EP 75: Understanding Disease

This podcast featuring Dr. Laxmi Naik, an ER physician, is an inspiring story about her journey in Medicine and covers everything from her origin story to the health complications she faced that transformed her life and her medical practice.  Trials and tribulations and passion and self-fulfillment, her journey has a little bit of everything!

 

Connect with your guest:

Dr. Laxmi Naik is an ER physician located in Atlanta, Georgia and is the owner and CEO of Spectrum Integrative Health (https://spectrumihealth.com/), a holistic medical practice.

 

Transcription:

Dr. JB: Hi, everyone! Welcome back to the Hope4Med podcast. I am your host, Dr. JB, and today’s featured guest is Dr. Laxmi Naik. She is an ER physician located in Atlanta, Georgia, who is the owner and CEO of a holistic medical practice called, Spectrum Integrative Health. Welcome to the show.

Dr. Laxmi Naik: Thank you. Thank you for having me.

Dr. JB: So, Dr. Naik, I love hearing people’s stories and so I love starting these podcast recordings from the very beginning, so can you share with my listener, your origin story?

Dr. Laxmi Naik: Thank you. I loved medicine since I can remember, I knew in high school I wanted to be a physician.I loved the whole healing aspect of the journey and I just love talking to people, I love biology and all that good stuff. So, I ended up doing medicine in New York and then chose to do emergency medicine for my residency and I trained in New York. We moved down to Atlanta in 2006, and just—my husband got another position.

So, came here and practiced ER for about seven, eight years. And then had some personal health challenges, and I come from a tradition where holistic wellness is the initial go-to modality. You watch your diet, you do some herbs, you sort of do mind body stuff where you do yoga, meditation, breath work, and, and that’s how you initially try to heal.

So, when I started having some health challenges, I was in the middle of an emergency medicine shift and my legs went numb. There was a lady literally having an MI in front of me and my legs were numb, and I called the other attending that was on staff with me, and I said, “Can you just cover for me? Something’s really going wrong with me.” And they got someone to cover my shift, I went home and I’m sitting, I’m thinking, doing my differential diagnosis, kind of work up in my head. And I actually ended up sending labs on myself and I said, “Okay, l.et me start doing my own workup.”

And so ended up started having some autoimmune symptoms, and went to my traditional rheumatologist who wanted to put me on some heavy dose stuff, immunosuppressants and stuff, and at that point, I had a choice to make as to what road I’m going to walk down. And there’s, you know, Western medicine is evidence-based scientific approach to healing the body. They do trials on medications, they take patients with a certain disease, and they do studies and see how many people get better with that drug now.

Now, no one’s ever really done studies with, “Hey, are these herbs going to help? Is this diet really going to help in this cohort of people with auto immunity because it’s not a revenue generating kind of structure?”And so at that point when my doctor—I said to him, I said, “You know what? I’m going to really sit and think about this. For some reason, energetically, this just doesn’t feel right.”

And so, I went home and I started researching and reading about: well, what do you do? Gluten-free diets and what herbs do we use for decreasing inflammation? Like, is it turmeric? Is it ashwagandha to improve my adaptogenic system? All of this, I just started reading about it, and I was just fascinated, it just pulled me in and I said, “Wow, this feels right, this feels really right to me.”

I would just go stand in the sun, do grounding, put my feet in soil and feel the earth. And it just started feeling like I was coming home to myself again. And there, the journey started with my training. I trained and I got board certified by the association of Integrative and Holistic Medicine, and my interest was peaked further. And the Western approach to integrative health and healing is more sort of functional medicine, which is: we test biomarkers, genetic testing, those sorts of things, hormones. And so, got certified by the Institute of functional medicine as well. And come full circle, I think I was diagnosed with autoimmunity in about 2017 and come full circle, following this path and studying all this stuff, I no longer have an autoimmune disease, so…

Dr. JB: Oh, wow!

Dr. Laxmi Naik: So, really reversed myself fully on my own, and it’s been such a journey along the way. I’ve met fantastic consultants following this path, other colleagues sort of delving into the science of this.

Dr. JB: Hold on, one second.

Dr. Laxmi Naik: I think I might have lost you.

Dr. JB: Let’s go back to other colleague.

Dr. Laxmi Naik: So, I finally said to myself, “You know what? I’ve got to do something. I’m going to start this.” And started the practice, Spectrum Integrative Health, and the origins of that name are also interesting. I have a son with autism, so he’s on the autism spectrum and he was also sort of my inspiration to pursue this path. So, I called it really after him, Spectrum Integrative Health. Integrative, because I am conventionally trained, and I am integrative holistically functionally trained. And so, I like to blend the two.

So, my patients come to me because they’re looking for those mixed modalities to get better because conventional medicine has not been serving them. It’s a symptom-based approach to treatment. So, if I have high blood pressure, the doctor gives me blood pressure medication, if I have asthma, I get some sort of an inhaler or a steroid inhaler to suppress the inflammation.

There’s no approach to…And there’s frankly no time for the physician based on the reimbursement model to sit there and tell the patient with hypertension, “Hey, you need to lose weight. Hey, you know what? This is the diet you really need to be on, potentially low salt diet, dash diet to reduce your hypertension.” They will refer the patient to a dietician per se, and we don’t know what the follow up of that is like.

And so, there’s not that approach to say, “Hey, let’s start with foundational stuff. Are you working? This is your diet, are you doing this? What’s the blocks do you not doing this? What can we put you on?” And you know what? Honestly, the herbs and all of the additional supplements, I would say probably can get layered in later, but the foundational stuff is very, very important.

And when the patient hears it from the physician, it’s a very different story, it’s a very different dynamic in terms of coachability and their ability to perceive the importance of it. And so, I mean, I do the foundational stuff and then we add on targeted supplementation as to what will get them better. And usually, they turn around in about, let’s say about three to six months, depending on how severe they are. So, that is my story.

Dr. JB: So, there’s a couple things that you mentioned in your story that are really interesting. One is that you are cured of the autoimmune disorder.

Dr. Laxmi Naik: Yes.

Dr. JB: In medicine, there’s a lot of things that—really not a lot of things, there’s a limited amount of things that we actually successfully cure. We manage a lot, right? But curing, it’s one of those things that the infectious disease doctors say, “Well, you know, I love infectious disease because I give this antibiotic…”

Dr. Laxmi Naik: Sure, yeah.

Dr. JB: “…And you’re cured,” right? So, how did you cure yourself of this autoimmune disorder and not have to be on steroids for forever?

Dr. Laxmi Naik: Exactly, right? Because the approach to integrative medicine is: what is causing your autoimmunity? Why is your body turning against itself autoimmunity? Like, it’s attacking your own cells, why is that? Is it because you’re exposed to too many toxins? Is it because you’re exposed to a foreign substance, potentially reactive, we don’t know what that is, we have a thousand different things in our gut, that now your body cross reactivity to you and you’re attacking your body.

And so, instead of just saying, “Hey, here’s some steroids, let’s suppress it,” functional medicine and integrative medicine says, “Hey, you know what…?” And by the way, naturopathy, ayurveda, Chinese herbal medicine, all the traditional Eastern arts always start with the gut, no matter what, they always start with their gut and they say, “Well, let’s see if she needs some reinoculation, let’s look at the gut microbiome, let’s see if the bacteria—I mean, we’re more bacteria than we are human per se, whatever that is. But is her gut bacteria balanced? Is that why? Does she have any food allergies that are very severe that’s preventing her from absorbing nutrients? And she might be micronutrient depleted.”

None of these questions are really asked, and so that’s where my interest was. Let’s look at the cellular stuff, let’s start looking at the cellular structure. It just wasn’t available in Western medicine. And coming full circle, I’m proof that this is possible. There’s also the question of hormones, which were not really deeply addressed by my traditional OB/GYN or my primary. They just didn’t know. And as we age, obviously, as women and menopause and our estrogen progesterone. Well, there’s a pattern to your estrogen progesterone when you have autoimmune disease. So, they weren’t really sure. I just never got answers on, “Well, why am I feeling foggy? Why am I feeling confused and just weak and tired all the time?’

And you can balance the gut microbiome, you can balance your hormones and you can actually have great energy and feel vibrant. So, it was layering in the nutrition, I got rid of gluten in my diet and dairy and a lot of other allergenic foods that were not good for me. Then I layered in testing my microbiome and balancing that out, and then I also helped kind of balance my hormones out and kind of a combo of all of this—and each person’s different, of course, but kind of got me on the path to recovery which the tools were just not available in conventional medicine.

Dr. JB: So, question. You’re a physician, of course, this was taught in medical school.

Dr. Laxmi Naik: I’m sorry.

Dr. JB: I said, you’re a physician, of course, this was taught in medical school, right?

Dr. Laxmi Naik: Actually, no. In medical school, how much nutrition training do you get? Almost nothing, you don’t. It’s just not talked to physicians in terms of nutrition and I have to say this because it’s like the big elephant in the room, pharma is a very revenue-based industry, right? So, you’re not going to make money on turmeric, right? Now, the question now is, we do have supplements that physic… we’re selling and supplements do make a huge income, but that’s not really as revenue-generating model as pharma is. So, there’s a control there also that’s happening in conventional medicine that we’re not open to allowing these modalities in, there’s that peace.

Dr. JB: What’s the goal of traditional medicine? I mean, what’s the goal of medicine in general? Isn’t that to take care of the patient, to cure the patient, to improve their life and livelihood, no?

Dr. Laxmi Naik: It is absolutely. I just think that because of all these factors, whether its revenue based, whether it’s the approach of the Western mind to say, “Hey, I need evidence-based medicine, I need scientific studies.” You’re not going to get large scale scientific studies on, “Hey, does turmeric heal autoimmune disease, do we have randomized, double blind control studies to show turmeric?” We don’t, because we can’t isolate that there’s so many different factors happening, but while with this one drug, we can do double blind randomized studies in Western medicine, which is science-based.

So, is it approach to healing scientifically? Is it a revenue-based issue influencing the system? And three, we just haven’t been taught, and so you bring all that together. There are plenty of wonderful physicians on conventional medicine and wonderful physicians on integrative, each just has a different exposure.

We are our training, right? Like, I’m not, you know, if you tell me to do a spine surgery, I’m not trained in that I’m trained in ER, that’s what I was taught. It’s the combination of all those things, so intention is only as good as the tools that you have to carry out your intention, otherwise it’s just in your head.

So, I think that’s a challenge in the industry, and hopefully, with time, we will get better. Integrative functional medicine is getting a lot of attraction now. The need for functional medicine doctors across the country is huge in terms of a conventional model, Cleveland Clinic has a fully operating functional medicine center in terms of a large institution. Majority of them are private practitioners, running their own private practices like me, but it is getting quite a bit of traction because we are seeing it in our patients and we’re saying, “You know what? just covering up symptom, it’s just not going to work. It’s not going to work; patients are not getting better fully.”

That being said, I have patients that are autoimmune, that are on steroids and immunosuppressants, and guess what? We do all this lifestyle stuff and holistic stuff and believe it or not, they need less of their immunosuppressants, but we don’t take them off it. If they need it to get better, they do. But this is a somewhat of a medium—middle road, I guess, middle way to do this. So, it’s not all or nothing, black or white, it’s just, we all need to sort of have these conversations and approach this in an integrated way, and what’s best for the patient.

And we also negotiate with the patient. It’s their life, they have a choice to make and how they want to approach their healing. And I present all options to them and then we proceed. You’re not going to get the evidence in Eastern medicine as much, just because of the approach. Eastern medicine approach is healing from an energy perspective, and Western medicine sort of approaches healing from an evidence perspective. So, it’s just a different approach, but yeah.

Dr. JB: You mentioned something about putting a band-aid on things and patients not getting better. If you would allow me to take you back to your life as an emergency medicine physician, what was that experience like for you?

Dr. Laxmi Naik: It was very gratifying, when I was doing it because you see such a wide range of medical issues come through, you have to stabilize as well as potentially treat patients in the ER. And it’s amazing, you become this incredible clinician and you not just academically, even energetically. You can sniff that EMS bringing that stretcher in, you’re like “That person, level one, needs to be in this room.” You can sniff the MI from across the ER, you just look at that lady and you know she’s going to be admitted, you know, this intuitive sense, you just get intuitive, you don’t even need to look at the chart, you just know.

Dr. JB: They Just call it in and it’s like, “Oh, 85-year-old chest pain,” “Yep, admitted.”

Dr. Laxmi Naik: Right? You just know, and then the repeat offenders that come in and it just becomes your neighborhood. So, it’s beautiful because I think ER docs are incredible clinicians and compared to many other fields, they are frontline, they see it all, they do it all, they know so many different diseases, it’s incredible.

So, I loved emergency medicine. That being said, when my legs went numb, and as the years went on, I found it definitely challenging, and I felt that sense of burnout. I had two kids, I was working full-time ER and nights. It was hard on my body. I would come on shifts where there would be nursing shortages and 20 people waiting in the waiting room, and all beds full, and you know the story. So, it’s tough. You’re supposed to now perform at this level where you’re supposed to be on your game, you’re being now reviewed by patients and the offices.

You’re also at the mercy of the ER group that’s contracted with your hospital. And my journey was to be there to heal and to work and to get these patients better. And I enjoyed my profession for sure, but given my medical challenges and the logistical challenges of the career caused me, I think, to make that shift. But yeah, I mean, I loved emergency medicine, I still do.

Dr. JB: The logistical challenges of the career, dissecting that a little bit more but we keep going back in time, now we’re going back to residency. Your experience in residency, how was that different than your real-life experiences in attending basically?

Dr. Laxmi Naik: Attending in the ER, you mean, or…

Dr. JB: In the ER.

Dr. Laxmi Naik: I was in a community-based ER, so I didn’t have residents under me. It was all just me making a lot of the decisions. So…

Dr. JB: No, when you were in residency, so when you were training as a resident working side by side you’re attending and now you’ve graduated and you are the attending. Did you know–what were the differences in that?

Dr. Laxmi Naik: It’s interesting you’re asked me that. I feel like the differences were essentially just obviously more autonomy, right? I’m making the decisions not the attending. Being a resident the first, second, third year… I was in a four-year program, so obviously, I was chief resident my fourth year. So, I did make all the decisions that the attending did and the attending just sort of signed off, so that was fine, but the first three years, I was a student, right? I was just learning, running around, seeing a lot of cases or you know, you think you know it, and of course, the attending that’s been practicing for 20 years, just sniffs out some random diagnosis. That’s like “What? That’s porphyria,” I’m like “Porphyria in the ER?” it’s like, whatever. But you’ll get these red hearings that the doctors know about.

And the hospital I practice was community hospital, it was phenomenal. Long Island Jewish Hospital. If anyone’s listening, it’s attendings were phenomenal. We were across the street from a nursing home, so literally every organ system was affected coming in. And so, our training, my training, I thought was excellent in that hospital. I learned a lot from my attendings and I think they really humbled me that every time you think you know, you really just don’t know in the ER, every time you’re certain about a diagnosis, there’ll be something in the patient’s history or the labs or something that just surprises you.

So, I love the part about learning from my attendings when I was a resident and the transition to me becoming my own attending, I tasted it when I was chief resident. So, it was me and two other people that were chiefs that year. And so, we had, I think, about 20, 25 residents that we were managing schedules for, shifts for. And so, I kind of got that taste of being an attending, I guess. And when I transitioned to being my own attending in New York, as well as Atlanta, was more of that. I felt more confident about my decisions given the training, but it was also a little bit sad because I lost the community a little bit. When I’m working the ER shift, it’s just me.

And so, I didn’t have my resident colleagues or my other attendings to bounce stuff off of. So, I missed that academic piece, it became all clinical in a way during the shifts. So, it was a little bit more isolating and it was a little different, it just took time to get used to, but it’s pretty amazing that these four years of residency just trains you to handle so many different things, it’s exceptional actually.

Dr. JB: Even with that, you have this really steep learning curve afterwards, when you don’t have the attending to say, right? You agree, right? So, it’s like, no, you have to…

Dr. Laxmi Naik: No backup, it’s just you.

Dr. JB: And with no backup. But part of the reason why I asked that question was…. so, as a resident, I also went to a four-year program, but as a resident, you’re working side by side you’re attending, and you’re seeing some of these things that you mentioned that really cause a lot of this guess grief, in terms of staffing shortages, in terms of holding in the ER. The question is: how did that affect you differently as an attending than as a resident? Because some of those things still happening as you were resident.

Dr. Laxmi Naik: You’re right. I mean, I don’t know, it’s just maybe youth—it’s just youth. I mean, a lot of times also we’re not taught the business of medicine as residents or medical students, right? We’re just not taught the business and operations and administrative ends of things, and even in residency, I mean, how much training do we get on operations of the ER and bed availability and things like nursing shortages, staffing, shortages, all those things? I mean, nothing. As a resident, I just sort of worked, did my shift, just like so many shifts you don’t know what else to do, you’re barely sleeping in residency.

And so, you just do your shifts and go home. It’s almost like you’re not taught, so you don’t know. It’s kind of like the training with integrative medicine. I am like “My God, they taught us nothing about nutrition in medical.” So, how would I know, I just didn’t know. And so, once I’m in it, thrown into it and it’s all me, it’s just—I have to learn. And then I was like, “Wow, this is the real world, this is no more protection around me, is just me with all this issues and admits and staff and fighting attendings, or for admission or this or that. It’s just me.” So, we’re just not taught, I think, or exposed, unless things have changed.

Dr. JB: I also did not get exposed. I think I actually did a—I created a lesson for my colleagues when I was a resident, I think, a third year that was entitled: The Business Of Medicine, I think it was a theme day. Yes, had a theme day that I did the business of medicine and about charting and billing and things like that. But that’s about as much. And I taught myself that, so I could teach it to others, but it’s definitely not something that’s highlighted and the effects of the shortages of boarding and things like that on us in terms of compensation, in terms of metrics, in terms of throughput and all those things.

Dr. Laxmi Naik: I mean, that even picked up after I left ER, in terms of reviews and RVs and all of that. And also, when you’re doing your chart as a resident, you’re documenting the clinical piece, you’re not really knowing the other end of the piece where the billing is happening from the ED side to the insurance. You don’t know the level of billing, the ICD codes, you don’t know any of that happening.

Well, guess what? When you become an attending and you’re not documenting correctly and they’re not able to bill, based on your documentation and all of that, you’ll hear about it from your administrator, you’ll hear about it from the CEO of the group, etc. You know what you’re bringing in, what you’re doing, what you’re documenting. Well, you’re documentation costs us this much money in terms of revenue. So, you’ll hear all of this, but we never heard it, we never heard of it as a resident, so just didn’t know.

So, I think that would be phenomenal if someone would incorporate that into the curriculum because I didn’t know how to negotiate a contract when I left residency, no one taught me. I had a couple of groups I was considering and I’m like, “Well, what do you do? You’re going to cover this, you’re not going to cover tail, or what’s the non-compete like.” No one really told me anything, I looked at the contract and I ended up calling a bunch of my friends and saying, “Hey guys, what do your contracts look like?” And I guess I need to talk to a lawyer, but lawyers are expensive.

Dr. JB: Yes, true.

Dr. Laxmi Naik: And I’m coming out of residency with all this debt and like… So, it was just I think a lack of training and knowledge in that area that made it different and difficult I think coming out.

Dr. JB: And the thing is that it’s not like you’re not being taught anything, you’re being taught so much other information too, but some of these key practical life skills, foundational stuff that you need to survive life after being a learner for so long, that’s the part that’s lacking.

Dr. Laxmi Naik: For sure. And I mean, having done all of it, like seeing all of it, the entire industry. I look at the plug points where they need to happen, your podcast is “Hope For Medicine.” So, it is that, right?

If we’re more informed as physicians, as attendings or coming out into the world, we’ll know how to navigate all of this better in such a way that we’ll decrease the risk of defaulting on a contract or leaving, causing a headache down the line with this practice or that practice or this hospital or that hospital group, because we’ll know what contracts are being put out there. So, definitely.

Dr. JB: I’ve said this before in terms of the benefits of a podcast like this for the learners is: that they’re able to enter into the field of medicine with their eyes wide open by listening to other people’s stories and experiences, highlighting these things about like “I didn’t know how to read a contract, what am I supposed to be looking for? What’s this non-compete clause? What is exactly does that mean? What are these consequences that I could endure if something goes awry? All of these, you piece all these stories, because all of my guests have highlighted different parts and different pieces of this puzzle that somebody listening will really be able to be very enriched from these conversations.

Dr. Laxmi Naik: Yeah, I know, it’s much needed. It’s almost like we need to have some sort of a round table discussion with all of us and figure out what needs to be done. Definitely, absolutely.

Dr. JB: So, another interesting thing about your story that I want to talk about a little bit more is: you were in the middle of your shift when your legs became numb, and what did you do? Did you check in as a patient?

Dr. Laxmi Naik: I didn’t. It didn’t seem acute. It wasn’t like an acute MI or a stroke, I was like, “It’s bilateral,” I’m like, “Okay hard for stroke to present bilaterally initially anyway,” butanyway, so I’m like “it’s bilateral symptoms.” There was actually no actual deficit in terms of sensory sensation, I was doing my own neuro exam on myself and I’m like, “Ah, everything looks fine and there’s actually no deficit even to pin prick or whatever.” And I’m like, “But I feel numb, there’s an inner numbness sensation that I’m having, but it’s not objective on the exam.”

So, I waited, it’s in the ER, so I called my attending over and I said, “Hey, my legs are numb, something’s wrong, I’m not sure what? Can you cover?” And he covered, and we called backup person in, and then I went home and went to my own physician the next day and did my own testing as well, blood testing, he wasn’t sure what this was. And my titer were very high for ANA and ultimately etc., that’s what happened.

But I think the stress of emergency medicine was definitely, I think, a contributor. I was really tired, I was working long hours, I had two kids at home, my older one had autism, so he had a lot of needs as well that I had to attend to, so I was just really burnt out, I was really working around the clock, and so I’m sure that did not help. I’m sure that shot my immune system as well.

Dr. JB: That’s right.

Dr. Laxmi Naik: So, everything happens for a reason, just to make it a little more interesting. They still couldn’t figure out why? What autoimmune disease I had, they ran tests and tests and tests, they finally ended up referring me to a Johns Hopkins Neurologist, who’s this genius man who ran some titers on me, and apparently, I have a one in a million autoimmune disorder, where I make auto antibodies to my potassium channels.

Dr. JB: What?

Dr. Laxmi Naik: It’s one in a million.

Dr. JB: Hold on, hold on, hold on, hold on. So, what awakened this autoimmune disorder, right? Because you didn’t just start developing potassium channels later in life, right? So, what was that trigger that made it happen?

Dr. Laxmi Naik: So, I mean, typically with most diseases, right? it’s always a two-hit hypothesis, right? It’s genetics and environment. So, the question is at this point, obviously nobody in my family has this one in million genetic disorder, and I certainly did not have it most of my life.

So, the question is: what happened? And so, the root cause is where I think integrative medicine helped me to say, “Okay, is there a trigger? Is it diet? Is it some toxins in the environment causing this?” Obviously, that’s impossible to isolate because we’re exposed to thousands of toxins a day. But can I minimize certain processes in my gut and look at my gut for healing and say, are there things that I couldn’t improve that are in my control?

So, if my microbiome is off, do I increase certain amount of insoluble fiber to help motility? If there’s inflammation in my gut which you can test? Fecal calprotectin levels, certain things through markers. If there is inflammation, how do I now create an anti-inflammatory diet for myself and my short enzymes in my gut? If so, do I add enzymes to help the digestive process and to absorb my nutrients better to heal? The body needs nutrients to heal.

So, therefore, I addressed what I could address, right? And when I did that, that definitely got my symptoms better because I chose not to go the other route of immunosuppressants and plaquenil, etc. So, my neurologist that you know who found this, because of the numbness, they sent me to him and so he found this.And he goes, “Well, there’s one entity that causes this level, and there’s, I think, hundred women in the world with this.” And I’m like, “Oh my goodness, of course, it happens.”

Dr. JB: It’s special.

Dr. Laxmi Naik: I’m like what? Hundred women? I think he said something like, “Basically this disorder is highly studied at university of Pennsylvania and blah, blah, blah.” And he was quoting all these studies and stuff. And I said, “You know what?” He was really amazing though. I said, “look, I’ve chosen this integrative route, this is what I’m going to do. There’s no evidence for this, but in general for autoimmunity, this is what’s done in the east and this is the approach in functional medicine.” And so he was very open to conversation.

He said, “Well, you’re functional, yes, you have this numbness, let’s try it, let’s see. It’s not an acute situation where we need to throw high dose steroids and stuff on you. You’re functional, you’re eating, you’re sleeping. Yes, you’re walking around with this numbness, but let’s try it.

And so, he worked with me, he’s very open. You know, he did all his stuff, which is the MRI [inaudible 35:12] all the other tests. But he said, “Let’s try it.” And he let me kind of, you know? And my rheumatologist as well. He also said, “I think you’re reasonable in your approach and what you’re explaining to us, we don’t know what you’re talking about, but we trust you and we’ll work with you and we’ll keep track of your blood work and see if you’re worsening, but we’ll let you kind of do this integrated round, see if it works.” And thankfully, it did. So yeah, that’s where.

Dr. JB: So, how soon after being diagnosed with this autoimmune disorder did you transition out of working in the emergency department?

Dr. Laxmi Naik: It was pretty much, I would say, over a six-month period. In that period I said, “You know what? I had to come to a decision and I internally made the decision.” And then it took a couple of months to figure out, well, where am I going to work? What am I going to do for my income? And try to figure out the logistics and everything. And that took just a few months. And everyone understood, everyone was very supportive, and it felt right. It actually felt very right to leave at that point, I felt like I had given, I think, overall 17 years to emergency medicine before I left.

So, I still talk to colleagues on the front line. It’s such a deep passion of mine, emergency medicine, so I still keep in touch with everybody and see what’s going on. All my colleagues were frontline in New York for COVID, all my friends. And so, that was a really deep moment in time for me, because almost all of them were frontline during COVID and we lost one friend to COVID.

So, it’s a deep love, but it’s also a point in my life where I had closure from practicing ER, and having seen this integrative side and the way I healed and seeing other patients heal with me, it’s just very tough to go back. Philosophically, it’s very tough to go back because I just don’t practice that way anymore.

Dr. JB: Speak more about that, what do you mean by philosophically, it’s tough to go back?

Dr. Laxmi Naik: When I know this other side exists. So, that patient with hypertension, for example, it’s in the ER, maybe if it was out of control or in primary care office, I would probably give him some hypertensive medication, right? And try to get his hypertension down and follow him for that. But with the integrative route, I can say, “Hey, take your blood pressure medicine, but you know what? Let’s get your weight down, let’s work on your diet, are there particular herbs that we can potentially use to decrease your blood pressure?” And for my cholesterol patients who don’t want to be on statins, they’re always thrown statins, which have huge side effects. Can I put berberine red east rice on them and titrate that, and see if they’re cholesterol profile improves.

Then you’re exchanging a medication for a supplement, so that’s not my goal. My goal is: it’s still the same approach, right? So, if they are on a medication, I say, “Let’s do all the foundational stuff first, let’s work on that, and then we’ll do additional testing to check you, gut microbiome and food allergies and any other targeted testing that we need.”

And then we’ll say, “Okay, you know what? let’s try these supplements and herbs, potentially. If you’re having side effects with the statins, let’s try this.” But that option is not available in the conventional route, that’s all. And so, it’s hard for me to go back to that because it’s just, I don’t practice that way anymore.

Dr. JB: And how long are your visits with your patients to be able to even have these conversations?

Dr. Laxmi Naik: So, my first visit is, I don’t take insurance, so it allows a lot of time. I typically spend an hour in the first visit, an hour in the second visit to go over everything. The second visit is about three weeks later, three to four weeks later. And depending on the acuity and the level of intricacy and the medical issues, typically, it’s about four visits a year, and the second year it’s about two to three visits until they normalize. If they’re more complex, I see them regularly, probably once every two to three months consistently until markers are stabilized, they’re feeling better.

And it’s such a team approach, in terms of creating a relationship with the patient, trust, negotiating explaining everything. And so they feel they have ownership of their journey. It’s truly a fit, truly how medicine, I think, was meant to be practiced because I’m there, I never function as the healer, I function as a partner in their healing journey that they dictate based on the knowledge that I share with them.

So, it’s sort of that way, we sort of walk the path together, and it’s beautiful because they get better and we have very good, numbers in terms of symptom. We have MSQ score, so it’s a medical symptom questionnaire that we actually have on patients. What are your symptoms when you first present to me? And at six months and a year, let’s look at those numbers, how are you feeling? And we track those numbers very carefully to see if they’re improving, instead of just saying, “Oh, I feel better.” Which is a very nebulous answer.

So, we look at actually system by system, how do they feel? Headaches better, migraines better, bloating better, joint pain’s better, vision better, whatever, we actually track every single thing, every metric. And we see that with the integrative approach, they’re better, they’re much better.

Dr. JB: I guess in closing, do you have any pearls of wisdom for our listener?

Dr. Laxmi Naik: You know I do. I guess I was going to say this before, which is that, each of my patient appointments begins. I ask the patients, would they like to begin the appointment in silence with some breath work, chanting, yoga, prayer, whatever they wish, because I think what’s missing in medicine being practiced today is a very disease-centered approach to a patient. And really the patient is a spiritual being entity first, right? They’re a human, they’re a being, they’re not their disease, right? The disease is something that they have, it’s not something they need to identify with, right?

So, the approach is very different when you look at the person holistically that they’re a spiritual being, and the patients are truly remarkably, I mean, they don’t have to believe like in God or higher power or anything, they’re just sometimes super happy just for one minute. And literally, one minute, one minute of just silence. So, we dig in the appointment sometimes with just silence and then sometimes they just want to breathe. And so this just tells us the level of stress, and distraction and overwork, overtired society that we are. That we don’t even have time for a minute to stop and rest and breathe some of us, right?

So, I would like to say that, blending the east and the west is the most beautiful way to practice medicine and to look at each patient and each… actually, look at each patient as a human being, as a spiritual entity, as somebody who has a presence, not just a diagnosis.

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