Did you know that in Oregon, Naturopathic Doctors are paid less than MDs, DOs, even Nurse Practitioners and Physicians Assistants - for every single office visit?

And I'm not talking 2% or 5% less. I'm talking 30-60% less.

That doesn't seem right, does it?

Yet insurance companies are allowed to pay us less, just because they can.

The Oregon Association of Naturopathic Physicians is trying to correct this injustice with  a Pay Parity bill, House Bill 2673.

Our first attempt at passing a Pay Parity bill was in 2019. It was unsuccessful, largely due to blockades and intentional faulty messaging provided by the insurance companies. We have come up with (what we hope are) effective tools to address this.

A lot has changed since 2019, I don't need to tell you that.

But what I can tell you is that as a profession in this state, the economic impact of unfair insurance coverage was not fair and not great in 2019. In 2021 it is truly devastating.

If we do not act, there will be widespread negative repercussions in Oregon for anyone who is an ND or would like to see an ND. Perhaps permanently.

The OANP needs to demonstrate we're not alone. That others care about this issue.

Here's a short list of who should care:

• NDs who bill insurance (for the obvious reason that we can continue to serve our patients if we are reimbursed at equal rates)

 

• NDs who do not bill insurance or live outside of Oregon (because establishing this precedent will have positive repercussions far beyond the boundaries of this state)

 

• People who see NDs and use their insurance (for the obvious reason that we can continue to stay in network with your plans; I have already had to drop several as I was "volunteering" to see my patients due to abysmal reimbursement rates)

 

• People who see NDs and don't use insurance (because again, setting this precedent will expand our profession in this state because with equitable funding we will be able to further clinical reach, residencies for new and upcoming doctors, and more)

 

• People who are in other healthcare professions (because you will be able to coordinate care with providers who take your patients' insurance plan; we are being forced to leave insurance company contracts in droves currently)

 

• People who haven't even ever heard of an ND (well, Hi, nice to meet you. If you would at any point in the future like to see a Naturopathic Doctor and have any hope of insurance coverage, I invite you to get on board, NOW!)

I'm so glad you asked.

I invite you to use this very simple letter template, edit and write in it what you wish (even 1 or 2 sentences is wonderful), and email it to legislative@oanp.org.

They will be collecting up all the letters and using these to show that we have public support for our bill. Though these will all be collected up together, if you do not know your senator and state representative, you can find out who they are here>>>

We do have far-reaching support for our bill. It is supported across the aisle, and also across the healthcare fields. We just need to show the evidence.

 
I have attached word document templates below. You can send in a word document, or even just copy and paste your message into an email and send to legislative@oanp.org:

Deadline: please send it in this week! Things are moving fast, and we need to show our support now!


Subject: Re: HB2673, Support Fair Pay for Naturopathic Doctors (NDs)
 
Dear House and Senate Health Care Committees, Oregon Legislature,

My name is (Insert Your Name) and I am a patient of a Naturopathic Doctor (ND) and your constituent. I would like to share my experience working with an ND as a medical provider and ask you to please support HB2673.

(Insert your experience here. Use the following as a prompt)
I have worked with many types of medical providers, and none have taken the time and shown the care in my health and welfare like my Naturopathic Physician. The level of education, support and competent care that I have received has not only helped me move forward with my health conditions, but has renewed my faith in the healthcare system.

Unfortunately, right now in Oregon NDs are not being fairly compensated for their valuable contributions to healthcare in this great state. This makes it more difficult for people like me to access this unique and essential level of care. It also limits my choices when it comes to healthcare.

My ND manages the majority of my healthcare needs whether it be my annual physical, lab orders, health screenings or prescription(s). They also refer me to other competent providers and specialists when appropriate. In addition, they teach me about diet and nutrition, how to stay active, manage stress, improve my sleep and become more proactive in my own healthcare. All of these things come together to create a more complete treatment plan for my health and I have never felt better.

I am asking you to vote yes on HB2673 and support fair pay for Naturopathic Doctors.
 
Sincerely,
(Insert Your Name)

Yes, yes it will. I have sat in on numerous senate and house healthcare committee hearings and can tell you from experience that our organization saying, "please bring our bill to a vote, we have 1,500 letters of support" will make a much bigger impact than, "please bring our bill to a vote, we have 5 letters of support."

Politicians are much more likely to act, even whether to call a vote or not, if they know that there is a ton of support behind the bill.

Every letter of support counts.
Now the question is, can I count on you???

I hope so, and truly appreciate your support.
Dr. Angela

After encountering tech issues. all. last. week, I'm finally able to share all those tons of resources I was mentioning in my IG and FB videos>>>

At around 45 min, it was much longer than anticipated, and while dense, I think encapsulated a lot of the hot button questions I've been receiving around the vaccine, primarily:
Does the vaccine work?
What are the side effects?
Who shouldn't get the vaccine?
That other doctor over there (on the internet) is telling me not to get it. Why do you two disagree?
And finally, if I'm pregnant or breastfeeding, should I still get vaccinated?

***disclaimer***
If you need yet another reminder, I am not an immunologist, epidemiologist, virologist, infectious disease specialist, or anyone doing research in any of these fields.

I'm simply a Naturopathic Physician who is doing their due diligence to learn, then pass along, all the good resources, research articles, and related information I can to my patients and audience.

And as a reminder, Dr. Zwickey's interview>>> is a great primer on what the vaccines actually contain and do.

Here in the US we have two manufacturers of the vaccine available, Moderna and Pfizer.

This information is taken directly from their Phase 3 trials, both following tens of thousands of research participants, both those who received the vaccine and also those who received a placebo.

First looking at Moderna>>>," Of 196 COVID-19 cases in the study, 185 were in the placebo group, making the vaccine 94.1 percent effective. The vaccine completely prevented severe disease. All 30 severe cases and one death among study participants were people who had gotten the placebo."

And here's the info on Pfizer>>>, "The trial has so far enrolled more than 43,000 people. Of those participants, 38,955 have completed the vaccine regimen, which consists of two injections spaced three weeks apart. At the time of the analysis — which looked at data seven days after participants received a second dose — a total of 94 people in the trial had confirmed coronavirus cases."

So yes, for both vaccines, those who received the vaccine were far, far less likely to catch Covid-19 than those who received the placebo (fake).

In the previous vaccine info article, I posted the Moderna fact sheet. Here is the Pfizer one>>>
They are nearly identical in terms of common side effects (pain at the injection site, fever, chills, generalized aches and pains, headache) and also ingredients.

Serious allergic reaction to these is rare, "during December 14–23, 2020, monitoring by the Vaccine Adverse Event Reporting System detected 21 cases of anaphylaxis after administration of a reported 1,893,360 first doses of the Pfizer-BioNTech COVID-19 vaccine (11.1 cases per million doses); 71% of these occurred within 15 minutes of vaccination."
https://www.cdc.gov/mmwr/volumes/70/wr/mm7002e1.htm

Compared to other vaccines, these two have relatively less ingredients, stabilizers/ preservatives and contain no heavy metals - which makes them "cleaner" than many others commonly used.

The only absolute reason why someone should not get the vaccine, as posted on their fact sheets are:

"WHO SHOULD NOT GET THE PFIZER-BIONTECH COVID-19 VACCINE?
You should not get the Pfizer-BioNTech COVID-19 Vaccine if you:
• had a severe allergic reaction after a previous dose of this vaccine
• had a severe allergic reaction to any ingredient of this vaccine."

"WHO SHOULD NOT GET THE MODERNA COVID-19 VACCINE?
You should not get the Moderna COVID-19 Vaccine if you:
• had a severe allergic reaction after a previous dose of this vaccine
• had a severe allergic reaction to any ingredient of this vaccine"

Even having had an adverse reaction does not preclude you from being able to obtain the vaccine. If you choose to receive either of these vaccines, and have had an allergic reaction to a past vaccine (or an anaphylactic reaction at all) you will likely be observed for a longer time post-injection.

I am not a prenatal expert, so if this is relevant to you, please discuss this with your expert.

However, I can share with you that people who are pregnant and breastfeeding are making individualized choices for what is right for them, and thus some are being vaccinated right now.

Experts are currently recommending that each person determine if it is right for them, depending on work exposure and risk.

Here are a few helpful resources:

https://blogs.bmj.com/bmj/2020/12/21/healthcare-workers-who-breastfeed-should-be-offered-the-covid-19-vaccine/

From https://www.nhsinform.scot/healthy-living/immunisation/vaccines/coronavirus-covid-19-vaccine/pregnancy-breastfeeding-and-the-coronavirus-vaccine

"Vaccination in pregnancy could be considered where either:

• your risk of exposure to coronavirus is high and cannot be avoided
• you have underlying conditions that place you at very high risk of serious complications of coronavirus

"
https://www.health.harvard.edu/blog/wondering-about-covid-19-vaccines-if-youre-pregnant-or-breastfeeding-2021010721722

Here in the US, states are taking input from the federal government, and releasing access in tiers according to workplace exposure and health status.

On January 25th Oregon entered a modified 1B phase. Our governor recently released that educators and child care workers would become eligible that date, then seniors would become eligible February 8th. I expect to see more shifts and changes as the landscape of vaccine availability is constantly changing.

Here's a refresher on who's in what phase:
From https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations.html
Phase 1b

• Frontline essential workers such as fire fighters, police officers, corrections officers, food and agricultural workers, United States Postal Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the educational sector (teachers, support staff, and daycare workers.)
• People aged 75 years and older because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 75 years and older who are also residents of long-term care facilities should be offered vaccination in Phase 1a.

Phase 1c

• People aged 65—74 years because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 65—74 years who are also residents of long-term care facilities should be offered vaccination in Phase 1a.
• People aged 16—64 years with underlying medical conditions which increase the risk of serious, life-threatening complications from COVID-19.
• Other essential workers, such as people who work in transportation and logistics, food service, housing construction and finance, information technology, communications, energy, law, media, public safety, and public health.

That about answers all the questions I've been receiving for now, with what I hope are helpful resources for you to learn more.

To your best health,
Dr. Angela

Today I'm chatting with two awesome Aussie ladies- Nat and Cecelia from The Wellness Collective Podcast. We talk about why pain happens, what inflammation actually is, and how injection therapy can help. Listen on apple podcasts <<here>> (or find them wherever you get your podcasts).

Today I talked with Dr. Dawn Andalon, the host of Women's Health Happy Hour, all about things we can do to keep aging joints healthy. We discussed therapies such as PRP injections and prolotherapy- some of my specialites! Tune in <<here>> to learn more. (Podcast is available on apple, spotify, google, or anchor.fm).

​Today I'm talking with Dr. Michelle Peris about my favorite topic- joint health! Please join us as we discuss lifestyle and dietary interventions that can help reverse arthritis, and dive in to my 7 step plan to reverse chronic joint pain.

First off, if you care about this topic, take 16 minutes and listen to this interview by Dr. Zwickey>>>
She's an immunologist and was my immunology teacher in medical school. This is an interview for the Natural Medicine Journal.

Here's the Facebook live I shot, sharing my experience and answering everyone's questions>>>
This was filmed the morning of Monday, Jan. 11th.

Here's the Moderna fact sheet I was given when I received my vaccine:

(and get on my list to get future updates here>>>)

first up, no I don't know when you can get a vaccine

 
My clinic doesn't know. No clinics know. Unfortunately, I don't recommend calling your doctor to ask right now. All medical centers are being inundated with calls about the vaccine. The distribution is just now starting to trickle out to us medical providers outside the hospital setting.

but I can share with you what the plan is


While I don't have the exact when, where, and how of vaccinating our community, I can share what the Oregon Health Authority has planned.

Here's the main information website>>>

The vaccines are becoming available according to Phases. Different people fall into different phases, based on their occupation and medical history.  We are currently in Phase 1A, which includes all of us who see patients in person.

You can read more the specific Phases this local newspaper article from Nov. 19th>>>

but how will I know when and where I can get it???


I get that there is a lot of high emotions around this right now. I get that many want a concrete plan, now! But like so much over this last almost-year, we're having to be flexible and go according to ever-changing time frames.

If you want email updates from the Oregon Health Authority, give them your email in the little pop up box on their website>>>

I will send out further emails when we have reached Phases that are more relevant to my community. I will be sending out as many updates as I think will be helpful. Even if they don't pertain to you, maybe they will be helpful to a friend, family member or coworker, so stay tuned for more details to come.


do I think you should get it? (and variations on this question)


A vaccine, like every other recommended medication, supplement, or any other treatment, should of course always be an individual and informed decision.

There will always be public health recommendations that some cannot or should not follow based on their unique medical history.

So while I won't make a blanket statement telling everyone what to do, I will talk about the joint decision making conversations I have with patients.

You need to weigh the risks and benefits of doing [the thing, whatever it is] with the risks and benefits of not doing the thing.
Add to this conversation your present health status, workplace exposures and potential for family exposure, and there is no one-size-fits-all answer.

With that being said, from a public health standpoint, I am supportive of community-wide vaccination of those for whom this is the right decision.

yeah, but are you getting it?


A lot of people want to know.
Am I getting it?

Yes, yes I am.

If I were a 100% telecommuting person, never seeing any patients in person, and 100% of my loved ones around me were in absolute perfect health, then I may feel like I have the luxury to delay being vaccinated.

But I am not in that position.

Because while of course I am taking care of myself and my immune system in many other ways, I see this as one additional way I can help prevent the spread through my community and through my household. I consider this particularly imperative for the good of my patients I see in person.

But again, this is an individualized decision. I'm just sharing it publicly.

If you have further questions, I encourage you to discuss them with your trusted healthcare provider and come to a decision that is right for you.

Lastly, while you are collecting relevant information and making decisions during this time for you and your family, I encourage you to do a "source audit" on your newsfeed.

Where does it come from?
Who is saying it?
Who else is saying this?
Who are those countering this argument?

There's a lot more I can say about analyzing logical fallacies, but we'll leave it here for now.

I can tell you, from years of reading and interpreting primary literature (published research articles) that if your only sources of information are social media and YouTube, you will be missing out on a lot.

So cast the net wide to make sure you are getting the full picture, not just what the algorithms want you to click on.

More to come later, but that's all for now,
Dr. Angela

What are your New Year's plans? 🥳
Mine involve guiding a small group through reversing chronic joint pain and degeneration.

That's all 😆

Starting Monday, I will be leading Foundations of Resilience.
We will be making big impacts & positive changes over just 4 weeks.

If your resolution is to have healthier joints, join us now.
Check it out,  full details and sign up here>>> 

We have space for a couple more, sign up before we're full.

I just had to write about food during the week of our national food gorging, aka Thanksgiving (for those of us in the States). And during the week of Thanksgiving, when we show gratitude and feast to our heart’s desire, this is also the worst time to talk about diets.
 
So I’m not going to do that.
I’m instead going to talk about the mindset behind why we change our diet, what is diet anyway, what are we looking for, and just how do we know it’s working anyway?
 
Let me share an excerpt from my book Younger Joints Today. It’s a book about reversing chronic joint pain, and has a ton of information on how nutrition affects joint health.
People use the word “diet” in many unhealthy ways. It often involves severe restriction, a sudden change in a desire to get healthy. Many times, there are unhealthy motives behind dieting and diets.
 
Instead of “diet” meaning “restriction,” I prefer these definitions instead: “habitual nourishment” and “regimen of intent.” How do you intend to nourish yourself every day?
 
So, diet can mean how you regularly nourish yourself. Or it can mean restriction, and deprivation.
Start out by asking yourself, ‘why am I dieting?’ Why are you changing how and what you eat? What are your reasons, and what are your goals?
I find this piece immensely important, and often overlooked.
Your intention and your reason set the stage for how successful you are in making changes.
 
If you are going on an extreme detox diet because you read about it in a book, or a blog, or because someone you know is also doing it, or because you feel guilty for over-indulging over the holidays…. Pump the breaks. Those are all external factors influencing your decision.
What they say you should do.
 
How about you? Don’t you have any say in the matter???
Instead, I would like to invite you to make dietary changes because you want to, because your curious, because you’d like to experience some novelty, fun, and learn a thing or two about what foods are right for you along the way.
 
All books, blogs, videos, and social media posts can do is provide information. Some of that is relevant, but it can’t all be relevant to everyone. Is a carnivore diet the key to everlasting health, or will a vegan diet save us all? Trying to lump us all into one, “this is best for everyone” diet just won’t work.
 
You would be smart to look for guidance through this process by a professional. Many types of professionals can assist, such as Naturopathic Doctors, functional medicine practitioners, nutritionists, and holistic health coaches.
 
The success of your dietary changes will depend on your goals that you established from the start. You did set goals, right? Otherwise, how can you tell if it’s working and worth doing?
A trial of a dietary elimination, for example dairy elimination to see if it is affecting digestive health, may last 3 to 6 weeks. A nutritional intervention to address autoimmune, neurologic, or rheumatic conditions may last much longer. The key is to have a plan, be well prepared, and know what your benchmarks for success are.
 
Whatever your plan, I suggest you take phrases such as “cheat day,” and “cheat meal” out of your vocabulary. It just plain sets up negative thought loops, reinforces shame, and is just overall creepy verbiage. What, are you monogamously married to this diet?
Instead, just acknowledge when you are following your dietary changes, and when you are choosing to not follow it. That’s all. A rational adult making a well thought-through decision.
Any diet, or diet-pusher who leans on “no cheating”-type anti-cheerleading (bullying, if I’m being honest) earns an instant “eww-factor” in my book.
 
By all means, make the dietary changes you wish, based on internal-derived interests and goals, with a specific expectation established. And if all of this seems a bit too much, get some assistance whenever you need to help you create your path forward.
 
Wishing you a holiday season full of gratitude for your meals and those you share your meals with,
Dr. Angela