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East meets West: Stanford students invited to sample Tibetan medicine during clerkships

Stanford medical students must master genetics, biochemistry and immunology, among other disciplines. But school leaders don't want these future doctors to be stumped when their patients describe their acupuncture sessions, or have questions about herbal supplements or other alternative therapies.

To help familiarize Stanford medical students with these practices, the students spend a day shadowing a practitioner at a participating integrative medicine clinic during their family medicine clerkship.

"We want to introduce students to the idea that the patients they see in clinic are using these other health-care systems," said Art Johnson, coordinator for the family medicine clerkship. "They need to partner with patients in managing their health in the best way possible, and utilize all available resources."

The Kunde Institute, a center for Tibetan wellness and healing located in Daly City. is one of these participating clinics. It offers a unique opportunity for students because most integrative medicine clinics in the Bay Area focus on Chinese medicine, Johnson said. About 10 Stanford students per year shadow practitioners at this center, said Tracy Rydel, MD, who directs the family medicine clerkship.

Tibetan medicine, which originated more than 4,000 years ago, attributes the roots of all disease to an imbalance of the three Nyepas (rlung, tripa and peken) that emanate from the three mental poisons of desire-attachment, hatred-anger and closed-mindedness. Treatments at the Kunde Institute include herbal medicines, hot oil therapy, acupuncture, copper cupping and individualized counseling on diet, nutrition and lifestyle behaviors.

At the Kunde Institute, participating students learn from Menpa Yangdron Kalzang, LAc, who has a Tibetan medicine degree from the Tibetan Medical University in Lhasa, Tibet and a master's in traditional Chinese medicine from Five Branches University in Santa Cruz. They learn about the connection between the physical, emotional and mental health of patients, one student told me.

Stanford medical student Victoria Boggiano first learned about Tibetan medicine when she attended a symposium at Stanford, she said. When she shadowed Kalzang, she told me she became very interested in how Tibetan medicine can complement the biomedicine traditionally taught in medical school. Boggiano described her experience via email:

I spent an afternoon with Menpa Kalzang, shadowing her as she saw patients with a variety of ailments. I remember really distinctly that two separate patients we saw that day had very bad plantar fasciitis, an inflammation of thick tissue in the foot that leads to pain in the heel and bottom of the foot. Before coming to the institute, neither patient had been able to walk without feeling terrible pain that had been resistant to any of the medications or physical therapy that their primary care physicians had provided them. Both patients started seeing Menpa Kalzang to receive acupuncture and herbal remedies, after which they both saw dramatic reductions in their symptoms. It was incredible to see how much Menpa Kalzang had helped them!

Since 2008, about 100 Stanford students have visited Kunde, Kalzang said. She said she plans to continue with the program.

"I do this to build bridges between the Western and Eastern medical systems," Kalzang told me. "We need to establish integrative medical systems that allow providers from different disciplines to share information and put in referrals for both types of treatments. This is particularly important for patients with complex cases when Western or Eastern medical systems alone can't answer or solve the problem."

Boggiano hopes to be part of this vision of integrative care. After medical school, she plans to specialize in family medicine and work in a primary care clinic. She explained:

I am eager to learn more about alternative medicine, and particularly Tibetan medicine, both by continuing to work with Menpa Kalzang and by gaining additional clinical experience. It would be incredible to work at a clinic where both biomedicine and alternative medicine are practiced side by side. Tibetan medicine encourages us to view patients in a holistic way and reminds us that mental health and physical health are incredibly intertwined. Patients deserve to receive both types of health care.

Previously: A look at integrative medicine with Stanford's David SpiegelExploring the role of integrative medicine in treating chronic health conditions and Ask Stanford Med: Pain expert responds to questions on integrative medicine
Photo by StanfordMedicineStaff

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