"THE HEART OF THE MATTER"
a special program of the National Emergency Medicine Association (NEMA)


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Week: 574.7

Guest: Dr. Kathi Kemper, Pediatrics, Bayview Hospital Ctr., Univ. of Washington
Topic: Melding traditional medicine and a holistic approach for kids.
Host/ Producer: Steve Girard

NEMA: Today, we're talking Dr. Kathi Kemper, a pediatrician and instructor at the Bayview Hospital Center of the University of Washington in Seattle. I called to ask her about her book, called The Holistic Pediatrician, from Harper Perennial, which delves into the melding of traditional medicine with the so called holistic attitude and home and herbal remedies. Dr. Kemper, a lot of work in your book...what was the impetus?

KEMPER: I wrote The Holistic Pediatrician in response to a couple of drives: one is that patients are asking more and more about alternatives to regular mainstream medicine in treating common problems like colds and diarrhea, and that sort of thing. Unfortunately, we didn't learn a lot about those things in medical school and so I wanted to educate myself so that I would be able to answer my patients questions. Since I also have a background in medical research, I wanted to apply the same standards to the things I was learning in alternative medicine, as we might apply in conventional medicine. So, I wanted to look for whether or not studies had been done to evaluate some of these things. So the book actually brings together the best of mainstream medicine and alternative medicine to address the most common childhood illnesses, the 25 most common childhood illnesses, and applies the standard of scientific medicine to evaluate whether or not they work and whether or not they're worth parents spending their money and their time on for their children...and whether or not they're safe.So, it's a very comprehensive approach to common childhood problems, but it's also very solidly grounded in science, so parents don't have to worry that they're going to hear something weird or dangerous or something like that.

NEMA: That's one of the aspects that I see changing....do you think that the general idea of the term 'holistic' is changing from that 'out there' and 'oddball' connotation to something that is more accepted and worth taking a look at...?

KEMPER: The word "holistic' is used by a lot of people in a lot of different ways, and unfortunately it's been used heavily by marketers who are trying to sell particular products. When I use the word 'holistic', I mean something very much like 'comprehensive', and I use it to mean an approach to the patient that considers the whole patient, not just their ear infection, or not just their diarrhea, but their whole body/mind/emotion/and even spiritual values in the context of that patient's family, their culture and their community. For example, the same child might come in with an ear infection from a family from Southeast Asia or a family born and raised in Seattle...and you might approach them differently because the family values are different and the belief system is different. So you want to have a wide range of options in treating kids from different backgrounds, but you still want to be grounded in science and care for the patient. So it's really, I think, what good medicine has always been, it's just broadening our options in terms of treatment a little bit.

NEMA: It seems the claims for herbal products and homeopathic medications have really exploded, and it's tough to figure out which, if any of these treatments will work. There are barks, and flowers...roots and natural minerals. What are some of the maladies that you find success in treating with a combination of traditional medicine with a holistic approach??

KEMPER: Well, I would say something like the common cold. It's probably the thing we see most often in pediatrics and probably even in adult medicine clinics. Many parents will come in asking for antibiotics for a cold, and we know from the scientific literature that antibiotics are not helpful in treating the viruses that cause common cold. It turns out that neither are many of the cold medicines that parents are spending lots and lots of money on to try to help their children. So, that they can save money on those types of products and instead spend it on things that have been proven helpful...like vitamin C, and zinc, and even herb echinacea, which is helpful in boosting the immune system....and good old fashioned home remedies like chicken soup, which our grandmothers may have recommended to us. There are actually scientific studies supporting the use of that. So when parents come to me, I try to support what they're already doing....if they say the vaporizer is helping, I encourage them to continue to use the vaporizer. I try to discourage them from using things that are costly and have not been proven helpful...and I try to direct them toward other things that might be helpful that have support in the medical literature. And many physicians ask me, 'is there any evidence for this holistic stuff' in the literature? And there is. In fact, even though we maybe didn't learn about vitamin C and zinc in medical school, there have been lots of studies over the past 5 years evaluating these kinds of things, and there is more and more data out there to support the use of these kinds of remedies. And most of the physicians I talk to are very eager, once they see the data, to adopt some of these things into their practices. I think one of the misconceptions that a lot of families have is that physicians are closed minded, and aren't going to be interested in this, and don't want to hear about it. And I don't think that's true. I was just invited down to Alabama by the medical students there who wanted to hear about holistic medicine. And I'm getting calls from physicians' groups around the country who are interested learning more, because they know their patients want to know about these things, and they want to be educated and be able to help their patients.

NEMA: The holistic approach to medicine has really been taken to heart, I understand in your state of Washington....where naturopaths have been embraced by the communities. Tell me more about that....

KEMPER: Naturopathic physicians are licensed in now 14 states in the United States. They have four years of training after college, that in many ways is very similar to medical doctor's training. They study anatomy and physiology and histology and all those same kind of things, however they don't have long rotations in surgery and they don't have long classes in pharmacology. In most states, they don't have hospital privileges and they aren't licensed to prescribe medications. Instead, they have classes in herbal medicine, in nutritional medicine...some of them also study massage and acupuncture. So, they study a different range of therapeutic tools, but their basic science background is very similar to medical doctors, so their approach tends to be more natural remedies, or home remedies or those sorts of things. And I think that their practice is a nice complement to mainstream medicine. In fact, in my practice, I have a naturopathic physician who works with me, and we have been learning from each other the last year or so, and I think in Washington state, there is going to be more instances of medical doctors and naturopathic doctors working together, because we have some similarities in our background that allow us to talk to each other easily, but our training is also different enough that we can complement each others' strengths.

NEMA: Over the past several years, I've gone to see massage therapists, acupuncturists, and people who describe themselves as herbalists, in trying to understand the efficacy of these more natural modes of therapy and treatment. And it seems the naturopath is someone who combines all these disciplines into one area...with the main idea really prevention...

KEMPER: Their approach tends to be more natural as I said, they don't have extensive training in pharmacology or medications, so they aren't going to be able to help you, for example, if your asthma is very severe, and you need to be on beta-agonists, albuterol, steroids or those kinds of things. They won't be able to help managing those kinds of medications, however they will be able to help you with nutritional support, avoiding allergens, sort of having a healthy lifestyle...those kinds of things, which are very important for treating asthma.

NEMA: You mentioned echinacea earlier...I've used it to help fight off upper respiratory problems, and I find it's very helpful. How do you find out what brand of herbs are good?

KEMPER: One of the things about herbs that I think it's important for physicians and the regular public to understand is that herbs are not regulated by the FDA the same way medications are. So, at this point, so there's an enormous variability in the quality of the products available, in their purity and their potency. And that's a very unfortunate thing about herbs, because it may be that if somebody takes echinacea and doesn't have any benefit, it may be that they weren't really getting much echinacea at all, because of the quality of the product they were using. And I think it's going to be important for the medical community and the general public to join together and urge the FDA to exert more quality standards over the herbal industry, so that consumers can get what they're paying for and get consistent, high quality products. Just as we've learned to expect from medications. If I order 250 milligrams of amoxicillin for a child in Seattle, I'm sure that child is going to get that from the pharmacist and they will get the same product as if I ordered it in Baltimore or someplace else. So, we need to have that same kind of reliability in the herbal industry, and that does not really exist right now. Which has made it difficult for many of us who routinely recommend a lot of herbal product for more serious problems.

NEMA: Is it possible right now, to order herbal remedies from somewhere, with any confidence....?

KEMPER: There are some publications that are very helpful for consumers, such as Consumer Reports on Health, that every once in a while will run reviews of things like garlic supplements or other supplements to evaluate those kinds of standards, and the variability in the products...to let you know what products contain what. In my practice, I tend to refer folks to the pharmacy at the naturopathic school here in town, because I know they monitor that very closely, so I don't have to worry about it so much. The other alternative is to go with manufacturers who are based in Europe, because there is more quality control, for example in Germany, than there is in this country, because in Germany, herbal medicines are used much more commonly by physicians.

NEMA: Our thanks to Dr. Kathi Kemper. Her book, The Holistic Pediatrician, is published by Harper Perennial, and available at bookstores nationwide.

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I'm Steve Girard for The Heart of the Matter.

 

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