ACAM: You’ve lived in Alaska your whole life, and now you practice there, have you seen a growing trend toward complementary, alternative and integrative medicine?

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.

The 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.

I 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 ACAM.

I’ve 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.

Then 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.

The 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.

We 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.