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For months now, Massage Therapy Works has had occasional visitors from a place called Natural Standard. On these days, pharmacy students show up in the mornings in groups of three to four to experience sample massages and talk to Richard about the benefits of bodywork and complementary health care.
I became intrigued by these guests. Traditional Western pharmacy students interested in complementary health care? I wouldn't have believed it five years ago, but with all the positive press natural and holistic remedies have been getting lately, it seemed, well, natural. I talked to one of the students and she told me they had come from schools all over the country to do an academic rotation at Natural Standard, the authoritative worldwide database of herbal and naturopathic remedies, which happened to have its homebase right here in Davis Square.
Natural Standard was founded by Catherine (Kate) Ulbricht, PharmD, MBA[c], and Ethan Basch, MD, MSc, MPhil in 1999.
Kate meets with me the day after she returns from one of her many business trips. Her two Boston terriers are comatose in her office, sprawled out and snoozing off the jet lag. Kate is doing no such thing.
We leave her office to the dreaming pooches and walk out to the comfort of the lobby. This sojourn affords me a nice little tour of Headquarters. It's a big, sunny, open setting with two large rooms filled with desks and cubicles. ""This is the student room," Kate says as we go through the first, bubbling with activity. "It's where the pharmacy students work." We go through another room of employees. "Of course, Natural Standard is an online database, so most of the company exists on the internet. Our medical writers contribute from all over the world. But we need a place to meet people, and an address to get mail."
The employees and students are all busy, bustling, even, but still jovial. It's that frenetic calm that comes when all of the action is under control.
In the quiet lobby on red, plush chairs, I ask Kate how it all began.
She brightens and says, "When I was fifteen, I wanted to work." In her small Connecticut hometown, she convinced her parents to sign the documents that would allow her to take a job at the local pharmacy, a tiny operation with one full-time pharmacist and one sub. "There wasn't a soda counter there," she says, "but it wouldn't have been out of place." Kate worked sweeping floors, vacuuming, and ringing up customers.
At the cash register, she discovered she loved the one-on-one aspect of customer service that came with small business. She would speak at length with the client to hone in on the product that would treat his or her individual needs. She learned about herbs, vitamins, and drugs, and when it came time to go to college and choose a course of study, she decided she wanted to become a pharmacist.
"I knew I wanted a career where I could be a part of a community, where I knew I was really helping people and giving back," she says.
Kate put herself through the University of Connecticut working at a chiropractor's office, where she continued to be exposed to integrative health treatments. "It also taught me a lot about business," she adds. "Things you don't necessarily learn in pharmacy school."
Let's hope one day Kate's attitude becomes standard.
Natural Standard would like to extend to the readers of MTW's Boston Healing Blog a two week membership to the Natural Standard Database absolutely free.
Just go to the Login page of naturalstandard.com and enter the following username and password.
When she graduated she moved to Boston and took a job at CVS. The job paid well, and she liked that it gave her the opportunity to learn her way around Boston by working at a different location nearly every day, but in the end it wasn't a perfect fit. "I felt like a number there," she says. "It didn't have that sense of community I had experienced at the pharmacy back home."
After a year at CVS, Kate applied for a Staff Pharmacist position at Massachusetts General Hospital hoping to gain more clinical experience. Always a hard worker, she moved up the ladder to Senior Attending Pharmacist quickly.
As she worked in the hospital, Kate began to notice that a lot of patients were taking herbs and using other "complementary" remedies, many of which were not scientifically tested, or if they were, it was impossible to find the studies or results for them. While doctors and pharmacists have access to a vast array of databases and informative Decision Support Tools for manufactured drugs and treatments, there was a large hole in the knowledge of all of the natural health practices in which the public routinely engages.
"When I would hear someone say they took ginko biloba and I would try to look up evidence of its efficacy or drug interactions, all I found were very tendentious articles either for or against what people called 'alternative' medicine. It was either someone from a traditional Western standpoint with this scree against all herbs as if they were witch's potions, or a very unresearched article lauding the benefits of herbs and decrying traditional medicine without much scientific evidence."
Kate and her co-founder, physician Ethan Basch, decided to fill in the gaps. They set out to make an online database which compiled all available scientific evidence regarding integrative medicine, holding these practices to the same scientific standard as Western medicine. Their website would become a Decision Support Tool for doctors and pharmacists that would include natural treatments. Natural Standard was born.
"The thing is, the information is out there. Somebody just needed to take initiative and pull it all together. When we'd tell doctors, pharmacists, and specialists what we were doing, they would light up. Everyone wanted to help. Articles by doctors all over the world started pouring in. It was as if it was a party everyone was waiting for, and I felt like the party planner."
Over the past ten years, Natural Standard's database has grown to include everything from evening primrose oil to yoga to the Atkins Diet to psychotherapy. Each treatment is cross-listed with the maladies with which they are associated, so you can search either by disease or treatment. Evidence of efficacy is laid out in detail for each treatment as it relates to each disease, and the treatment is given a grade of A-F, A showing strong scientific evidence, and F showing little to none. For instance, for the treatment of Depression, St. John's wort and music therapy both earn As.
And just because there is little evidence supporting a certain integrative treatment now doesn't mean there won't be in the future. "It's a growing field, and new studies are always being conducted," Kate reminds me. "When we first started, a lot of things had Cs [meaning conflicting or insubstantial evidence], but over the years many of the Cs have changed to As, Bs, or Ds. It's growing before our eyes, and it's very exciting."
In addition to evidence of efficacy, Natural Standard also lists all known possible interactions, dosages, and safety guidelines for each treatment. "The medical world for a long time was pretending these things didn't exist. Their answer to any question about herbal medicine was 'just don't take it,' so there was no information about dosage or interaction, and we were seeing people megadosing and seriously hurting themselves."
Doctors and scientists contribute articles virtually from all corners of the globe, and all of the treatments are cross-listed in as many different aliases and languages as are available. Many treatments also include comments by different specialists regarding that treatment from their specific point of view. For instance, what are the benefits of probiotics from a dermatological point of view? Or the caveats of vinyasa yoga from the standpoint of a chiropractor?
By incorporating pharmacy students' academic rotations into Natural Standard, Kate and Ethan are further helping to ensure that the next generation of pharmacists will not be in the dark about integrative medicine. "I know the programs they're all going to," Kate tells me. "They're still not much different from mine, and I learned nothing about this stuff in school. Thankfully, many schools are now sending their students to us so they can at least get some exposure to integrative medicine. They won't be flung out into a pharmacy somewhere and have a customer ask them about echinacea and not have a clue what to say."
For Kate, and for Natural Standard, ethical healthcare includes awareness, information, and balance. Natural Standard does not use the terms "alternative," or "complementary" to describe natural medicine because those words imply these practices are at odds with or are less valid than Western medicine. Rather, the vision of Natural Standard is an integration of the two approaches, using what is most effective for each specific case.
"It's not that natural medicine is better or worse than Western medicine," Kate says. "We believe truly holistic medicine involves both working together."
Let's hope one day Kate's attitude becomes standard.
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Natural Standard would like to extend to the readers of MTW's Boston Healing Blog a two week membership to the Natural Standard Database absolutely free.
Just go to the Login page of naturalstandard.com and enter the following username and password.
Username: healingblog
Password: massageworks
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