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Integrative Medicine: Chiti Parikh
37 Plays5 years ago
Season 1, Episode 14: Dr. Chiti Parikh is an integrative medicine physician at New York Presbyterian – Weill Cornell Medical Center. Listen to Chiti talk about the types of patients who seek out integrative care and the importance of spirituality in medicine.
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Transcript
Introduction to Podcast and Guest
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, Jon Neri. Today, my guest is Dr. Chidi Parikh. Dr. Parikh is the Executive Director of the Integrative Health and Wellbeing Program at New York Presbyterian Hospital, Wild Cornell.
00:00:31
Speaker
She received her MD degree from UMDNJ Robert Wood Johnson Medical School and performed her residency in internal medicine at New York Presbyterian Hospital while Cornell.
Dr. Parikh's Healing Philosophy
00:00:42
Speaker
Chidi, welcome to the show. Thanks, John. Very excited to be here. So first, I just wanted to ask you in your own words, what is healing? So healing from my perspective is just allowing the body to do its job.
00:01:01
Speaker
So very often diseases and symptoms happen because we often get in the way of this immense intelligence our body has inherited over years and years of evolution. And often things that we do to our diet and lifestyle just gets in the way. I know you even work in palliative care. So is there healing that can happen sort of when you're not necessarily guaranteed of a good outcome? Absolutely.
00:01:31
Speaker
Just like, you know, just like we talk about healing that can have multiple definitions, so does health.
00:01:37
Speaker
So healing also takes on a new meaning for each individual at different stages in their life. There's always an opportunity for healing. There's always an opportunity to have a conversation about health. So I think that's a door that's always open for
Health Beyond Tangible Outcomes
00:01:53
Speaker
everyone. It's just a matter of how we approach it and what it means to the person in front of us. So I'll give you an example. So for instance, we see patients, I see personally see patients anywhere
00:02:04
Speaker
you know, people in their late teens, early 20s, who are otherwise healthy, and I also see people who are towards the end stage of their life. And I always have a robust discussion and lots of things to talk about when it comes to health and healing. So I don't think, you know, sometimes we end up thinking about outcomes in the sense or material objective outcomes, you know, as to
00:02:27
Speaker
Can I get the blood pressure under control? Does this chemotherapy make someone live longer?
00:02:35
Speaker
When we talk about healing, you have to expand the conversation beyond just the physical, objective, tangible outcomes. And you really have to start the discussion of what does health really mean to the person that we're healing? Because their definition really dictates what that healing journey looks like. And it doesn't always have to be objectified in, you know, lab tests and sort of tangible things.
Patient Goals and Healthcare Models
00:03:02
Speaker
Could you expand on when you're having those, like you said, robust conversations about what health looks like? I imagine, like you said, age might be one factor that kind of steers that discussion. But what are some other things that will sort of give you more direction? So one of the first things in my visit with a new patient, the first questions I ask is, what is your goal? What is the patient looking for?
00:03:32
Speaker
because it's great that I have my own set of ideas based on my medical training, what the patient should be doing or what they should be focusing on, but ultimately the patient drives the discussion. So I always start the conversation by asking the patient, what are they looking for? What is the goal that they would like to set for us to focus on?
00:03:53
Speaker
And the discussion is far more comprehensive besides just saying, you know, talk to me about your, you know, medical history, surgical history, things that we learned sort of checklist in medical school. It goes way beyond that. So conversation often indicates, you know, it includes
00:04:12
Speaker
the goal for the patient, but also looking at the whole biopsychosocial model of health. So the questions will pertain to from childhood history to psychological history to talking about their diet, talking about their stress level, talking about their coping mechanisms, their support system, exposure to environmental toxins. So it really goes far beyond just asking
00:04:37
Speaker
you know, what hurts today, what, you know, what brings you into the doctor's office that can be fixed, you know, sort of set into a box of ICD-10 codes. The conversation is really all-encompassing because we know health is not just absence of physical disease or symptom. It's really a balance between all of these components of health, whether it's
Evolution of Integrative Medicine
00:05:00
Speaker
you know, emotional, psychological, spiritual, community, environmental, all of these aspects play a big role in health and healing.
00:05:11
Speaker
For our listeners who may not be too familiar with integrative medicine, can you just describe what it is and what tools you have at your disposal? Yeah, so the definition of integrative medicine has really evolved over the last, I would say at least a decade. So before this field of medicine was often referred to as alternative medicine.
00:05:32
Speaker
The image that conjures up is always, hey, let's say someone is diagnosed with diabetes or high blood pressure. And instead of taking a medication, they chose not to see a Western medicine doctor. Instead, they did something on their own, whether it's diet changes or seeing an acupuncturist or whatever it may be.
00:05:51
Speaker
So it's really, you're avoiding the Western medical approach and choosing an alternate. So that's how it always was viewed upon as. Then the people realized that again, there's more and more scientific evidence backing up some of these modalities. And then the terminology shifted from alternative medicine to complementary medicine.
00:06:11
Speaker
What that entails is, let's say someone is diagnosed with high blood pressure, they see their doctor, they start a medication for high blood pressure. But on the side, they also end up doing a lot of research and starting some sort of a diet or start exercising with the fitness trainer. But the doctor doesn't really know that the patient's doing that. And the doctor who prescribed the medication is not necessarily the one who is recommending some of the other things that are evidence-based. So now integrated medicine brings all of this under one roof.
00:06:41
Speaker
If I see a patient who I'm diagnosed with high blood pressure, I'm not simply just prescribing a medication. I'm also trying to look at the root cause and understand what is contributing to the high blood pressure. Doing a very detailed history taking when it comes to diet, lifestyle, stress factor, family history.
00:06:59
Speaker
and recommending things beyond just the medication that we know through research that these things work, whether it's a DASH diet, whether it's encouraging patients to exercise, lose weight, maybe addressing stress through meditation. All of these have shown to help with hypertension in research. So this is a true integrated model where you're combining the best bodies of research, whether it's from the Western medicine world or whether it's Eastern medicine, and you're combining that
Therapies in Integrative Medicine
00:07:28
Speaker
really to bring and support, to bring the best medical therapies to the patient and really give the best chance for the patient to succeed along their health journey. Could you talk more about some of the therapies you employ? One of them is nutrition, which is obvious. The second is psychotherapy. We also have acupuncturists as part of our staff. We also have a meditation instructor. We also have yoga therapists, Reiki therapists, massage therapists.
00:07:57
Speaker
All of these are working together for the patient. So very often a patient will see the physician, but they also end up seeing a lot of these other providers. And all the providers are discussing the patient's case so that everyone is on board and everyone's sort of working together in a team that's supporting the patient's journey. So hypothetically, let's say I'm interested in reducing stress by doing yoga.
00:08:25
Speaker
Should I, in theory, it seems like you could either A, go to a yoga studio and kind of take that up independently or do it through this integrative model where you're kind of bringing your physician into how would you go about advising patients on what way to choose to do that?
00:08:47
Speaker
So I always recommend a more integrated model for two reasons. First of all, very often, you know, patients come across some of these therapies because they heard about it by reading an article or heard about it to a friend or family member. So
00:09:04
Speaker
So they might not really know exactly what that treatment is, but you might not exactly know what yoga is, but you heard that it really helped your friend and you heard it's really good for you. But you might also not know where to find the best therapist or someone that's going to suit your needs. So I always recommend trying an integrative model because then you cover all bases, especially for patients, usually patients who are otherwise healthy,
00:09:30
Speaker
It's not that big of a deal, but when it comes to patients who do have a complex medical history, I always recommend going through a physician consultation first so that all of the treatments can be in a supervised setting and in a more coordinated setting. Second of all, even patients who are otherwise healthy, they often come to us for guidance because they might have heard of yoga, but there might be other modalities and things that could also help them. It's always good to
Role of Integrative Medicine in Primary Care
00:10:01
Speaker
go through the integrated model because then you know you're checking all the boxes and you're doing it in a safe and effective manner. So to be clear though, seeing an integrative physician like yourself isn't considered a primary care visit. It's sort of a specialty of sorts, correct?
00:10:18
Speaker
Yeah, it is. In most places, I mean, there's a hybrid model. So some integrative practices do both. They act as a primary care physician and also add the integrative model, where some practices like our practice chooses to just focus on the integrative piece, but we work very closely with primary care physicians within Cornell, New York Presbyterian, or any other primary care physician that the patient already has a relationship with.
00:10:42
Speaker
So looking more at the patients you treat, what are some of the most common conditions you see? So I would say about top five, and this is common across most integrative centers. There was a survey that was done for top integrative centers across the country, and they all found a similar theme that
00:11:02
Speaker
The main reasons patients seek integral care, number one, is mental health. So when patients are suffering from depression, anxiety, or stress, second tends to be chronic pain. Third tends to be more GI symptoms like IBS, IBD, or irritable bowel syndrome, inflammatory bowel disease like Crohn's, ulcerative colitis.
00:11:21
Speaker
then followed by patients with a history of cancer and also followed by patients who are looking for more sort of cardiometabolic, so whether it's trying to lose weight or address heart disease, diabetes, and things like that.
00:11:37
Speaker
So it's really very sort of comprehensive in the sense you, and again, you know, we always think about in integrative medicine is we treat patients, not diseases or symptoms, right? So the same patient could have a manifestation of many of these different diseases, but ultimately the treatment approach for that patient might vary from someone else who has sort of the same diagnosis as labels.
Western Medicine Limitations
00:12:02
Speaker
So do you see it as like a lot of those conditions you mentioned are just saying is that the Western
00:12:07
Speaker
that Western medicine hasn't done so well yet, that for a lot of people, just like mental health care hasn't really advanced enough in the Western context to be satisfactory, so they look elsewhere? Yeah. Is it sort of kind of like a pivoting to look elsewhere, really?
00:12:22
Speaker
That's a very good point. So one of the reasons why patients come to us because they know they could be doing more. It's not necessarily that they haven't tried the Western medical approach. Often these patients have seen multiple specialists and kind of done what they're supposed to do from Western medical approach, whether it's medications or whatever it may be. They've already tried those things.
00:12:41
Speaker
So either they're not having full results just from that approach, or some of the patients are interested on not having to take medication. So before they try medications, they want to see what else they can do. So it's either they're in early stages and they want to explore other options that they know can work, or they want to do more than just take a pill.
00:13:04
Speaker
So those are the patients we typically see. And unfortunately, a lot of these conditions that I mentioned that patients come to us for tend to be more chronic and tend to be not very well addressed from a Western medical approach, right? So not everyone benefits from just, you know, antidepressant. And like you mentioned, not everyone has access to mental health care, whether it's psychotherapy or even medication management.
00:13:29
Speaker
And when it comes to GI symptoms, we often just focus on the symptoms and try to prescribe pills when we know a lot of these GI conditions are very intimately tied to diet and lifestyle. So often the focus is just medications, but no one is really addressing the big, big root cause of a lot of the GI symptoms, which is diet and lifestyle.
00:13:50
Speaker
Same thing with chronic pain, especially nowadays, everyone becoming more and more aware of the problems with taking opioids in the long run, the opioid crisis. More patients are seeking to do things that are really going to help them in the long run rather than just taking opioids.
00:14:07
Speaker
Again, integrative medicine is not necessarily for everyone because a lot of the patients that come to us are looking to go the extra mile. There are no shortcuts in integrative medicine, there's no magic supplement, there's no magic diet. This is a commitment, this is a journey. Patients who come to us are often willing to dedicate their time and be disciplined about following this path,
00:14:34
Speaker
because they know that that's going to give them more long term, you know, better outcomes than just taking a pill.
00:14:43
Speaker
I want to ask you a
Philosophy of Integrative Medicine
00:14:44
Speaker
little more about, I guess, just the philosophy of integrative medicine. And you've kind of touched on this already, right? That we stayed away from this alternative attitude. But as I understand, everything you do is pretty much evidence-based. So why bother to kind of make this, why are you integrating anything? Why isn't just kind of like one medicine? Exactly. So that's often my answer to a lot of integrative medicine questions. Like, this is just how medicine is supposed to be, but unfortunately it's not.
00:15:12
Speaker
So like you said, all this is evidence-based. In fact, most of the diseases that we treat in Western medicine, most of the chronic conditions, the first line of therapy is often diet and lifestyle changes. And to give you an example, in medical school, I probably learned about four hours of nutrition in four years. So it just doesn't make sense that when we have this robust data,
00:15:38
Speaker
when it comes to just diet and lifestyle management. And we're not really teaching physicians the tools they need to combat majority of chronic conditions. That's where the gap is. So if 80% of the conditions that most Americans suffer with are preventable, then how come not 80% of our efforts are not focused on prevention? Less than 4% of all the health care funding actually goes into prevention, rather than everything else just goes into treatment, which is very reactionary approach.
00:16:08
Speaker
This is honestly, when I was about to go into medical school, this is how I thought medicine was practiced. It just makes sense. Anyone you ask, they'll say, I'm surprised that not other doctors are doing this. I'm surprised that not other medical centers are doing this. Because first of all, we're embracing preventive medicine approach. Second, we're incorporating evidence-based medicine techniques that are far safer, less invasive, cost-effective. And third,
00:16:38
Speaker
We are talking about making a time, you know, a commitment to our patients in making sure that we support them throughout their health journey. It's not just incidental, accidental encounters when something goes wrong, patient comes in, we give them a medication and we see them a year later.
00:16:55
Speaker
This is more of a commitment and understanding what health means to that patient, investigating, and also investing a lot of time and effort and understanding what the root cause of the disease is, rather than treating all these symptoms in isolation. So when you can actually do this in a team-based approach in a more holistic model, it really is a win-win situation for both patients and for the provider.
Balancing Science and Art in Medicine
00:17:19
Speaker
I do want to ask though about just like science, I guess as a philosophy. I think we often forget that science is a philosophy that it's, and it is, you know, especially and like at the end of the 19th century and the 20th century, science has kind of become the king in medicine and like rightfully so, but are there, I just sort of feel bogged down in this idea of
00:17:48
Speaker
you just sort of accumulate a bunch of data and like plug and chug and figure out whether there's some sort of statistical significance and that's supposed to help you with the patient in front of you that is very likely different than all the people that you analyze in your study. So is that something that's kind of going through the back of your mind when saying things are evidence-based and maybe saying,
00:18:11
Speaker
Yes, science is obviously very important in maintaining the integrity of medicine, but also
00:18:19
Speaker
you know, taking it with a grain of solid. Absolutely. So when we talk about evidence based medicine on the research studies, we are practicing the science of medicine. But first and foremost, medicine is an art. And when it comes to art, you know, you, you really have to bring in this more abstract concept of tailoring and customizing treatment to the person in front of you.
00:18:41
Speaker
because like I said, two people can walk into my door and both have the diagnosis of diabetes, but what I'm going to do for these patients and what these patients are looking for will be very, very different. Sometimes that gets lost in the science of medicine. I think a lot of the success we've had is really because we combine the art and science of medicine. I think as we go forward, we're looking at
00:19:08
Speaker
more and more recent studies are now starting to focus on patient-reported outcomes rather than just objective findings, whether it's the lab results or just how many extra days the patient lives with chemotherapy. So I think as we shift more focus and a good amount of focus on patient-reported outcomes, hopefully we'll pick up on this variation
00:19:28
Speaker
And we'll finally acknowledge the fact that no two patients are the same. And understand, we do have to group people together for the sake of research, but we don't always have to do that when we see a one-on-one encounter with a doctor-patient relationship. We can practice the art of medicine just as robustly as we practice the science of medicine. And I think that will really ultimately determine the success. And the future of medicine is
00:19:56
Speaker
taking into account this holistic model. It's not just looking at patient organ system in isolation. And I think it was William Osler who said, it's more important to know what patient has a disease rather than what disease the patient has, because that will ultimately determine what treatment you choose.
Building Trust in Patient Care
00:20:18
Speaker
So I think we need to shift the focus from treating a disease to treating the patient.
00:20:23
Speaker
I definitely like what you're saying, the art, the combining of the art and the science, but imagine at times those can kind of feel like they're butting heads and you sort of need to favor the science side because that's maybe deemed more culturally ethical. So that's what most people think when it comes to integrative medicine. And that's what I thought before weighing into the field, that very often I will stand at crossroads where I'll be forced to pick
00:20:51
Speaker
you know, which way to go, whether to go with the conventional approach or whether to go sort of the alternative approach. And I can tell you in the last several years I've been practicing integral medicine, there's never been a case where I had to do that. So if I see a patient who, I've seen, let's say I'll give you an example of a patient I have, I still see, you know, young man in his 30s, athletic, very healthy, but has severe, you know, very high blood pressure.
00:21:20
Speaker
had seen the best doctors you can think of and an entire workup. And he tried some blood pressure medication, had some side effects, he just completely gave up on it. And he saw multiple specialists and no one had any luck in, you know, getting him to take the medication. When he came to see me, you know, his focus was, I want to do, I want to control the blood pressure, but I really don't want to take any medicines because they make me sicker.
00:21:43
Speaker
So I don't want to do that. So after developing a good relationship with the patient, really working on, you know, then we said, okay, fine, we want to approach a topic of medication juice. Yeah, why don't we focus on the diet and other things, stress management, other things we can do in the meantime. And as you develop that rapport, you know, the patient has trust in you and they say, you know,
00:22:04
Speaker
We've tried all of these things, which is great. This is the foundation, the diet and lifestyle. But I do think, given your risk factors and everything, I do recommend a medication. And I'll work with you to find a good fit for you. Let's figure out what medications you've tried. Let's try the ones you haven't and see if you tolerate them better. And now he's on two different medications, right?
00:22:25
Speaker
My approach was a little bit different. He had seen some of the best doctors, blood pressure, hypertension specialists, but it's not that patients are coming to me because they don't want to take medication, often because it's just that they're not educated in the right way or their goals were not heard, right? So again, the art of medicine in this case was to work with the patient, identify what's important to them, and bringing every option to the table.
Eastern Practices in Modern Medicine
00:22:53
Speaker
and developing their rapport. And that rapport ultimately determines the therapeutic success in any relationship between a doctor and a patient. So it's not so much about patients saying, I don't want that. And a lot of time that I don't want this Western medicine approach often comes because they had a bad experience with the provider or the treatment. They don't really understand it completely. So when you establish the trust with the patient, they are far more open to every option you bring to the table.
00:23:23
Speaker
So so again, that's a testament to really combining the art and science of medicine because when we do just science we leave a lot of people out. Yeah, what you're saying definitely reminds me of of what one of my friends is reiterated to me on multiple occasions that when she just goes see a doctor it just sort of at times can just feel like rushed and like we need to spend more time like listening to you you're saying the patient's goals and and kind of what's going on and
00:23:53
Speaker
I think, obviously, looking at more as an art will allow that doctor and patient relationship to build more of that trust. Another thing I was going to ask you about is, in your practice of integrative medicine, I think one thing that is unique, a lot of the therapies we talked about earlier have been around for hundreds, if not thousands, of years. What's it like sort of?
00:24:23
Speaker
In a lot of ways, looking back to the past to find some wisdom and insight for your medical practice when a lot of your peers are likely looking forward towards the new breakthroughs in medicine.
00:24:45
Speaker
That's very interesting you say that because often when I explain to patients or anyone, all my family members, when they have to be what I do, I often say I combine the best of the East and West. So it doesn't have to be one or the other.
00:24:56
Speaker
So in my practice, I'd say a patient comes in with IBS. They might walk out with a treatment plan that includes testing their gut microbiome. And it might also include some herbs that are based in Ayurveda and some diet changes. So it really is the best of both worlds. And the more time I've spent learning things like Ayurveda, which is traditional Indian medicine that goes back thousands of years, and traditional Chinese medicine. So I learned acupuncture and learned
00:25:23
Speaker
that there's a lot of correlation between these ancient techniques. So whether you look at tradition Chinese medicine, whether you look at Ayurveda or whether you look at some of the more indigenous medicine practices or shamanic practices, a lot of the concepts are very, very similar. And the reason why these modalities and these, you know,
00:25:50
Speaker
these traditions have survived because they've really stood to the test of time so it's just fascinating to see how things have been practiced for thousands of years and they're just as relevant as they are there were thousands of years ago as they are today and in my experience right now my practice i would say i practice about 20 western medicine and 80 sort of eastern medicine because
00:26:15
Speaker
Most patients who come to me have already gone through the Western medicine route. And so when they come to me, my job is to think outside the box and really see what else can be done. And when I learned Ayurveda, when I learned Chinese medicine, it just blew my mind how refined, how advanced these ancient, you know,
00:26:40
Speaker
these ancient ways of practice in medicine have been. So when you learn about it and you find parallels with Western medicine, it was fascinating to think that, oh, they knew about this 5,000 years ago. So for instance,
00:26:53
Speaker
You know, in Chinese medicine, the idea is that if patients are very anemic or they have any sort of blood disorders, so hematological abnormalities, it's often, you know, sometimes it's often related to the kidney meridian being weak. So the kidney meridian often includes you know the kidneys and also the adrenal glands as well.
00:27:13
Speaker
So it just makes sense if you strengthen the Canadian meridian, which also produces orthopoietin, that it can often help with anemia, right? So things like this that you, you know, when you find these correlations, just fascinating to see how much they knew about the body. And I feel like learning about Eastern medicine has only deepened my understanding of medicine in general, and made me a much better doctor.
00:27:39
Speaker
So because these ancient traditions often rely very much on the art and the science. And when you add thousands of years of experience, that's just the cherry on top. So it's just been fascinating to see how advanced, how detailed, how elegant they are. It really is humbling and it just feels sort of foolish not to take advantage of that.
Interest in Eastern Medicine
00:28:10
Speaker
Was it like, do you think those things were sort of lost and are being rediscovered or are they only isolated to geographic regions? How come this wasn't more on the radar, especially, I guess, for instance, just people in the United States far before and now? Yeah, I do think, I mean, these
00:28:31
Speaker
Ancient traditions have been around for thousands of years ago, and they still to this day are practiced in certain parts of the world. I think over the last 20, 30 years, as we've seen a tsunami of chronic diseases, patients have started looking for more, right? So if you think about the incidence of cancer going from one in four people 40 years ago to now one in two people have cancer to
00:28:55
Speaker
the epidemic of obesity and hence the consequences of obesity, whether it's heart disease, diabetes, again, cancer, autoimmune conditions, when these have skyrocketed and we realize the limitations of Western medicine, there is a renewed interest in learning more about Eastern tradition. And as more and more evidence starts supporting the efficacy and safety profile,
00:29:18
Speaker
I think more and more people are eager to incorporate that into their practice. And again, getting more media attention with social media and everything, these isolated areas in the world, they're practicing medicines have become a lot more, they have received a lot more limelight in recent years.
00:29:35
Speaker
So it's just amazing that you can be in New York City and you can have access to acupuncture, to Ayurveda, to meditation classes, all of these things. It's just fantastic. And I think this is sort of we're heading into the best age of medicine where you really have the best of both worlds.
00:29:59
Speaker
After college, you embarked on a solo spiritual journey throughout Southeast Asia. Can you tell our listeners about this experience and some of the insights you gained? Yeah, so I grew up in India. And my parents, thankfully, were very open-minded and embraced this holistic approach. So I always joke that I probably learned to meditate before I learned to walk. So a lot of these modalities were new to me.
00:30:29
Speaker
So when I moved to the US and when I went through medical training, I often put those things that I grew up with on the back burner and focused a lot on the Western approach. And it was fascinating to learn about that. And when I came to practice, as a resident, as an attending, you very quickly realized the limitations of Western medicine.
00:30:56
Speaker
I realized that this is so important that we really bring all modalities to help our patients. And having done that year between, you know, between college and medical school, I literally just decided to defer for a year and just pack my bags and travel through Southeast Asia by myself for six months. And it was an eye-opening experience because I really at that time
00:31:19
Speaker
delve very deeply into a lot of these traditions.
Dr. Parikh's Spiritual Journey
00:31:22
Speaker
So I did, you know, just give an example, I did a 10 day silent meditation retreat when I was 22.
00:31:27
Speaker
And most people think of backpacking as you party on some island in Thailand when you're backpacking at that age. But I said, let's do this. And that 10-day meditation retreat was basically you don't speak for 10 days. They take your phone, your wallet, everything. And you're just in complete silence for those 10 days. And you're literally meditating 12 to 16 hours a day. And it was just one of the most incredible experiences of my life.
00:31:58
Speaker
And that just opened my eyes that there's so much more out there. And as I traveled to different countries in Southeast Asia, I learned more and more about the local traditions and healing modalities and experienced them firsthand. Because a lot of things about integrative medicine comes from a place of authenticity. So if I'm recommending anything to a patient, it's something that I have tried, that I have practiced and I have deep, because knowledge has its limits, right?
00:32:27
Speaker
I can read all the books in the world, but what experience brings to the table really adds that element to authenticity when it comes to the patient relationship. Because that's when I can develop that trust relationship in a very short period of time. Because patients can see that it's coming from a place of genuine, that I really care about my patients and what I'm recommending, I really believe it's going to help them.
00:32:57
Speaker
And that effect is so powerful. It's far more powerful than any medication or treatment I will prescribe. So if I don't have that relationship, I could have the best medications for the patient just won't have the same effect as having that trust relationship. So anytime I recommend something to a patient, I always talk about my personal experience with it. And that just adds more to
00:33:23
Speaker
that art of medicine that I'm talking about. And having that year really was life changing in so many ways, not just for personal growth, but also professional growth. But that time has served me to this day and continues to serve me because that's when I learned that, you know, when you experience it, it completely, it can never take place. You know, it can never replace all the books that I'm going to read in the future.
00:33:48
Speaker
So to this day I've kept that lesson and I continue to practice and as we're speaking this week I actually took a week off at extra vacation time and I'm actually going through a very detailed Ayurvedic detox called Panchakarma.
00:34:03
Speaker
Um, there are a lot of patients I think that would really benefit from it, but I wanted to personally experience it. So I'm actually doing it, um, right now to see what it entails. It's not easy, but I wanted to experience it firsthand so I can share my experience and be authentic when I suggest that to my patients.
Spirituality's Role in Health
00:34:22
Speaker
So again, this is a, that's a lesson I learned during that year and it's probably the most valuable lesson has served me very well until this day and hopefully, you know, uh, in the future too.
00:34:33
Speaker
How do you conceptualize the spirit and like mind body spirit and how do you see spirituality? What role does spirituality play in someone's health? I think it's one of, if you talk about Eastern medicine, spirituality is one of the most fundamental aspects of health because when spiritual health is out of balance,
00:35:00
Speaker
it has a domino effect. So spiritual health and out of balance manifests itself as imbalance in psychological or mental health, and that manifests in the physical health. So often the physical symptoms we're seeing comes from the psychological imbalance that was because of the spiritual imbalance. So one of the questions I often ask my patients is what brings you a sense of joy or purpose in life? It seems like a very,
00:35:28
Speaker
like a frou-frou question to ask, but probably one of the most powerful questions out of all the questions that I ask my patients. And that tends to bring the most tears, I would say. I would say more than half of my patients typically cry within the first, you know, when I see them for the first time during our initial consultation. And I don't think it has anything to do with my demeanor, I'm not kidding, I don't bite. But it just goes to show you that
00:35:54
Speaker
A lot of times we just don't ever contemplate these questions, let alone have a doctor ask you this question. Because the doctor thinks that this is probably one of the most important things that I can learn about the patient in front of me. So that's where the spirituality comes into play. It doesn't have to be religious. It's something that what makes us human. One of the fundamental questions we ask as a human being is, why am I here? What is my purpose? What brings me joy?
00:36:23
Speaker
And I find that if that question is unanswered, that will be an imbalance in psychological health and physical health. So I can do everything to fix up the physical health. But if I don't address this fundamental question or encourage a discussion or conversation about this, then I'm not really practicing holistic medicine. So I find spirituality to be a very, very fundamental thing that has to be addressed and often completely ignored in a more
00:36:52
Speaker
Western sense of medicine. So you're kind of saying, though, the essence of those those big questions you asked your patients, that kind of is how you tune in to their spirit. Absolutely. And that's how I really get to know the person in front of me. Right. So I can have them fill out a form and tell me about the family history and allergies and the medications they've taken, surgeries they've had. But for me to really establish a connection with the patient,
Q&A with Dr. Parikh
00:37:21
Speaker
um that question really opens so many doors and and sometimes it shakes people and my job is to shake people and start the discussion of health and I cannot have a discussion about health unless I address the spirituality the the psychological aspect and the physical because people often come to me for physical
00:37:43
Speaker
symptoms and diseases, and they're often sort of shocked when I ask about these questions. But no one has ever questioned me on those questions because everyone understands and recognizes that it is instrumental in any discussion pertaining to health. Want to finish up with a lightning round? A series of fast paced questions that tell us more about you. Sounds good.
00:38:11
Speaker
So you were on the Dr. Oz show. I recommend that all our listeners check out the clip. It talks about identifying your digestive type. So what was the coolest thing about being on that show?
00:38:25
Speaker
I think it was great to recognize how hard it is to be on TV and how Dr. Oz does it effortlessly. He must have incredible memory because he, you know, you think, when you think about shooting a movie, it's like retakes and retakes with shows like that, there are no retakes, you just go. So I have incredible, you know, incredible respect for anyone who does live television or any TV shows like that.
00:38:51
Speaker
I will say I thought you were very refined and eloquent, so kudos. I felt like for a while I associated Dr. Oz and Dr. Phil, so I didn't know too much about his legitimacy, but then I looked him up. He's like a very, he's like a cardiothoracic surgeon, correct? Yeah. Yeah. So I guess I should maybe pay a little more attention to what he has to say.
00:39:19
Speaker
What's a go-to fun activity in New York for you? For me is eating. I love exploring different cuisines. So I think that would be my go-to for sure. I have a running list of all the restaurants I want to check out. What's your favorite genre or like ethnic food or whatever? I can't pick one. I just can't. There's just so much. Can't do it. It's so hard. All right. Best movie or TV show you watched during COVID?
00:39:49
Speaker
god now this is really embarrassing uh 90 day fiance nice what's your one uh shameless indulgence or like i don't know do you have any like yes um i love to travel and whenever i can i try to fly
00:40:13
Speaker
business class, first class, this is my treat. It sounds ridiculous, but I just love that experience. What's your go to self care technique? For me, go to self care technique, hands down pranayama, which is breathing exercises based in yoga. Most powerful thing in the fastest. Awesome. Last question. What's the biggest misconception about integrative medicine?
00:40:42
Speaker
that it is not evidence-based. I mean, it's completely opposite. It's actually the most evidence, and what we're often doing is actually not evidence-based. You heard it here. Start meditating. Start doing yoga. Reach out to your local integrative medicine physician, Dr. Chidi Parikh. Thanks so much for joining the show. Thank you. It was a pleasure.
00:41:18
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host John Neery. Be well.