Conventional medicine has gotten pretty complicated, but so has alternative and integrative medicine. From acupuncturists to chiropractors, osteopaths to homeopaths, there’s a number of different options out there. One of the quickest growing, however, is the ND. Naturopathic Doctors are blowing up, but what do they do, how do they treat disease, and how are they being challenged with licensure limitations? That’s what this episode is all about.  

This is the story of Naturopathic Medicine with Dr. Tia Trivisonno.

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Connect with Dr. Trivisonno & NYANP

Website: www.NYANP.org

The Transcript

Caspar Szulc: 00:19
Hey everyone, Caspar Szulc here. Conventional medicine can be a complicated field for many to navigate. You’ve got so many specialties and it seems like new ones are coming up all the time, but the truth is integrative and alternative medicine isn’t that easy to follow either. From acupuncturists to chiropractors to osteopaths to homeopaths, there’s a number of different practitioners out there. And then you have one that is growing in popularity but also some mystery. I’m talking about Naturopathic Doctors. But do you actually know what an ND does, or what to expect from one? Are they even physicians, and can they prescribe medications like a conventional doctor would?

At Innovative Medicine, we’ve always been about presenting multiple views and shining lights on the best options to restore and preserve health. That’s why this episode is focused on naturopathy, and the efforts to better define what that means as well as how you can have more access to this approach to healing – because as you’ll see, it’s not always easy to be accepted when you’re the new kid on the block, especially in medicine. To help out in explaining what NDs do and what some of the challenges are that they’re facing right now, I turned to an old friend and president of the New York Association of Naturopathic Physicians (NYANP). This is the story of Naturopathic Medicine with Dr. Tia Trivisonno. Let’s start with really going into your starting points here and kind of your path. Because it is an interesting one and you discussed this just before with me, but I want to reshare this with the audience. So how did you get into holistic health and what led you into being a naturopathic physician?

Tia Trivisonno: 02:04
Sure. It’s a great question. So initially actually when I was in high school, my father was dealing with some health issues. His kidneys and his heart, he was having some symptoms in both of those systems. And eventually, he had kidney disease and he was on dialysis. And as my family was going through that, we were having a lot of visits to different specialists and things like this. And he had his challenges with some of the medications and some of the procedures that he had to have. And I just remember it was like a light bulb moment one day when we were in the doctor’s office after he had had a procedure. My mother saying, I just wish someone would look at him as a whole person. You know, right now we’re really focused on his kidneys. We’re focused on his heart, but these treatments sometimes seem to be, you know, if we do the heart focus treatment, there’s a problem with the kidney and vice versa. And what seems to be missing is, is viewing him really as a whole person. So in that moment, before I was even considering medicine, a light bulb went off and I thought to myself, well, there has to be that, that has to exist already. I really wasn’t familiar at that point with naturopathic medicine. I knew about different kinds of medicine but didn’t know so much in terms of exactly what the degree was or things like this. And at that point, I was in college and beginning college and wasn’t studying medicine at the time. But as I started to become really passionate just about reading about these things on my own, I was really drawn to the natural medicine approach, the holistic approach. And then I began through travels to kind of learn a little bit more about indigenous medicine and started reading up on the career of naturopathic medicine and the more I learned, the more I wanted to learn. So ultimately that kind of propelled me forward.

Caspar Szulc: 04:02
Right. And you brought up there traveling and I think that’s a huge piece in understanding medicine. Again, from a different perspective. Cause you’ve mentioned indigenous people, Ecuador, Ayurvedic in India, you spent time in Paraguay. How, how did those travels to those places really impact you as you move forward? More into the medical side?

Tia Trivisonno: 04:24
Yeah, they definitely just paved the way for me in terms of education and empowerment for people and to learn more about how people across the world are relating to their environment and then even using what’s in their environment for health. So my father did pass away when I was 20, so part of my education and my travel was a little bit of soul searching for myself. But also every place that I went, kind of spending time with families and different cultures and seeing what they were using in the kitchen for their health. And then specifically when I was a Peace Corps volunteer in Paraguay, you are aligned with a homestay family. And my homestay father knew that I was interested in natural medicine. So he would walk me through the garden and we would go through all the different herbs that were there. They have a tradition of drinking mate, which is a warm tea beverage that’s kind of a really beautiful ritual they do every morning as the sun’s coming up, it’s a time to kind of just talking about what’s going on in life and with the family and a quiet time before the working day starts. And so they’ll, they’ll handpick remedies from their garden to put into the mate and then once it gets hotter during the day, they drink an iced version. And so he would teach me about all of the different herbs that were in the yard and how this one is good for the stomach. This one is good for a sore throat, and even more complicated things. Like they were quite aware of this as good for treating a parasite or a microbial infection. And just kind of a knowledge that people have it because they’ve learned through the tradition of natural medicine in their own environment, how to care for themselves when they don’t have maybe access to some of the more conventional things we’re using.

So a couple of experiences I had there including I myself had a really bad poison Ivy and was able to heal it just using oats that they had in their kitchen. And it was pretty severe. And at that point I thought, maybe I’m going to have to go and seek some medical help for this cause I was getting really swollen. And just through talking with the community members, I was able to find a remedy that worked and really just kept me passionate and kept me eager to learn more about what are things that we have in our environment that are affordable to us, available to us, that would also enhance our desire to protect the natural environment and work with it for our healing.

Caspar Szulc: 06:56
Yeah. So a lot of naturopathic medicine, as I understand it, as I’m sure a lot of people understand, is utilizing what is in nature to help us heal. Correct? But, but people still, I think don’t understand exactly what a naturopathic doctor does. I mean, there’s a lot of confusion I think even on the conventional side of what certain roles do in there. What’s the difference? RN, NP, MA, but then you go into a whole other side of acupuncturist versus osteopath versus ND versus DND. So could you tell us in simplest terms, layman terms, what is a naturopathic doctor and basically what do they do?

‘I really felt like if I want to help the medical paradigm and I want to educate my family, my friends, and ultimately future patients about a system that can work for them, naturopathic medicine to me is the one that blends these things in such a way that you speak the language of the conventional doctor because you go through, gynecology and dermatology classes and your clinical rounds and you go through understanding and interpreting lab work.‘

Tia Trivosonno, ND

Tia Trivisonno: 07:38
Yeah, that’s a great question. And you’re correct, there’s so many different things out there now in terms of, medical professionals, it’s really hard to know. And the term naturopathic doctor incorporates quite a lot, but it is very commonly confused with things like homeopath, a naturopath, health coach, many of the different things you mentioned. So in simplest terms, a naturopathic doctor is trained as a primary care physician, but from a preventive standpoint. So the idea is that you optimize health and wellness using the least invasive methods possible. Now, so that said, a naturopathic doctor who attends an accredited school within the United States, we go through national board exams once we finish our education, similar to that of a medical doctor or a DO a naturopathic doctor has to take all of the same biomedical courses initially the bio-sciences and then we go through clinical rotations and these kinds of things. They’re trained to read labs, to evaluate lab work, basically, essentially to diagnose and treat illness. Now the scope of practice is different in different states and we may get into that later, but essentially a doctor aims to get to the root cause of any illness and looks at preventive measures first and is at the level of a diagnostician, a clinician truly a doctor right now.

Caspar Szulc: 09:12
A lot of people who probably know something about medicine would say, isn’t that very similar to what a functional physician would do or an integrative physician. So there are obviously similarities, but are there differences in how a naturopath would approach a patient versus a more functional and integrative doctor, MD, would approach patients?

Tia Trivisonno: 09:32
Sure. Absolutely. I think that you’re correct. Those things are very similar. And I would say the main difference would be the guiding principles of naturopathic medicine. So naturopathic medicine, as I mentioned before follows certain principles and a philosophy and that philosophy is to get to the root cause of the imbalanced, doctor as teacher, prevention first, and treat the whole person. Functional medicine is looking at things from that standpoint. But perhaps from more looking at biochemistry and seeing where pathways in the body may be having some issues and then utilizing, let’s say, nutrition, herbs, minerals, to correct that. In naturopathic medicine, I do feel that the aim is to still go a little bit deeper in terms of looking at the root cause of imbalance for the patient and including things like, could there be some emotional trauma? Could there be something directly in their own environment? So there are similarities with functional medicine. Absolutely. But I would say that the naturopathic doctor is looking a little bit more into the natural environment and from a vitalist perspective, using these guiding principles to really look at the whole person.

Caspar Szulc: 10:55
Now, in terms of things like energy and you’re talking about TCM, Traditional Chinese Medicine, is that something, a naturopath would be educated in and, and apply in practice?

Tia Trivisonno: 11:06
Many naturopathic doctors also have licenses in acupuncture and did study Chinese medicine. So you may find naturopathic doctors who have that license as well. If they don’t, because they chose to just pursue a degree as a naturopathic doctor and didn’t pursue any Chinese medicine, they would be trained still in energy. And kind of a lot of the naturopathic medical tradition comes from European nature cure practitioners who looked at let’s say the four humors, the different fluids in the body, the energy pathways in the body and how to support that. So again I would say that’s where the tradition is a little different than what let’s say, integrative medicine or functional medicine is doing now. The old, let’s say, older doctors that came, looked at the human body as a reflection of the natural environment. So from that standpoint, yes, a naturopathic doctor would be, but not all naturopathic doctors do acupuncture and Chinese medicine.

Caspar Szulc: 12:17
And, and how I always saw it, and I always look at things on a spectrum and kind of see it as conventional as one side of the spectrum and you kind of move towards it. And functional of course incorporates diet and other things. And I think naturopathy is really that next step in it. If I’m looking at it correctly, going towards the more spiritual or shamanic side of things, being on one spectrum and the surgeon being on the other, right? And naturopath, you finding itself somewhere centered. Actually people actually think it’s further off because they like to think it’s so alternative and put quotes around that. But it’s actually quite centered, isn’t it?

Tia Trivisonno: 12:53
That’s actually truthfully to kind of circle back to my personal journey. That’s why I chose the degree in naturopathic medicine because initially as I’m learning through these indigenous traditions, I did learn about energy and let’s say in Ayurveda, the chakra system and the energetics of foods, the energetic of herbs and learning from cultures in different biodiverse ecosystems, what they’re using in terms of herbs and nutrition. But I really felt like if I want to help the medical paradigm and I want to educate my family, my friends, and ultimately future patients about a system that can work for them, naturopathic medicine to me is the one that blends these things in such a way that you speak the language of the conventional doctor because you go through, gynecology and dermatology classes and your clinical rounds and you go through understanding and interpreting lab work. But again, you’re doing so in advance of things becoming problematic. You’re starting to look at patterns, let’s say in blood sugar or in inflammation, these kinds of things, to kind of optimize wellness as they stand at this moment. But then also to prevent any kind of further degradation. So, in my opinion, as I was doing my research to the difference between let’s say a health coach or a nutritionist or an herbalist or many of the other things that exist in terms of the health world. To me naturopathic medicine teaches you the language of medicine as well as being grounded and also balanced with carrying a lot of what we know from these indigenous traditions and in terms of how we can use nature and herbs and nutrition and many of these other healing modalities in combination with the science and the intellect of the doctor.

Caspar Szulc: 14:47
Yeah, it’s, it’s a really well-rounded approach. I saw and I was actually surprised because I didn’t know much about naturopathic medicine getting into this field. I knew about of course, conventional from my father and integrative medicine and European biological. But then Mark my co-founder, Dr. Iwanicki now went to NCNN over in Portland and I remember speaking with him as he was going through training and he was talking about so many clinical things. I was like, are you going to a conventional school here? Are you going to go over to that side and stop practicing? Because you really have to get such a base on the conventional side. People don’t realize that and they think naturopaths are bashing conventional, don’t learn anything about or don’t understand it when that’s a huge fallacy.

Tia Trivisonno: 15:34
Right, right. That’s completely, yes. Yeah, you’re absolutely correct. And in naturopathic medicine, the whole beginning, the first few years of the training are, very similar to what an MD and what a D would be doing. You’re really very, very focused on all of the medical sciences and then all of the different specialties within medicine and you’re doing all of your clinical training. But then on top of that, you are receiving a really deep education in terms of naturopathic therapeutics, natural therapeutics, things like hydrotherapy, herbal medicine, homeopathy, perhaps classical Chinese medicine and many different things that are on the natural side. But it’s absolutely correct that you are very deep into what you go through in conventional medical school as well.

Caspar Szulc: 16:25
And to me when I hear that, I’m just thinking, why doesn’t conventional medicine apply that in their normal educational process? Right? A medical school, why wouldn’t they? And I know they’re very reluctant to do that, of course, and they’re going to look at things and kind of attack other sides of it. But knowing what we just heard here, that you’re learning conventional, you’re applying some natural, you’re applying so many different, what are the challenges for a naturopath these days that they’re running into, even though they are so well rounded?

Tia Trivisonno: 16:55
I think, one of the biggest challenges is exactly what we’ve been talking about right now is just that consumers don’t really fully understand depending on where they are. There are places in the United States where naturopathic medicine is incredibly popular and it’s already been around for years and years and years and it’s incorporated into insurance and it’s incorporated into some hospital settings and things like that. And if you’re in a place like that, it would be very clear to understand the difference between going to let see a specialist in conventional medicine, perhaps a gastroenterologist or anyone who’s doing that kind of specialty versus working with a primary care physician who’s a naturopathic doctor, we’re not really specialists. Some people choose to go into specialties, but we really are more trained as primary care. So that is a challenge is just integrating us into the system and being recognized as primary care because as you’re saying, a lot of people just are confused in terms of what a naturopathic doctor may be. Personally, really enjoy collaborating with medical doctors and in every single specialty. And usually, it’s very well received. If you have a patient and they need to be working with a specialist, then you get to collaborate and you learn a lot more about those specialties in conventional medicine, which I find fascinating. And then we can work together. But I would say that integration has been the biggest challenge for the naturopathic doctor. There’s also consumer confusion because there is a term called naturopath, which is more like a health coach and it’s a different education. So sometimes people may be working with a naturopath and they have an idea of what that may mean, but it’s actually different from a naturopathic doctor who goes through, four to six years of postgraduate education and does come out with this primary care type of education.

Caspar Szulc: 18:55
So there is a difference of course when you say you’re a naturopath versus an ND, correct. A naturopathic doctor, a naturopathic physician, I think it goes state by state differently. So that is a big distinction. You need to recognize it.

Tia Trivisonno: 19:08
A big distinction and it can be very confusing. And truthfully, at this point it’s a consumer safety issue. Because patients may go into an office and they may be working with someone who, especially in the state of New York, we currently don’t have any title protection. So you can walk into an office and a person could be a naturopath, but they are not a naturopathic doctor. And it would have to be very clearly explained to that person, the level of education because the naturopathic doctor, for example, is trained to triage and you come in with a certain set of symptoms and we’re trained to say, you need to go to the hospital immediately, or we need to call nine one one in this incident. You know, we are trained in that way. Versus let’s say a health coach or a naturopath or many of the other things that currently exist in the natural health realm, especially with technology, the internet, there’s so many places you can go for advice. So it’s really important to know when you’re going for advice, what degree of education and training is the person you’re asking advice have they received.

Caspar Szulc: 20:15
Now, one of the things I feel has to add onto to that miseducation and misinformation and kind of confusing the patient is the state to state differences, right? Of what’s allowed, because I know in California, West coast areas, Oregon and Washington, you’re on par basically with a physician. You can do almost anything. You could own your own practice, you could, you know, perform certain types of procedures, right? And in New York you’re not even recognized. You’re not even, like there’s nothing out there for sure.

Tia Trivisonno: 20:48
It’s a huge problem. It’s a huge difference and it’s a huge problem. And truthfully, you know, they took a poll recently as far as the students at all of the different naturopathic schools in New York was one of the most desired States where students who are about to graduate as a naturopathic doctor would practice if naturopathic doctors were licensed here. And absolutely creates more consumer confusion that we don’t have title protection and we’re not recognized in New York because there’s less of us here because most naturopathic doctors want to stay in a state where we are fully recognized of course, where we can practice within the full scope of our training, where we are able to run our labs as we wish. And we are able to do, let’s say certain procedures and we’re able to diagnose and treat and these kinds of things. So having less doctors in the state of New York because the license is not here, means that new Yorkers who don’t have access to this medicine and truly don’t maybe know the extent of what it could do for them.

Caspar Szulc: 22:00
Yeah. And you’re the president of New York Association of Naturopathic Physicians, so you have really good insight. What is going on that’s taking this so long is there just a reluctancy of people to acknowledge the knowledge process or what you go through to become a naturopathic physician? What is it that’s really causing this problem right now?

Tia Trivisonno: 22:24
I wish I could give a simple answer. It’s not simple. Truthfully I think the politics and the political process is different in every state. And so it has taken a longer time on the East coast. And I think some of this does have to do with the fact that many of the schools are on the West coast and the medicine there has a much longer tradition. So to change things from a political standpoint does take time. But I can say that we have, a really excellent board and we’re working with really wonderful people to get this process done in New York and to continue educating people and to have people involved in the process. Because I think that, people are willing to travel these days for medicine and they will go to the West coast and they’ll go to clinics, that have what they’re looking for. So I think that we haven’t made our presence known in New York maybe as much as we have needed to be for this reason, this very reason that many people do choose to stay or they’ll do a split practice. For example, people will work in New York, but then they’ll also have an office in Connecticut. Right now in, in the New England, New York, New Jersey area, most of the States do recognize the profession. So that should be pointing New York in the right direction. We should have more hope with those numbers. But it is true that these processes they do take time.

Caspar Szulc: 23:52
Can take a long time. Unfortunately, New York has always been behind. I’m a mixed martial arts fan. And I remember it was one of the last States to actually, they were still calling it out as very cruel. And every other state’s been doing it for like 20 years. And New York was still lagging until they finally gave in recently. I remember going to that first fight at MSG and then being so happy it came about. And that’s what really hoping for naturopaths here. Cause listen, my cofounder, Mark is in New York, so many people I know are sitting here and have such skills and such an ability to help patients and just have their hands tied up by state laws basically, things that just aren’t getting passed in time. I think everything’s there behind you and other States are already showing that it’s working.

Tia Trivisonno: 24:41
Absolutely, absolutely. And, that we have some really great resources through the NYANP website and as well as the AANP website. There’s great information about all of these things, FAQ sections where you can really find out, how would a naturopathic doctor be trained and how would they treat X, Y, Z. And then there is, there are some pieces of information just in terms of when licensure was passed in a certain state, how did that support the economy? How did that change things within with insurance? How did that cut down on healthcare costs? So there really is an urgent need for this to be done in the state of New York. And we are just working with such a brilliant board of doctors who really are volunteering their time to stay on top of all of these issues and really dig into that question that you just asked. Why is it taking so long? And, is it mainly just because when we have to pass legislation that does take a long time what could be the other potential obstacles and really looking into that? And right now I think that everybody that’s working on is doing a really great job to educate people to answer any concerns that there may be about what would it mean for other professions if naturopathic doctors are just looking to be who and what they are no more than that, so we’re really looking to work within our training and we have a bill now that we’re working on and it’s really been through a few incarnations and the most recent one does have everything pretty clearly outlined in terms of what it is we’re doing, who we are, what we’re asking for.

Caspar Szulc: 26:28
And from your side as president, are the actions you’re taking really at educating the public? Is that your main focus right now? Or is it still kind of trying to persuade legislation where is your focus now? The steps you’re taking? All of the above. It’s all of the above.

Tia Trivisonno: 26:44
Our website is called NYANP.org. And it’s pretty clear with the mission and the vision for the association. And certainly we are involved in education. We have a conference annually where doctors from all over the country come and we’ve been doing that for a very long time. And so that can kind of bring people together to rally some momentum around naturopathic medicine in the state of New York. But aside from that, the website has some pretty clear information in terms of what is happening with legislation. And there are buttons there where you can click to send a letter to your legislator to support licensure as well as, you know, places where you can support us, donate in these kinds of things. But aside from that to become a member is wonderful because there’s sections where, of course, ND’s can all be members of the association, but it’s possible for other doctors that support, or even, people who aren’t in the medical field, but they do want to be involved. There’s just different ways through that website to kind of understand more about the process as it unfolds. And as it’s been through its incarnations here in New York, some brilliant and dedicated people have been working for many years on this. So I’m really hopeful that now that we do have everybody’s connected more with technology and things, the words get out that as we continue to educate the general public, but also educate people involved in policy, that it’ll become more and more clear who we are, what we do, and really what we have to offer medicine as a whole and offer New Yorkers.

Caspar Szulc: 28:29
Yeah, I’m really hoping that all States that aren’t there yet get on board with this because there were really no downsides I see to it. It’s just offering more people, more options to take choices for their health and then they proceed with that. You mentioned before collaboration, working with other doctors and specialties and you enjoy that. From our standpoint, Innovative Medicine is a tenant. It’s collaboration, not competition. It’s bringing everyone to the table. The specialists, the surgeons, the spiritual group, all of them around the table. And in your experience, you enjoy it. What about the other side? Do you find any reluctance even in New York state with specialists, you know, saying, Oh, I’m dealing with a naturopath, is it openness really? Because I don’t think people see that side of it and the patients don’t see what’s going on. And I do know from our practice, a lot of times there is a little bit of back and forth and head-butting almost of Hey, you shouldn’t be getting that treatment at that other place there that’s doing it a little different it’s unconventional. You should only be getting the conventional treatment whereas some doctors are very open to it. So what has been your experience?

Tia Trivisonno: 29:42
I think it’s mostly positive, but there have definitely been mixed experiences and I think at the end of the day, for all of us, there are many things that we’re not trained in and we don’t know about. And I always try to not come from a place of fear when it comes to collaborating with other people or being willing to say, this is outside of my scope of practice and we need to refer you or I need to hang up the phone here and look to some of my mentors and some specialists to be able to get you the information that you need. But I do think that when we are under a certain paradigm that has been a certain way for a long time and then you start hearing more, through the news, through the internet, through your patients that, Oh well I went and I have these supplements and I have these herbs and I’m doing this, that the other, it would be a natural kind of reaction to perhaps be a little bit fearful of that and to say, I don’t know that that’s safe, so therefore you shouldn’t do it. And I think that in the same way that a naturopathic doctor is trained to say, this is an issue where you need imaging, you have to go, let’s say for an endoscopy or you have to go for an ultrasound that I would love to see medicine evolve to the place where the specialists and all the conventional medical doctors could say, you know what, you really need to talk to a naturopathic doctor because it’s clear to me here that you have some, you’re, you’re looking into these natural options for yourself. And this is not within my training, it’s not in my scope to talk to you about drug herb interactions. Drug herb interactions are one of the specialties of naturopathic doctors.

And it’s true that you can walk into any health food store and you can pick up herbs on your own and you can pick up nutritional supplements and things like this. And if you do have a certain diagnosis, it may not be the best option for you. And so in these cases it can do more harm than good. And it’s really important that if we all have, like you mentioned, I mean an even broader and more advanced system of medicine where we, where we have the gurus and we have the surgeons and we have everybody sitting at the same table in a cooperative way that, we would be able to contribute a lot of insight into these cases and help patients that are already seeking this out on their own. And that again comes back to this thing that I mentioned before, which is just consumer safety and consumer protection. That if naturopathic doctors are recognized as a profession in New York, and I always say when not if, then we will be able to provide our expertise and really help the other specialists and MDs, DOs, NPS, everybody because we have a lot to offer in that regard and people should know that we’re here and that we have that training.

Caspar Szulc: 32:40
What I’ve seen is that it’s hard for the average person to admit they don’t know something. It’s really hard for a doctor to do that. You go to your doctor and you expect them to know. And I think there is a little bit of that, I do. When you don’t and it’s okay.

Tia Trivisonno: 32:58
It’s really okay to say that you don’t know. In fact it can sometimes save a life. So I actually work in a clinical setting and have worked with many MDs and different practitioners, over the years. And it’s so wonderful to have access to your mentors to be able to say, this is what’s going on. Is there anything that I’m not seeing, can you help me here because we are supposed to be for the patient and it’s really important to surrender our ego and let the patient guide the healing process and guide the treatment. And when you put your heads together, then you have this synergistic, you know, situation where the sum total is greater than the individual parts. And I may know a lot about one thing, but I may not be the person. There are times when you need to go to the emergency room. There are times when you need that surgery. There may be times when you need this medication, but what we’re seeing now is a trend of a lot of medications, a lot of chronic illnesses coming up and naturopathic doctors through lifestyle management and through a lot of other supportive methods can help patients heal these things without always having to go to the thing that may be a little bit more harmful to their system.

Caspar Szulc: 34:09
Right. And I think you hit the nail on the head because a lot of people think that alternative medicine or integrative medicine or even ourselves at Innovative Medicine are against specialties. And it’s not that I’m against specialties at all and I don’t think it’s necessary. I think the problem is they’re not communicating with each other. think that’s the problem with so many things. It’s the relationship to the world or communication.

Tia Trivisonno: 34:43
It’s coming full circle. I mean, when my father was my hero in many ways. And so losing him was a challenging time in my life. But when you take your suffering and you turn it into your passion, it really puts you on a journey that is beautiful and incredible in so many ways. And so what struck me in that moment of here we sit confused by specialties, not taking care of the whole in this moment, it just sort of lit a spark within me that said, well, this is important. We need to be here and he needed to have these surgeries and we needed to go through this. But I wish we had also worked with somebody that could have done the holistic piece. And so as that came to me, I realized, yeah, we need a world where we have both. And it’s all about communication. And because of that it just kind of guided me on this journey to say in no part of my being did I harbor any kind of animosity for the specialty medicine that was dealing with him at the time. Instead, I thought it’s not either or. It’s both – and

Caspar Szulc: 35:48
Right, and that’s a huge point. I really do think the medical centers and hospitals of the future are going to be where everyone’s under one roof working together, not separately. Because I think that even happens in alternative medicine a lot, I have to say. Right? You can’t say it’s a conventional problem or it’s a whole medical problem. Right? Because I’ve been to some centers where you go into this mass alternative center and you only go see that one doctor and they have only their own design protocol. If you want to see the other doctor, they’ll give you something totally different and they’re not talking either they’re in their own offices the whole time and it’s like, Oh, I’m going to this alternative practice. It must be doing it differently. Not always. It’s not always putting people on one side or the other down. It’s is everyone needs to communicate.

Tia Trivisonno: 36:39
Everybody needs to communicate more. 100% and I think that’s where for naturopathic medicine, it’s just so important that we have that seat at the table so we have that title protection in the state of New York so that we can kind of come to the center and we can be part of the conversation. But I absolutely agree it’s not that there’s, issues in conventional medicine that don’t exist in naturopathy, people are people everywhere you go. And cooperation is challenging and like you mentioned saying that you don’t know sometimes is difficult. So we’re really talking about a paradigm shift here and to kind of participate in that paradigm shift to me as a consumer of medicine, cause we all are people and we’re all consumers of medicine. What happened on my journey when I saw what my family went through, it was just this kind of idea of I want to be able to provide an educated and an empowered choice. If you come to me and you say, I 100% want surgery and there’s nothing else I’m considering and you feel educated enough that you have at least been told that there are other options, then that is 100% your choice. And you’re right. And so, but if we’re not, if naturopathic medicine is not part of the conversation, then I don’t feel it’s a fully empowered decision.

Caspar Szulc: 38:00
I agree with you and I think that that you hit on another point there, we talked about this before we got started, was patient indecision. In a sense, what you just mentioned is actually great. A patient actually deciding, they know what they want. They’re almost in tune with their body and feel absolutely comfortable saying, this is what I want. I’ve explored my options. Here’s where I’d like to go to after doing my research. But we said a lot of people out there, there’s tons of information as the paradox of choice. One person said the surgery worked the other side, it almost killed him, you know? And of course everyone is so individual. So my complaint about looking at other people’s experiences as a guide for what you’re going to experience is never going to be the same. I think the patterns are there. You’re looking at a place and say, Oh wow, but you can’t ask, what did you do? I’m going to do it and get better. But what are the challenges for people that are in that indecisive place of just asking questions and not knowing what to do? Is there anything you would suggest to a patient that’s been to 10 specialists to you, that’s been all over? Is sitting there just go and rubbing and go like, I don’t know what to do to you, answer this for me. What should I do? And you can’t answer that for them, but what can they do to get closer to the answer?

Tia Trivisonno: 39:19
That’s a great question. And I do see that quite often in my practice and I think it never hurts to learn a new language. And I kind of liked to speak the law, always try to speak the language of the patient. You know, there are people that are going to come in and they want scientific literature. So you can provide people with scientific literature and there is a lot of literature about many of what we call the alternative methods, be it acupuncture or anything else. So when a person is trying to make a decision for their health, I always like to point them in the direction of the resources that are available. Somebody else might be more inclined, like you say, if there’s a spectrum in medicine and some of it may be is a little bit more on the spiritual side. Some of it’s more on the material in the conventional side, they may be more interested in those things. So I’ll provide them resources about that, but the most important thing is that to kind of walk for the most part side by side with the person and not try to push things faster than the pace of where they are. I think if you’re in a place of indecision, then we still need to kind of sit with things a little bit more. I need to provide you with a little bit more resources and kind of sit with you while you contemplate what you’re feeling and what you resonate with, what you align with the most. And it’s okay in a period of time to kind of say, I am a little confused right now and I’m not really sure what the best way is to go forward.

Tia Trivisonno: 40:50
If it’s a non-urgent situation, a person can kind of take their time and sometimes people will drift a little bit, between different practitioners or ways of doing things. But what I find the most, even in terms of something as simple as a dietary change is, many of the people around my own office, we kind of do the same things and we try these things that support our health and healing that you’ll get off and you’ll get back on and you’ll get off and you’ll get back on, cause we’re human beings but that it may be by the first time you get back on, you realize, Oh wow, this is just good for me and I am going to keep it up to the best of my ability. For other folks maybe it takes a little bit more on and off before they really see. But again, to kind of reiterate this idea of empowerment, I just think that, when something works for you, right? Sometimes it takes time to get there, but when you know, when something really works for you, whether it’s an exercise routine or it’s a certain nutrient or supplement protocol, or whether it is a dietary change I have to leave my job and do this new job because it’s just creating so much stress for me, ultimately you can get to that place of just knowing what works.

Caspar Szulc: 42:04
Yeah. I was speaking with a patient the other day and their recommendation was, you’re never going to get to 100% knowing what’s best for you. Even when you’re truly in tune with your body, it’s more of a feeling and your mind will all always jump in with skepticism, indecision. And that’s okay. Like you said, it’s completely okay and natural to be a skeptic. It’s completely natural to say, which of these things is true? I’m getting 10 different treatment plans and they’re all saying they’re good. I do think that fear factors in sales tactics should be pushed aside in medicine. Whereas some doctors say, Oh, if you don’t do this, your percentage of risk goes up this much. Like, okay, that’s, that’s maybe a ballpark figure or something. But it doesn’t mean it’s yours at all.

Tia Trivisonno: 42:50
You are your own statistic is what I always say to them. But you’re right, that did that. It is okay for there to be some bit of indecision and sometimes you’re doing so many things right that you don’t know which one is helping you the most. And that’s okay too because as long as you are feeling good and you’re feeling like you’re making progress, then you’re on the right path. But it is sometimes hard to know. And so as that journey is unfolding and people are having trouble making decisions, I just say we’ll work with all the options. We’ll tease them out, you know, and you do not have to be perfect and you don’t have to overhaul your entire life in one moment. So if you’re given a list of 15 things to do, I often question that.

Tia Trivisonno: 43:32
I say, okay, we have to back up a little bit. Let’s try to integrate three this week or even one this week and then maybe the next one and the next one. You have to kind of give it time. I look at it like a sustainable toolkit for people, and really how do they make these changes that are lasting that ultimately save them time and money down the road because they’re doing it and they’re seeing some benefit from it. It works for them. There’s that cost-benefit analysis that they see tangibly.

Caspar Szulc: 44:00
Absolutely. And just getting back to my point, it was that 80% this patient said, and then it’s a leap of faith almost, right? Because you’re never going to get all the way there. And it is about building a trust and who you’re going to work with your team or your coaches that are going to get you there and then building, trusting yourself right in your body to heal with this approach.

Tia Trivisonno: 44:22
And I do think when it comes to healing, I mean among many other things in life, it’s not courage if you’re not overcoming a tiny bit of or doubt, it’s okay to have it because the courage gets you going in such a way that you then feel better and you get to reap the reward. But if if there’s no fear and there’s no doubt and it’s just right there and it all makes sense and it’s packaged up perfectly, then you’re not really part of the process.

Caspar Szulc: 44:51
You’re not, it’s too easy almost. Right. It wouldn’t be worth it to heal. And healing is transformation and change, which is sometimes difficult, but it’s worth it. Right? It’s like going to the gym. It’s hard. You’re sweating. You got to go get wake up early. Sometimes you be great.

Tia Trivisonno: 45:10
Same way. And so I had a patient one time come to me and say, ah, this natural medicine, it’s all like, makes it seem like everything’s rainbows and wonderful. And I said, Oh no, no, no. We understand that there are times when it’s no pain, no gain. You know, that you’re, we’re asking you to do something right, difficult. We’re asking you to really kind of change your life in a positive way and to take steps to hold yourself accountable to practice self-care. Which in and of itself cuts down on healthcare costs, but we feel selfish doing it. And so all of these things that were, that a naturopathic doctor would be asking you to do in a visit is, is not easy. And we don’t think that it’s necessarily easy. It’s not just about taking a capsule or taking an herb instead of a medication.

Tia Trivisonno: 46:02
It’s really like we’re asking you to kind of take a look at your whole life, your stress, your patterns of behavior and see where we find things that in naturopathic medicine we might call obstacles to cure. And how easy is it to remove some of these, you know, some of them might be here and we can’t remove them at all. So we got to find a way around them or over them or underneath them. And, and that’s where you kind of become a little bit more like a coach in a sense too.

Caspar Szulc: 46:29
I would have to think that part of the problem is that we as a society going through the conventional route, expect really quick results. Again, I had a patient writing me wanting to come into the center, understanding a lot of the approach and saying it really resonated with them after his research. Okay, great. And he said, I could come in for a few days. Would that be enough for a treatment? Would I be better? I was like, Whoa, Whoa, Whoa. You’re a little off here. Again, like the whole workout analogy, if you’ve been out of shape, overweight for 10 years, which is what chronic disease normally is, even if you don’t know it, it’s a progression over a number of years to where you’re chronically ill. Three days ain’t going to be enough to turn around just like three days in the gym. You’re not going to be a professional athlete.

Tia Trivisonno: 47:15
Yes. And I appreciate your interest in the athletics cause I talk about that a lot to my patients. And I do say it is like you’re an athlete and training, many of us, we sit down to meditate and we want to be levitating already. And, we sit down to do these things. We think I should already have this all figured out and why is change so hard and I keep getting in my own way and I can’t clear my thoughts. I’m still feeling stressed, I’m having difficulty losing weight. And this is like, we all have to kind of slow down and breathe through it and take a look and say, you are like an athlete in training. In the beginning it’s hard to run even just a few steps and then you, but you put the time in and pay attention to your own challenges and what’s working for you.

Tia Trivisonno: 47:54
And then before you know it, you’re running and you’re running well and you’re going long distance. So I do think that it’s, it’s correct. It’s when you’re seeing symptoms and especially symptoms that have been there for a long time. There’s been a process going on behind the scenes for even longer. So if you’re looking for a really true healing, you do have to have that patience and the doctor has to have the patience. It’s both. You’re both in it, you’re both in it and you’re both in it together and I do see a lot of patients where I think that they feel like maybe they have been given up on and so it’s really important to work with them and to say there’s always going to be some kind of an option to make a difference. There’s always something that we can do to support your life, to support your wellbeing and we just have to be honest and reasonable and realistic about what that is and what it looks like and what the time involved is.

Caspar Szulc: 48:52
Set the expectations with them. Because if you’re chronically ill, the expectation can’t be within six months. Even to get there, I have to say that that it’s going to be healing is a lifelong process. Right? And I think a part of that is that you probably will not feel as you did when you were 18 which is what some people want at 50 it’s like, yeah, you can feel it better in a different way, in a different way though, right? It’s going to be different. I can’t compare because you change, you don’t go back. And I think people want to live that and they’re like, Oh, I still have a little bit of a negative mood or fatigue. It’s like everyone does.

Tia Trivisonno: 49:30
Well what’s so fascinating to me about all that as like the language that we use, you know? And under the paradigm that we’re in, it’s like everything is anti, like we’re fighting germs, we’re anti-aging war. But so much of that is literally setting up an immediate and kind of permanent conflict of I am not okay to be where I am and I am against the natural process. So I prefer to think of it more of aging gracefully and how do we preserve youthful look and youthful mentality with while we still age, so you’re right that the expectations have to be reasonable and realistic. And if it is chronic something going on for a long time, still you can use a lot of these methods and a lot of the treatment modalities to eradicate symptoms pretty quickly. So I do see a lot of positive results from using these things and saying, all right, the overall healing, we may be looking at a longer period of time, but I do expect that your vitality and your sleep, let’s say, or your physical, your joint pain, these kinds of things with X amount of treatments, you should really start to see some results.

Caspar Szulc: 50:34
Right. And, you mentioned these things, these therapies that are giving you this vitality, giving you the results. What are some of the treatments and therapies that you’ve seen that have been really positive for you as you implemented them with patients with chronic conditions? And really seeing results with?

Tia Trivisonno: 50:52
I’m definitely a huge fan of acupuncture. I do have an acupuncture license and I studied a lot of different styles of acupuncture at NUNM, also my alma mater where Dr. Mark went. But so I do offer that to most patients in the initial visit and then followups and I see great results with that. I’m also certified in NAGT, which is an allergy desensitization technique and see great results with that. I do BAH of course. And so that is to sort of make the treatment protocol more patient-specific and that helps to eliminate a lot of misinformation, perhaps choose the best form of supplement protocol for the patient right off the bat. And so then we’re able to speed the process of healing. So those are some of the biggest ones. Definitely working with diet and lifestyle cause sometimes you just see something that is really simple but also really glaring.

And I also look at diet as completely patient-specific. It’s not that everybody needs to be free of one thing or another. It’s what is the best diet for you at this time. And I’ve seen amazing results where people’s health will really kind of be propelled forward just from one pretty simple change. And I feel like that is just worth its weight in gold because you can do it, it doesn’t cost you anything. And then even something like you wouldn’t think how does my diet affect my knee pain? Well if it’s an inflammatory connection, it can and it does. And so you think maybe you’d have to be doing physical therapies, but just making those kinds of changes work really well.

Caspar Szulc: 52:33
Right. And I think a lot of people miss that point of asking what is the best diet? Ketogenic versus paleo, it’s confusing. And how do you tackle that? Because I’m sure a lot of patients come in and, and patients are very attached to some things. They’re seeing paleo and they’re gung ho or their team Keto. I mean, they are measuring their ketones throughout the day. So how do you tackle that? Because I’m sure sometimes they’re going to say, Hey, this is my diet. I don’t want you to touch that. I would just want to keep going. I feel good, but I have all these other symptoms I want you to address.

Tia Trivisonno: 53:26
Right now you’re speaking my language. That’s every day. And I do think that I’m team patient so I will, if their diet is, if I don’t see anything wrong with it, and as far as something really glaring that would be creating a problem for them, we will leave it. If they’re paleo and they want to be paleo, if they’re vegetarian and they want to be vegetarian, if they’re vegan and they want to be vegan whatever it is, as long as it seems like it’s working for them. And that’s where sometimes where both the BAH testing and then NAT helps me a lot because if there is something that is maybe triggering a problem through some of those techniques, you can figure out how to shift that for the patient. If it’s really an issue, like somebody coming in and they’re saying, I want to be on this diet, but based on some kind of gastrointestinal issue that they may be facing or perhaps some allergy or just it seems like something is contributing to some other kind of symptom, then I try to just make sure that I don’t change it too radically, too quickly. That we discussed the key points to say, okay, you can stay within this framework, but there’s a few things that I’d like to switch.

Are you open to that? And what I think is the most helpful for patients, what I always try to do is say, I’d like to focus on what we can do more than what we can’t do. Because oftentimes you go into any kind of doctor’s office and they may say, I want you to be gluten free, dairy free, sugar free. And then it’s like, well, what’s left? And to follow something like a paleo or ketogenic may be a lot more complicated and people have to be guided through that. Well. But so if it’s, if it’s something like this, we need to take something out based on some lab report or a symptom that they’re feeling, then I try to come up with a replacement in that moment. You know? And sometimes I’ll work with coaches or a nutritionist too that can kind of say, all right, we have resources, there are places you can go, books and recipes and these kinds of things to help you if we’re going to take this thing out because it seems to be a real problem, then you have to give something, otherwise patients leave more stressed out than when they came.

Caspar Szulc: 55:13
Right? And that’s, that’s the thing you don’t want to overwhelm them with too many changes.

Tia Trivisonno: 55:16
No, not at all. And if people are into their diet and they feel like it’s got a lot of benefit, then I just like to add a little bit of extra education in there to say, okay, you’re right about X, Y, Z and this is a great thing and it fits you pretty well and let’s just make sure that it’s working for you. So we’ll just look into all of your systems and your symptoms and make sure that it’s a good fit.

Caspar Szulc: 55:37
Yeah. From a naturopathic standpoint, do you have any issues with any of the diet fads you could say or just diets in general right now because we wrote an article recently from innovative medicine talking to some doctors about Keto is the new black but isn’t for everyone, right? What are some of the risks because everyone’s talking about all these amazing things and pushing it. But I have to say, anyone with any gallbladder issues, things like that, increased fat consumption while fat is healthy, yet too much is a huge burden on the gallbladder, longterm effects could be very bad.

Tia Trivisonno: 56:13
Yeah. Yeah. It’s a great question. I don’t necessarily take issue with any one diet, but what I like to do is I kind of say I will pull from all best, so as I’m looking at what all of these fad diets have to offer, I like to kind of coach patients in the sense that, Keto has this going for it. And autoimmune has this going for it and the paleo has this going for it. This specific carbohydrate has this going forward, the blood type has this going for it. Let’s think about these things and see what matches you the best. Because again, I do think that what we’re up against, let’s say as naturopathic doctors or innovative medical practitioners, is that we are still trained to think there’s a one size fits all or that something could be best. Someone thing out there is going to be the new best and that it’s the right thing to do. And I think human beings, we crave that because we’d like to have it be that simple that, Oh, we finally found that one cure or we’ve finally found that one diet. We finally found that, this is bad for you and this is good for you. And what’s truly difficult is balance and moderation and recognizing that.

Caspar Szulc: 57:32
Well, right when you say that, it’s like, no, I want to go with that complex one where it tells me what to eat, exactly what time.

Tia Trivisonno: 57:38
Right? And, and truthfully it’s like, okay, I don’t think that necessarily any one thing that’s out there within those dietary things is bad. But the question is, is it bad for you? Given let’s say you do have some kind of a gall bladder issue or a kidney issue or something like this, then you do have to be mindful of the things that could perhaps tax those organ networks. So that again comes into I think some of the differences between the naturopathic medical approach versus perhaps some of the integrative in the functional that we really do always aim to follow that principle of looking at the deepest layer for the person, the patient and there is no one size fits all pattern, but that makes it a little more challenging. You really have to do your investigative work, dig deeply and dig deeply for everybody. So I have standard dietary information that I work with, but I always try to kind of take that information and tailor it to the individual.

Caspar Szulc: 58:35
Yeah, I think it’s okay to have those standardized pieces. Those are necessary. Right? It’s not to say that isn’t there. And there are guides of course, yeah. For most of us we need more water and more green things, alkaline things. And that’s a pattern. But then you can go in with those specifics patients by patients. And that’s what naturopathy does very well. So we establish that a large portion of what you’re trying to do is educate patients, educate the public and everything. And, and I will say one of the best things to educate, especially when you’re going into a new paradigm, are books because there’s only so much yet and if you really want to go deeper, there are some great, great books with hundreds of pages of great things in there. And I know that has really guided me more into different aspects of healing that, that opened me up to whole new things and then go down that rabbit hole. Are there any books you would recommend that really made an impact or really kind of, you know do a good job at explaining either naturpathy or holistic healing that you could share?

Tia Trivisonno: 59:32
Sure. I mean, there are some, the naturopathic medical encyclopedia, it’s there. There’s one that’s more tailored toward, if you’re going to become a doctor and that digs deeper, but there’s a naturopathic handbook let’s say. That just kinda goes through information about how different conditions would be treated if you’re looking into what the naturopathic medical approach for those conditions would be. I really love history. And so I got very passionate about naturopathic medicine learning from this book called Nature Doctors and Nature Doctors traces the history of the different pioneers of naturopathic medicine from Europe to the United States. And this is kind of interesting that I’ve been really thinking about as I’ve been working more with the board of the NYANP, the New York Association of Naturopathic Physicians, is that naturopathic medicine was actually born in New York.

And the first school was in New York in the early 19 hundreds. And so I feel it’s time for us to come home full circle. So naturopathic medicine in New York is not new. At that time, medicine was changing. We had germ theory was coming about and we were using more seeing the benefit that there can be benefit for using antibiotics and some of these things for really chronic and stubborn infections, these kinds of things. So as that was changing at that time naturopathic medicine across the country kind of shifted in terms of what its presence was, so this one book, Nature Doctors is really interesting as far as the different types of things that were happening in Europe with hydrotherapy. And one doctor very specifically came over to New York and was diagnosed with a really terrible illness and they literally filled out his death certificate in front of him, and he went back to Europe and he went to a hydrotherapist to his sanatorium and received hydrotherapy and was completely cured and took it upon himself to come back to the United States to pioneer the medicine. And that was in New York.

Caspar Szulc: 01:01:56
And to rub it in the faces of those people, like it’s a ghost in front of you, right?

Tia Trivisonno: 01:02:03
And he had a very challenging time politically, but it just says that, there was so much heart and so much passion behind using these kind of nature cures. So that’s one of my favorite just as far as how nature cure gave birth to naturopathic medicine in the United States. So you certainly can find these naturopathic medical encyclopedias and things that would give you the more modern interpretation of medicine as it is now. But the nature cure. And then there’s another book called the magical staff by Matthew Wood, talks about the vitalist tradition, which is another one historically that gave birth to naturopathic medicine.

Tia Trivisonno: 01:02:45
There’s so many.

Caspar Szulc: 01:02:48
Yeah, I know there are so many. Those are two really interesting ones.

Tia Trivisonno: 01:02:50
They’re interesting. Maybe people don’t know about them as much. And I read them before I went to NUNM in Oregon. And it just really got me excited about the tradition of natural healing and the roots of the medicine, which I think that when you get lost in the woods, reminding yourself what the roots are and sort of it is in a way simple but also elegant that we have a lot that we came from and a lot that we can do beyond where maybe modern medicine is right now. So those were two of my favorite books and I’m really kind of so fascinated that we had a presence here in New York and so now we’re reclaiming it. Get back to where it all started.

Caspar Szulc: 01:03:39
That’s great. And you mentioned earlier that during your travels, a big part of what you saw was routine was a specific routine. And I’ve been reading a book, actually daily routines about the greatest routines of the creators and the Van Goghs of the world. And all of them had very specific routines. What’s a routine that you abide by for health and just optimization that you could share because people are always so interested in. I get this question all the time. What’s your supplement? This is going to be boring. It’s really not much. I usually like to eat well and get my nutrients from there and people like, Oh, that’s not interesting at all, but there are routines that I go through. That I absolutely see and I think they’re shared patterns within the routine. So definitely. What’s your routine?

Tia Trivisonno: 01:04:40
Oh yeah. Well this kind of goes right back to what we’re talking about, this book, Nature Doctors. I happened to be reading it before I entered medical school when I was in Brazil. I was on vacation there and my routine is really getting up and being by the ocean. And so I get up very early in the morning and very early for me is like six o’clock. I would say that’s early but manageable. Yeah. I’m not up at the 5:00 AM club Yeah, I wake up by six and most mornings I’ll get out by the water. So I live near the ocean and that has really changed my life in a positive way. But before I was living there, my routine has always been to just spend time in nature and to take quiet time in the morning, spending time in nature before I get into whatever the day may bring. So I absolutely have always had an exercise routine and I think that that’s one of the best ways to manage stress hands down. But just like diet, exercise is not one size fits all. Sometimes you prescribe yoga, sometimes you prescribe more cardiovascular, sometimes martial arts, boxing, these kinds of things to get out a lot of excess energy are wonderful choices.

So I maintain that exercise routine. I wake early in the morning and I’ll take either a long walk or maybe I’ll run or do some kinds of exercises on the boardwalk by the ocean. I go surfing as much as I possibly can. I do try to make sure that I take some vacation and incorporate travel just to keep myself very inspired and passionate and learning again from other cultures what the traditions are there. And I also go to bed at a decent hour and I do that every night of the week for the most part, unless something really exciting is going on. In Chinese medicine, they say you need to be in bed between 10 and 11:00 PM. And so I really work on doing that because truthfully the liver and the gallbladder are working hard at that time and they prefer to do it while you’re asleep. They’ll still work for you while you’re awake, but they prefer to do it while you’re asleep. So waking around the same time, going to bed around the same time. Unplugging from technology at around nine, even earlier if possible, trying not to work late into the night is really helpful. Maintaining the exercise. I drink plenty of water all day throughout the day. I personally wait a little bit or later in the morning before I eat because that works well for me to just kind of take some time to flush toxins and drink water first. And so I eat around the same times. I sleep around the same time.

Caspar Szulc: 01:07:20
This sounds very simple, but that’s what I read in all of these routines, these great people. It was like they had to start this time, they worked from 9:00 AM to 12. They took their walk at 12. And it was saying the neighbors knew what time it was because there he goes, it’s 12 o’clock. There goes Van Gogh on his walk. It’s absolutely right.

Tia Trivisonno: 01:07:40
True. And your routines. Speaking of great books, there are so many good books that talk about people that report just successful living. And one of them, I think it was Give and Take, was by Adam Grant, was talking about just how you would rate your life successfully. And that one of the things that many people did was they put time into their hobbies and they consider that to be as important as every other appointment that they would make. And these are people that work incredibly hard and the harder they work, they tend to work even harder, but they don’t compromise on the things that bring them joy. So taking the time and putting it in there and not feeling guilty about it and knowing, Hey, surfing is my thing, so I’m going to go and I’m going to make sure that I have time to do it is absolutely key to greeting each day in a more balanced way.

Caspar Szulc: 01:08:37
And it’s absolutely key to staying healthy. People just think it’s a hobby. It’s just extra to your health. And I find too many people make, I’m not going to say excuses, but they kind of say I’m too busy to do that. Right? They’ll say, I’d love to do this again. I’d love to play the piano. I did it when I was younger, brought me so much joy. I don’t have the time. I know you have to make the time and you prioritize.

Tia Trivisonno: 01:09:07
And truly, honestly, if I could give one more just health tip that’s completely free and hard to do, but it will make such a lasting impact is recognizing that a lot of the things we complain about from day to day that contribute to negative health patterns are a direct result of time management. So working on time management and thinking about the fact that like, okay, this is when my workday starts, this is when my workday ends. I take this amount of time to eat my meal. And I also recognize that if I don’t make time for the things that give me joy, playing the piano, going out in nature, hiking, whatever the exercise routine is that I come into each day already depleted of some of my joy and then it becomes even harder to manage my time properly. So it’s almost like just flipping the perspective and saying, if I know that I need to structure my time in this way to make sure that I have time for the things that helped me relax and all of this, then actually my work will get easier. I think my work is the reason why I’m so unhappy because it keeps me so busy, et cetera. And it takes away from the time that I have with my family or the time that I have doing the things that I enjoy. But truthfully, it’s mapping out those things and making them part of your lifestyle that actually make everything else more manageable.

Caspar Szulc: 01:10:28
Absolutely. And it’s almost reverse psychology it’s like I have so little time, right? And you’re asking me to make time, but we all have 24 hours in the day, and it’s not exactly trying to stretch those. It’s how you manage those. It’s what you do with those. So if you are in a place of joy, of happiness, of vitality, you can do so much more in an hour. You do so much more.

Tia Trivisonno: 01:10:55
You think about just how a piece of good news energizes you for a few hours and a piece of bad news takes the air right out of your tires and the wind out of your sails. And so when you come into each day saying I did get up and I did get outside and I did do that thing that I love for a few minutes, you come in already less stressed, more wind in your sails and then it’s actually easier to manage your time. And I also notice when it comes, so much of healing and the healing journey is also about boundaries. Knowing that it is absolutely okay to say no to certain things and to preserve your own boundaries in terms of navigating the day in a way that works for you. It’s kind of that airplane mask mentality too where you say, I have to take care of myself in order to take care of other people. Otherwise, this isn’t a sustainable thing that I’m doing.

Caspar Szulc: 01:11:43
Yes. And that’s a big part that people have a lot of guilt with. I think and trouble dealing with, but self-care is not selfishness. It is your able to do so much more. And that’s why I always say you need to prioritize health because without it you can’t help other people. You can’t do things as well. You won’t have the vitality. So invest in your health. There was this patient the other day that I was talking to and basically stated, yes this is expensive, this type of care that you guys provide. It’s out of pocket. It’s very unique. It’s thousands of dollars. It could be this and that. But at the end of the day I had to ask myself, do I want a new car this year that I’m probably not going to drive much cause I’ll be bedridden and won’t see my friends at all with and won’t be going anywhere with because that’s the life I’ve been living up until now. Or do I just invest in this treatment and then buy the car next year feeling good and ready to drive all over the country. She says, when I put it like that to myself, it was the easiest choice I ever made.

Tia Trivisonno: 01:12:46
That’s very true. So much of it is about our perspective and where we’re feeling in the moment and how we’re looking at what it is we value. And there’s absolutely nothing wrong with investing in yourself and investing in your health. In fact, it’s the best investment you’re ever going to make.

Caspar Szulc: 01:13:01
Ever. It will pay back dividends, right? More than you could ever imagine. And I think people get comfortable with living in a state of semi disease or just managing disease and not realizing what it’s like to be healthy and how much more productive you can be. And that alone is, you think of how much more you can accumulate, not just in wealth, monetary, but in experiences, enjoy and all these things that have no tangible value.

Tia Trivisonno: 01:13:29
Yeah, you get used to your baseline. We all do. We, and we all go through periods that are more stressful and less stressful. And in the more stressful times, that’s when our baseline kind of takes over and it is what it is. You think, well, no, I don’t have any digestive complaints. I’m just bloated after I eat this food. Well, to me that’s a digestive complaint and I can help you with that. Let’s get rid of that. Let’s get rid of that. So, again, it’s just a process of awareness and a process of kind of taking those first steps on the journey and learning that you are free to make choices and you are free to advocate for yourself and you’re free to the education and to have a conversation about what seems like it’s gonna work for you and that you don’t have to kind of keep yourself in a same baseline because that’s what you are hearing that everybody else is doing. Or that’s what you think is the way that it’s always going to be, or it always has been.

Caspar Szulc: 01:14:31
Within your ritual. Which was, very, I think a very strong approach to just getting to what you like and the joy of everything. Are there any supplements or techniques you’re using within that?

Tia Trivisonno: 01:14:46
Supplements? I don’t use any one thing every day except unless I’m dealing with something, you know, so I certainly have a good vitamin-mineral supplement that’s good for cold season that I will take if I’m feeling like I’m getting run down. I try to support myself with proper minerals and stay hydrated, but I do tend to rotate the things that I’m taking, the supplements that I’m on because I find that the body really appreciates that. So I’ve certainly taken many herbal remedies over the years,, both Western botanical and Chinese botanical. And I’ve done, the natural remedies for a long time. But unfortunately, I wish I could again, give that simple answer of there’s one thing that I tend to shift things up.

Caspar Szulc: 01:15:43
Yeah. And I think people ask that question a lot and there are things I take normally, but it’s really to supplement what’s going on in my world. If there is a cold going around the office, vitamin C goes up a little bit. Other things go up, some adaptogens I’ll include and other things. So, I think you have them in your cabinet but you don’t need to take them every day.

Tia Trivisonno: 01:16:06
No, no. If you’re feeling well, there are times when you don’t really need to be on any one thing every day. In fact, I kind of tend to, this is more my personal professional opinion, but I, anything that I feel like you need to be on every day for the rest of your life, I question it unless there’s some kind of a real genetic reason or something like this. So there are absolutely things that are just generally good ideas and you, and you do and you’ll see my cabinet is full and I have them there. And you know, you’ll go through periods of taking them on a really regular basis, perhaps for a few months or so. But I do believe that the body is wise and the body heals itself and the body at certain times maybe needs to be retrained to support one organ system or another. And then after that has adjusted, then maybe it’s time to work on something else.

Caspar Szulc: 01:17:01
Right. Are there any therapies or anything in medicine on the horizon or naturopath that is exciting you that you’re seeing is going to possibly be big coming up?

Tia Trivisonno: 01:17:14
This is a little bit outside of naturopathic medicine, but it’s a place where naturopathic medicine fits is that I am very excited about incorporating dentistry with medicine more and I do think that that’s up and coming, really looking at the importance of what it means to keep the head connected to the body and work with biological dentists and collaborate just more in general with different specialties. As far as naturopathic medicine is concerned, I really do think that people are just seeking out these natural ways of healing. And of course, we use this word natural and it’s kind of broad, what does it really mean? But essentially that people are looking for quote-unquote healing. Not managing, healing, which is a totally different thing. And that excites me because I think that, again, it’s almost this return to our roots that we’ve been disconnected a little bit from our natural world and even from a community-based way of thinking and really collaborating with other professionals and recognizing that everybody has something really unique to offer and that we can learn from each other. So this idea that that people are seeking that out and you will see it via technology, whatever channels it is that you’re tuning into, that there are movements in a return to a healthier quote-unquote way of being, whether it’s through yoga and exercise, meditation, positive thinking, all of these things are just as much out there as the negative trends that we’re seeing, chronic illness and more diagnoses and all these kinds of things. So it very much excites me to think about where naturopathic doctors fit into that and how we can kind of continue to have that conversation and to help people to know that they can receive guidance. If that’s what they’re looking for.

Caspar Szulc: 01:19:09
I agree. I think we’re where most people are kind of putting their excitement is still a little bit a miss in my mind because they’re looking at genetic testing, they’re looking at technology and I do think those things will advance to a way that that help us in some ways, but I think it’s going back to looking at what worked already. We’re trying to reinvent the wheel and say it’s going to be a magic pill that cures everything. It’s not, it’s not, I’m sorry I will inform you and never will it be. It just won’t.

Tia Trivisonno: 01:19:38
It won’t. No, it’s definitely looking back into what creates harmony for us. And I think that what I learned in my travels, I was just blessed and fortunate that I got to have that experience before I really kind of buckled down into all my studies and my career. That, that kind of thinking about what human beings have in common in all areas around the globe in terms of, we’re all eating and we’re all doing these kinds of things, different types of exercise regimes or different types of healing practices, that there is a unique thread that is common within all of those traditions. And how does that tradition fit into a modern model and a new paradigm? I think that that’s what’s so exciting because we are returning to the roots and we are returning to things that we already did. And again, that brings me full circle to this concept of I do believe naturopathic medicine does that really beautifully because they’re taking from what we’ve learned in advanced science and advanced diagnostics and combining that with a return to the roots of the nature cure type of practices or the things that heal us when we are in harmony with our environment. And that doesn’t just have to be in harmony with I’m out in the woods hiking in the natural environment. It’s in harmony with my job. It’s in harmony with my family. It’s in harmony with my relationships. You know, all of these things that affect our overall health to sit with what creates harmony for us is exciting. I think people want it. I think we can see that they want it. And that’s a new trend, a new old trend.

Caspar Szulc: 01:21:16
And a new old train. And I do think it is this ability to bridge gaps between nature, science, ancient and modern. We’re doing that. We are on physics. I know that that term gets thrown around a lot and I think so much is just explaining what ancient traditions were looking at different words. That’s it. They used more of, you could say primitive words, but we’re explaining it. Whatever you want to say. And I think that it’s all aligning, right? And it’s allowing us to understand it a little differently and appreciate it more. And that’s what we need to do is literally look back and appreciate at all these wonderful things these people understood so well, but we’re just now catching up with modern terminology.

Tia Trivisonno: 01:22:03
You’re correct. And I think that our technology, you know, this what we have, how science has advanced technology has advanced it. It’s just then now coming from like a fusion oriented thinking place where you can say all of these pieces play a role in this, in shifting the paradigm forward. Yo not say, Oh, because it’s old, it doesn’t mean anything to us or because it’s new, it’s better, or that it’s the only way forward. It’s really kind of taking a bird’s eye perspective of all of this information and then recognizing that if it’s all information, it’s all coming through, then how do we create a cohesive, holistic paradigm using all the best of what’s there.

Caspar Szulc: 01:22:44
Right. And that’s the approach I think we’re all hoping comes into place sooner rather than later. So what’s next for you? The NYANP, naturopathic as a whole. What do you have in store? What are you hoping that next year is the year that New York gets licensed?

Tia Trivisonno: 01:23:03
We’re making a lot of progress. So we probably will be having a lobby day and we would have information about that up through the social media channels and on the website. So again, through the website, you can find information about what’s happening legislatively. So within this session, we’ll probably be sending out some information fairly soon, about a day when people could go up and talk to the legislators about getting this process going in New York. So within the NYANP, we have a lot of different things that we’re working on. Of course, we’re working on legislation and that’s one of the biggest pieces, licensure for naturopathic doctors in New York. But there are also other ways that we’re trying to incorporate more memberships so that doctors can be aware of who all is spread out within New York already. And really kind of use that as a resource to educate people, the public, different professionals about naturopathic medicine. So there are ways to do that. And you know, a call to action would be that right on that website you can put in your information and as your zip code pops up, it will give you information how to write a letter right in this moment saying that you support naturopathic medicine in the state of New York and that you want licensure so that we can be protected here in this state. So, that is all happening. So a lot of education and a lot of push to be more in the front lines in terms of explaining who we are and what we do and that we’d really like to be here and we’d like to bring even more doctors into New York.

Caspar Szulc: 01:24:43
So that’s an action people can take right there, right? You literally sit down at your computer.

Tia Trivisonno: 01:24:50
Literally all the work has been taken out of it. So all you have to do is put in your address information and then you’ll see how to generate a letter and you hit send and it goes right out there. And I would also say that’s something that can be done immediately. It takes three minutes if that, but also just using the websites, the NYANP.org. And then the American Association of Naturopathic Physicians has a wealth of resource information to just clarify a lot of this consumer confusion that happens. There’s tons of information about what naturopathic doctors really do. How are they trained, where is their full licensure? What are the different scopes of practice throughout the United States. So we’re really hoping that using these different types of media channels that we’ll be able to clarify a lot of the confusion that’s there. And then as we clarify that confusion, we will also push to have licensure in the entire country.

Caspar Szulc: 01:25:54
That would be great. And if you’re listening, go do that. Take those three minutes cause that gives you power, that gives you power of choice. Even if you’re not sure you’re ever going to see a naturopath or maybe you don’t feel you need to do anything right now. You’re going to want to have that choice at some point and someone you know will want to have that choice.

Tia Trivisonno: 01:26:13
We deserve to have it. Whether or not you believe that’s fine, you know, but you should have that choice.

Caspar Szulc: 01:26:19
You don’t want to go into the grocery store and have only one cereal by like people would not let you have the choices even if you don’t like them. Sometimes I think that that provides you with power freedom. So I think taking just three minutes and that does make a statement correct. It’s not just a wasted sword.

Tia Trivisonno: 01:26:36
No, no. It’s a statement that goes right immediately to your legislator. And so that is the best way because I, I everybody, whether you’re a patient or a politician or a professional of an in any other field, we all need to understand what naturopathic medicine is and you’re absolutely correct that we all need to have that choice. We have to have access, just like we have access to the other things that are available for us now. So, going there, yeah, it sends something and that letter will be sent, it will be received and the more we send, the better.

Caspar Szulc: 01:27:10
The more the better. So absolutely. Take those couple minutes just to and that really empowers you and then your health choices. Where can people learn? Because you said NYANP.org. They can go there. We’ll put that up as well. Where can they learn more about you?

Tia Trivisonno: 01:27:25
So I am up there, they can find me there. But also on my website, which is transformationalhealing.me That’s with my practice.

Caspar Szulc: 01:27:38
So that’s a good resource as well. Any last things you want to add in this? Anything about naturopathy or anything to share?

Tia Trivisonno: 01:27:47
I’m really just so grateful to have this conversation with you because I really think that it’s these kinds of conversations that are gonna create the paradigm shift that we’re looking for. So I think it’s just a wonderful way to have an open-minded conversation about where medicine has been, where it is now, where it’s going, and that there are so many different things that we have and so many different skilled professionals that if we’re able to continue these types of conversations, then even if people leave this session with more questions, they know where to go to have some more access to information for educated responses to their questions.

Caspar Szulc: 01:28:33
And that’s what we’re trying to do. Right? We said communication, having this dialogue, having the questions, having the skeptics.

Tia Trivisonno: 01:28:40
And not being afraid to have it right and not being afraid to have the conversation and to say, I’m really confused about this. What is it? Is it safe? Is it not safe? Who are you? We just have to get out there more often and have these talks and really recognize that this is just about our human evolution and how feel moving forward, what kind of a world we want to have with medicine and healing and, and all of the things that we’re currently involved in. It’s really exciting just to continue these discussions and think about how to support people as they make these serious decisions about what to do with their health, what to do with them. It’s probably the biggest decision they will make. Again, health is everything and trying to regain your health is a matter of life and death. Absolutely. You know, we’re, we’re facing some really kind of serious issues within our country and around the globe with a lot more chronic illness. And diseases that are complicated and hard to treat. And like we said before, I just think that it’s the most important piece to me as a professional is to make sure that people have access to all the information, whatever you know, is out there so that they feel like they can make an educated choice. And I would really love to see it come to a place where it’s fully collaborative, that would be the best.

Caspar Szulc: 01:30:04
That’s the dream. That’s the dream we’re all hoping for. And we’ll get there.

Tia Trivisonno: 01:30:08
We will get there because here we are and where we’re talking about it right now. How to help people, to be walking that path.

Caspar Szulc: 01:30:16
Yeah. Well, you’re doing a wonderful job and thank you for all you’re doing to push this forward. It’s really important. If you’re listening go to the website.

Tia Trivisonno: 01:30:24
Yeah, go to the website because that will keep you tuned into what’s going on. And, for people who are able to, within the profession or a healthcare profession want to become a member, then you’ll receive the newsletters that give the updates. What we do. We do always have an annual conference in the fall, so we’re out there and we would love to just be available to more people in New York so we can be reached through any one of those channels.

Caspar Szulc: 01:30:53
Here’s the thing I hope you got from this episode. There are lots of approaches to healing and staying healthy out there, and the greater your awareness of them are, the more power you have to make the best choices for your health. Dr. Trivisonno did a great job showcasing what Naturopathic Doctors can do, but there’s another side to the story where you can get involved, and that’s to let your voice be heard and support these causes that are limited by bureaucracy and old regulations. I know a lot of Naturopathic Doctors, my co-founder at Innovative Medicine being one, and I’m still disappointed that they can’t fully practice what they’ve been taught in New York state. So if you’d like to help do something about it, the NYANP is having a lobby day for interested supporters of licensure of NDs in NY in Albany Wednesday, April 22nd. They also are having their annual conference called “Lighting the Path to Success” in NYC on Saturday, October 17th. You can learn about these events or how you can help on their website, NYANP.org.

Remember, you don’t just have the remarkable power to heal yourself, but you have the power to spark action and change that can create a movement towards a new paradigm of medicine. Till next time, this is Caspar Szulc hoping you continue to write your own amazing healing story.