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I am no longer married to my children’s father, and obviously we have our differences. The temptation to make every conversation hostile and polarizing can be substantial, particularly when we are discussing topics about which we feel passionately. However, at the end of the day, the well- being of the people we care most about, our three offspring, has to trump any desire we might have to be “right” all the time, or to prove the other “wrong”. The kids love both of us and both opinions matter to them.
In many ways, my former husband and I had better training for this process than most divorced parents: I am a Western physician and he is an acupuncturist, and we took care of the same patients with some regularity. In the rural community where we lived, it was pretty common for patients to seek care from both the doctors at the hospital and the herbalists and acupuncturists who tended to work out of their homes. The town was too small for polarization and undermining, and if we did have an opinion about our cardiac patient’s Reiki master, it was best expressed in a tone that was respectful and kept the patient’s autonomy and safety as top priority. A patient visit is no time to grind an axe, particularly about a provider to whom the patient may feel great affection and loyalty.
The feature article of this edition of OFP reviews botanical interventions for treatment of diabetes. The use of plant- based medication is as old as aspirin and as contemporary as medical cannabis, and is bound to stir a great many passionate opinions on all sides of the discussion. Proponents will describe their patient or relative whose rheumatoid arthritis was pushed into remission using entirely herbal products, or whose menopausal symptoms finally got under control after she talked to her midwife about the cohoshes. Those who are more antagonistic toward botanical therapies may have come by that opinion honestly, and are easily drawn out about the “hippie idiot” who threw themselves into pulmonary edema after drinking copious amounts of a Chinese herbal tea, or the gentleman whose heart attack could have been prevented if his wife would have just allowed him to go on a statin rather than the yeast product she had read about.
A more measured approach would suggest we review the evidence, which is usually a good stance when exploring any intervention, even though not all botanicals have a delivery system which is easily subjected to placebo-controlled double blind studies. The reality is, though, that many of our patients are going to use herbal supplements or plant-based products whether we like it or not, and it may be more productive to keep the lines of communication open than to state, either with words or our sneering body language, that we think botanicals are a bunch of wacky voodoo.
Whether we are cheerleaders for our complementary/ alternative counterparts, respectful team members, or suspicious but worthy adversaries (remembering some of them aren’t our biggest fans, either), it is our patients who matter, and there is no more important tool for the osteopathic family physician than the relationship we have with the people we serve. And just as my children have a relationship with their father that has little to do with my opinion or feelings about him, our patients have relationships with providers whom we may not trust or whose management we question. It does not help our own learning process, our professional credibility, or our patient’s trust in us to create an environment in which a patient would be ridiculed for adding a botanical or energetic therapy to her regimen, or in which she feels that she has to lie to us in order to seek care from a person she admires and trusts. We need to be “co-parents”. We need to be a medical home that is truly patient-centered.
Please enjoy this edition of the OFP, and we hope you get something useful out of the conversations it may spark.
Osteopathic Family Physician 2014 Call for Papers
Editor-in-Chief – Merideth C. Norris, DO, FACOFP Associate Editor – Amy Keenum, DO, PharmD
Call for Papers
About Osteopathic Family Physician: Osteopathic Family Physician is the ACOFP’s official peer-reviewed journal. The bi-monthly publication
features original research, case reports and articles about
preventive medicine, managed care, osteopathic principles and practices, pain management, public health, medical education and practice management.
Instructions for Authors:
Reserve a review article topic today by emailing ACOFP Managing Editor Belinda Bombei at belindab@acofp.org. Please provide your name and the review title you would like to reserve. Available review titles appear in the right- hand column.
Once you reserve a review article topic, you will receive an email confirmation from ACOFP. This will initiate a three-month deadline for submission. If the paper is not received within three months, the system will release the review article topic for other authors to reserve.
Osteopathic Family Physician Call for Paper Topics
» Abnormal Loss of Weight
» Anemia
» Chest Pain (Request OMT component in this paper)
» Constipation (Request OMT component in this paper)
» Dysuria
» Hemorrhoids
» Monetary Incentives in Care - Both the Ethics, and How Do I Calculate my RVU Bonus?
» Nausea with Vomiting
» Otitis Media, Acute
» Osteopathy: Beyond OMM
» Sprain/Strain Neck (Request OMT component in this paper)
Didactic Images
We are seeking clinical images from the wards that covers essential concepts or subject matter to the primary care physician. Please provide a brief synopsis of how the case presented along with 1-4 questions and approximately 1 page of education with reference to the image and questions.