Maggie McKay (Host): Maybe you've heard of Integrative Medicine, but how much do you know about it? Today, we'll find out how to change your health using it with Dr. Hannah Gordon, naturopathic physician.

Welcome to Together We Rise, a podcast from International Community Health Services. ICHS advocates for health as a human right and welcomes all in need of care, regardless of health, immigration status, or ability to pay. It's great to have you here today, Dr. Gordon. Would you please introduce yourself?

Hannah Gordon, ND: Yes, of course. Thanks for having me. My name is Hannah Gordon, and I'm a naturopathic doctor, and I am the site Medical Director at the International District Clinic for ICHS, and I've been here for about two years. I was recruited here also to expand and deliver Integrative Medicine offerings at this organization. So, excited to be here.

Host: So, let's start with what is integrative medicine?

Hannah Gordon, ND: Yes. So, I'm going to quote some people who have defined it. So, the World Health Organization recognizes Integrative Medicine as the combination of conventional, traditional, complementary, and herbal medicines. The Academic Consortium of Integrative Medicine and Health seeks to advance integrative medicine and health through academic health centers and health systems. So, that's kind of the approach to it. And then, essentially, I could cite a lot of other references, but really the core is that Integrative Medicine includes multiple modalities to support the individual in their own health goals.

I personally believe that Integrative Medicine allows for a missing link in medicine, which is health promotion. Often we focus more on prevention and treatment. And while these are really helpful, there's a little bit less allowance and arguably time on the provider side for teaching individuals around health promotion. And promotion is actually not prevention. We can screen people all day, but not really offer ways to promote health, which includes being mindful of social determinants as well, because we can't deliver the same treatment plan for every individual.

And then, additionally, there's multiple provider types that can provide Integrative Medicine, but we always need to check with what their accrediting training was or that accrediting body to make sure that information and treatment plan is well vetted.

Host: And what's the difference between Holistic Medicine and Integrative Medicine?

Hannah Gordon, ND: Yeah. This term, it's interesting because it runs alongside previously used terms or currently used terms of complementary and alternative, and it really just emphasizes the importance of whole person care, which includes mind, body, and spirit. I think right now integrative medicine is really the most in vogue term. It used to be more complementary and alternative. But now, in my profession profession of Naturopathic Medicine, we're kind of discouraging the term alternative more from the concept that alternative means instead of conventional medicine, which we really don't want to see it as instead of. We want to see it as collaborative, and we really want to present multiple modalities within multiple frameworks to allow for an evidence-informed decision that empowers participants in that shared decision-making with their provider.

And so, the last thing I'll add to is the idea around protected terminology. So for instance, like, I'm a Naturopathic doctor, and I have a certain degree behind it, which is a doctorate, and including residency. The term naturopath is not a protected term. Pretty much anybody can use that term. So if a provider says they provide Integrative Medicine, they're a naturopathic or a naturopath, we really need to, again, back it up with what was the training, what was the education, and then what are those credentials to move forward in those recommendations.

Host: Dr. Gordon, what inspired you to study and specialize in this area?

Hannah Gordon, ND: So, my initial training was as a nurse, and I did pre-med alongside Nursing. And my first job was Cardiac and Cardiothoracic Surgery. I really loved this job. I enjoyed the complexity. I learned a lot with my team. And I also learned we seem to teach people more about the pharmaceuticals they needed to take after the heart attack instead of any sort of diet and lifestyle change to prevent recurrence. And we know per evidence, like we need both, right? Both pharmaceuticals and health promotion are really needed to affect change for individuals as they are healing from these really big procedures and lifesaving procedures. I saw really a complete disconnect between lifesaving and health promotion and prevention. And again, hospital setting is very different than outpatient and primary care, where you actually have time to focus on prevention and promotion in those areas.

So at that time, I then decided to kind of look at a different avenue. I've always been interested in being a provider to have those kind of discussions around like health prevention and promotion. And so, I looked at other options, found Naturopathic Medicine as this interesting dialogue around adding and contributing to the medical system at large. So, I really landed at Bastyr University, which is in Washington State. I got my doctorate in Naturopathic Medicine. The training was really expansive. It added a lens of focusing on evidence-informed treatment plans, which was aimed at the individual's health goals, and this is right alongside Pharmaceuticals as, you know, this is really a part of safe and effective care. And within Naturopathic Medicine, a modality for us is pharmaceuticals. And so, that is an important way to deliver and offer wonderful care.

So, my education really focuses, well, not only just prevention and promotion, but the motivational interviewing part, which is becoming more and more in vogue in Medicine, which is amazing, because really we're trying to figure out what the patient wants. Like what are their goals? How does somebody tick? And only really until we understand that I think that once we understand that we can have an effective treatment plan. I personally resonate really strongly with doctor as teacher, and I really see myself as a partner.

I also want to make a quick note that I do not see this as an exclusion of my other colleagues that I work with, with a wide variety of degree types. I see all provider types as a huge contributor to our large puzzle pieces of Medicine. We are all needed. We all have different and overlapping skills, which makes it just really fun to deliver care with such a wide variety of colleagues. So, I always make that kind of comment. This is never exclusionary. I really think of team-based care from even a colleague perspective in order to affect really great change for our nation.

Host: Have you ever had anyone say to you something like, "I don't trust Alternative Medicine?" And if so, how do you respond to that?

Hannah Gordon, ND: I hear this all the time. Even from 10 years ago, there's maybe less of that commenting, but it's still very common. And a lot of times, it's from my professional colleagues. I encourage a reframing, and then I really just ask them, like, what's their understanding of that term? And then, based on that kind of, then I can provide additional resources, I can educate on Integrative Medicine. A lot of times, it's around my degree type, so Naturopathic Medical training. And so, there's an opportunity. I see it as an opportunity. I think any of us that come with like, "What is that? Why?" And all of that, it's just really an opportunity to have a discussion and educate and learn something from them about what their possible experience was. A lot of times people will have maybe a negative experience based on what patients have said or they've experienced. And really, I think we just need to drill down to that.

And then, I oftentimes include within that discussion, the idea of protected terms like I've already mentioned just so we have our definitions straight. And I think in Medicine, we really would do well to learn more about the wisdom of traditional Medicine. It's been around a lot longer than conventional Medicine. So, I think the reminder for all of us is that there's been a long history that has preceded us. And currently, we're in our current state of Medicine, but it has not been like that for a very long time.

And then, you know, Integrative Medicine, again, is becoming more popular. My conventional colleagues, I've noticed, are jumping on the bandwagon more and more. There's more symposiums. There's more conferences. There's more interest, including specialty care, whether that's outpatient, primary care, community care. It's really cool to watch.

And then, my plug is I think we need to recognize that there's multiple provider types that offer this and that we don't need to exclude them. I think we need to continue to embrace them and pull them into the system versus keeping any of them out, because really all that matters is high quality patient care.

Host: Do you take part in any activities that are typically associated with this field, like yoga or meditation or something like that?

Hannah Gordon, ND: Yeah, it's interesting. I also get that question where sometimes I'm like, "Huh, why is that associated?" I personally don't associate those with Integrative Medicine. And I think the idea around you have to do those things as the entrance to Integrative Medicine, I really kind of push back on when I get these questions. Sometimes, I think in this country there's a little bit of a privilege sense around some of those terms as if you need to be healthy and natural by doing yoga. And therefore, you're like naturopathic or integrative or something. So, I really push a little bit back on that.

Yoga. Meditation, obviously awesome. Whether that's personal practice, whether you go to a classroom, whether you do retreats, amazing. I also think people who take walks in the woods that are quiet and don't have the income to actually pay for maybe a yoga class that's outside of their budget, I think, can equally bring as much peace and quietude to their life and is well-focused on what their needs are. So, I think both are valid, and I think it's keeping that expansiveness on like what resonates with that person and what they like to do.

I personally love being outside, love being in nature. I'm probably more of a kickboxing personality. I like rock climbing. I like biking. And I think even with my personality of being a little bit more on the fast, need-to-keep-movement-and-going, I often talk to patients, especially those with really high anxiety, around maybe matching those feelings versus combating it. I feel like so many times either I was told to calm down or we tell patients, "Oh, just calm down. Don't have anxiety," not helpful. And so, sometimes I'll talk to people about matching those symptoms. So like, "Okay, maybe we're having a little bit of a high heart rate. We're sweating. We're not feeling very good. We're really anxious. How about let's go for a walk? How about let's go for a run?" Let's match what's physically going on with actually what is going on in your mind versus being like, "Oh my gosh, I'm just going to sit here and feel all these things." Some people resonate with that idea. Some people do not. And they'd rather stay quiet or do the meditation, which is great. I don't care personally. I want to know what the patient needs so that we can have that educated conversation, and they can use those skills to maybe help calm down, get them out of that panic attack or anxiety situation.

Host: Are there any specific conditions best suited for this type of treatment?

Hannah Gordon, ND: I like to say everything. I think more from the perspective, right? Like multiple modalities need to be utilized to affect health outcomes and change. I think the biggest focus, in my opinion, to teach people about their body is to give simple ideas and then see what happens. You know, a lot of times in Medicine, I think we have kind of a top-down approach, which is common, and that's regardless of the provider type. And I don't want patients to feel like they are dependent on me. It's a little like the saying goes, "I want to teach someone to fish, not just keep giving them fish." And, you know, I can prescribe a supplement or a pharmaceutical in the same exact way. So, one is not better. It's not an exchange. But I think it's how we approach the prescribing that can really be quite different.

I personally, as far as conditions, really love to look at the combination of hypertension, high cholesterol, and diabetes. There's an incredible amount of overlap with those three diagnoses that we can have pretty simple plans to help affect health outcomes. And of course, everybody's got different genetic cards, right? And so, we have to look at those very specifically for what the patient needs. But I think there's a really incredible overlap that I personally like to work with to try to, I don't know, have that simple, elegant plan that doesn't overwhelm any individual.

 And then, I really also like focusing on pain. So during my schooling, I focused and did a lot more training on manual therapies. So, I do craniosacral therapy. I do visceral manip. I osteopathic manipulative therapy, which is kind of like chiropractic adjustments; manual trigger point therapy, muscle energy stretching. I love all of the hands-on because I think there is pain is wrapped up in so many spaces within our body, whether that's the mind, whether that's certain areas. And I think it's really important to use that physical piece to allow for some mind-body connection. And whether that's to help manage chronic pain that is not going to go away, maybe it's to alleviate an acute pain, but I think that connection is really important. So, those are some of the things I resonate with and really enjoy, but technically the answer is everything.

Host: That's awesome. Well, this has been so fascinating and informative. Thank you so much for sharing your expertise and sharing with us today.

Hannah Gordon, ND: Well, it's my pleasure being here. Thanks for the interview.

Host: Absolutely. Again, that's Dr. Hannah Gordon. To learn more, you can check out our website at ichs.com. Again, that's ichs.com. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Together We Rise, a podcast from International Community Health Services.