We aren’t accepting patients.

There is a sort of culture change when healthcare consumers choose practitioners who work outside the insurance model, as opposed to those within the conventional medical model. While I believe most our clients choose our practice because they “want something different” or they “want to be an active participant in their healthcare,” I am not sure they always understand this transition requires a shift in their mindset.

We don’t accept patients.

As a young nurse starting to recognize how the medical system was railroading women in childbirth, I started to question the relationship between healthcare providers and consumers. It seemed we were too often forgetting these women were adults, with their own thoughts and opinions, their own rights as human beings. I understood the culture in the emergency room when patients were brought in by ambulance and were dependent upon our every skill to save their lives, without question trusting our management. Childbirth however, was a different scenario. Women weren’t ill. They weren’t incapable of making decisions. In fact, many came in quite educated and knew what they wanted. Why were we so challenged by this? I think because we wanted them to be patients, and didn’t recognize them as clients.

As a nursing instructor I was very clear that while in their maternity rotation, students were to avoid using the term patient, and rather refer to women as clients. I do believe this helped them approach their daily assignments with a different mindset, one that shared responsibility in decision-making and one that considered their client’s points of view. Most importantly, I hoped they recognized that this experience was the client’s and she was the expert in her own individual care.

As a midwife, not once have I slipped and used the term patient, nor have my staff as I am aware. In fact, those that fail to utilize this term clearly indicate they don’t have the right mindset for our practice. As we’ve expanded our services to functional medicine and have started implementing programs of care, we are also referring to our clients as members. This is important because it creates a community of like-minded individuals with a similar goal. It also eliminates the fee-for-service mindset.

Ironically, we still have clients who prefer to be patients. They may not recognize this, and some would argue with me, but we find that there are those that want something different, but they really aren’t ready to change their mindset. They still want us to make their decisions. They want a quick fix. They want us to manage all their insurance claims. They don’t want to invest time, travel, or any expense to invest in their health. They want to be dependent entirely on their practitioner, and entirely on their insurance company to cover the fees.

Visit our functional medicine page for more information on insurance companies and functional medicine. We choose to work outside the health insurance model so we can work together to determine what is best for your individual needs, rather than being director by a third party payer who is responsible first to their own shareholders.

Our system isn’t set up for patients. We don’t allow for walk-ins. We don’t have a wall with a sliding window to converse through that separate us from you. We won’t tell you what to think. We won’t just write you a prescription. We won’t stand during your visit as you share a few thoughts and we give a few instructions before we’re out the door. We won’t email you clinical advice. We do not care for clients on an assembly line, allowing only six minute visits.

Our model is different, and here’s why: WE ARE DIFFERENT.  We value education. We value one-one-one care. We want to give you our undivided attention. We want to hear you and we want to create individual plans of care for each client. We value informed consent. We believe you are the expert in your individual plan of care.

If you are eager to be our client, consider a mindset change.

If we are extending this commitment to you and you get it, and you want to be our client, Yeah! The truth is midwives have the WOW factor. We spend an incredible amount of time with our clients, and really invest in them. I can’t even count the number of times we’ve heard a nurse or physician say, “I’ve never seen a practitioner spend so much time with a client, helping them breastfeed in the NICU, visiting their home, or coming with them to their procedure.” However, keep in mind, we extend this same dedication to all our clients. Investing in clients is demanding. It is time intensive. We spend hours teaching and hours upon hours in consults or laboring with women. We work all hours of the day and night, and all days of the week, including holidays. When we’re serving a client, we do not simultaneously review labs and return phone calls for others. You have our undivided attention.

As a client, you have to work, invest, and engage. You have to follow through with the plan and communicate your needs so we can adjust accordingly. You will have to return for follow-up visits and trust that long term changes require patience, perseverance, and persistence. You will also have to recognize that we will commit to spending hours, or even days, with clients – the same client without ceasing. While it may make us somewhat distracted from the routine of the daily clinic, remember, we will dedicate the same time to you – which is why you chose us in the first place. We don’t have a staff of twenty to delegate all our clinical care, because our clinicians want to be involved in every aspect of your care. We value you. We have a partnership.

We don’t blame you when you have unrealistic expectations. Our culture has trained us to be patients. We have been trained to be demanding. We’ve been trained to demand being put first or our needs will go ignored. The loudest squeaky wheel gets oil. The biggest bully wins the greatest attention. However, this isn’t our culture. We are different. We want to educate you in how to be your best advocate. We want you to see yourself as a healthcare consumer. We want to be your partner in healthcare. We have high standards of clinical excellence, and we have standards for how we want to be treated as well. If you’re seeking a partnership and are willing to invest in that, I can’t imagine you’ll find anyone more committed to your success than our clinicians.

Why Detox?

We are rolling out several new and exciting programs, and having just completed a very detailed detox program, I wanted to share a wee bit about why you might consider this as part of a healing program.

Have I mentioned how exciting our new maternity program is and how much our clients are loving it? The thyroid program is our newest program and we are already having lots of excitement not just from our clients, but the staff love providing care in this format. The amount of education we can provide in a group setting is incredible and gives us so much more peace than trying to squish in the mere basics in a single consultation. Not to mention, these programs allow us to move beyond the immediate need and address long-term health.

Keep in mind, I did mention this is a complex issue and our clients receive hours of education within these programs, as well as a thorough written guideline and guidance via text messaging. This post only tips it’s toe into the topic of detoxing.

We live in a very contaminated world.

It can be very overwhelming when one starts learning about food and environmental toxins. It is easy to think, “There is no way I can rid my body of all these toxins or prevent future exposure, so I give up.” However, never before have humans lived among so much contamination and never before have our bodies worked so hard to detoxify our system. Small discomforts, and on a larger level, most all chronic diseases can be contributed to toxic burden whether through environmental exposure or through our foods. Being mindful of these triggers can provide a great deal of relief that you may have began to tolerate, even accept as your lot in life.

Detoxing requires a variety of nutrients to support your body through the process, and encourage elimination of toxins that have been stored within your body. Elimination is crucial however. For example, if one is prone to constipation, this needs to be corrected prior to detoxing. Otherwise, the toxins will be released into the body but can’t be eliminated. They are then recirculated and stored. As more toxins enter the body, they too can’t be eliminated so are stored, accumulating, eventually altering our metabolism, cell health, and symptoms present.

Detoxing is Step One

Migraines, brain fog, digestive discomfort, sinusitis, bloating, joint and muscle aches, chronic nausea, ringing in the ears, skin breakouts and rashes, strong body odor, bad breath and weight gain may all be related to a disease process, which requires evaluation, but they can also all be assisted with detoxification. When we meet with clients, they often have a multitude of issues whether infertility, anxiety, obesity, fatigue, and even chronic pain, we can create a thorough plan with diagnostics, nutritional and functional labs, allergy testing, neurotransmitter testing and a plethora of other integrative and complementary therapies, but most all require detoxing initially.

Our Body is Equipped

The body has a multitudes of methods for detoxification: it truly is fascinating. The liver however, is the star player. It assumes the responsibility for not only identifying toxins, but also transforming them into something harmless and preparing them for elimination. The key here is having sufficient nutrients the liver will require to convert or bind the toxins for elimination. Again, if these nutrients aren’t available, toxins can recirculate as new toxins and are sometimes more harmful after initial conversion than when originally introduced. Keep in mind, the liver isn’t just handling toxins, but also hormones, natural waste, pharmaceuticals, and fat-soluble vitamins.

Cruciferous vegetables, onions, garlic, and eggs provide the sulfer needed for better toxification. Avocados provide the B6 necessary, shellfish offer the zinc, and fish or poultry offer the protein for assisting the liver in accomplishing its rather daunting task. As toxins are being eliminated, free radicals are produced. These too must be cleared from the body as they can encourage disease. Colorful foods are the key here. Think blueberries.

Water and fiber are also important aspects of detoxification because remember, the bowels and kidneys must be effective in eliminating the body after the liver has made these available for elimination. Vegetables and fruits again, are the key. Purifying water is an important topic we thoroughly discuss within our program. Tap water has even been identified as a cause for early pregnancy loss.

Detox Twice Each Year

Generally speaking, detoxing twice each year is good practice for optimizing health. However, if you thought learning about environmental toxins was overwhelming, wait until you dig into the multitude of detox programs! Some, in our opinion, encourage a sort of image of your body as impure or dirty, which can impact self-esteem quite negatively. I suppose we hope to educate our clients in a manner that is both empowering, and supported by the literature wherever that data is available. There is most often a middle ground and this has proven true for us with detox as well. The key here is to eat clean and optimize elimination.

Limit your exposures to harmful chemicals. These we devote an entire class to and while yes, it can seem insurmountable, we promise you the effort is not only worth it, but becomes a mindset you enjoy and within which you’ll thrive. I suspect this is not unlike those who spent many years smoking cigarettes, achieved eliminating that very addictive habit, and are now very opposed to the thought of returning to that lifestyle.

Our family now has this mindset about water. Consuming unpurified water is just not acceptable. And did I mention our staff have eliminated the microwave from our office? This did require a bit of an adjustment. These steps span into household products, furniture, bedding, air purification, home maintenance, cooking utensils, and consuming cleansing foods. Yes, all this we discuss without our detox program.

The Emotional Journey

Admittedly, we’ve had an important number of clients who faced rather significant anxiety when the thought of altering their diet was presented. This may result from a history of abuse, eating disorders, addiction, or from deep-seated cultural traditions. We work with these clients especially cautiously, and because our teaching about detox is more about learning how to make smart decisions, in many ways it becomes a life-style change rather than an extreme restriction of food or gross elimination (in every sense of the word).

Food and life transitions can also bring about memories that are unexpected, and sometimes our reactions are a bit out of character to what we expected for the situation. These detox programs can release those emotions to the surprise of their owner. On occasion, we refer for talk therapy, behavioral therapy, or even REM therapy. Holding onto unresolved hurtful emotions can seriously compromise long-term health and most certainly, the success of your detox efforts. Admittedly, only a few sessions of REM therapy completely changed my life after a post-traumatic experience and not because of the specific traumatic experience but because in therapy, it quickly identified emotions I had compartmentalized to my own detriment.

Is this all a great deal of work?

Yes. Is it worth it? Yes. Can the busiest of all adults accomplish this task? Absolutely. If you don’t make time for wellness now, you will have to make time for sickness later. As a practitioner, I can’t tell you how confined I felt trying to help clients within a 90 minute session, which is an absurd amount of time compared to the typical 6 minute visit with a physician. Our responsibility is to educate you – to encourage optimal health. This requires an investment on your part, but we can’t imagine any other way than to address these conditions in a program based heavily in curriculum. Interested in more information? Explore our website. Call our office. Attend one of our free educational sessions. We are eager to share what we’ve learned!

Food For Thought

Food for Thought

"It is much more important to know what sort of patient has a disease than what sort of disease a patient has." Sir William Osler

Food for Thought

Happiness is underrated and critically important to health. Seriously! Unfortunately, many people just have no idea how to be happy. Aviva Romm

Food for Thought

Physicians simply do not have time to be what patients want them to be: open-minded, knowledgeable teachers and caregivers who can hear and understand their needs. Snyderman and Weil

Food for Thought #1

They say that time changes things. But you actually have to change them yourselves. Andy Warhol

Food for Thought

To think is easy. To act is hard. But the hardest thing in the world is to act in accordance with your thinking. Johann Wolfgang von Goether

Food for Thought

"Birth isn’t about avoiding one set of realities in favor of another. It’s about embracing all facets of birth--contradictory, messy, or unpleasant as some might be--as vital to the whole." Rixa Freeze PhD

Food for Thought

Why I appreciate being a certified nurse-midwife, as opposed to choosing another route for midwifery: I feel learning the science is vital so the art of midwifery is safe and effective. Dr. Penny Lane, nurse-midwife

Food for Thought

When the debate is lost, slander becomes the tool of the loser. Socrates

Food for Thought

To accomplish great things, we must not only act but also dream; not only plan, but also believe. Anatole France

Food for Thought

"Science and uncertainty are inseparable companions. Beware of those who are very certain about things. There are no absolute truths in biological sciences - only hypotheses... 'We need to train medical students and residents more in the art of uncertainty and less in the spirit that everything can be known or that it even needs to be known.'" Grimes (1986)

Food for Thought

American physicians are rewarded for doing things to patients, not for keeping them well. Grimes, 1986

Food for Thought

The false idol of technology. "Having a widget screwed into one's scalp has become an American birthright." Grimes, 1986

Food for Thought

"Between 1985 and 1987, a hospital instituted a successful program to reduce its cesarean rate. The rate fell from 18% to 12%, losing the hospital $1 million in revenues - no small sum in those days." Goer & Romano, 2012, p 37

Food for Thought

"Obstetricians are much more likely to perform a cesarean when they wrongly believe the baby weighs 4000 g or more based on sonographic estimates than when the baby actually weighs this much but the obstetrician did not suspect it." Goer & Romaro, 2012, p 35

Food for Thought

"If you play God, you will be blamed for natural disasters." Marsden Wagner (2006)

Food for Thought

An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you know and what you don't. Anatole France

Food for Thought #3

"Birth is not only about making babies. Birth also is about making mothers - strong, competent, capable mothers, who trust themselves and know their inner strength."

Barbara Katz Rothman PhD (1996)

Food for Thought #4

Believe there is always, always, always a way.

When you have exhausted all possibilities, remember this: you haven't. THOMAS EDISON

Food for Thought #5

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." Arthur Schopenhauer

Food for Thought #2

Yet you brought me safely from my mother’s womb and led me to trust you at my mother’s breast.

Psalm 22:9