Conscious Choice Seattle: Best Practices

March 2004 | Cover Story

Best Practices

The six steps to follow for finding the best natural health practitioners in the Puget Sound

BY BOB CONDOR

People come into her office at the Kirkland Holistic Center every day looking for a referral to a natural health practitioner. So CJay—that’s her name, first, last, only—has a ready set of questions. She listens carefully to the answers.

“First I want to know the person’s definition of wellness,” says CJay, an administrator and massage therapist at the healing center. “Next, I ask how they see themselves fitting into that picture of wellness, what therapies will help them accomplish results. It’s important to gauge how clearly someone is thinking.”

Step 1: Be clear about what you want from a natural therapy.

Most of us need to take one step back before we can find the best natural health practitioners in the Puget Sound area—and there are plenty out there. We have to start with the basics. Why are you seeking a practitioner? What result will satisfy you (it’s okay to think big)? You can’t find the right person without first uncovering the right reasons—or the right therapy.

For example, CJay recently counseled a man in her office who wanted to know about guided imagery classes at the Kirkland center. She asked about his goal for the class. She found out the man was hoping to lose weight and wanted to do more than simply go on another diet. That led her to talk about other options that might be more effective, such as seeing a hypnotherapist or a naturopathic physician/acupuncturist who specializes in weight control.

The man left with some leads and a more specific plan for finding the best practitioner.

Step 2: Ask people you trust for a referral.

Lesson No. 2 is a consensus point among every expert interviewed: Ask other people which practitioners they see for natural health care, who they like, who they trust. Word-of-mouth referrals are time-tested in both conventional and integrative medicine. It is a critical step to finding the best practitioner.

“What’s important is to get recommendations from people who match your style,” says Dr. Christy Lee-Engel, a naturopathic physician and licensed acupuncturist with a practice at One Sky Medicine in the Lake City neighborhood. “You will be happiest with referrals from like-minded thinkers.”

“Ask people you know well enough to trust their assessment,” says Dr. Ralph Golan, a Seattle holistic M.D. and author of the respected book “Optimal Wellness: Where Mainstream and Alternative Medicine Meet.” “When they recommend someone highly, then you can feel confident.”

Lee-Engel says it is ideal to find a “nexus type” person in the health care profession. That’s someone who knows a lot about local practitioners and their work styles. It might be a massage therapist, chiropractor, social worker or nurse. As a faculty member at Bastyr University, she instructs naturopathic medical students themselves to seek out nexus persons as they build a base of knowledge and skills.

Step 3: Find out about any prospective practitioner’s credentials and experience.

“Getting a recommendation from a friend shouldn’t be your only source of information,” says Steve Given, coordinator of the acupuncture and Oriental medicine clinic at the Bastyr Center for Natural Health. “Get clear on a practitioner’s background and specialties.”

We are fortunate here in the Puget Sound area to have a built-in advantage. Bastyr is a leading natural-medicine university with rigorous standards for both clinical skills and scientific inquiry. Any practitioner with a degree from Bastyr—from naturopathy to acupuncture to nutrition to health psychology—has undergone solid training. There are lots of Bastyr graduates tending to our natural-health needs in communities from Tacoma to Everett and West Seattle to Bellevue and beyond. The university’s Internet site (www.bastyr.edu) is a valuable resource.

Be wary of practitioners with degrees from “schools” that are hard to research in depth (even on the Web) or don’t require experience with actual patients or clients. Some specialties, such as naturopathy and acupuncture, require licensing, which helps provide consumer protection. Other natural-health modalities are not as regulated. Certain health-care professionals, such as massage therapists and reflexologists, have benefited from national movements to certify practitioners in that area.

Superior health care is steeped in experience. Credentials are one step. Ask about the practitioner’s areas of expertise, what sorts of successes he or she is having with what sorts of patients. Don’t hesitate to ask for numbers of patients or clinical hours. If you were undergoing orthopedic surgery, you would want to know if the doctor does several operations or more each week or maybe a handful every year. There’s a big difference, especially as it translates to your healing.

“For instance, your friend might recommend a medical doctor who has performed as little as 200 hours of acupuncture on patients,” says Given. “A licensed acupuncturist will have thousands of hours of experience.”

What’s more, not all practitioners approach their specialty the same way. Given explains there are several popular forms of acupuncture. Some are better suited for patients who don’t mind feeling the presence of a needle while other acupuncture disciplines are perceived as gentler by patients. Bodywork practitioners and energy healers work in a lot of different ways. Ask for some description of the healing work before you start treatments.

Step 4: Ask for a free consultation.

Part of determining credentials and the right fit between patient and practitioner is a face-to-face meeting. If you have any concerns or doubts about whether a practitioner is right for you, request a free consultation. That’s the fourth lesson in this Evergreen Monthly guide. Do your investigative work in the form of a personal meeting with the health-care professional.

“It is your opportunity to interview the practitioner,” says CJay. “It is not focused on what ails you. That is saved for an actual visit. Stay on the subject of learning the practitioner’s approach and experience. If the practitioner is not willing to do a consultation, don’t go to that practitioner.”

The consult meeting might be as little as 10 minutes with a busy doctor such as Golan. But if you get a practitioner’s full attention, that is enough time to size up the potential relationship. It’s even time to get an impression or instinct about the practitioner; you might call it “picking up a vibe.” Some practitioners hold “open office” days to educate potential clients in a more informal gathering. Even then, stick with direct questions.
In any case, it is smart to ask about educational background, training, certification and continuing education in every case. A practitioner with evasive or vague answers is not a good choice. It is also a warning signal if the practitioner “rushes” your interview to get into a paid part of the visit.

On the other hand, understand that it can be difficult for a practitioner to answer questions such as “How many treatments will it take to fix my problem?” without more information about your condition. One acupuncturist said a rough rule of thumb is it requires a month of twice-weekly treatments for every year someone has endured a chronic condition, but then quickly added it is a rule with a fair share of exceptions.

There are exceptions to this step of asking for free consultation. Some practitioners are not necessarily looking for new patients or clients, so they might not schedule many get-to-know-me sessions. If you have heard wonderful reports about the practitioner, it might be worth paying for an appointment time. The reasonable practitioner is likely to reduce or waive the fee if somehow you agree he/she can’t help you.

Step 5: Size up the practitioner’s support staff and healing organization.

“In the end, after you get personal referrals, you will want to call the practitioner’s office and talk to a member of the staff,” says Golan. “You can request information, get materials mailed or find out the Web site. You can ask questions about the practitioner’s experience, how long they have been in practice. You will begin to learn about whether this practice will be healing and supportive for you.”

Golan’s point can be underscored by recalling any medical problem that required conventional treatment. Typically you interact with the nurse or physician’s assistant about as much—and sometimes more—than the doctor herself. If your practitioner has support staff, you want to size up their talents, especially the ability to help you get better.

Perhaps even more important are the practitioner’s associates. Some practices have different therapists available to address your health concerns. One of Lee-Engel’s partners at One Sky Medicine is a M.D. and shamanic healer. She provides acupuncture treatments to the patients of fellow doctors.

“The best of integrative medicine comes in the form of an integrated team,” says Lee-Engel.

If you see a solo practitioner, then you want to be assured he or she can refer you when necessary. Don’t be afraid to ask about whether the practitioner can offer some names of other providers, or how to tap into resources. It’s similar to asking a doctor if he has admitting privileges at a preferred hospital. When a health crisis arises, you want a full complement of healing possibilities.

Step. 6: Listen to your own body; pick a treatment that motivates you.

The final step is a worthy reminder to stay focused on why you starting looking for a practitioner in the first place. It is particularly good advice for anyone with chronic health troubles.

“Listen to your body every day,” says CJay, 34, who speaks from the experience of someone who severely injured her neck in a 2000 snowboarding accident and endured two years of conventional orthopedic care before a chiropractor discovered her problem (ruptured discs where the neck and shoulders meet). “Don’t slide on that point. Be proactive and accountable to yourself. You live in that body. Treat it right.”

Dr. Linda L. Issacs is a M.D. who has worked nearly two decades with famed alternative cancer care Dr. Nicholas Gonzalez, who is based in New York and noted for several pioneering federal research studies on nutrition-based therapies. She wrote these passages in an archive issue of the Townsend Letter for Doctors & Patients, the longtime integrative medicine newsletter published by Dr. Jonathan Collin of Port Townsend and Kirkland:

“We realized very quickly that patients who had not thought through their treatment choice stuck with their program long enough to see if it worked.

“ … If a particular treatment involves something that you simply will not do, look elsewhere. For example, a part of our therapy that people frequently find unappealing is the detoxification routine called the coffee enema. Most patients, once they try the coffee enemas, report that they like them very much because they make them feel better. We routinely hear from startled patients that the coffee enemas have become their favorite activity of the day.

“However, callers sometimes ask if we can design a program that does not include coffee enemas, because they will not do them or have decided that the enemas are unnecessary. We simply suggest that these patients find a program they are willing to do.”

Part of deciding for yourself is realizing when a practitioner is helping you and when not. If the practitioner said it would require x number of treatments or y weeks, and you’re past that point without results, it is time to reconsider your options. It can be daunting to find another health professional—or another therapy altogether—but that is often the best next step. It starts with you.

“I listened to everybody else for two years,” recalls CJay about her neck. “I finally figured out it was time to pay attention to me.”

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