Interview with Eva Lana Minkoff for Invisible Not Broken Podcast: we talk about my path to integrative medicine, healing of anxiety disorder, chronic disease and HOPE, among many other health-related topics.
Interview Q & A
1. What makes your approach to care unique?
My approach is rooted in wearing my 4 hats at all times:
- One hat is that of a discerning internist.
- The other is that of an integrative medicine physician – one that applies multiple evidence-based modalities, when appropriate and works with a trusted network of colleagues
- The third is that of a functional medicine doctor – searching for the root cause(s) of symptoms and conditions, understanding problems on the subcellular level and searching for solutions upstream of the actual problem.
- My fourth hat is that of a patient, a patient’s family member and a mom. I approach my patients the way that I would want to be approached. I empower my patients with knowledge of their condition(s) and a fundamental understanding that they can affect their physiology through their lifestyle choices.
2. What in your personal journey led you to complete a fellowship in integrative medicine, and obtain training in functional medicine, after you were already established as a general internist and a primary care physician?
There were several triggers that led me to his path of training in integrative and functional medicine.
I started seeing patients with real, chronic symptoms who had not received optimal healthcare, and were told that they were ‘fine’, while they were clearly not feeling well and suffering from fatigue, digestive problems, anxiety, depression, brain fog, etc. There were many patients who had reversible chronic conditions, such as prediabetes or diabetes, that could be successfully treated with diet and lifestyle changes, but they were instead given one pharmaceutical after another.
I realized that in order to truly help my patients heal, I needed to advance my training and upgrade my approach.
Personally, I was also coping with burnout, post-partum depression and anxiety, after having my children and starting my practice, and I wanted to learn about evidence-based modalities that I could use to heal myself.
One day, I was looking up the Integrative Medicine Center at University of Arizona (where I eventually did my fellowship) and Dr. Andrew Weil, a pioneer in integrative medicine, who founded the fellowship program. I saw that he was giving a talk at the Chopra Center at a 4-day meditation retreat rooted in Ayurvedic practices. I knew nothing about meditation or Ayurveda at the time, but a friend and I decided to go. It was life changing. And career changing.
When my daughter was diagnosed with selective mutism and anxiety, I knew that there were paths we could take that would help her heal without taking pharmaceuticals. Being able to successfully work through my own challenges, as well as my daughter’s challenges, by using modalities in the scope of functional and integrative medicine, was empowering and eye opening.
Learning about patients who have healed and significantly improved the quality of their lives once they addressed the root cause(s) and applied integrative and functional medicine approaches, changed my view of the process of healing and the role of medicine.
As I started to apply these principles with my patients, I saw results, which was not only validating, but made it impossible for me not to pursue further training and incorporate it into each interaction with my patients.
3. What types of patients/conditions do you work with?
I work with adults, mainly women, with a range of symptoms and conditions from chronic stress and fatigue, thyroid problems, anxiety, depression, hormonal imbalances, gut conditions (IBS, SIBO, bloating, Celiac disease), autoimmune conditions, allergies, chronic headaches, high blood pressure, high cholesterol, prediabetes or diabetes.
Some of my patients are trying functional medicine for the first time, and others have tried multiple modalities in the past. What they have in common is that they are committed to doing what it takes to improve their condition and they seek empowerment through education and active changes they are making.
4. What do/did you do when you don’t know what to do about a patient?
Great question. I am obsessed with reading and researching. Whether it’s peer-reviewed articles (I’m a PubMed nerd), functional medicine lecture material and articles, integrative medicine textbooks, podcasts, I love it all! When helping a patient with a complex constellation of symptoms, I may reach out to my network of colleagues.
I am part of a functional medicine network of providers where we discuss complex clinical cases weekly, so it’s a great opportunity to learn from each other. I also seek mentors’ opinions if I feel stuck. No one should be practicing in a vacuum, and we are far more impactful when we work together.
5. Why do you think the patient-practitioner relationship is important?
Patient-provider relationship is at the root of the healing process. We know that outcomes are highly dependent on this. Also, it is important to create an environment where the patient feels comfortable to talk about their lifestyle, past experiences, fears, goals and hopes, and be vulnerable. This is key in getting to the root cause(s) and triggers.
6. What does “trust” mean to you in the patient-practitioner relationship?
Trust involves the patient’s faith in the doctor’s competence and caring, as well as the doctor’s trust in the patient and his or her beliefs and report of symptoms.
Too many people hear “this is all in your head”; or “everything is fine”; but the patient is still feeling unwell and knows that is not the case.
7. What are you most passionate about in regard to your work/helping people?
Making a difference, empowering people, helping people be their best selves – mentally, emotionally and physically.
8. Do you tell your patients what you tell yourself/do you practice what you preach?
Yes! If I didn’t, I don’t think I would be very good at what I do. That being said, no one is perfect. I have a healthy diet, work out 4-5 days a week, have good sleep habits, but there may be a week every few months when I don’t. When we train ourselves for the habits that support and nourish us, and practice these 90% of the time, following through with these habits requires less and less effort.
9. How do you research conditions? On your own? Drug companies? Medical journals? Colleagues? How do you convey this knowledge to patients?
All of the above except drug companies. In addition, I go to conferences, regularly participate in continuing education and listen to webinars and podcasts by knowledgeable physicians who are experts in their fields.
10. Tell us about a special experience with a patient that you found to be inspiring.
I find that for many of the patients that I work with, anxiety plays a significant role in their symptoms as well as their day to day life experience. The power of breathing exercises, meditation and mindfulness-based stress reduction is limitless.
I have patients who have been able to come off of medications after rediscovering their inner resources to deal with extremely challenging situations.
11. If you had one message to send out to every chronic illness patient out there, what would it be?
There is hope. Although there are many things we cannot control, focus on things you can control.
Dig deeper and think about your alignment in life.
I often find that some of the most difficult chronic conditions are deeply rooted in our emotional life. Once we shed light on this, the fear, the emotional and physical symptoms become more predictable, our perception of them changes, and we experience life differently. We become empowered by the challenge.
By practicing a nourishing lifestyle – physically, emotionally and cognitively, we start the healing process.