Integrating CAM in Seattle

The Seattle Times reports that Group Health Cooperative and Bastyr University will initiate a program this summer where senior students in naturopathy will “shadow” Group Health doctors and nurses during patient visits.

Please accept these recommendations based on my experience as a clinical pharmacist, educator, and student who made rounds during the early days of clinical pharmacy education.

The 10-week program is intended to provide an opportunity for senior naturopathy students to observe patients, learn how various health conditions are treated with conventional medicine, and answer questions about naturopathic alternatives.

The bottom line?
Here’s my advice to the students.

Be prepared

• Make time to learn about these patients before rounds every day.
• Review their charts to identify patients who might benefit from your expertise.
• If possible, interview those patients (simply to obtain information, not make treatment recommendations) before rounds.

Contribute.

• During rounds DO NOT just wait to be asked questions. That makes you a pincushion — a target for every left-field question a self-impressed resident thinks is cute.
• Ask patient-specific questions (always with the intent that the answer will give you an opportunity to contribute something in response, not just say “thank you.”
• If the patient has a condition that might benefit from a naturopathic intervention, and it isn’t being treated, point it out and suggest a treatment option.
• You are not expected to know every answer, but you are expected to contribute.
• For questions you can’t answer, follow-up quickly to get the answers to the resident, and be prepared to discuss them.

Evidence is king

• The fact that you were taught something is worthless.
• Be ready to quote references.
• Be ready to retrieve the references and get them to the resident.
• Never say “treatment ‘x’ has been used for 500 years.”

Be on time and stay late.

• Remember what Woody Allen said: “80% of success is showing up.”
• The work is just beginning when rounding ends.
• Residents, nurses, etc must implement care plans.
• Be there to help implement your recommendations.

Remember Dr. John’s dictum.

• No original questions are ever asked on rounds.
• All doctors, nurses, etc have the same questions, they just haven’t asked them yet.
• Make a commitment to get answers to all questions related to naturopathy.
• Then, even if you never know the answer the first time you are asked, by the end of your training you will know about 90% of the answers to the issues in naturopathic medicine of greatest interest allopathic heatlhcare providers.

The Group Health/Bastyr program is a great opportunity. Good luck.

7/15/07 11:09 JR