Thursday, March 4, 2010
Monday, March 1, 2010
What is a doctor?
The mind body expo this weekend in Minneapolis gave me a different perspective on my title. If I said I was a "doctor" or a "physician" I got constant requests for clarification! The only unambiguous title was "MD" but this was not always a welcome one. Considering insurance companies now insist on calling me a "provider" (which I always thought was something I helped do for my family, being one of only two) I'm beginning to wonder if society has a role for people like me. Surely the education, study and practice of the past 30 years are of value. I know my skills are helpful to people and believe in my own worth independent of titles, but they do help people understand roles. I am not really ready to given them up either to generalization from "physicians" who have had much less training, or to be downgraded by insurance to a generic cog in the wheel- the role is only to see patients and generate revenue.
This brings me to what I should call the people who come to me for care. For decades I have used the term "patient" (and many of them have been VERY PATIENT with me, especially in the early years!) but I am coming to prefer the more modern term of client. This puts us on more of an equal footing which I do like. We are really collaborators in health.
Once the relationship is established, I don't think it matters as much what we call each other, but names do have implications.
This brings me to what I should call the people who come to me for care. For decades I have used the term "patient" (and many of them have been VERY PATIENT with me, especially in the early years!) but I am coming to prefer the more modern term of client. This puts us on more of an equal footing which I do like. We are really collaborators in health.
Once the relationship is established, I don't think it matters as much what we call each other, but names do have implications.
Friday, February 19, 2010
Where am I today?
My decision to act this time resulted in a shorter delay than initially! I started our program Jan 1st, 2010 and have lost 20 pounds already! Although fully aware of the importance of proper balance in my diet and the need for regular exercise, I still struggle. Schedule changes have made my old positive patterns more difficult regarding exercise, and the cycle of splurging on carbs is hard to break! Focusing on developing new patterns seems to be working better than "getting back" to my old ones, since it is now clear that my old patterns are not possible.
Spirituality and centernedness are the cornerstones of the patterns I am now trying to develop. I can do daily Yoga before I even leave the house and focus on being centered when I eat. Lent is a good time to focus on spirituality and face one's darker side. Repentance is turning away in a Wholistic sense, body mind and spirit. Perhaps this will be a useful and inspiring concept for me over the next several weeks.
Spirituality and centernedness are the cornerstones of the patterns I am now trying to develop. I can do daily Yoga before I even leave the house and focus on being centered when I eat. Lent is a good time to focus on spirituality and face one's darker side. Repentance is turning away in a Wholistic sense, body mind and spirit. Perhaps this will be a useful and inspiring concept for me over the next several weeks.
Thursday, February 18, 2010
What is Wholistic Health?
As a starting place, for a practitioner to be "wholistic" there must be a genuine acknowledgement of Body, Mind and Spirit as related. My belief is that they are inseparable aspects of the same reality. To use the theological concept, a trinity. This is a multi-directional webwork of relationships. What affects the body affects the spirit and affects the mind. This is true of any permutation you can imagine. At Sage, each of our staff from reception to physician buys into this concept.
There needs to be a willingness to address each of these major areas in more than a superficial way. A complex web does not lend itself to a single program or a uni-directional approach. There needs to be an understanding that relationships are multi-directional and what affects one aspect will affect others in often unforeseen ways. Each strand has intrinsic value and a contribution to make. At Sage we have collected providers of as many different modalities to address as many different aspects as possible. (See our website: www.sageweightandwellness.com) We are open to others as availability and need present themselves.
Wholistic medicine is also integrative. It in not just a collection of different practitioners under one roof. To be wholistic, the model itself must be integrated. At Sage, we talk with each other, have a common record, share information and ideas and act as collaborators with our clients in their transformation to health. At a very real level we have a common mind, common body and common spirit.
These concepts need, themselves, to be more than mental constructs! They need to be integrated into the hearts and souls of those who would serve others. At Sage Weight and Wellness we have recruited an entire staff who not only acknowledge this but put it into practice in their own lives as well as their relationship with our clients.
I do not mean to imply that the "medical model" has no value. It is very valuable but is only one strand. As a strand, its values must be respected, including: the scientific method, "evidence based medicine," technology, and pharmacology among others. Wholistic Medicine is not simply discarding Western Medicine for other "alternatives" which may or may not be superior in a given situation. At Sage, we get this. You will not hear us badmouthing doctors or discounting science. We ARE aware, however, that Western Medicine is only ONE perspective.
Although as an entity, Sage Weight and Wellness has only existed for four years, our staff has been involved for decades. As a physician, my initial choice of Family Practice was heavily influenced by the fact that it recognizes relationships and family systems as important to health. It was the closest thing to wholistic or integrative medicine that existed 30 years ago! I have not abandoned this approach, but only expanded and deepened it. My recent Bush Fellowship, in Traditional and Alternative Treatments for Obesity, my experience and explorations into meditation, yoga, exercise and many other disciplines are evidence not just of an interest but a commitment.
My work with the Episcopal Church Pension Fund through CREDO has further broadened my understanding to include financial, and vocational aspects of health as well as physical and spiritual. Our other staff also have long journeys in wellness which need to be respected, but which I will not detail here.
I welcome questions or comments. Come and see for yourself! I'd love to show you around!
There needs to be a willingness to address each of these major areas in more than a superficial way. A complex web does not lend itself to a single program or a uni-directional approach. There needs to be an understanding that relationships are multi-directional and what affects one aspect will affect others in often unforeseen ways. Each strand has intrinsic value and a contribution to make. At Sage we have collected providers of as many different modalities to address as many different aspects as possible. (See our website: www.sageweightandwellness.com) We are open to others as availability and need present themselves.
Wholistic medicine is also integrative. It in not just a collection of different practitioners under one roof. To be wholistic, the model itself must be integrated. At Sage, we talk with each other, have a common record, share information and ideas and act as collaborators with our clients in their transformation to health. At a very real level we have a common mind, common body and common spirit.
These concepts need, themselves, to be more than mental constructs! They need to be integrated into the hearts and souls of those who would serve others. At Sage Weight and Wellness we have recruited an entire staff who not only acknowledge this but put it into practice in their own lives as well as their relationship with our clients.
I do not mean to imply that the "medical model" has no value. It is very valuable but is only one strand. As a strand, its values must be respected, including: the scientific method, "evidence based medicine," technology, and pharmacology among others. Wholistic Medicine is not simply discarding Western Medicine for other "alternatives" which may or may not be superior in a given situation. At Sage, we get this. You will not hear us badmouthing doctors or discounting science. We ARE aware, however, that Western Medicine is only ONE perspective.
Although as an entity, Sage Weight and Wellness has only existed for four years, our staff has been involved for decades. As a physician, my initial choice of Family Practice was heavily influenced by the fact that it recognizes relationships and family systems as important to health. It was the closest thing to wholistic or integrative medicine that existed 30 years ago! I have not abandoned this approach, but only expanded and deepened it. My recent Bush Fellowship, in Traditional and Alternative Treatments for Obesity, my experience and explorations into meditation, yoga, exercise and many other disciplines are evidence not just of an interest but a commitment.
My work with the Episcopal Church Pension Fund through CREDO has further broadened my understanding to include financial, and vocational aspects of health as well as physical and spiritual. Our other staff also have long journeys in wellness which need to be respected, but which I will not detail here.
I welcome questions or comments. Come and see for yourself! I'd love to show you around!
Wednesday, February 17, 2010
Physician Heal Thyself!
As I continued to adjust to running a business and all that involved my stress levels grew and my waist line with them! Excuses were too easy: I don't have time, I'm too tired, if I can just get ahead a little then... or I'll start tomorrow. Listening to myself talk to clients about their weight was educational. What I knew in my head had not yet made it down past my neck! Tomorrow was becoming a long way off. I had regained half of my former loss and it was time to do something. "Physician heal thyself!" But what I learned was even with all my knowledge and experience I could NOT do it myself! Fortunately I have the best staff in the world! (Come meet them and you'll see!) When I looked in the mirror and got on the scale, the change was evident. I was also starting to have the return of fatigue, less exercise capacity, more back pains and generally not feeling as well. I had regained almost half of the 60 pounds I initially lost. Time to act.
Monday, February 15, 2010
A New Venture
Our next major development was moving out of New Prague Clinic. This move could be more about the history of Sage than my personal history, but it did change the dynamics for me personally. I learned (or rather was reminded, since I have been in solo practice before) how stressful having a business can be. I had lost most of my excess weight and managed to follow my own advice as well as what I had learned from The National Weight Loss Register about keys to long term success. Soon after the move, I was accepted as a Bush Fellow to study traditional and alternative treatments for obesity in children, adolescents and adults.
There was some stress related re-gain of weight but only a few pounds and my program was on course. Having the Bush fellowship was exciting and in spite of the stress of having a business, things were going well. Focusing on helping others was beneficial for my own health. For me, key in staying healthy was exercise daily in the moderate to vigorous range, monitoring diet, eating breakfast and limiting my carbohydrate intake. I had learned my lessons, or so I thought....
There was some stress related re-gain of weight but only a few pounds and my program was on course. Having the Bush fellowship was exciting and in spite of the stress of having a business, things were going well. Focusing on helping others was beneficial for my own health. For me, key in staying healthy was exercise daily in the moderate to vigorous range, monitoring diet, eating breakfast and limiting my carbohydrate intake. I had learned my lessons, or so I thought....
So what is OPTIFAST?
OPTIFAST is a trademark of Nestle nutrition. It is a formula based diet (shakes and bars) which allows a physician to utilize a very low calorie diet with patients. It is specially balanced and formulated to allow for an intake as low as 800 kcal and still maintain full nutrition, vitmain and minteral intake, and avoid starvation response. Because of it's restricted nature it is only safe when used under a physician's care. It is only one tool which can be used for weight loss and is only effective if combinted with nutrition education, behavior change, and exercise. It is mostly for people hoping to lose more than 50 pounds or those with medical problems related to weight.
The principles involved include proper balance of protein, fat and carbohydrate. This balance helps reduce hunger. Another is called "stimulus narrowing". I call this the "reverse buffet" effect. When we go to a buffet we overeat in part because of all the stimulation of seeing and smelling the food. It seems we are taking small amounts but we take and eat more than we think. By limiting choices, we eat less. having a choice of only shakes, soup, and bars in a few flavors, just makes people lose interest.
There is a lot more information on the OPTIFAST website. Most of the questions I get have to do with safety (only under MD supervision) and weight regain (no more than any other program and dependent on PEOPLE STAYING ACTIVE in their treatment.)
Although we utilize this tool a lot, we never force people to choose it. It can be very effective, however.
The principles involved include proper balance of protein, fat and carbohydrate. This balance helps reduce hunger. Another is called "stimulus narrowing". I call this the "reverse buffet" effect. When we go to a buffet we overeat in part because of all the stimulation of seeing and smelling the food. It seems we are taking small amounts but we take and eat more than we think. By limiting choices, we eat less. having a choice of only shakes, soup, and bars in a few flavors, just makes people lose interest.
There is a lot more information on the OPTIFAST website. Most of the questions I get have to do with safety (only under MD supervision) and weight regain (no more than any other program and dependent on PEOPLE STAYING ACTIVE in their treatment.)
Although we utilize this tool a lot, we never force people to choose it. It can be very effective, however.
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