You’ve lived in Alaska your whole life, and now you practice there,
have you seen a growing trend toward complementary, alternative and
Dr. Vincent: I’ve
been practicing medicine here in Wasilla, Alaska since 2005 and in that
amount of time I have seen an increase. We’ve had a naturopath move
into town and we have two acupuncturists that currently work out of my
clinic. There are also practitioners that do energy medicine, colon
hydrotherapy, body wraps and other things that could be considered on
the health and wellness continuum. We also probably have more
chiropractors than we do primary care physicians in the area. So, I’d
say although this region tends to be pretty politically conservative it
is surprisingly embracing of integrative medicine.
ACAM: Your bio says that even before you went to medical school you had an
interest in complementary and alternative medicine, did that prompt you
to go to medical school?
Dr. Vincent: No,
but it also did not discourage me. Whereas, if I knew then what I know
now I unfortunately probably would have been discouraged to go to MD
medical school. I was kind of naive before going in, not knowing that
original thought was discouraged and that alternative medicine was
completely shunned and not embraced. Since I had the interest before I
got into medical school I was able to maintain that perspective and keep
an open mind and learn everything truly good that conventional medicine
had to offer me, so that I could then add to that later on and I could
learn more in addition to it. I certainly do not discard what I learned
in conventional medical training in my current practice.
ACAM: Where did you get additional training in integrative medicine from?
Dr. Vincent: During
the last year of my family medicine residency in Anchorage I had the
opportunity to train in acupuncture through the Helms Medical Institute.
Learning acupuncture opened up my mind and my world to the concepts of
Chinese Medicine and how the diagnostics are completely different and
yet it works extremely well. It was my first exposure to an integrative
or alternative medicine technique.
same organization offered a training course in Chinese herbal medicine.
When I finished the acupuncture course I took the Chinese herbal
medicine curriculum and I learned how to use patent herbal formulas to
help people with various things and then combined that with acupuncture.
also decided to learn about nutrition which had always made sense to me
as being one of the most important things. In my search online for
nutrition books I found the Institute for Functional Medicine’s (IFM)
nutritional textbook for clinicians. I read it and got really excited
because it talked about things in the way that I thought they should be
discussed in terms of how the body actually works and what it takes to
make the body work right. Then I found that they had a textbook of
functional medicine and I got that book and read almost the entire thing
in about a month. I started going to IFM conferences and through that
network I discovered the American Academy of Environmental Medicine,
ACAM and the Autism Research Foundation. So, I started attending lots of
different conferences with these different groups. Then I found a
hormone training conference which interested me because I learned
through some other exposure that hormones seem to be important. I did a
more formal hormone therapy training through the International Hormone
Society in the beginning of 2007 and then started doing a lot of hormone
therapy, which is now the subject of the course that I helped set up at
gathered education and material from all kinds of different
organizations and lots of conferences, reading journals, researching
things online and there really isn’t a comprehensive place to learn
everything at this point, which people ask me all the time. Medical
students and residents ask me, ‘Where can you go to learn integrative
medicine,’ and there isn’t one single place. My hope would be that ACAM
could become that single place, where we could offer workshops and
ongoing longitudinal educational experiences and the things that give
you everything you really need to know to be a very functional
integrative medical practitioner. I think that ACAM does the best job
out there so far.
ACAM: Is your practice mainly hormones patients?
Dr. Vincent: No,
I’m a family practitioner by board training. I used to deliver babies,
perform colonoscopies and a very broad spectrum of family medicine. Now
that my practice is sort of specialized, I see people who have chronic
medical complaints that other doctors haven’t been able to figure out
and a lot of times hormones are involved. I also deal a lot with
autoimmune disease and immune system problems, gastrointestinal
problems, and other sort of functional disorders. I see all kinds of
chronic illness, but in the majority of chronic illness problems people
come in with including fatigue syndromes and other things I see hormones
as playing a role.
ACAM: Do you see the interest in HRT growing by both patients and practitioners?
Dr. Vincent: I
do. Hormones are in the mainstream media, in mainstream reading and
people are talking about the subject, especially women. Now women in our
society feel much more empowered, they feel like they have a voice and
that they can come in and get their needs met better than they used to. A
lot of the patients I see come in wanting hormonal things, specifically
women, and they have already read books and done research. So, it’s
definitely something that’s increasing in public awareness. I think the
approach integrative medicine should take is to appeal to the consumer.
It is a consumer industry, but it’s still up to the physician or
practitioner to know what is safe in terms of hormone therapy, know how
to answer questions correctly and know how to steer therapy decisions.
It’s important to try to accomplish the goals and the needs that the
patient comes in with, which are often different than what I think the
patient ought to do. So, we have to figure out where we can agree.
ACAM: Since Summer Camp last year, how has the Hormones program changed?
Dr. Vincent: At
Summer Camp in Fort Lauderale it was a one man show where I was tasked
with trying to put together a comprehensive hormone curriculum workshop
in one day. I did brief overview lectures on every major hormonal topic
in a 7 hour lecture period.
for the San Diego conference, which was this past May, there was a team
of us that put the workshop together. We chose speakers from outside of
ACAM and we had two days of workshop to put together, so we could
really address things in greater depth and detail and with a variety of
speakers. At the conclusion, we had panel discussions with the multiple
speakers and it was certainly a very different format that I think was
much better for everybody. It’s nice to get different opinions, views
and fields of medicine where everybody has their own take on things.
course we’re planning for November in Las Vegas is going to be a
similar format. There will be a number of speakers and we’re going to
try and cover material in a more basic format. In San Diego we weren’t
really sure what the audience was looking for persay and we weren’t sure
what level they were coming in at, so we put together a workshop that
we thought covered material that was important. Some of the feedback
from attendees suggested that we should probably make it a little more
basic for people that are coming in with no previous hormone training
whatsoever. We decided that was a good idea, so down the road we’re
going to try to do a basic workshop one time and then the second
offering of the year will be a more advanced workshop on the same types
of topics. So, this November will be our first time doing what we
consider the more basic workshop.
really want people to come who have preexisting knowledge on hormone
therapy and we want people with no knowledge of hormone therapy. I think
there is something in it for everyone who attends. We also really want
feedback to tell us how to better teach the course as time goes by
because this is a really important aspect of medicine that is involved
with the majority of my patient care experiences. It’s one of the most
powerful tools we have in integrative medicine so I think it’s an
important thing to continue to fine tune for our attendees.
ACAM: If someone took the Hormones course in San Diego, what is something new they can expect in Las Vegas?
Dr. Vincent: This
time I’m doing the thyroid lecture, we don’t have an outside person
giving it. In San Diego there was some very obvious disagreement between
myself and the speaker we had for the thyroid talk. I’m also giving the
lectures on women’s hormone replacement and Matthew Cavaiola is giving
the men’s hormone lecture instead of me. Basically we have some
different speakers giving different talks this time. We are also taking a
more basic approach. We’re going to step back and take a little more of
a basic, concise and clear approach to understanding hormone
replacement. Hopefully it will be more clear and it will be more user
friendly and it will leave plenty of time for question and answer and
we’re going to try and have things be a little more case based as we do
each presentation also. There are a few changes we’ve made and they’re
all based on attendee feedback from San Diego.
ACAM: What is one thing you want attendees to take away from your lectures?
Dr. Vincent: That
the issue is extremely complex and it requires them to think on their
feet. There isn’t one way to do it, there is no protocol for hormone
replacement. You have no idea what’s going to happen to any given
individual when you give them a hormone no matter what their laboratory
data shows or what their symptoms were. Every time you give someone
hormone therapy you have to pay really close attention and follow them
clinically based on their response. There’s no ‘cookbook’ way to do it.
So, the way I teach this material is from a conceptual basis and that
it’s complete chaos which is disconcerting for some people but that’s
really too bad because that’s just the way it is. People really want to
have clear cut answers and a protocol and an algorithm and that has to
go out the window when you start doing hormone replacement therapy. I
have a lot to say about what can happen when you start doing hormone
therapy, but it’s certainly not the gospel and everybody has to go forth
and gain experience and do their own learning on their own beyond that.