| 2015 Q1 | story by ANNE BROCKHOFF | photos by STEVEN HERTZOG |
Anxiety, hormone imbalances, disrupted sleep, depression—Emily Curran Day suffered from all of them in her late 20s. As a nurse, she knew none of it was normal for an otherwise healthy young woman, but she worried that any conventional treatment would address only her symptoms. She wanted more than that.
Day wanted to understand and cure the underlying cause of her ailments, so in 2009 she made an appointment with the University of Kansas Medical Center’s Integrative Medicine Clinic in Kansas City, Kan. A comprehensive screening revealed Day was intolerant of dairy and gluten, so she cut them from her diet. She also began an individualized supplement program and made other lifestyle changes. Over time, her health improved.
“Yes, I was pursing something alternative, but it made intuitive sense,” Day said.
So much sense, in fact, that she joined the clinic as an advance practice nurse.
“A lot of us who work here were drawn to this clinic by our own various health reasons,” Day says. “We try to walk the talk, not for the sake of being examples, but because it’s what we believe.”
Day isn’t the only one. Almost 40 percent of Americans use health care practices developed outside mainstream or Western medicine, according to the National Institutes of Health’s National Center for Complementary and Integrative Health.
These approaches are often truly complementary, used in tandem with conventional medicine rather than as a replacement for it.
For many, that means practicing yoga or meditation, getting a massage, changing their diet or choosing herbal supplements on their own. However, an increasing number are also seeking care from integrative medical clinics, such as KU’s and from naturopathic doctors.
What’s the difference? Integrative medicine brings a range of non-traditional therapies into a hospital or clinical setting. At KU Med Center’s clinic, physicians, a naturopathic doctor, nurses, neurofeedback technicians and registered dietitians strive to, as the website puts it, “nourish the whole person and stimulate the body’s natural healing response.”
Naturopathic doctors share the same goal, whether they’re located within such a clinic or operate a stand-alone practice—or both, as is the case with Natural Medical Care in Lawrence.
The group has three physicians: Mehdi Khosh, Farhang Khosh and Deena Beneda, who all work out of their office at Wakarusa Drive and Research Park Way. Services there include nutritional and dietary assessments; lifestyle counseling; acupuncture; botanical, or herbal, medicines; homeopathy (remedies made from herbs, plants, minerals and other natural ingredients) and laboratory, allergy and other testing.
Mehdi Khosh and Beneda also treat patients at the Satsun Center of Integrative Health Care in Overland Park offering family medicine; naturopathy; acupuncture and Chinese medicine; mental health and wellness; bodywork and energy healing and nutrition and lifestyle coaching.
Regardless of location, their approach is not a replacement for primary care, Mehdi Khosh says. Rather, he sees it as a collaboration with a patient’s other physicians to treat illness, fortify the body’s natural defenses and build a base for long-term health.
“It is a partnership,” Farhang Khosh agrees. “I want to establish a very healthy relationship with the other doctors here for the sake of the patients.”
While naturopathy is still relatively new in Kansas, it’s a long-held family tradition for the Khosh brothers. They grew up in Iran, grandsons of a well-regarded physician and direct descendants of Avicenna, who is considered one of medieval Persia’s most influential philosophers and scientists.
But when the post-Islamic revolution government began persecuting non-Muslims in the 1980s, the Khoshes, who belong to the Bahá’í Faith, fled to Pakistan. Farhang traveled with a guide, but Mehdi and a friend set out alone. They were stopped at the border, where guards took their possessions and threatened to kill them.
Then an amazing thing happened. The militia leader recognized Mehdi Khosh as a relative of his own family’s doctor.
“My grandpa had treated his family in the past. Because of that, he let us go free,” Mehdi Khosh recalled. “I decided then to go into medicine.”
Farhang and Mehdi Khosh reunited in Pakistan before making their way to the U.S. They both earned bachelor’s degrees in biochemistry from KU and doctorates in naturopathic medicine from Seattle’s Bastyr University. They completed their residencies in Wichita, and then returned to Lawrence.
The Khoshes established Natural Medical Care in 1999. Beneda, who has a B.S. in organismal biology from KU and a doctorate in naturopathic medicine from Bastyr University, joined Farhang (her husband) and Mehdi at their clinic in 2008 after six years in integrative medicine at KU.
The practice is going strong now, but it wasn’t an easy start. Sixteen years ago, Lawrence was welcoming but largely unfamiliar with naturopathy. So, the Khoshes gave seminars, talked to the media and published articles. They began attracting new patients, but soon faced another challenge: licensing.
Kansas at that time did not license naturopathic doctors, so the Khoshes practiced under their Washington license. When critics protested, they could have simply moved elsewhere. Instead, they chose to stay in Lawrence and lobby state regulators for change.
In 2001, Kansas began licensing naturopathic doctors. It is now among 17 states that do, and 19 active N.D.s were listed on the Kansas State Board of Healing Arts website as of January. Some practice in other states; those at Natural Medical Care are the only ones in Lawrence.
Another shift is in the offing, too. Provisions in the Patient Protection and Affordable Care Act prohibit discrimination against state-licensed providers, including naturopathic physicians, Mehdi Khosh says. They and their colleagues are urging regulators and insurance providers to recognize the provision and are hopeful such services will soon be covered.
That would improve access for patients, who at this time must pay out-of-pocket, and create jobs for Lawrence, the Khoshes say. Natural Medical Care currently has two full-time and two part-time employees, in addition to the doctors. Being able to accept insurance would allow them to hire additional staff to handle claims processing and management, Mehdi Khosh says.
With 5,000 square-feet, their location has ample space for them. The practice utilizes the majority of the footage while leasing an office to Irene Bockelman, a clinical social worker and marriage and family therapist. West Side Yoga occupies a 2,000 square-foot studio on the building’s west side.
This is their third, and hopefully last, site, Mehdi Khosh says, and it embodies their natural ideals by incorporating energy-efficient design, low-VOC paint, a serene color scheme, fish tanks and large windows overlooking a grassy pasture. They may also install solar panels this year, he says.
Word-of-mouth remains naturopathy’s most powerful marketing tool, although the media’s embrace of alternative practices also plays a role. Take television’s “Dr. Oz Show,” whose host, surgeon Dr. Mehmet Oz, regularly endorses natural diets, practices and supplements.
“We’ve been using astaxanthin, an antioxidant, for 10 years, but not many people knew about it. Then when Dr. Oz mentioned it, lots of our patients wanted it,” Mehdi Khosh said, who notes Natural Medical Care only supplies such products to patients.
At the same time, concern over health care access and rising costs are boosting naturopathy’s appeal, said Dr. Lorilee Schoenbeck, a Vermont-based naturopathic doctor and spokesperson for the American Association of Naturopathic Physicians.
“This is a medicine whose time has come,” Schoenbeck said. “We are by far the most expensive nation per capita when it comes to health care costs. This is one answer to creating a more sustainable health care system.”
Clearly the field has positioned itself to answer that need. There are seven accredited naturopathic medical colleges in North America, compared to just two 20 years ago, and more are in development, Schoenbeck says. That, plus the increasing prevalence of state licensing, provides more certainty and safety for patients. It also boosts the creditability of naturopathic doctors who, to be considered as such must graduate from an accredited school; pass standardized national board examinations; hold a state license; and meet state requirements for continuing medical education.
Increasing awareness of those standards will only lead to wider acceptance, Schoenbeck says.
“Naturopathic medicine is an emerging profession,” she says. “It’s in a similar place as osteopathic doctors were 30 years ago, and nurse practitioners were 10 years ago. We’re going to see the same sort of progression in this profession.”
That’s happening in integrative medicine as well, Day says. Dr. Jeanne Drisko established KU Med Center’s Integrative Medicine Clinic about eight years ago, and it’s grown steadily since then. The clinic now has 14 staff members including Drisko, an internal medicine specialist; a pediatrician; technicians; dietitians; nurses; a research coordinator and office support, Day said.
The space itself spans six exam rooms and offices on the med center’s second floor. There is also an infusion area, where intravenous treatments for various conditions are administered; neurofeedback facilities and a kitchen where dieticians teach healthy cooking classes.
While patients are sometimes referred by other doctors, they can self-refer by making an appointment with one of the clinic’s nurse practitioners, physician’s assistants or physicians. The clinic at this time does not accept insurance.
Initial exams can last as long as an hour and a half as practitioners seek to understand symptoms, previous diagnosis and other variables. Food, nutrition, hydration, exercise, environmental factors, sleep, stress, toxins—the impact of each on a patient’s overall health is evaluated.
“It’s the practitioner’s job to see what’s missing,” Day says.
Filling those gaps strengthens the body’s foundation, allowing it to operate more efficiently, repair damage, heal and fight disease while working in concert with more traditional medical care. These are long-term, fundamental strategies, not immediate acute care, Day says.
“If you have an ear infection or strep throat, we’ll urge you to go to your primary care doctor,” Day says. “But if someone is having chronic sinus infections four or six times a year, and repeatedly needing antibiotics, integrative medicine has great tools to prevent that recurrence.”
Because KU Med Center is a teaching hospital, fourth year medical students and residents have the opportunity to rotate through the clinic. A year-long fellowship allows recipients, who can be from any medical specialty, to work within the integrative medicine setting.
“Education of future students and providers is paramount,” Day said.
So is understanding the science behind integrative medicine. The clinic is collaborating with several of KU Med Center’s departments to study the effects of high doses of intravenous vitamin C on cancer cells. Early results show it’s most effective when used in conjunction with chemotherapy or radiation during the early stages of cancer. Vitamin C infusions can also reduce side effects and improve quality of life in the later stages, the clinic’s website states.
“We now have a better understanding of vitamin C’s anti-cancer action, plus a clear safety profile, and biological and clinical plausibility with a firm foundation to proceed,” Drisko said in a statement on the clinic’s website. “Taken together, our data provide strong evidence to justify larger and robust clinical trials to definitively examine the benefit of adding vitamin C to conventional chemotherapy.”
It’s all just part of their mission, Day says.
“KU’s overall mission is to deliver world class patient care,” she said. “I believe we’re doing that in this clinic.”