Bastyr UniversityBoucher Institute of Naturopathic MedicineCanadian College of Naturopathic MedicineNational College of Natural MedicineSouthwest College of Naturopathic MedicineUniversity of Bridgeport
Education: Southwest College of Naturopathic Medicine & Health Sciences (2003)
Years in practice: 4
Location: San Carlos, Arizona (licensed state)
Position: Medical Director, San Carlos Apache Tribe, Diabetes Prevention Program/Weight Management Clinic (opened September 2006)
Practice setting: Single-practitioner clinic, division of the Tribal Health and Human Services Department
Areas of focus/specialties:
- Diabetes prevention
- Weight management
- Metabolic syndrome
- Endocrinology
Career highlights and contributions:
- Adjunct faculty, Nutrition Department, SCNM
Current professional endeavors:
- Healthy cooking classes
- Research project documenting the success of a naturopathic approach to weight loss
Associations
- American Association of Naturopathic Physicians (AANP)
- Arizona Association of Naturopathic Physicians (AZNMA)
- New York Association of Naturopathic Physicians (NYANP)
- Homeopathic Association of Naturopathic Physicians (HANP)
Favorite Personal passions: Cooking, especially seafood
Other interests: Animals, jogging, hiking, ocean fishing
Web site: None. Word travels much faster by mouth and telephone that it ever could by computer.
Favorite quote: “With God, all things are possible.” - Matthew 19:26
Alumni Career Spotlight
Andrew J. Kaufmann, ND
We recently interviewed Dr. Kaufmann – the first and only physician to be employed by the San Carlos Apache Tribe – to learn more about the culture in the community which he serves, how they have embraced and blended the naturopathic treatments with their own healing and lifestyle traditions, and what they bring to each other ...
A personal culture
Discovering an avalanche of underserved needs
San Carlos culture
Working on a reservation – the benefits and the challenges
A personal culture shift
AANMC: As a New Yorker, what made you decide to attend SCNM?
AK: I really wanted sunshine, and that is what I got. I did not think I would stay in Arizona following graduation but God had other plans for me. This is my home now, and I have no regrets.
AANMC: How heavily did you weigh the financial aspects of the profession in your decision to become a naturopathic doctor (ND)?
AK: Income potential following graduation is certainly a factor, especially for those of us who have spouses, families with children, and other family members who have given their financial and emotional support. But it doesn’t take a lot to make me happy. I’m just glad to be doing what I’m doing. I’m a simple person. I have a good life, a good salary with good benefits, and I’m doing what I love.
AANMC: What led you to decide to attend naturopathic medical school?
AK: Becoming a naturopathic physician was not a life-long dream of mine. After a routine medical test in 1989, I received a diagnosis of chronic kidney disease and was told that I would never get better. Three specialists offered aspirin, hormone and steroid therapy. They would monitor the deterioration until I was ready for a kidney transplant. When I rejected that treatment, one nephrologist showed me the door. Then an MD and an ND working together at Hahnemann Health Institute totally changed my life. I owe my inspiration to them. I began a course of homeopathic and botanical medicine treatment along with intensive nutritional counseling and radical lifestyle changes which initiated the long and winding road back to wellness. Along that road I found chiropractic medicine, traditional Chinese medicine, reflexology, massage therapy and most importantly of all, spiritual growth and a renewed faith in God. In 1994, I went into pre-med to become an ND. After eight years of this new lifestyle, I had normal kidney function again.
Discovering an avalanche of underserved needs
AANMC: You work with underserved populations. What does that term mean as it relates to naturopathic medicine?
AK: Underserved populations are those that have very limited or no access to any type of quality health care, and that would especially include rural Native American and Hispanic populations, with urban areas as a close second. With respect to naturopathic medicine specifically, cost, availability and awareness are the limiting factors.
AANMC: You specialize in diabetes prevention, endocrinology, metabolic syndrome and weight management. How did you come to focus on these areas?
AK: Oftentimes a physician’s practice will be determined by the needs of the local population. In my case the decision had already been made before I arrived at San Carlos. There are 13,000 people living on the reservation. Ten percent are diagnosed with diabetes. In reality, probably 50-60 percent are either Type 2 diabetic or pre-diabetic. We also treat many other chronic, debilitating diseases associated with overweight and obese individuals. We often see patients with arthritis, cardiovascular disease, hypertension, acid reflux, food allergies, chronic fatigue, hypothyroidism, menstrual disorders, anxiety, depression, and the list goes on and on. We treat these conditions because they have a direct impact on one’s ability to lose weight and to maintain that weight loss over time.
AANMC: Can you give me an example of how naturopathic medicine has helped one of your overweight or obese patients?
AK: A 17-year old female recently presented with Hashimoto’s thyroiditis, an autoimmune disorder where the body doesn’t make thyroid hormone. It causes huge problems because the thyroid affects everything in your body. It requires lifelong medication. She is also morbidly obese and had amenorrhea. She is currently seeing another doctor at Indian Health Services (IHS) who is managing her case using thyroid hormone (Synthroid) but was referred to our clinic for weight management. We did a complete assessment, then started her on a high-potency multivitamin and fish oil, portion control, lower-fat protein sources, restricted complex carbohydrates and an exercise program designed at the San Carlos fitness center. Within two weeks she’d had her first menstrual cycle in approximately one year. She was so elated. Then she missed her cycle for the next three months because she wasn’t sticking to the diet, supplements, meal plan and exercise routine. We started her on adrenal support and a liver cleanse because all of her organs need to work together, and we emphasized the importance of complying with the complete treatment protocol. Two weeks later she had another menstrual cycle. She had also lost eight pounds in the previous four weeks. You could see a nice glow in her face and her mood also had changed dramatically. She was much more engaging and not as hesitant to talk. I’ll see her again in another month.
AANMC: Many tribal people have traditions of natural healing. Does that history open doors for you that are not so easily opened in the dominant American culture?
AK: There is great respect for elders and other community leaders, such as medicine men and medicine women who are knowledgeable in ancient healing methods and customs. The vast majority of botanical remedies have Apache names but they are not generally documented in writing. They are passed down through the generations verbally and often not exchanged outside the immediate family. Overall, Native Americans are highly receptive to Vis Medicatrix Naturae (the healing power of nature), which has started a dialogue on many occasions and earned that very critical aspect of any patient-doctor relationship: trust.
AANMC: How does your different cultural background come into play on the reservation?
AK: There was a learning curve, in terms of greeting people and making eye contact, for instance. Elders (50 years and older) don’t make a lot of direct eye contact because it’s considered disrespectful. Also, when shaking hands, I learned not to use an aggressive, firm handshake. Both women and men just touch hands in greeting. There is also a battle going on between Christian and pagan theologies. I stress all three aspects of healing: mind, body and spirit. I urge each patient to take 15 minutes away from everything daily to listen and connect to that still small voice within. For me, being saved as a Christian was the answer. But how they interpret my personal experience is not for me to control. Culturally sensitive communication with an emphasis on strict adherence to patient confidentiality is essential.
AANMC: What ground have you broken in establishing a clinic on the San Carlos Apache Reservation?
AK: I am the first and only physician employed directly by the tribe because they wanted an ND. All other physicians (MDs and DOs) working at San Carlos are employed by IHS, the federal government entity that provides health care to tribes. Secondly, we are the first truly preventive medical facility employed by the tribe. I’m hoping to lay the groundwork so it will be easier for others to duplicate our model. I want to provide a policies and procedures template that can be followed in the future at other clinics on Native American reservations throughout the U.S.
Working on a reservation – the benefits and the challenges
AANMC: What are some of the unique benefits of working with a federally recognized tribe?
AK: The benefits of working in this environment include a salaried position, excellent benefits, autonomy to make all medical decisions, free services and supplements for all patients, research opportunities and the ability to help rewrite the new Diabetes Prevention Program five-year grant beginning next year at this time. But the greatest benefit of all is observing the healing effects of natural medicine while getting to know the patients and having them place complete trust in our staff so that they refer family and friends. In the process, I have been blessed to learn about the amazing language, culture and traditions that date back hundreds of years in this beautiful, remote, two million acre, rural area of southeastern Arizona.
AANMC: And what are some of the challenges of working with a federally recognized tribe?
AK: While the Tribal Council’s Health and Welfare Committee can dictate to IHS what they want done in terms of health care, there was still a challenge initially of gaining acceptance and support by IHS. IHS does not officially recognize the ND license. So I’m restricted to seeing only non-pregnant, age 13 and older, enrolled tribal members who have an IHS physician referral. But I was part of rewriting the grant this year, and we unofficially changed our name to “N dee Bi zeh,” which means “Apache Medicine” in Apache. In the very near future, we will be the only tribal clinic that is a full-blown natural medicine clinic. I am still trying to receive credentialing at the IHS hospital and to get my student loans repaid under the IHS Physician Loan Repayment Program, as they do for other health care professionals such as MDs and DOs working for IHS.
AANMC: So how does licensure factor into your practice?
AK: IHS does not recognize my license, but since I am a tribal employee it is not a limiting factor. In Arizona NDs are recognized as primary care physicians with all the rights and privileges described under the Arizona Revised Statutes for NDs, including full prescription writing privileges and the ability to diagnose and treat disease.
AANMC: What is your message to someone considering becoming an ND in a setting like yours?
AK: I think the opportunities are tremendous for anyone interested in serving an underserved community. Right now, the Gila River Indian Reservation is in the process of introducing naturopathic medicine to their community, integrated with current allopathic services already being provided. And I plan to establish a residency program here with Southwest College of Naturopathic Medicine because of the need for another ND.
Dr. Kaufmann has big goals ahead to expand his facility into a comprehensive natural medicine clinic. Hospital credentialing and repayment of student loans are two major hurdles he has yet to clear. Yet, he is living his dream. At the end of each long day he knows without a doubt that he has made a difference in the lives of his patients. His is a real-life experiment of the mutual impact that a small-town Long Island mechanic-turned-physician and his Native American patients can have on each other. Through their interrelation there is learning for both, and a greater ability to live a meaningful life.
Author Patty Bates-Ballard is a mother, freelance writer and owner of WordSmooth. Patty's articles have appeared on the Environmental News Network and in Environmental Design + Construction magazine. She has guest lectured at Presbyterian Hospital of Dallas, Sherman's Austin College and El Centro College in Dallas. She works from her home in Dallas, Texas, where she raises her sons, Kory and Kaden.