ND Income & Loans

ND Income & Loans

jasonbarkernd

Message 1 of 36 , Oct 23, 2014

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I know, I know, this has been discussed ad nauseam but I think it's an interesting topic. I know this information has been provided before but I'm not finding it, so here are my questions again, if you'll oblige me...
1. What is the average income of an ND today?  (I'm looking for Gross and Net) - Anyone have any solid info on this?
2. What is the average student loan burden an ND graduate will have today (only ND school, not prior undergrad loans)?   My loan was about 100,000k taking advantage of all I could, and I graduated in '01. I've heard this number is now 200,000k. ??? Please tell me that isn't true....
Thanks!
Jason Barker, ND
Fort Collins, CO


James Prego, ND

Message 2 of 36 , Oct 23, 2014

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1.  I tried to find this out for my area, and most NDs I talked to (even the supposedly very successful ones) didn't even know how much they make and/or profit...that was really scary to me!  Personally I would gross between 35k and 45k/yr and I would net between -6k to +4k/yr.  That's why I had to close down my practice after 9 yrs, there was no growth, and the last 2 yrs were in the negatives.

2.  I graduated in 2004 with 154k in loans from ND school (as a comparison my brother's wife graduated MD school in 2006 (or it might have been 2007) with 80k in loans).  I also hear the number for NDs is around the quarter million range now.

Dr. James Prego
Naturopathic Doctor
Bay Shore, NY


Anne Van Couvering, ND

Message 3 of 36 , Oct 23, 2014

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I graduated 2 years ago, and most of the folks were looking at $200K if they were doing 4 year, more if they did 5 year or dual degree (6 year).  And the option for subsidized loans ended the year I graduated, so the interest is now accruing while students are in school, and they are having to take out more of the higher interest loans (these were at 9.8% when I graduated, vs. 6.8% for the federal loans).

Cheerful, ain't it?

Don't know the answer to #1 - this is only my second year in practice - doors are open, bills current - but 50% of my practice is massage,  and I don't think I would be afloat without that. I definitely made more just doing massage than I am now (no overhead, worked out of my house, etc).  We still use the food pantry for food as we have some steep credit card bills from not working for four years and moving across the country twice, and I haven't yet paid a dime in student loan payments as I applied for income based and last years "income" was negative - but that I expected with the expenses of starting a new business. We also rent out a room in our house through AirBNB and that keeps expenses down.

 I definitely have some obstacles to success that I am looking to overcome - high rent (expensive area), no licensing, difficulty ordering functional testing (yay, NY), lack of steady MD/NP support to refer to or sign off on labs, seasonal economy, and the financial drain of a 23 year old very sick with Lyme and coinfections that needs medical care that is not reimbursed by insurance.

I feel good that I am keeping the doors open and bills paid, but if I am in this position in two more years, I won't be.

I'm actually hoping to find some kind of situation in a licensed state where I could work part time, because I'm frustrated with the lack of scope and inability to help patients when I know how but am not allowed - preferably California because of family - and so trying to get my skills and expertise to a point where I would be a valuable addition to someone's practice - doing preceptorships with Lyme and autism docs and getting my knowledge of MTHFR honed.  Probably take IV classes and ozone classes too along the way, as I can afford them.  And doing the NESH program now because I love homeopathy and don't use it enough. . .

I take it month by month, market a lot, try to improve systems and referral networks, stay cheerful, don't allow desperation to seep in and realize it could be much worse - I'm doing what I love and helping people, I have a roof over my head, food in my belly and loved ones around me, and I live in a beautiful place.

Anne


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--
Anne Van Couvering, ND, LMT, CNS
Hamptons Naturopathic


Karl Goldkamp

Message 4 of 36 , Oct 23, 2014

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Jason & James,
You do realize these questions are the one no one wants to answer.  It leads to the realization that most of us that depended on student loans to get through med school are now looking at a life of indentured servitude. This is a huge issue nationally: student loans.

My informal numbers pretty much agree with James's. net range of $30-40K/year.
When I graduated 1998 had $135K for a combined ND/MSAOM for the 5 year program.

a third question would be what percent of grads are earning an income in the field, as a physician or otherwise.

When I was at Bastyr we were encourage to do some volunteer work at the AANP which was nearby. I worked with Shila Quinn (she is really one of the founders of Bastyr, in addition to Bill Mitchell, Les Griffith, and Joe Pizorno btw). We tried to find the percentage of working NDs in N. America.  The problem was those who couldn't make a go of it didn't what to answer the surveys we sent out. We finally gave up.

It is alleged that, for instance at Bastyr, after they got their certification (I forget the specific name of the educational governing body) that the tuition quadruple quickly over a short period time. I haven't graphed this out but it is easy to do. just have to call them.  Not saying anyone got rich, however in the course of my 5 years there the school went from sharing an elementary school to buying a former catholic seminar on Lake Washington. It was amazing. very beautiful.

Karl Goldkamp ND.,LAC
Cape Cod, Ma


James Prego, ND

Message 5 of 36 , Oct 23, 2014

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Yes.  But as we all should know, the first step to resolving a problem is realizing/admitting there is one.

There are some excellent articles and videos out there on how screwed up the cost of college in general is and how messed up the student loan system is.  I wish we knew what to do about it.

For our profession in particular, we just do not have the infrastructure to support graduates with this level of debt (as I mentioned before, my brother's wife graduated MD school with 1/2 the debt I did and has near infinitely more opportunities than I have for employment and for loan payback), and it will take decades for it to be created.  In the meanwhile I have a feeling becoming an ND is just going to become something that is impossible for most people.

The only chance we have is for everyone in the profession to realize this problem and be willing to figure out how to do something about it...the profession as a whole, the professional associations, the specialty associations, the accrediting bodies, the schools, clinicians, graduates, students, etc.


Dr. James Prego
Naturopathic Doctor
Bay Shore, NY


Eric Blake

Message 6 of 36 , Oct 23, 2014

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NCNM did surveys that can be found here:
http://www.ncnm.edu/alumni-ce/alumni-survey-results.php

I have been told the AANP did a 2012 survey and the average (I assume median) income of practicing NDs was $75K. Gross. So assuming overhead of 50%.... that would be $37.5K.

--
Dr. Eric Blake Naturopathic Physician and Diplomate of Acupuncture


dr_sacha_elliott

Message 7 of 36 , Oct 23, 2014

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I just came across this now.  It was published in the Globe and Mail yesterday, titled "I want to be a naturopathic doctor, what will my salary be?".  The article sheds a very favorable light on us. :)  Written by a freelance writer.

Here's a quote:

"Salary: Those starting out can earn about $50,000 a year, increasing steadily to more than $100,000 as they gain more experience. Naturopaths who run their own practices also tend to earn more.

Job prospects: Good, especially as naturopathy becomes more widely accepted in today’s society. “There is pent-up demand for high-quality natural health care,” Mr. De Groot says. More employee health and wellness plans are also incorporating naturopath services, which is helping to drive demand."


I want to be a naturopathic doctor. What will my salary ...
Naturopaths use natural remedies to treat and prevent illness

View on www.theglobeandmai...
Preview by Yahoo


Sacha Elliott, ND
North Vancouver, BC


chamiltonnmd

Message 8 of 36 , Oct 24, 2014

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As a newer grad, I have wanted to reply to posts such as this many times, but thought anything I said would sound like whining because I was struggling - working 14 hours + 6-7 days/week with multiple hats: office manager, receptionist, MA (phlebotomist, nurse, records, Rx and lab orders, etc.), marketer (including "social media") and doctor with very little monetary return.

Thankfully, I now have a practical nurse, who has agreed to also be a receptionist until both can be afforded. Currently I am paying her more than I make, but at least I'm not killing myself and the office is flowing smoothly.

I graduated from SCNM in 2012 with a $220,000 student loan that was taken out solely for the ND education (thankfully, no private loans were accrued in that 4 years). I'm on income-based repayment, so I'm up another $10,000 in interest as of last year and will have another $10K+ after this year. CRAZY! INSANE!!! At least I DO NOT worry about identity theft!

I was "lucky". I had a little money from a divorce incurred while in med school to start a practice. However, I do not have other financial help - no husband, sugar daddy (sorry, but I've been told many times this is what I "need"), or family help, so I PLOW ON out of necessity (and really, what else do I have to do). However, I can't imagine what it's like to graduate with no nest egg and to have to work for split wages - and have a spouse with income so you can't qualify for income based repayment...

For a while, I joked that I wanted to go down and picket at SCNM to warn the incoming students - DO YOU REALLY KNOW WHAT YOU ARE GETTING YOURSELF IN TO?

Right now I'm struggling with insurance - the Affordable Care Act. I spend a great deal of time looking up and re-looking up codes (something we get NO training in) so people can try to get insurance coverage for the very low amount they have paid me to make them well. We just had a conversation yesterday that it might be best to just say "no more codes". We make nothing for the amount of time we are spending - other than having a patient come in the first place because they thought they would get reimbursed. AND, the ICD10s are incredibly confusing - even with Ross's excellent attempt to simplify and explain them.

What's really frustrating is that I get 3-4 phone calls a day that don't book because I don't bill insurance and it wouldn't matter anyway because 95% of them have Blue Cross Blue Shield of AZ - which follows in Medicare's footsteps.

As an aside: I did interview a person who said she used to work in BCBS's "blood money" department. Of course my interest perked and I inquired - apparently the insurance company submits prescriptions written by doctors to the pharmaceutical companies and gets a "healthy kick-back". Is this why Medicare/Medicaid, etc. won't cover us? I digress...

Yes, like Ann, I love what I do,  even while spending a great deal of (incredibly frustrated) time trying to figure out how to get a patient's labs covered (usually a referral to a nurse practitioner) or referring a patient so they can get insurance coverage for complicated health care and prescriptions because they can't afford to pay me.

I have had many successes - doing what a ER doctor friend said - "working myself out of a job" and I feel incredibly fortunate to have this incredible knowledge. I love being a general practitioner, but I ask myself every day - should I do the marketing thing - promote myself as an expert in one field in order to attract patients that can pay out of pocket so that I can somehow pay back my student loan and make a comfortable living? Will I ever have the money to do that? AND, since I'm over 50, will I ever get to "retire"? Do I just resign myself to living in poverty for the next 23 years so that my loans will be forgiven? Would I do it again? Ask me in 10 years and I can probably give an honest answer - or maybe better to wait 23 years.

Cheryl Hamilton, NMD
Prescott Valley, AZ


Karl Goldkamp

Message 9 of 36 , Oct 24, 2014

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Cheryl,
I’m responding to your comments because you dared to be open and share your personal experience and concerns about your situation.  That deserves both compassion and respect.

Two things I’ve come to accept since my doctor hood was achieved by in ’98. One is that schools are a business, like any other. You are their customer. They are not responsible for creating employment for us doctors. And two, that we will not become financially successful if we cannot achieve a degree of leverage in our business. That’s why docs write their books in hopes they are recognized as an expert and that people with buy their book and pay them to speak etc., or that they create a special supplement, or that they own a company, or part of a company, or that the build a practice where there are other docs working for them.  That’s the goal for most of us.

The 15 years since I was let loose from Bastyr to create my future has been rocky. In part, my arrogance was my biggest obstacle. I was asked to apply for a residency at the school, and a Urology group in downtown Seattle, asked me to join their practice. Since I had been class speaker for our graduating class I felt I could achieve more…. So I went east to join a practice southeastern CT. Did all the things one had to do build up their practice, give talks (lots) network with chiros and educate MDs etc., etc. In 3 years, I was “let go” with the accusation from one of the more senior docs that I was stealing his patients. That hurt. Apparently 10 other newbie NDs had preceded me in the course of the proceeding 10 years at this practice, one while I was there, and the ND who accused me of stealing their patients was also “let go” within the next two years.

I scrambled to figured out what to do. I was ready to go “Daktari” (as in the TV series in the ‘60s)  and go to Costa Rica, or Panama and make a difference in a more hospitable locale.  Former patience called and encouraged me to stay. Found a location 25 miles away in Old Lyme. The doctor, who had hired me initially, sent me a letter telling me to honor my non-complete clause which stated that I couldn’t work in the two nearest counties to her practice. I got an attorney and challenged her…. and won. Found out what she was doing was actually illegal. Who knew??

Did a business plan, presented it to banks, got a loan for $75k and jumped in. Paid it back in two and a half years, which was two years early.  Read everything I could on running a practice. Had money to take Walter Crinion’s environmental med. course and go to the functional med. conferences.  My wife was my front desk (she had another fulltime IT job but could work remotely). I was the engine that kept it going though many patients told me otherwise and pointed to my wife. She booked appts and did the books. Had a big pharmacy and started feeling like a real doc. An entire medical build in town became available…. We bought. $500K. Given our good credit took out a loan for another $250 and used our home as additional equity.  Now I was working 24/7. Worked 4 and half days/week seeing patients and 2 and a half worked on rehabbing the build with the crew we hired.

Had three tenets. Loved getting the rent checks….. then 2008 happened …. And our patient load dropped like a stone… and for our tenets as well. They had to break their leases, We struggled for another two years…. And filed for bankruptcy… and due to the student loans…. It meant federal bankruptcy. We had to hire an attorney. Federal Bankruptcy court is basically a criminal investigation. As if you were on an episode of Law and Order. You are interrogated. My wife, with our attorney, was grilled for 4 hours in a bulletproof small conference room. I waited in a 4 x 4 waiting room with bulletproof glass on all sides. I was grilled for 90 minutes. Though we verified beyond a shadow of a doubt that we had NO money, they didn’t believe us so we couldn’t discharge our unsecured debts. They felt that since a was “a doctor” I had the money hidden away somewhere. Unbelievable! We were offered a deal that if we could still “prove” that we qualified for BK in 6 months the Federal trustee would grant it.  We did, and It was.

After the Bankruptcy was granted, the years of stress manifested itself. I developed severe UC and Crohns which lead to severe, uncontrolled anemia. Major meds were ineffective. At this time my only and older brother passed after his 9 battle with multiple myeloma.   My wife was diagnosed with a meningioma the size of a plum that had impinged on the right side of her optic chiasm… after 3 years of gradual vision loss in her right eye. (Her retinologist thought it was psycho-somatic).  Then on to the surgeon, surgery scheduled two months out. Meningiomas are slow-growing. There wasn’t any rush… and then the 10 hour surgery. OMG. The minutes waiting were like drops of acid dissolving on your skin. Drip, drip, drip.

We were a pair dangling by a thread. I felt like Job. At the time, I was so weak I could hardly climb stairs yet I was to be her caregiver for the months following her operation.  Since she is such a type “A”, she had accumulated months of sick days. On her last sick day they laid her off… after telling her, they were looking forward to having her back. WTF?

Our situation had changed so completely so quickly we could only laugh, sometimes hysterically and even around others….. especially when someone would bring up some concern that thought we should have or they should have.  Our list of things to worry about was nearly non-existant.

My days were helping her and sleeping when I could due to my uncontrolled anemia I was wiped out. I called this my ‘sleeping with God’ phase. Family and friends would drop by and delivery food or do some cooking. My voice was so hoarse from the anemia it scared people when I spoke. But we were on the mend..

Ends up that a disability policy that I had sold my wife back in the few years I was in the industry long, long ago, could be activated.  Consequently, a tax-free check for $6.5K check arrives monthly. Unbelievable!

Though blood transfusions, supplementation and dietary change I eventually stopped scaring people with my voice, got off my meds that I was told to be on for LIFE!  and got to work on all things related to IBD, Microbiome, FMT, helminthic therapy, supplementation, etc., Lots of research, pubmed, endnotes, google scholar, went to conferences, emailed docs, called them, again realized, this time personally, how dangerous these freely Rxed for IBD were. The relationship between the insurance companies and the pharmaceutical companies is nothing less malicious. Evil is too naïve a word to use. I almost think I have seen too much, learned too much. There no sweetness to that situation. It’s killing people, uncontrollable,  and bigtime influencing the FDA and congress.

Ordinarily I would have guided my attitude to a healthy place with a quote I like:
“…the race is not to the swift, nor the battle to the strong, nor bread to the wise, nor riches to the intelligent, nor favor to those with knowledge, but time and chance happen to them all”……but not this time.

While off on an errand, I was listening  to NPR,  to an interview with Henry Waxman, congressman retiring from ca.  At the end of the interview, he was asked what his greatest disappointment was. He paused unusually long, choked softly, and said “… I used to think if you educated yourself, worked hard and applied yourself, a person could do well in our society. I no longer believe that. The game is rigged.”   I almost crashed into a tree.  WTF!   Here’s the link to that interview.
http://www.npr.org/blogs/itsallpolitics/2014/01/30/268890691/rep-henry-waxman-ferocious-liberal-says-he-will-retire

I question everything now and care A LOT less about what people think of me.  I question all the info in this beloved chatroom, and from the AANP, the voices of authority in this rarified world in Naturopathic medicine. My classmates have always been gods (incredible humans) to me and their spirit runs through my blood….. as I believe it is with everyone here, and their classmates. However, the world has changed so severely that a major rethinking is in order for NDs to be able to live a life that is not that of an indentured servant. I do think that is possible.

Karl Goldkamp ND., LAC
Cape Cod, Ma


Tara Skye Goldin, N.D.

Message 10 of 36 , Oct 24, 2014

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Wow, reading these stories is nothing less than heartrending. I am now what may be considered an "oldtimer".  I graduated Bastyr in 1990 with "only" 40k in loans, which are paid off thanks to my house appreciating and refinancing .  I have always, ALWAYS had a low overhead cash practice.  When I had receptionists, they were shared, and even now I use an offsite service to book appointments and call patients. Technology makes this easier nowadays.  Almost always worked in a healing arts type of building where I had my office and shared the waitroom. While I don't always bring in the mega bucks, and perhaps I am limited in my growth potential (no IV's, no MD's on staff that I either hire or work under, but this all goes along with our CO  scope of practice, unless I hire an MD), I have always been in the black and able to support my family in a modest but decent lifestyle (I am lucky to live in a beautiful area with a great PUBLIC school system, and bought a house here before it became ridiculously expensive).

 It seems to me that medicine, especially naturopathic medicine, risks becoming a game for the independently wealthy to both study, practice and maybe to consume. This goes against my hippie roots, but I don't think a new grad with massive loans in the hundreds of thousands could afford to practice the way I do.   One needs money to start a big practice, hire an MD, pay staff,  one needs money to go to school, and yes, most of my patients are  wealthy so can afford to pay cash. It seems that the expenses of school and practice may have reached a tipping point.  Yet when I go to conferences I see well dressed docs 1/2 my age who seem to be happy, smart and doing fine and still in love with the medicine, but of course I don't really know them or their situation.  Are they independently wealthy?  Did their  1% family pay their tuition? Are they all in massive debt? Probably a combination.

I think this really needs to be addressed but have no idea how. More residencies need to be created.  More salaried positions need to become available. Entrepreneurship and practice management need to be emphasized as a part of the education.  Otherwise this profession may not be sustainable.  Thank you all  for getting real  and vulnerable and sharing your stories.  They are truly eye-opening.


Tara Skye Goldin, N.D., Naturopathic Doctor


Dr. Archer Atkins

Message 11 of 36 , Oct 24, 2014

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In answer to the average student loan burden, I thought I'd share mine.

I'm also interested in this topic and hope to write a blog post about it on my blog soon (debt to income ratio for NDs). I asked similar questions on the ND Facebook group.

I really appreciate the honesty and vulnerability in this thread so far.

I graduated in 2013 with about $190K in debt. Around $24K was from undergrad, so technically I racked up 166K from going to naturopathic medical school at Bastyr. I started the program in 2006, did the 5 year track, had 2 kids, took a year off for my first child, and for my second child I divided my last year into 2. Technically I did the program in 6 years, since I took a year off.

Most of my colleagues were graduating with about 250K, just from their ND education at Bastyr. If you did midwifery or acupuncture, the numbers were higher.

My second year at Bastyr, I waited tables, and paid off about $5000 from undergrad. But I never slept.

I only took out exactly what I needed for tuition & books, so that helped keep the costs lower. I was fortunate to have a husband who worked two jobs to pay rent and also childcare.

In my year off with my first daughter, I had to use up my grace period, so many of my loans automatically went into repayment the day I graduated in June 2013. From the time I graduated to the time I started payments in February 2014, about 8 months later, my loan total jumped another $10,000 just from all the interest that gets capitalized on the loans once you start repayment. So in Feburary 2014 when I started making payments, my debt was $200K. It's looking like it'll be about 10K a year in interest until I can really pay down a significant chunk.

The thing that gets me the most, is that I feel like I have to live a non-naturopathic life to pay off these loans. In essence, treat my body the OPPOSITE of how I was taught to treat it in school, just to make enough money to get out of these loans. The enormous financial cost of being an ND these days, takes a toll on our bodies, because we're running ourselves into the ground trying to pay back our loans... after most likely running our bodies into the ground just to get through school. It just doesn't make sense to me. I highly value living a naturopathic lifestyle, but sometimes I feel like it is at odds with having to be that Go Getter to really make it work financially.

Thanks for sharing your stories so far!


Dr. Archer Atkins, ND


Lynnwood, Washington


Mona Morstein

Message 12 of 36 , Oct 24, 2014

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Hello, Cheryl,

Thank you for sharing about your experiences.

One thing--insurances DO cover us doing labs in Arizona.  Even though they do not cover office visits (although I've had a number of patients send in my super bill to the insurance and wound up getting money back--its something to encourage them to do), they pretty much all cover labs.  Medicare with a supplement can be run through Labcorp but not SonoraQuest.  If they have insurance, you can usually have Commonwealth cover the SIBO test, and food allergy tests can be covered, too (if they have met their deductible).   Don't bother with BlueCross/Blue Shield and HealthNet who don't cover any alternative labs, but they'll cover regular ones.  Cigna and United are pretty decent though.

I know a lot of docs mark up alternative tests a lot and charge cash, and that's fine, but it can be set up another way for some of them with insurances.

Make sure you do code well, though, on requisition forms.

Mona Morstein, ND
Tempe, AZ
www.diamend.info
Official Sponsor NatChat--Doctors Data Lab


dralpinewellness

Message 13 of 36 , Oct 24, 2014

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Today, I was having lunch with my daughter (she was home from pre-school). Since they are working with farm animals in class, I asked, “Soooo. Where does milk come from?”
She thought a minute, then said, “The refrigerator.”

I graduated in 1990 with $200k of debt after doing two programs, despite graduating from college with only $5K of debt and working 32 hours (two back-to-back 16 hour shifts) on a hospital unit every weekend that I was in medical school.

For a decade, I was unable to get dual reimbursement for my services via insurance – I had to choose to be reimbursed for ND services or acupuncture services. I was never told that this would be the case. So paying back my student loans was particularly arduous. I was also not told that, after I consolidated my student loans once, I had no further options to refinance, unlike almost any other loan in the financial universe.

When I started, I had zero business skills. If it wasn’t for my wife, who is both an amazing clinician and a skilled entrepreneur, I would no doubt be working in a zoo. In fact, it was because of her successful administration of our practice that I am not still paying off my student loans today. She actually left the ND program after her 1st year because of her concerns about debt and not wanting to live in “indentured servitude.” If her parents hadn’t helped her, this incredible resource would have been lost to the profession. It is sobering to consider how many other bright lights have been lost to us.

I was recently contacted by a prospective ND student who wanted to know my thoughts about choosing naturopathy as a career. Questions ranged from how she could set up a concierge practice to what I thought about telemedicine to how she should set up her practice so she could deliver naturopathic services to Medicare patients with immunological issues, because she thought immunology was interesting.

To me, this is like thinking milk comes from a refrigerator. As I told the prospective student, a successful practice does not come from cobbling together modalities that worked for other people or structuring your practice based on what is intellectually appealing. A successful naturopathic career comes first from a deep intimacy with yourself, understanding vocational orientations that align with your life purpose, and having a reliable source of inner guidance to help you navigate those tough vocational choices.

Ideally, future NDs would be guided through an intelligent orientation/educational process that starts by giving potential students the raw data about the reality of life as an ND so they can make an informed choice. This would be follow by an intensive questionnaire/personal inventories that would assist the student in understanding their values, strengths, weaknesses, skill sets, passions, etc. so that when they are exposed to different experiences and modalities, they can make considered judgments about what will and will not work in their own unique practice. Finally, the powerful business insights and expertise of mentors like Eric Blake, Mike Whitney, Andy Belanger, etc. would be available to students while they are in school and forming key perspectives.

Instead, the prevailing view is that we can toss students into a Vitamix, throw in various educational ingredients, spice with a smattering of business suggestions, and let them figure it out on their own once they graduate.

To her credit, the prospective ND student was well aware of the corrosive effects of high debt burdens, having seen the negative impact amongst her peers. She found the program she was evaluating (NUHS) “limited” and was very concerned about the future earning potential of NDs due a perceived lack of institutional support and the seeming inability of the naturopathic profession to achieve the “market penetration” of even chiropractors. In other words, rather than being embraced as the cream that rises to the top of milk, we continue to struggle as a powdered, evaporated alternative. Time to remodel the kitchen.


Gary Piscopo, ND, LAc
East Wenatchee,  WA
www.alpinebewell.com


Gregory Pais, ND, DHANP

Message 14 of 36 , Oct 25, 2014

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There are 3600 stories in the Naked City…
I had no idea what I was getting myself into when I graduated NCNM in 1992 (guess that makes me a golden oldie too (more silver actually). I graduated with 'only' $44,000 in loans (I can't imagine $200,000+). I was so unprepared for business--my very first patient in September 1993 looked at me after the 1.5 hours of our first visit and told me she had no money to pay for it. Not the most auspicious way to start.
We were blessed to have the support of my wife's family while in school and after I graduated. They made sure that we never got completely destitute while I fumbled my way through my first several years of practice. I've always practiced in an unlicensed state, CO for 4.5 years, then PA for the last 16.5 years. From the beginning I've had a cash practice. None of my patients are rich but they bring their friends and family to me (and their kids and grandkids) because naturopathic medicine and homeopathy work. They want what I have to offer. I've turned people away because I can't afford to work for less than I'm worth. Discounts and sliding scales have only brought me non compliant patients who can't afford my services while they spend $100+/month on the supplements the fake nd in town told them they need to use.
How am I still in practice after 22 years? Very special people that have helped me along the way. Wendell and Juanita Ball, may you rest in peace. Margaret Helenschild the acupuncturist who helped me believe. Cascade Anderson Geller who reminded me of my herbal roots. David Kramer, an incredible homeopath who has helped me heal. And all the patients who've let me be a part of their healing process.
I DO love what I do. The simple power of hydrotherapy. My special herbal friends-calendula, comfrey, slippery elm. The amazing ability of homeopathy to reach into the core of human existence and shift the dynamis back to the path of healing. When I remember all this I am once again able to help my patients experience the Vix Medicatrix Naturae. I know that as we return to Colorado to start anew again these tools will not fail me.
Thanks Karl, Cheryl, Tara, and the rest of you that have shared your stories. You're an inspiration for us all.
Peace, Gregory   GREGORY PAIS, ND, DHANP


James Prego, ND

Message 15 of 36 , Oct 25, 2014

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Something I finally figured out too late, and the success stories on here reminded me of it:  After a few years of practice, I spent years looking for and talking to NDs who were successful to find out how they got successful, at first I found it weird that many weren't able to tell me how they got successful, until one ND pointed something out to me:  They all had support.  Its true of the stories I had heard about here.  A spouse/family member/loved one who supported them either financially, skill-wise, manpower-wise, moral-wise, and usually some combination of these.    I had to pretty much go it alone.  The only support I had was my parents allowed me to move back in with them for a pretty low rent (if it wasn't for that, my practice would not have lasted anywhere near 9 yrs), but other than that I went it alone, and often surrounded by negativity for my field and/or the chances of my success.  I often like to think that I can go it alone against the world, but after that experience, I discovered I couldn't keep the negativity I was around from affecting me.

The other factor of success I discovered that greatly helps, but isn''t always required, is to be in a licensed state.  Even in the state, location seems to matter much.  For some reason, most of my patients who got great benefit from me never really shared their stories with others, or if they did, they told me the people they talked to were very unreceptive.  I remember one gentlemen was a bit skeptical at 1st, but saw pretty much total reversal of his DMT2 and great improvement in his HTN, but would tell me that when he would tell his friends, they would say 'why don't you just take a pill and do whatever you want?'  even though some of them were losing body parts to diabetes.

I somehow seemed to have ended up with the lack of support and picked the worst area to do what we do.  No wonder I had to close my doors, lol.

So the advice I'd give prospective students today is if you want to be an ND, make sure you have some kind of support network in one or more of those areas, make sure the people in your life are actively supportive of what you do, and very seriously consider going only to a licensed state, unless you are an amazing entrepreneur, or know someone who is.


Dr. James 'dammit Jim, now I'm a professor not a doctor' Prego
Naturopathic Doctor
Bay Shore, NY


chamiltonnmd

Message 16 of 36 , Oct 26, 2014

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Thank you for the input! And Karl - your story. The recession was incredibly hard on so many...thanks for sharing!

Mona - as far as labs -

	•	Does Blue Cross Blue Shield (BCBS) cover labs ordered through Sonora Quest and LabCorp? Most of the people in this area have BCBS so this is a crux for me.
	•	To double check on Commonwealth - I called them and was told that if labs weren't covered, then it's a $175 charge to the patient. Is that what you understand?
	•	Finally - has anyone worked with Atherotech Diagnostics - they say that if a patient can't pay, then all they charge is $39.00 for which they bill twice and then write everything off even if unpaid (saying they make so much off insurance that it "doesn't matter").

Finally, are people using the VAP Lipid Panel (for which Atherotech charges $39)?


I also want to re-iterate that I didn't want to whine, but I do wish I would have taken the time to evaluate what I was getting myself in to, which is why I wrote. Regardless, I just did a talk on beating burnout: "Developing an Attitude of Gratitude" and the thing is - I really do use this:
	•	Every morning I journal at least three things I'm grateful for and when I'm down, I re-read it. In the talk I spoke about the types of neuropeptides created in response to an emotional state and how our cells become addicted to them - i.e. Candice Pert, PhD (Molecules of Emotion). It's so easy to sink and it really does take practice and dedication to feeling good. 99% of the time I choose to feel good.

It feels good to have so many tools, rather than just pharmaceuticals/surgery, to assist people in their journey to wellness.
I'm grateful for NatChat and Mona's dedication to it!
I'm grateful for having a sound mind and body that allows me to have a practice and wear most of the hats (even the cleaning)!

To us and to health!!!

Cheryl Hamilton, NMD
Prescott Valley, AZ


jasonbarkernd

Message 17 of 36 , Oct 26, 2014

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Thanks Eric - these are the numbers I was looking for.

Thanks everyone for your stories.

Jason Barker ND
Fort Collins, CO


Mona Morstein

Message 18 of 36 , Oct 26, 2014

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Hello, all,

The traitor is still uploading info from NatChat.  Gorski wrote up another blog showing his ignorant bias of everything aside from using drugs and surgery as medicine using more recent posts.

I am of the mind to remove everyone from Natchat who signed on in the last six months and require them all to resign on, when I will be more stringent with my vetting process.  I will contact everyone removed personally to ensure they are valid students or physicians.

It seems like its from someone who signed on the last six months.

What do people think of this plan?

Mona Morstein, ND
Tempe, AZ
www.diamend.info
Official Sponsor NatChat--Doctors Data Lab


Karl Goldkamp

Message 19 of 36 , Oct 26, 2014

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Good idea Mona. Will follow your lead.
Karl Goldkamp ND., LAC.
Cape Cod, Ma


James Prego, ND

Message 20 of 36 , Oct 26, 2014

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I agree.  Since this is not stopping, something needs to be done.


Melanie Whittaker

Message 21 of 36 , Oct 26, 2014

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Do whatever you have to Mona.

Melanie Whittaker, RN. ND


Emily Kane

Message 22 of 36 , Oct 26, 2014

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Sorry you have to do this Mona but I agree it's a reasonable idea. Thanks for your ongoing passion for our shared wisdom
Hugs
Emily Kane ND
On my way home from ozone conference in Reno

www.DrEmilyKane.com
www.naturopathic.org

"Let your highest aspiration organize your life."


Virginia Oram, ND

Message 23 of 36 , Oct 26, 2014

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Great, thank you Mona!!

Sent from my iPhone


Show message history

Sorry you have to do this Mona but I agree it's a reasonable idea. Thanks for your ongoing passion for our shared wisdom
Hugs
Emily Kane ND
On my way home from ozone conference in Reno

www.DrEmilyKane.com
www.naturopathic.org

"Let your highest aspiration organize your life."


DrDee

Message 24 of 36 , Oct 26, 2014

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Ok with me!

Transformational Medicine PLLC
Dr. DeeAnn Saber, NMD


Tara Skye Goldin, N.D.

Message 25 of 36 , Oct 26, 2014

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Do it!


Tara Skye Goldin, N.D., Naturopathic Doctor


Stephenie Riley

Message 26 of 36 , Oct 26, 2014

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Absolutely Mona!
Stephenie Riley, ND
Tahoe City, CA


Rachel Oppitz, N.D.

Message 27 of 36 , Oct 27, 2014

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Mona,
Well worth a try!

Rachel Oppitz, ND
Park Rapids, MN


markdavisnd

Message 28 of 36 , Oct 27, 2014

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Just because he uploaded a post with more recent information doesn't mean that additional information was exported - he could just be mining new information from the original data dump. Just offering up another possibility, not saying yay or nay to Mona's proposed plan.

Mark Davis, ND
Portland, OR


dr_sacha_elliott

Message 29 of 36 , Oct 27, 2014

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Jim,

I think you're forgetting something.

In terms of support, you have received hours of accumulated time that generous successful naturopathic physicians spent, offering you wisdom and guidance to your posted questions.

You may want to consider reframing your experience.  I haven't seen any other doctor on here receive the same amount of encouragment, business tips and strategies, and level of support you received.

Sacha Elliott, ND
North Vancouver, BC


---In NaturopathicChat@yahoogroups.com, <drprego@...> wrote :

  I had to pretty much go it alone.  The only support I had was my parents allowed me to move back in with them for a pretty low rent (if it wasn't for that, my practice would not have lasted anywhere near 9 yrs), but other than that I went it alone, and often surrounded by negativity for my field and/or the chances of my success.


Dr. James 'dammit Jim, now I'm a professor not a doctor' Prego
Naturopathic Doctor
Bay Shore, NY


Mona Morstein

Message 30 of 36 , Oct 27, 2014

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Hello, Mark,

I think there was some new info, but nonetheless, having silence from him without new info for a little bit seems nice.  It's said that all the good people have to be removed as well.   Gorski says he doesn't know who is sending him the info, btw, but it's not in my habit to believe pretty much anything he says.

I read all the comments, and out of 72, around 5 were directly related to his post about naturopathic physicians.

Mona Morstein, ND, DHANP
Tempe, AZ
www.diamend.info
Official Sponsor of NatChat--Doctors Data Lab


Mona Morstein

Message 31 of 36 , Oct 27, 2014

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Well, Nestle has a hydrolyzed version:

Hide message history
https://www.healthykin.com/p-467-nutrisource-fiber-supplement.aspx?gclid=CjwKEAjw2reiBRCaobK3udOj-Q4SJACXWyYmpyGn87Dsfvq2C24P7cSc-00G2gen_7ZMjKYnxmpdpxoCp7Lw_wcB

Mona Morstein, ND, DHANP
Tempe, AZ
www.diamend.info
Official Sponsor of NatChat--Doctors Data Lab


James Prego, ND

Message 32 of 36 , Oct 27, 2014

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Of course I have, and I love natchat.  I was meaning on a more day-to-day, in-person, and financial way.  One thing that ND pointed out to me was the financial support as a big factor.

James Prego ND
Bay Shore NY


sarahcimperman

Message 33 of 36 , Nov 3, 2014

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Are student loans really forgiven after 25 years?

Sarah Cimperman, ND
NY, NY

---In NaturopathicChat@yahoogroups.com:

... Do I just resign myself to living in poverty for the next 23 years so that my loans will be forgiven?

Cheryl Hamilton, NMD
Prescott Valley, AZ


Mahalia Freed

Message 34 of 36 , Nov 3, 2014

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25 years of living below the poverty line, is my understanding.

(Yes, I'm Canadian, but I have big US student loans. Thanks, Sallie Mae)


jdm1226

Message 35 of 36 , Nov 3, 2014

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From my research into yet....
Yes, on the income dependent payment plan it is true that the balance left at the end of the 25 years is forgiven...BUT you owe taxes on that amount as unearned income. So, yes your loan is forgiven, but you are left with a tax burden which could be very burdensome. My plan is to do whatever I can and to fight tooth and nail so my loans paid off by then so I owe no taxes. Not paying any more taxes than necessary...plus it will look more positive on my Credit Score.
Jim

James Mullane, ND


Jaime Barker

Message 36 of 36 , Nov 3, 2014

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I'm not sure how the forgiveness part works but you don't have to live below the poverty line to qualify for income based repayment. It's just if all your loan payments would be greater than 15% of your income- then you qualify. I make over 300% of the poverty figure for my state and am on income based repayment plans.
Jaime Barker
Ithaca, NY