Dennis de Clare gas station that dinosaur is still there but the gas
station has changed ownership and so I went as much as I could I coordinated
some local activities as well and then along with our team this is absolutely
not just me there’s so many others hundreds of volunteers a year we have a
whole board of directors that have pushed this organization for it to be
what it can be I did come back to SCNM as director excuse me as Director of
Community Health for about a year and a half in 2015 so I was facilitating the
community clinics facilitating or getting students and additional training
outside of the community clinics helping to start the Roosevelt Health Center for
s CNN as well as starting a committee health selective that has kind of rolled
into the community health and group visit class outside of this enum so
enough about me let’s talk a little bit about global health before you start we
have a quick poll that we wanted to do for our folks to see who’s in attendance
right now excellent so if you can just fill out
your poll and then we can see who is joining us and Dr. Hesler feel free to
keep going sure let’s see if I can I think I’m sharing my screen so I don’t
know yeah you are there we go okay so
essentially what we mean by global health is not not licensure it’s not
necessarily for-profit practice it’s not necessarily not-for-profit practice but
essentially service work for for communities around the world who are
underserved so the approaches to this really vary by
organization by individual and what we have found is that and really
this is kind of the best practice now is that the best working global health is
driven by the community for the community and this contrasts with what
we commonly see from some groups especially again don’t want to paint
with a very broad brush it’s not all religious groups but there’s a tendency
to have a what we call a savior complex for volunteers who mean well but they’re
kind of coming down thinking that they know more than the community maybe they
they do in some areas you know maybe have areas of expertise we have that
expertise of naturopathic medicine for instance but you really need to start by
listening you really need to have a deep sense of humility and everything that
you do and understand that you as a person with an American or a Canadian
passport can go almost anywhere in the world and kind of in in a sense for for
better or worse exert influence and there’s so much more to a to a culture
to a society that you don’t see that’s running that’s running underneath that
you can with your privilege with your power exert change for a good change for
bad or a mix of the two and it’s not just what you think of it it’s how it
actually plays out and so some of that humility having work driven by the
community doing what’s asked going where you’re asked focusing on capacity
building focusing on support is to minimize negative downstream effects
maximize sustainable sustainable downstream effects as well you so how does not repair ignite and fit
with that so when I when I guess lecture at best year or or other classes in
naturopathic philosophy one thing that I pull my audience about is is know who
are you who is it that you want to be serving what do you want your practice
to look like what is it that you want to do on a daily basis for the rest of your
life and that I think can help steer steer you in your journey to decide what
kind of healer you want to be what kind of person you want to be and then work
on how can you sustain a lifestyle so one thing I pull these students on is
what is your definition of naturopathic medicine and so you know early on your
program you’re getting bits of philosophy you’re learning about
different modalities you know about holism and and things like that but
really my definition up here for for what it is not for my sales pitch my
elevator speech is not true I think medicines the ultimate synergy of
healing traditions from around the world with modern medicine and science and I
say this because what we have learned as a profession is a synthesis of systems
that have existed for hundreds if not thousands of years from around the world
it is a multicultural system of medicine that has been put together by our elders
and as such to me it it belongs to the world as well I don’t think it should
just stay in the United States and Canada and the the form that it’s in the
reality is that there are n DS and various versions of naturopathic with
different levels of training all around the world as well and so recently with
the work of the world non-traumatic Federation my eyes have been opened to
really how far it has spread and how these practitioners
are working around the world within indigenous healing cultures within
modern cultures so what we do is utilize and teach each of these modalities and
we do our best to also teach our students and our volunteers our
volunteer indees you know the history of of these tools and how best they work
within the communities where we’re working and within the set of volunteers
that we have and in training our own community health workers as well so
pictured is our trip from a recent trip to Thailand which I just came back from
a couple weeks ago I’m still like recovering sleepboys flipped time zones
as I get older or not are not compatible with with my body and then also this is
actually one of my favourite pictures that I use whenever I can and the bottom
right is a picture of Andres who is our head community health worker in Haiti so
in Haiti we are community health worker focused we have for laypeople who we
have trained to to have some basic medical skills and mostly to be able to
educate patients groups of patients on their own in their own group visits
their own group medical visits on on various topics so they could have a GERD
talk GERD is gosh just ballpark one in three adults that we see in her clinics
have have reflux acid reflux so many patients have hypertension about half of
our adult patients have chronic pain that we are addressing in the clinics
and so rather than us do just these one-on-one visits we would rather have
the community healing itself and so we hire with a good wage for community
health workers give them the skills to go out and help in their community to
the extent that they’re able to and then to continue their training and foster
their development so this is capacity building and so this is actually Andres
teaching some CCM students from last year
about local plants he knows a lot about local plants so I wanted to give kind of
a quick case study here this is a very this set of symptoms is is kind of
typical and I wanted to kind of highlight how how what we do very
uncommon ly involves medications I will say that there are some people with some
very severe conditions that are very far on the disease spectrum and to get them
safe and on the way back to health sometimes medications are warranted and
we’re in an area where follow-up can be very difficult but we’re always also
using our foundational naturopathic therapies as well but there’s a time and
place for medications and we do run into that in our travels abroad so I had a 34
year old patient patient this was maybe five six years ago she had shoulder pain
worse with a bee duction so coming up to the side and really she had trouble
raising her arm even up to 2030 degrees she also had some low back pain
radiating down her leg which is actually the medical definition of sciatica I go
on rants with my volunteers and students I go on rants in my pain class about you
know the appropriateness of that term SATA goats so often other causes I had
no access to imaging and so you know so my question students is what you do next
and they all say physical exam we need to get in there and touch our patients
touch itself is healing patients around the world are used to their providers
who I empathize with they are strapped for time they’re strapped for resources
and and oftentimes they don’t have the training and orthopedics that we do as n
DS to properly diagnose and treat patients enough times even if they had
it you know this diagnosis of that diagnosis no piriformis syndrome or
herniated disc they might not have the tools and their patience might not be
able to actually afford the care they might not have access to the care that
they need so to them if it doesn’t change their
treatment plan why further investigate and to us as Indies it really matters
what the treatment is because we are so good at physical medicine at SEM were
trained in a queue and the Canadian schools are trained in acupuncture and
so the diagnosis really does matter even if we’re just using our hands so anyway
no imaging did some PE basically she had a sub superspinatus damage she had a
tear some impingement syndrome with that and so okay why did that happen was it
was a traumatic did you did you have an injury no no it just kind of came on
insidiously and was just getting worse and worse okay what do you do for a
living what do you do on daily basis you know typical typical kind of you know
Haitian work how do you sleep so she goes like this she sleeps on her arms
sideways like this this is exactly how it caused impingement syndrome so on the
one hand what I can do in that visit is work on that area see if I can use some
cross fiber friction use some Active Release Technique to actually try to get
some release there to free up some space get that muscle healing but also right
treat the cause totally cause him so you know can we find a different sleeping
position for you can we be strategic with pillows etc and so that really made
a huge difference though it was very tender muscle work that I was doing with
her and the low back pain reading down her leg was not sciatica it was well not
due to a disc herniation there was piriformis syndrome wasn’t radiating all
the way down the leg like it was actually irritating piriformis muscles
probably irritating what we call the posterior femoral cutaneous nerve and so
she was having hamstring pain and some low back pain that also was due to
really tight muscles she would bend over and wash clothes with her wrists and
that gives people very tight back extensors lumbar extensors their rector
spinae z– but also performace was so tight so I worked that out radiating
pain was gone immediately gave her stretch for that so
um I treated her with my hands with education I did not need to use NSAIDs
which in this case she was taking as needed they would help temporarily but
they’re also kind of eroding your stomach lining causing inflammation in
the gut and preventing healing of the tissues themselves so better to avoid
opioids avoid unsaid again judicious use of medications when really needed and so
often times tell patients you know if you have a really bad headache you can’t
get in to see us right away you know there’s no harm there’s no there’s no
sense in suffering so take you know two ibuprofen call me in the morning kind of
thing but if we can get to them ahead of time we can educate them on using herbs
like passiflora on using castor oil massage on their own even better right
so the more education we can do the more we can prevent these things from
happening and needing medications so what I really love about naturopathic
medicine this is dot in an exhaustive list these are just the things I had to
pick to fit on a slide there’s so many things I love about our medicine the
breadth of tools is one of them so I’m I’m with the I’m with the chorus of
Andes that says let’s not be defined by our modalities when you’re doing your
elevator speech and you’re you’re telling people what you do and why you
know why people should choose naturopathic medicine and don’t just say
oh you know just don’t just list our modalities that said as a global health
ND having the breadth of tools that I have where I can use physical medicine
like for that case for a case of hypertension I have herbs I’ve dietary
change I can work on stress relief I can do acupuncture for GI cases the same set
of tools right if I don’t have something available
we’re in Haiti we don’t have access to supplements I don’t have those
probiotics that I would use I can mix it up I can use abdominal massage I always
have some tool for my patients no matter what’s going on with them I also think
so we just finished naturopathic medicine week last week so this is a
really good timing for this talk and I did a Facebook live with the integrative
healers Action Network which is an excellent organization in California
focused on disaster relief and so we had this talk about there’s there’s a really
good bridge that n DS build between public health and one-on-one clinical
consults one-on-one medicine stress relief trauma response whatever it is we
really speak both languages well and the work that we do is preventative which is
the crux of a public health you know identifying community population level
causes and mitigating them we do that on the individual level and so I encourage
my colleagues as well to take a step back and look at our six principles at a
community level treating the causes of illness preventing treating the whole
society and not just not just the people who come in to see you how can you
really spread that knowledge how can you get your patients empowered to educate
others as well and so what you will always have as an ND is you’ll always
have food to deal with you can do elimination challenge diets you can you
know initiate weight loss diets you could initiate diets to reduce
inflammation to reduce your food sensitivities to fill in micronutrient
micro and macro nutrient gaps we treat a lot of malnutrition in Haiti so you
always have that you always have the plants maybe you don’t you know in
Arizona we have desert plants and some of the other plants we have to bring in
but using local plants as much as possible
you’ll always be able to educate your patients on using plants that are
growing around them or in cultivating their own to take care of their health
you can you know grow basil in your house and there’s a good carminative to
help you with gas for instance and you’ll always have your hands so the
case I gave you was was purely a hands and educational patient
and those things even if I have no tools I drop in the middle of the jungle I can
start working I can still help start helping people no matter what I don’t
need medications I don’t need and anything
else to start not that those things aren’t great I love to have supplements
I teach using micronutrients as medicine etc but I’m always going to have the
stripped away from all those fancy things I always have my hands so a
couple travel tips I wanted to throw in here just for fun I just started
publishing on my my doctor seanix Instagram and Facebook as I’ve been
traveling the last few times I’ve realized as volunteers come to work with
us they’re there look they’re looking at my gear they’re looking at how I pack
and they’re they’re curious because I do it quite a bit and I I definitely have
some deficiencies I’m really bad at packing and luckily I work as a team
with dr. Sarah my wife to to to efficiently pack I just for some reason
can’t wrap my head around doing it really efficiently and she’s awesome at
it so anyway I started sharing a few Instagram stories and posts like some of
my little travel hacks which oftentimes are gadgets you can’t see right now but
I have you know a couple of Mike’s I’m streaming on a camera that’s a really
good travel camera I bring two lenses with me I bring a light and a mic for
the camera you know so I’m set to run all of the photos and videos for nwb as
I go the lighter I pack the more room I have for supplies the more room that I
have for maybe donations or you know upgrading my camera gear so I can get
some new shots to tell our story and tell our patient stories in a new way
I do recommend bringing probiotics and enzymes so travelers diarrhea is real
and it’s it’s not just due to microbes it’s not just due to unclean food
unclean water or you more often than not and hey
because we we have our kitchen dialed and you not having good hand hygiene in
the clinic and picking something up from a patient it’s also you’re just eating
different foods when you travel and so your macros change your micros change
more starch maybe less fiber constipation is is the thing with travel
it’s part psychological part this diet change and in some people they’re eating
just you know higher amounts of fat than they’re used to and so as your gut is
rapidly trying to adapt to this you can get some GI upset so enzymes can help
with that probiotics can help both with your defenses and help break down your
foods I have a whole soap box on the specificity of probiotic strains and all
that but most of the the quality off-the-shelf probox are going to help
prevent you prevent illness Global Entry is great for if you are I’m speaking to
Americans here but there is also a very advanced sorry amen if if you don’t have it or you don’t
have the hundred bucks or whatever it actually came with my credit cards
there’s another little if you can get one of those travel cards that gives you
perks awesome CBP mobile passport is underutilized so I actually recently I
don’t wanna say lost or misplaced my Global Entry card was coming back from
India and I was like oh geez am i I don’t know if I’m gonna make this
connection so CBP mobile passport has it’s an app on your phone you basically
input all the stuff that you write on the form you take a photo of yourself it
uploads to the officer they’ve already seen it they pull your thing it you walk
right through theirs I’ve so far not how to line with it and it’s totally free so
anyway little travel hack I learn to handle on offline Google Translate and
maps whatever languages you’re going to need Google Translate can now speak
between you and the person you’re talking to download offline to save data
I’m do it from apps and I have this little credit card size monkey tool
multi-tool thing that so I believe it’s TSA approved so far nobody’s given me
any grief about it but you never know when you need to they
something out or screwdriver or bottle opener River so anyway I just wanted to
kind of throw those things at you help you with your travels wherever you go in
the world so looking forward and ODB’s future so it’s funny I wrote these
slides before and it would be went through its to strategic planning
sessions we just two weeks ago finished that and so I can we’re still
synthesizing a final report and everything but we made a 1 3 5 year
goals and action plans are awesome board members and so we are looking at
expanding the work that we do here in Phoenix we currently support piecework
Medical which is an underserved clinic primarily for LGBTQ more appropriately
known as gender at sexual minority patients and it’s it’s been actually
more difficult to recruit ongoing volunteers for for work in Phoenix than
it has been to go abroad which is an interesting thing to reflect on but we’d
like to expand that and we have also just established relationship with an
organization called arrow guseva by our good friend dr. daya whose sister-in-law
is an MD who just graduated from Messina maybe patel and so pictured here on the
upper right is dr. sarah in a studio we recorded a session of the for their
series called speak for health and we basically did an hour of basic basic
health advice for office workers so some stretches exercises you can do at your
desks nutrition how to stay healthy what happens when everyone around you starts
coughing how do you stay well sleep and managing your stress
sorry managing your stress and it went really well so we’ve started this
relationship with our guest a but we finally got to visit them after five
years of talking about it with dr. daya and so we’re looking to do some
volunteer exchanges with them in the future and so I think also the future is is
just our volunteers and our in our students and it’s it’s fascinating to
see how the profession is developing and how that is is helping us do better work
abroad as well so learn all that you can regardless of what it looks like we are
you know 2/3 perspective students here’s and current students others if you’re
going to choose naturopathic medicine again make sure it’s what you want to do
on a daily basis and regardless of where you go lifelong learning
not as a cliche but but really I’m constantly studying up on different
cases that I’m seeing I’m I’m seeking outside skills I’m seeking seminars and
conferences as much as I can time and scheduling permitting so really focused
on that focus on developing into the the doctor the the health care provider that
you want to be get as much experience as you can in school you have a safe
supervised learning environment take advantage of that life is a little bit
scarier on the outside when that patient sitting in front of you and there’s no
supervisor there’s no resident to go talk to it’s just you it’s a lot more
stressful so try to get as much experience as with learning as you can
in during school really maximize that time so that you’re better prepared when
you get out and I’m I’m all about humor and I don’t mean making light of a very
serious you know dire situations again we work with we work with all ends of
life and death with our global health work we work with people with terminal
illnesses that even the United States would have very little hope for their
case and people who we we cannot properly diagnose because we don’t have
things available but we know it’s it’s not good news what I mean is that humor
early builds bridges it really can kind of melt down barriers between cultures
it can make light of some situations are again not not super
but you know again kind of build those bridges melt those barriers and so
picture at the bottom here so we take a group picture every time we go to to
Rocky Point is a particularly awesome group we had a mixed some S&M alums
helping us supervise we had best University California students and we
had as always a lot of SCNM students and as so that no one’s shooting this I have
my camera on the ground with the timer I ran back you know ten seconds I’m
counting down just as it shoots this dog runs across it was it was limping it was
we don’t know if it’s a street dog or belong to the place where we were
running our clinic we do mobile clinics in Rocky Point but like two seconds
later one of the girls said oh man that’s what my bread that dog has my
bread and starts trying to chase the dog and so the dog had while we were all
taking five minutes getting ready for our perfect picture there had stolen her
bread and just ran off with it so that was a memorable part of the trip
and I I try to keep things light I don’t yell at my students it’s not very
effective i I prefer to teach with humor like a light heart our work is very
serious so I can’t take myself too seriously and so that’s kind of
something that has that has stayed with me so I wanted to give you all my
contact information here so my email is here feel free to send me any questions
you may have after we do the little Q&A here it looks like I’m running about
five minutes back our website NWB is .ngo not .org and then we have Facebook
Instagram and Twitter I would say the face begins from the best way to follow
us and we do have a newsletter as well for more in depth information we are
looking to do some membership models in the future with our own set of webinars
and things so stay tuned for that so I am ready for questions I believe thank
you Hessler would you mind just going one
more slide so I can talk about the next events and we’ll go to yes sorry
no worries okay so before we start on questions for dr. Kessler a MC has a
couple upcoming events next month so we have a free webinar on naturopathic
approaches to type 2 diabetes which I’m sure dr. Hassler you see abroad quite a
bit yes and we also have an introduction to naturopathic medicine with me during
the naturopathic Medical College virtual fair on November 13th so if you want to
know a little bit more about some of the basics of what n DS do and some career
options stay tuned for that November 13th webinar and so with that I’m going
to ask you a couple questions so we have one question which is great and with the
the popularity of holistic approaches growing where do you see the future of
naturopathic medicine in five to ten years hmm oh boy commenting on the
larger profession you know it there’s actually there’s a process that a a
coalition of the naturopathic organizations are going through right
now they’re having some summits and everybody is kind of giving some inputs
so we’re not just trying to kind of predict the future but kind of
strategically shape it and so those conversations are ongoing and five to
ten years gosh I mean it we are continuing to get States license I’m I’m
I’m not I haven’t talked to the licensure people lately but I’m gonna
guess I don’t know two to six more states I have no idea I don’t know where
those bills are pending right now think you will continue seeing growing
public awareness and acceptance we are every day meeting MDS who are seeing our
patients and then wondering what we did that worked so well you know I think
there’s there’s always going to be kind of a skeptical movement but overall MDS
D D o–‘s pas NPS are kind of leaning our way therapeutically I think you also
see the growth of the integrative the larger integrative community not as you
said like the holistic modalities not just naturopaths MDS are signing up for
the Institute for for functional medicine their whole series of courses
so I think overall global consciousness is kind of raising to restoring healing
traditions from around the world restoring herbal medicine traditions I
couldn’t give you any specific targets I think just overall some some bigger
changes one person to follow to look at some of these milestones as they happen
is John weeks who publishes prolifically about this very thing that kind of
looking back lessons – looking forward so I defer to John weeks to more
properly answer that question but on a global scale we are seeing other
organizations also kind of following our lead and starting to learn about herbs
and and teach their patients about herbs as well thank you and as a follow-up to
that I know that you are always trying to stay on top of technology where do
you see the role of Technology in medicine and medical globally so with
dr. diaphragmatic Savea I just I did not just but gosh that must have been
February March in another episode of their series speak for health and they
have a really nice a whole series and a whole focus on tech in health and so
we just purchased from them an EKG 12 lead EKG that is that big and has some
wires coming off of it and it transmits to my phone which then uploads to to
their system and they have doctors who will interpret it and get back to us so
that is cool a health worker of ours can plug someone
and you know they can you know if they can identify some heart sound or at
least what’s not normal do this it takes you know start to finish maybe five
minutes to get them set up and then get an answer
we also our health workers are plugged into another organization called the
Addis Clinic which is a mobile mobile based telemedicine remote telemedicine
specialist organization so they have specialists from around the world who
will take questions they’ll answer within 24 hours so they’ll take a case
from one of our health workers and send back maybe some more questions about
what meds are available etc and basically tell the health worker what to
do from their phone that’s insane to me so on on the more you know state side
naturopathic side we’re seeing an explosion in genomic medicine there’s
some more testing there’s a lot more research coming about with the
microbiome in ways that we can modify that so sky’s the limit
we have robotic surgery now that’s old and so we’re looking into nanotech in
the future it’ll be interesting to see how how these technologies intersect
with naturopathic medicine I am teaching a series on regenerative medicine pain
musculoskeletal mastery and we will be covering some of these newer
technologies some of these newer cell based therapies and changes in
regulation on them as well so thank you so much yeah that
that EKG thing wow that is just that’s a game-changer yes yes it’s it’s amazing
I’ve used it a few times so far we’re kind of helping them kind of you know
beta test the software work out the bugs but yeah the resolution of it is amazing
I’ve been blown away so uh another question for you and this is this is
more focused on the US but I know your a lot of your work is with underserved
communities and I know one of the things often levied at naturopathic medicine is
that you know these natural therapies are often seen as a luxury and maybe not
as accessible and so can you speak to making increasing access for
marginalized communities here within the US for naturopathic medicine yes so
number of ways to do that so so for one you know you are deciding what you want
to charge what the market will support what your patients will support you know
your value there’s there’s larger conversations that we’re having in terms
of how do we how do we provide the best care of different populations in terms
of practicing cost effectively you know aside from cutting down your quality
doing really brief visits high-volume you know you can you can focus on with
all of our tools again using therapies that have a low supply cost so that it’s
your labor cost and you can determine what that is for your patients so there
are there are very fancy injection therapies that cost a lot of money that
do amazing things I don’t want to denigrate these lasers all kinds of all
kinds of amazing things our root cause foundational naturopathic medicine works
it has for a very long time and much of it doesn’t require those things and if
the more that we do the ground work the less that we need fancy therapies one
thing that I will say just to kind of add on that’s that’s not a very unique
perspective to add on to that is group medical visits so I have presented the
last four years a conference called integrative medicine
for the underserved it is a fantastic organization if you are at all
interested again even if you know prospective student you haven’t started
nd school or you’re opting for something else go to that conference then they
have a lot of resources on the website as well
it is a coalition of integrated practitioners who are serving the
underserved in different ways and sharing those those lessons so I usually
do like some kind of pain focused hands on thing to give practitioners those
tools I learned more system more systems and more like stress relief techniques
when I go but the biggest thing I’ve learned is group medical visits so
imagine instead of the one-on-one visits kind of doing what our health workers do
in Haiti where you have a group of up to you know – all of 20 people they they
might be united by a condition or service they might not they might be a
heterogeneous population all supporting each other all learning all asking you
instead of you lecturing at them but it’s a chance for you to get across the
things that we say over and over again so we do individualize diet and you know
exercise and stretches and all that but the further out you get the more that
there’s just certain things that you’re gonna say over and over right we’re not
going to encourage people eat junk food generally like excessive fried animal
products for instance so there’s some things that would be better done in a
group but at the same time well that’s happening you can pull people apart one
by one and do a brief five to ten minute medical visit follow-up you know have
you made the changes how are you doing take your blood pressure whatever we’re
monitoring put them back in the group depending on the state you’re in you may
or may not be able to actually bill state Medicaid for that and so you can
actually make more per hour doing that and serve people with quality care so
they get a whole hour or two hour group visit where they’re learning all these
things maybe it’s a cooking class maybe it’s an exercise class whatever you’re
doing and you do a brief medical visit on the side
so it’s just a different practice model that is one way to bring what we do and
more and more again integrative clinics are are using this model because patient
outcomes are actually better patient satisfaction is much better they get to
try new things and it treats loneliness because which is in the geriatric
population number one predictor of death within five years is how lonely they are
so all those things together thank you a couple questions have come in
regarding potential students or people interested in volunteering with your
organization so I’ll just kind of lump them together one can anybody apply for
it to be a volunteer or is it just us residents and as a student if they plan
to work with nwb are there any modalities specifically that help them
prepare for this and how do you block off time for international work great so
yes anyone can volunteer not just Americans not just Canadians and not
just current students not just Indies but we had this discussion about even
just you know continuing to highlight naturopathic medicine within our mission
and vision is that immediately there’s a whole set of say our PA students who are
like oh so I don’t think I can come and they’ll ask us can I come yes yes we
want all of your help to your skill level to the extent that we can
supervise you or that you can operate on your own depending on what type of
volunteer you are yes we need all the help that we can get what was the next
k1 volunteer can Oh modalities to focus on definitely physical medicine is good
no this is not to say that if you’re not good at it don’t come you will be
getting experience we will be teaching you in the evenings
whether it’s Haiti or or Mexico where Thailand we do what we call FISMA
parties so were again supervised fashion
practicing on each other learning some new techniques we do quite a bit of
acupuncture and tiling do a lot of IV therapy so that’s an opportunity to get
IV experience and you need you need to know medications because patients are on
medications whether or not we’re using them we need to know if patients are
affected by their side effects if they’re clashing with each other if
they’re even just appropriate prescriptions to begin with regardless
of what’s going on can we stop it can we taper it do they need to stay on it to
stay alive do we add natural therapeutics and then discontinue it or
so you need to have and again we will be discussing common medications etc but
having having a background in knowing what medications are is helpful but
again we have first-year students for who are helping with with the medicine
airy who are helping run the clinic they’re hearing the case presentations
even though they may not be you know directly as involved they can help take
vitals so I’m not saying I’m not implying that you need to already have a
complete skill set to come volunteer absolutely not but those are the things
that that I would focus on I came over the third question and so there there is
a there’s another question that came in and I I’m gonna do my best to get to all
of them and so practicing and D approaching their tenth year of practice
currently working with a not very diverse population in an affluent area
and how how do you you know start working with nwb and/or also
diversifying the population that you know I hear from from folks I just spoke
with a doctor this week in Greater Illinois area who has opened up a
non-profit so that she could create more access for the patient population that
really does need what we have to offer so do you have any guidance for existing
n DS out there in the field are people even considering wanting to have more of
a community-based this shirts so that reminds me of the
third question which I forgot which is kind of blocking off time so for the
student side we are typically know in in Haiti we’re open year-round we’re
currently not accepting volunteers for Haiti but we have Dr. Sarah Polanco
there who was my second year committee medicine resident at SCNM and who is
actually now a co-chair of our organization on the board
she lives in Haiti right now she has for the last year and she works with the
Haitian health workers so we typically will accept launchers on a kind of a
rolling basis otherwise for Rocky Point it’s weekend’s three times here we do
with the three-day weekends so that’s a little more amenable for for flying in
versus driving and we’re typically opening up volunteer weeks when students
have breaks so blocking that off as a professional
to come volunteer really depends I we we understand we sympathize that if most of
us are our own bosses and so that’s potentially you know rescheduling like a
week of less revenue and I don’t have a great answer for that other than locums
but how to how to kind of see different patients within your own clinic so one
way that some Doc’s are doing it is kind of creating a non-profit separate
organization using the same space within your space and inviting people to come
in who can’t afford your care you could volunteer in your community even if it
you don’t know of an ende clinic adding on to what’s already happening there are
entities that go and volunteer at st. Vincent de Paul and in Phoenix and and
just like how you might kind of mold your way into an MD clinic as they see
that oh yeah actually this and this nd knows what they’re doing and they can
help our patients yeah let’s have them start seeing patients you you might many
of our connections have organically operated that way where you know a group
has heard about us or we just kind of shown up and
they’re like oh you can do acupuncture we we’d love to send your acupuncture so
you could do this we and just kind of build your way into it as far as kind of
diversifying your own private practice that’s gonna depend on your flexibility
with pricing and you might consider that that group visit model that I just
discussed because it’s it’s totally different from one on one model Jeff
Keller is in my mind at the forefront of developing this group medical visit
model and he has I’m sorry I can’t remember the name of it if you if you
look up Jeff Keller MD he has a new he’s doing a whole series of courses here’s
alcohol clinic focused in Massachusetts on doing group visits and teaching how
to do group visits so that integrative medicine group visits so that’s again an
easy answer that I have is to start doing those start getting some of your
patients into those groups and then that’s one way to provide more low-cost
care to to underserved populations thank you so another question just in regards
to ongoing research with you know various different types I know that
we’re often asked you know where’s the research for this and you know just this
morning I was reading a study about hydrotherapy in geriatric patients for
sleep and so you know there I think there are and I’ll just I’ll let you
chime in in a second but I think there’s a lot of myths misperceptions and
misunderstandings about the perceived lack of research now there are areas
where research is developing but there are also areas that have been well
documented and well studied that maybe people just don’t realize that has
occurred so I don’t know if you want to speak to research a little bit yes I
think I think it’s kind of a evidence-informed practice
evidence-based medicine I think is very misunderstood it’s using the best
evidence that we have available and some of that involves getting off your butt
and doing a literature search instead of just saying by default like lalala
there’s no data there’s more than you would think and
not all of it is huge well-funded trials we have to do the best with what we have
and and generally not having patents for the products that we’re using for the
herbs that we’re using and the economics of that that said look for it there’s
more than you would think and it’s ongoing I I can’t speak for the other
colleges I do have some familiarity with SEMS research department they’re
focusing on infectious disease they’re doing some really solid you know
genomics and in vitro some bench science on botanicals with different cytokines
with different with sorry MRSA HPV other viruses as well that is really
translating well clinically as well so there’s there’s a variety of human and
in basic science research that’s that’s happening within the profession and the NDs are collaborating on outside of the profession as well thank you and each of
the AANMC member schools operates research departments their research
requirements for graduation so that that is something that we are constantly
looking at building the body of literature whether it’s case reporting
or well-funded studies like you said and one question that came in and I’m kind
of toying with how to phrase this and so you know we hear from students who maybe
they have family members that may not be familiar with naturopathic medicine or
you want to be a natural what or why would you do that why not be a real
doctor and and I think that you know especially with you know younger
students who may not have you know as much life experience under their belt to
stand up for themselves necessarily and what what is what is your advice for
folks and and I’ll caveat this wit because I ain’t I graduated in 2000 and
I definitely got that from some family members myself and but I will say
the tide is turning and has turned very much and I think that there is a
perception that there’s probably more backlash against us than there really is
in reality I have found very very open physicians medical doctors osteopaths
nurse practitioners midwives etc who actually want to learn more about what
we do and once they find out about the education and the training they’re
actually very very positive and enthusiastic supporters for us so and
including legislators as well so I just want to counter that there’s you know
huge body of people out there pointing their fingers and shaking their noses at
us and they’re you know they’re always going to be naysayers like you said
earlier Dr. Hesler there are always skeptics I have friends who are lawyers
where people are on them for you know why did you why do you want to be a
lawyer and be part of the bad guys like I’m my best friend who is a dentist and
people you know turned down their nose at him because he became a dentist so
you know I think at the end of the day it’s amazing it really isn’t yeah you
have to follow your heart and your passion and there’s always going to be
someone out there trying to bring you down and it’s up to you not to let them
yeah I mean I would um you know I think there’s a variety of cultural family
dynamics that you know hard to speak kind of cross culturally on that because
it really depends on your situation and you know I think there is there is the
group of haters who are gonna hate there’s a lot of supporters there’s a
lot of people who are curious in between and so like how my family was was
initially skeptical my dad had a bad experience with a chiropractor earlier
in his life that most people have great great times with their chiropractors and
and are really won over by the therapy and so you know you know but at the same
time safety is key and one bad experience could really color your whole
perception of things and so it was it took our
pa to refer me to the Cairo like that kind of that rapport that social
proofing Cairo is very it’s a musculoskeletal I’m mixer I’m only gonna
do what I know I’m gonna refer if anything’s a red flag and you know here
we go and I’ve seen hundreds of cases like
yours and we’ve got a good shot at getting it better and didn’t make any
big promises and boom Here I am so it really it really depends to me I was
just you know we just had this this first class if I can wax with a quick
story and so I was teaching with dr. Jose Molina this is his first real like
teaching experience like with the seminar and he was you know talking
about just some different pearls that I picked up from doing the group visit
classes from just you know educating students educating doctors educating
community members and I said you know take the person in the room who’s not
that excited about what you’re talking about
and engaged them find out why you know use motivational interviewing techniques
whatever it is but find out what their hang-up is because instead of just
assuming they’re automatically a hater see if they have a misunderstanding
maybe they’re just um you know they’ve heard some without you know better turn
like snake oil salesmen make all kinds of grand claims there’s a lot of I have
a lot of skepticism for people with a lot of multi-level marketing programs
really over marketing things that I’ve looked into that I’ve read and they’re
really overstating their claims and like why someone could be looking at us and
putting us in that manner when we say oh we do all these therapies we got our
patients better and they’re like okay really um I I enjoy that level of
skepticism because it’s someone who hopefully look into it and that and then
you know ultimately see the facts see the truth so I’d like to actually engage
them and find out what it what is their hang-up and am i coming off too strong
you know what what is it that I can do to really explain what’s going on
and you can’t change all the minds especially in today’s political
environment where things are so polarized and people tend to dig into
their into their tribal leanings that really happens and in all areas of life
and so to me everyone is you know potential person to explain to and
absolutely some people are just gonna try to tear you down
don’t give them any energy you don’t give them oxygen but I think the vast
majority of people like you said are not really dead-set dead-set haters so talk
to him I think that is wonderful advice and I know that we are just about out of
time here for those who have questions that have not been answered or something
comes to you after the fact please email [email protected] that’s info at AANMC.org and we’re happy to get your questions answered and I see a question
that came in regarding careers I’m going to be talking about that quite a bit on
the webinar on November 13th so if you’d like to join then or email us we
can we can definitely chat with you about that we also have resources on our
website so thanks again Dr. Hesler I appreciate your time thank you for your
passion for global health thank you for all you do for the worlds community and
from the bottom of my heart thank you for being with us today

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