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Integrating Practice: The Complex Relationship between Traditional and Modern

Despite my ramblings on plant medicine and my years of training as an herbalist, I consider myself a medical provider first. I spend most of my days at my practice office, where I see patients five days a week. And then, yes, I also maintain an herbal practice, teach and work weekly with my apprentices, but this is not the meat and potatoes of what I do. I am a nurse practitioner, despite being an “integrative” one. But what does that actually mean? How do does traditional medicine and modern medicine fit together? And lastly (and maybe most importantly), What we should we expect from providers and from herbalists regarding what they know about each other’s worlds?

I started my career as an herbalist first. I apprenticed for five years with the same teacher and completed various other academic herbal programs in addition. Most of that was completed before I even went to NP school. In fact, when I was in school, my herbal life was mostly put on the back burner – some of that was the necessity of being a full-time student, but some of it was just a shift of interest. There was this whole new world that was opening up to me – a world of ECGs and x-rays and lab tests and diagnoses. While I had dealt with a lot of that when I was an ICU nurse, it was different when I became a provider. I was starting to hold people’s health in my hands and that requires a great deal of attention. A lot of attention in fact. Other things had to wait.

When I got back to seeing clients as an herbalist, it had been at least four years since I had seen the last one. As you can imagine, it then took a lot of time to catch back up on that also and keep pushing my skills foward. At first, I thought what I did as an herbalist – teaching, practicing, etc. – would sort of be separate from what I did in my medical world. I had had dreams of integrating the two sorts of practice together but honestly had no idea how to do that or what that even really entailed. I had also in years past become fairy disillusioned with the “integrative medicine” world – after several conferences on functional medicine and in-depth involvement with local holistic health communities, I actually did not want much to do with those worlds. There seemed to be a deep hatred of modern medicine while at the same time, a complete misunderstanding of the principles of traditional herbalism.

Since then, I have undergone a shift in my thinking about what it means to be integrative. A person, whatever sort of healing they practice, doesn’t need anything but a shifted mindset in order to claim this title. It involves an openness – that the goal of assisting someone with a path to wellness should include whatever tools are going to help that person along, without judgement or hostility. It is the openness that defines what it means to bridge the gap.

Thinking about it like that, its easier to see how all different sorts of healing could potentially fit together. When the patient or client is at the center, then the rest of it really doesn’t matter. Our goal as practitioners is to help people however we can, to help people be as health as they can be – and sometimes that might mean raspberry tea, other times it might mean yoga, and other times it might mean blood pressure medication or a trip to the emergency department. It never means going off on a rant about how medications are poison or how herbs are useless, because both of those statements are ridiculous and don’t actually help anyone.

Cross training helps. It helps to know that gingko can thin the blood and shouldn’t be taken with blood thinners. It helps to know how to break down a CBC when a client comes to you with lab results. It helps to know how to advise a post-menopausal woman on diet changes for weight loss. All of this is good stuff. But it is also unrealistic to expect that a practicing Western medical provider be 100% versed in traditional medicine, and the opposite is also true – we cant expect traditional healers to function as doctors. There seems to be a of negativity going around lately in the holistic community shaming doctors because they don’t know the ins and outs of the latest applications of dandelion root, or something similar. But why should we expect medical professionals to have a comprehensive knowledge of traditional healing methods? We don’t expect herbalists to know how to interpret a CT scan and we don’t expect acupuncturists to know how to assess whether a skin lesion is suspicious. Why is that? To me, expecting a medical provider to know absolutely everything about the various worlds of traditional healing but not expect it to go the other way just plays into the idea that Western medical care must absolutely be at the center of everything in a person’s health journey. And its not. It is one aspect of someone’s care done by folks who are well trained in that one aspect. And part of being an integrated practitioner of any kind is knowing when to refer to a different expert for a different kind of care. And that’s ok.

So how do we reconcile this. What I can tell you is that building the bridge is a great deal simpler than it may seem. It doesn’t take fancy degrees or certifications, although this is not to say that building experience and expertise is not important. Here’s a few things that I do believe it takes, based on my own experience and that of other practitioners I know and respect:

1. Network relationships with professionals outside of your skill set or comfort zone. Get to know other people doing other kinds of health work. I guarantee they have something to teach you.

2. Ask patients or clients what they need and where they are in their journey. While medical providers in particular are bound by nationwide guidelines of which we must be mindful if we’d like to keep our licenses, knowing someone’s preferences and comfort levels with various sorts of interventions and treatments should be part of any decent intake. It should also be part of the ongoing conversation.

3. Keep an open mind! At the end of the day, this isn’t about us. Its about them. And we don’t know everything and continuing education and learning is part of the gig. And on that note – a little humility goes a long way.

4. As providers, we are teammates. We are not authoritarian dictators. We do not go home in the bodies of the folks we are trying to help and those bodies do not belong to us. Listen to what people are telling you about their bodies.

5. Lastly, remember that interactions with health professionals of any kind can be really anxious provoking. Patients and clients share thing with us that they don’t share with other people and there is a great deal of honor and privilege in that. Check your body language, actual language and reactions. Practice trauma informed care – help people feel safe in the space you provide to them.

These are the real keys to creating an integrative practice. And again, while I am not discounting the importance of all of us having at least a basic knowledge of different healing modalities, does it really matter if we don’t? I personally would rather have a practitioner who can look at me and say “I don’t have expertise on this, but let me help you find someone who does”, than a practitioner who spends more time in judgement than in help. Yes, more doctors need training in commonly used herbs, nutritional interventions and preventative wellness. More of us that do bridge the gap need to get involved in helping colleagues find that sort of training and advocate for it at our universities and organizations, but that is a post for a different time, and for a different audience. However, the word holistic doesn’t mean knowing the whole of everything. It means treating the whole person. The whole person is a mind, a body and a soul, if that is what that person believes (not what you believe). It is possible to not know everything and still be a practitioner that respects the whole picture of your patient or your client. All you actually have to do is listen to them.

And I promise you, at the end of the day, that’s all that any of us really want from the people taking out health journeys with us.

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