The Many Faces of Medicine: A Deep Dive Into Multiple Practices and Types of Medicine with LaKota Scott, ND.
For our first episode of 2024, we want to talk about how we can heal ourselves. Medicine is one of the first things we think of when it comes time to heal ourselves and an illness, but did you know there are multiple varieties of medicine?
We break the types of medicine down with the incredible LaKota Scott, ND, on an episode not to be missed.
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Our Host
Ari O’Donovan
Transcript:
Ari O'Donovan: (00:00)
Are y'all comfortable? We hope wherever you're listening to this, you're comfortable. This show is for the Bipoc communities in Oregon hosted by a black woman about the amazing work we do every day in this state. So let's build together, connect with our communities, add some laughter and humor even when it's a difficult conversation. Let's boost our voices.
Dr. LaKota Scott: (00:25)
And part of that is also addressing not just the physical symptoms that somebody's experiencing, but also addressing kind of like the social determinants of health and also like mental health because those will significantly influence somebody's physical health. And so when I'm working with a patient, I'm looking at all of these things altogether and then also basing on how they're feeling. So when I am coming into the room and talking with the patient, I'm asking how they're feeling that day. I'm asking how their body is doing.
Ari O'Donovan: (00:58)
Welcome back y'all to a brand new episode of Boosting Our Voices. As always, I'm your host Ira o' Donovan. I am boost org diversity program director and today we have an amazing conversation with Dr. Lakota Scott. Dr. Scott, can you tell us a little bit more about yourself?
Dr. LaKota Scott: (01:18)
Yeah, so my name's Lakota Scott. I am originally from white MEA Arizona on the Navajo Nation. I was in Portland from about 2017 and just moved back to Arizona about three weeks ago now uh, so I'm now currently in Flagstaff, Arizona and I completed my degree in naturopathic medicine in 2020. Uh, did um, some private practice. In part of my training I also did childbirth education or natural childbirth. Uh, so at the time I was assisting with home births and then I, in the past year have really transitioned into working more in public health. And so I work currently with the Northwest Portland area, Indian Health Board as a vaccinated program manager. And then I also work with the Center for I Midwifery and I teach, they started a midwifery school and so I teach one of their classes every semester. And then we're actually just starting to launch our indigenous childbirth education mentorship. So the applications will be out in about the next week and then we're gonna start with classes um, in the middle of January.
Ari O'Donovan: (02:32)
That's amazing. Such a great journey. And all the stuff that you're doing at one time, , it's so much but it's all amazing and great necessary work. ?
Dr. LaKota Scott: (02:46)
Yes, and I'm a mother. My daughter just turned three last week. .
Ari O'Donovan: (02:51)
Oh . Congratulations. .
Dr. LaKota Scott: (02:55)
Thank you.
Ari O'Donovan: (02:56)
And to motherhood, that is a job by itself. So
Dr. LaKota Scott: (03:00)
, yes.
Ari O'Donovan: (03:02)
We really do have superwoman with us today.
Dr. LaKota Scott: (03:06)
.
Ari O'Donovan: (03:08)
With all that in mind, I wanna get started with focusing on a quote that you have on your website. And I love your website and I've seen a bunch of the pages and everything and it's got a lot of great information. But the quote is, A patient's perspective defines health and you aim to assist patients in creating a plan to achieve their goals. Can you talk to us about what you mean when you say a patient's perspective defines their health?
Dr. LaKota Scott: (03:36)
The way that I see it is that when a patient comes in, I'm not just treating them based on like what the numbers show me. So a lot of times people might come in with like blood work that shows a certain diagnosis, but they may or may not be showing symptoms of some type of ailment. And so the opposite spectrum of that is if we're only treating the numbers and not treating what the patient is actually experiencing, then it can very often happen where somebody stops treatment because the numbers say everything have kind of normalized, but they're still experiencing symptoms. And part of that is also addressing not just the physical symptoms that somebody's experiencing but also addressing kind of like the social determinants of health and also like mental health because those will significantly influence somebody's physical health. And so what I'm working with a patient, I'm looking at all of these things altogether and then also basing on how they're feeling. So when I'm coming into the RIV and talk about the patient, I'm asking how they're feeling that day, I'm asking how their body is doing and then I'm checking on a lot of kind of like lifestyle factors of how they're doing and being able to address those things. Because a lot of times being able to address the lifestyle pieces can really help to influence like the mental and the physical symptoms that they're experiencing.
Ari O'Donovan: (04:58)
That's so important. I cannot stress that enough. I've said that in multiple episodes at various times on the show. It's so important to focus on the individual patient all the time, especially in public health. I've seen in medicine too, people might wanna focus on numbers because trends and things like that matter and data and numbers and and all of that is great, but every person is gonna be different and their care then is gonna be different. Their health is gonna be different, especially when we're thinking of bipoc communities and Native American communities in particular and those social determinants of health, like there's no number you can put on that that's gonna be more important than somebody's lived experience.
Dr. LaKota Scott: (05:44)
Yes,
Ari O'Donovan: (05:47)
So, so true. So I wanna set up some definitions that we can get started with and as we're talking about some things that people might not be fully aware of, can you talk us through the difference between traditional medicines, naturopathic medicines and allopathic medicines?
Dr. LaKota Scott: (06:10)
When I was born, my parents were in college and they were going to university that was in a border town to the reservation. And so my dad was pursuing a degree in civil engineering I think at the time. And then my mom was pursuing her nursing degree. And so I was born over spring break of my mom's, I think second year in nursing school. And then she had me and then went back to class like Monday with me in the creative board. Um, and so I stayed with my parents until I was about 10 months old. And then it just became too much for them because they were just barely making it themselves in school. And so they gave me to my aunt and my grandmother and my aunt and my grandmother, they never went to boarding school and they only spoke Navajo and their livelihood was still really based on livestock.
Dr. LaKota Scott: (07:00)
So they still had hundreds of heads of sheep and cattle and horses. And so they lived on the reservation kind of like, I think it was about 10 miles outside of town and there's no running water, no electricity. And so, but there was a lot of like a lot of our relatives that still lived out there. So there was like my aunt, my 3 4, 4 cousins and then my other aunt and her two sons and then my aunt that raised me and her daughter and then my uncle and my grandma. So we all lived in that one area together. And so I had a lot of people that I was around, but it was also very different in that like I didn't go to well-child visits because that wasn't a thing. Even though there was Indian health services that was in the town, it was just, that wasn't like a normal thing that my family did.
Dr. LaKota Scott: (07:45)
And so when we would get sick when physical ailments like mental health ailments came about, we used our medicines. So we used either herbs or we like did ceremonies. And so that's how I grew up for the first like five years. And then my mom finished nursing school and then when she finished nursing school she started working at the Indian Health Services Clinic and I moved to town with her At the time my dad was still in school and he ended up like pivoting all the way around and switching his degree like this semester before graduating. And so he took a couple more years to be able to finish his degree. And so it was just my mom and I that lived together and I would wake up in the morning with her and I would go to the hospital with her and I would hang out from the nursing station and then I would walk to school when it was time to go to school.
Dr. LaKota Scott: (08:37)
And so for me, like hospitals are very comforting. Like they smell like my mom. I have very like fond memories of being in the hospital . And so when I was in, I wanna say middle school, beginning of high school, I started volunteering at the hospital and just 'cause I was interested in in medicine because that was just a place that I was comfortable with. And so I started volunteering and I ended up in a couple different departments in the hospital. And the very last one that I, I did a rotation with and this is when I was like 13, I was not very old and I ended up in the emergency department. And at the time the hospital that my mom works at, there were no providers that were native and there were some staff that were Navajo. But because of like boarding schools, colonization, there's still a lot of people that like the elders, we have a lot of people that are still only Navajo speakers but then the middle generation, like my parents, there's some of them that speak it, some of them that don't.
Dr. LaKota Scott: (09:34)
A lot of people my age don't speak the language. Navajo was my first language because of my grandma and my aunt. And so what would happen is they would pull me in as a 13-year-old to translate for the elders because they couldn't communicate with any of the nurses or any of the doctors. And so that kind of made me want to go into medicine. I was like, I wanna be a provider that can actually talk with my patients and communicate with them because there's a lot of things that are lost in that translation. And then also like a lack of respect, at least back then for traditional medicine. So if somebody said that they were using traditional medicine, it wasn't taken that they were seriously addressing their medical concerns. And so that's where I got really interested in going into medical school. And so I was looking at BA MD programs and so with the BA MD programs, you finished medical school and your undergrad and about six years.
Dr. LaKota Scott: (10:27)
And so that was the route I was gonna take. And it was actually a family friend that convinced me not to, 'cause she's like, well you're only, I think I was 17 at the time. You're only 17. Like this may not be like the route you wanna take when you get a little bit older . And so she was actually the one that introduced me to different types of medicine because up to this point I had only grown up in Indian Health Services. And so when you go to an Indian health services clinic, you don't get a choice of what type of provider you see. You just see whoever is on staff. At the time, I didn't even know there was a difference between like a np, a PA or an MD or a do like, I didn't know there was different types of providers.
Dr. LaKota Scott: (11:07)
I just thought there was doctors 'cause that had been my experience such at that time. And so she kind of introduced me to, okay, there is allopathic medicine, which is what people get their degree as like a medical doctor in md. And this is much more, it's more invasive. There's gonna be a lot more like using pharmaceuticals, using surgery. It tends to be kind of like, it is very helpful but it is much more like we're gonna throw everything at it that we possibly can. And it, it's usually a little bit harsher on the body, but that's a lot of times what some people need. And then there's osteopathic medicine, which there's different variations of osteopathic medicine, like more traditional osteopathic medicine. There's actually a lot of physical manipulation that happens in the practice nowadays. A lot of osteopathic schools are much more like MIE schools and allopathic medicine where they are doing a lot more like pharmaceutical management, um, and doing some surgeries and things like that.
Dr. LaKota Scott: (12:08)
And so, but they tend to have more of a holistic view on on treating a patient versus MDs tend to be a little bit more like pinholed to maybe their specialty. Um, and then there is naturopathic medicine which has the perspective of whole body, but they don't use invasive techniques in terms of treating. So it tends to be focusing on educating a patient using either like nutraceuticals, botanicals, homeopathy, and really trying to address more of the the entire body. So physical, mental, emotional pieces to be able to, to help the patient. And so it tends to be really useful for people that are on kind of the lower spectrum of maybe a chronic disease like the early stages of a chronic disease because it can be really helpful to be able to manage that where somebody maybe doesn't need surgery yet. So those are like the three that I learned.
Dr. LaKota Scott: (13:07)
And so when I learned about the medicines, natu like medicine just made more sense to me just because of the way I grew up and using the herbs already and focusing on using our ceremonies. It just made more sense to me that naturopathic medicine is, is something that I gravitated toward and and just really worked with what I had already grown up using. Because even though my mom was a nurse, we only went to the hospital if we were bleeding. And then outside of that we used our traditional medicines to be able to, to help our bodies. It's interesting 'cause even when we're talking about like traditional medicine versus like within indigenous culture, there's different types of traditional medicine because even as a Navajo person, like I navigate a couple different planes on that. So like we have our traditional medicines that come from that have been handed, handed down like decades and hundreds of of years.
Dr. LaKota Scott: (14:04)
And those are really specific ceremonies that are done and passed down through oral history. And so those ceremonies are different than like Native American church. So Native American church was created because of colonization. And so the Native American church, what it is, is the nawa people down in Mexico, they use peyote and their so ceremonies. And so because the US government kind of banned our religious practices. And so the way that they tried to get around doing that was creating another type of quote religion that used the word church in it to be able to like try to get around the US government in being able to continue practicing. And so the peyote traveled up through Mexico into like the chia people in, in the plains area and then spread out through all the different tribal nations in the United States and all the way up into Canada.
Dr. LaKota Scott: (15:03)
And so that is a very different type of like religious practice I guess, or spiritual practice. I don't really like using religious 'cause. I'm like, it's not really religious, it's more spiritual . And so a lot of tribes have adapted the peyote ceremony. And so there's a lot of different ways that like Native American church ceremonies are run nowadays, but it's, it's more of like a inter-tribal thing where there's a lot of different tribes and it's run, it kind of has the same format, but there's different ways that people, people run the ceremony. So those are like even on the nomination like there the native ham church versus like our traditional ceremonies within the practice of using that as a healing modality.
Ari O'Donovan: (15:48)
Wow. Like medicine, especially westernized medicine takes out so much of the natural remedies for people. Any type of herbs that you can use, , we'll go straight to prescriptions or surgeries like right away. Like that's the go-to, and I really love that the naturopathic medicine that you practice and you combine it with your heritage and culture, don't immediately go to that. I think that's really important. Before I talked to you Dr. Scott, I really thought that naturopathic medicine was focusing on the holistic aspect of someone, but I didn't know that you could like you have. So well combine it with culture and practices and ceremonies and religion and I think that's fabulous.
Dr. LaKota Scott: (16:43)
Yeah, there's different, definitely different ways that people practice naturo public medicine. And it really depends on where the person is in the United States because our license, 'cause we're not federally recognized the way that MDs and DOS are, our recognition is by state. And there's some states where we are fully licensed, we have a pretty large scope of practice like in Oregon and Arizona, we can prescribe pharmaceuticals, we can order labs. Um, and then there's other states that are the total opposite spectrum like in Tennessee where it's illegal . Um, and so it's very different the way that different thoughts will practice. So a lot of natural thoughts in Oregon because they're seen as primary care providers. It's a really great option for people to be able to access like their regular pharmaceuticals, especially if you're thinking about somebody that's like maybe that has a diagnosis of diabetes.
Dr. LaKota Scott: (17:40)
So if they're trying to make some lifestyle changes, but also at the same time for their safety, it's helpful for them to be able to be on pharmaceuticals until they're able to make those lifestyle changes and then to downregulate the amount of medication that they're taking. And then there's other times where maybe they really do need to have more of those invasive treatments done to be able to help them. So my practice is a lot of kind assigned female at body patients where I had been doing a lot of pelvic floor therapy and so somebody with like a grade four prolapse where like none of the tissue was going back in, like they really do need to have like a surgery. And if they had maybe seen a pelvic floor therapist, um, like 10 years before or five years before, like maybe those exercises and maybe like addressing some of the, the lifestyle pieces would've been really helpful. But there is a time at which people do need to seek more invasive treatment if if they're not getting things addressed.
Ari O'Donovan: (18:37)
Absolutely. There there's definitely a time where surgery's gonna be the best option. , I appreciate that. You'll consider other things too. And it may have been, it may be a situation where people wait so long until a problem is so severe because maybe they haven't been treated by someone that actually understands and knows them and respects them and their culture.
Dr. LaKota Scott: (19:05)
Yes. I've definitely had a quite a bit of patients that had that experience of having really not great healthcare and then avoiding healthcare for 10 plus years and then having to address some of the things that may just haven't been addressed because they haven't been comfortable seeing a provider because of a bad experience.
Ari O'Donovan: (19:26)
Right. And that is so common with Bipoc communities, native American communities. Mm-Hmm. . And it's really unfortunate that it and terrible that it has to be that way because it's society that forces that on them. It's nothing they're doing wrong. And it's, I don't like, society is still very much like that and it's people like you that are gonna shift that, that normality to something different. I love the autonomy that Native American cultures have. I'd like to see it more widespread. What you told me about Tennessee is, is terrible . I'd like to see that change. Um, but I really love that. And thinking about that when we look to the future in a world where there's an intersection of naturopathic traditional and allopathic medicines and that becomes more present, what do you hope that it would look like on a community scale?
Dr. LaKota Scott: (20:28)
My dream is to be able to have like a clinic that's on a reservation that does have providers that are native, that are, or even bipoc people that are able to offer those services on the reservation. So like everybody's circumstances are different and like Indian Hall Services has its own little things about it and reasons why like I personally don't like want to work there like having a separate clinic, whether that's maybe an attachment to the actual clinic because the hospital that I grew up going to does have a traditional medicine department. So this is a possibility of being able to be an extension site to it. But being able to offer those services on the reservation, because right now a lot of people actually traveling like 2, 3, 4 hours plus to be able to access alternative medicine because the closest like natu, class acupuncturists, massage therapists are off the reservation because those things aren't offered through Indian Health Services.
Dr. LaKota Scott: (21:26)
And so if we could be able to create a site like that that offers naturopathic medicine and acupuncture and massage therapy, like on the reservation and chiropractic services, like to be able to, to have that for our own community that's outside of Indian Health Services where it's you're talking to another like native person would be amazing. It could happen. Like there's, since I have been and graduated from naturopathic school, there's three Navajo people that I know that are finishing up their naturopathic education. So I'm like, yay, this is so exciting. . And so that would be amazing to be able to, to have something like that offered in a community because especially in rural communities like ours, those things aren't accessible. And to be able to have those things accessible within the community would be amazing because coming from somewhere like Oregon where there's tons of naturo, there's tons of acupuncturists and they're all covered by Oregon Health Plan, and so people are able to access those services and then coming to Arizona where like naturopath medicine, acupuncture, chiropractic services are not covered at all by access, which is the Medicaid for Arizona, it's totally different.
Dr. LaKota Scott: (22:41)
Like if people wanna access these services, they have to pay out of pocket. And so it's really unfortunate that people don't have the opportunity to be able to use these in the community.
Ari O'Donovan: (22:52)
I would love to see your dream happen , it's so beautiful and I would love to see it happen. To have to commute two or three hours to get a, a needed service that will help you and your health and and to feel better is just crazy. And then to have to pay out of pocket, some of those services can get really expensive. Yeah. So I'd love to see that. And like you were mentioning, there's more Native American people that are becoming professionals and providers and that's a great place to start.
Dr. LaKota Scott: (23:26)
I think the biggest like hurdle with naturopathic medicine, like in Ber Harrison to like an MD or a do degree, like both of, because those federally recognized licenses, they're, you're easily able to get like Indian Health Services scholarships to be able to cover that upfront. And there's a lot of other scholarships that are available out there for students. But because MDs are not federally recognized, the, like you actually have to go in debt the same amount for at that degree, but you can't get the same scholarships.
Ari O'Donovan: (24:00)
Wow. That needs to change right now. Well, I I really hope to see these changes. I, I know that it would take time, but it, it's also going to take just caring people that are part of the communities where these changes need to take place. Doing the things and making the change and Mm-hmm, , I, I just, I hope to see that it's such a beautiful dream that you have for your community and, and so many other Native American communities across, across the country. Absolutely.
Dr. LaKota Scott: (24:34)
There's some communities that I know of in Washington that do have naturopaths on staff and that are providing primary care and acupuncture services. So like it's happening just like slowly in these like tribal clinics, like it's being offered .
Ari O'Donovan: (24:52)
Yeah. They're doctors and they , they're just as important as an md. They have training and they have knowledge and they have the ability to help their communities be Well, it has been so great talking to you, Dr. Scott. I've really enjoyed this conversation and I learned a lot, I learned a lot from you and what you do and your background. It makes such a big difference in your work. And I can tell that you have a lot of passion for what you do. I found all that out from your website, but just talking to you more, I can really see that. Thank you for being a guest.
Dr. LaKota Scott: (25:27)
Yes, you're welcome. Thanks for inviting me,
Ari O'Donovan: (25:30)
. Of course. And until next time, thanks for listening to this episode. Can bring the community info without the community. Appreciate you showing up. If you wanna reach out, hit us up on ig at boosting our voices or at our website, boost oregon.org. Keep doing great things, keep uplifting one another and we'll do the same. See you next time.