It was only a matter of time. Portland will soon be home to Broth Bar—located on NE Sixth and Couch next door to Ristretto Roasters—showcasing bone broth from grass-fed and pasture-raised animals.
Packed with easily digestible minerals and gut-healing gelatin, bone broth has been a nutritional darling for years, slowly working its way from the fringes to full-on trend status alongside green smoothies, hot yoga, and organic apothecaries. Popularized by proponents of the paleo diet, ancestral health movements, and food-as-medicine folks, it’s hard to open a magazine or scan a health blog without the buzzy broth popping up. Broth windows, food trucks, and cafés have been popping up in New York, Los Angeles, and Vancouver, BC. Several local restaurants have also jumped on the trend, including Noraneko, Lincoln, and JoLa Café—but Broth Bar will be the first Portland destination to focus first and foremost on the nutritional powerhouse.
What’s more, the idea may capture the healthy food zeitgeist, but the bar is the brainchild of Portland’s own bone broth pioneer, Tressa Yellig of Salt, Fire & Time, who brought retail bone broth to Portland in 2009. Long before broth became the “It Ingredient” of celebrity detoxes, Yellig was crafting healing, small-batch broths from pasture-raised, hormone-free bones sourced from local ranchers, and has earned a loyal following of fans who credit her products with restoring health during and after cancer treatments and other major health crises.
The small-but-mighty 800-square-foot Broth Bar will feature a rotating selection of bone broths—including chicken, beef, turkey, lamb, pork, and bison—with optional add-in “bundles” to turn a mug of broth into a meal, from seasonal kraut and kelp noodles to chickpea miso, grated turmeric, ginger, and soft boiled eggs. A self-serve condiment bar will take the customization even farther, with a dash of tamari, Hot Mama hot sauce, housemade seaweed gomasio, and a variety of salts.
In addition to the main event in a mug, the bright and cheery bar will offer four varieties of Salt, Fire & Time’s kombucha on tap, grab-and-go “picnic-style” fare, and a micro-market stocking hard-to-find supplements, high-quality butter, artisan ingredients, and seasonal produce from local farms.
Broth Bar is set to open in late June, and Yellig—along with sister and business partner Katie Yellig—hopes to host small classes, tastings, cookbook signings, healing food pop-ups, and weekly hamburger nights (featuring Salt, Fire & Time’s organ burgers and fermented condiments).
With the expansion, Yellig wants fans of the brand to have no doubt about the company’s continued dedication to impeccable sourcing of bones, add-ins, and market products. “We want people to never doubt the quality of the ingredients,” says Yellig. “We’re not compromising about how we source, and that will never change.” So grab a mug, get ready, and stay tuned for more details.
It’s another busy morning at Dr. Anthony Aurigemma’s homeopathy practice in Bethesda, Md.
Wendy Resnick, 58, is here because she’s suffering from a nasty bout of laryngitis. “I don’t feel great,” she says. “I don’t feel myself.”
Resnick, who lives in Millersville, Md., has been seeing Aurigemma for years for a variety of health problems, including ankle and knee injuries and back problems. “I don’t know what I would do without him,” she says. “The traditional treatments just weren’t helping me at all.”
Aurigemma listens to Resnick’s lungs, checks her throat and then asks detailed questions about her symptoms and other things as well, such as whether she’s been having any unusual cravings for food.
Aurigemma went to medical school and practiced as a regular doctor before switching to homeopathy more than 30 years ago. He says he got disillusioned by mainstream medicine because of the side effects caused by many drugs. “I don’t reject conventional medicine. I use it when I have to,” Aurigemma says.
Throughout his career, homeopathy has been regulated differently from mainstream medicine.
In 1988, the Food and Drug Administration decided not to require homeopathic remedies to go through the same drug-approval process as standard medical treatments. Now the FDA is revisiting that decision. It will hold two days of hearings this week to decide whether homeopathic remedies should have to be proven safe and effective.
“So this will be the first dose,” he says. “Then I’ll give you a daily dose, to try to get underneath into your immune system to try to help you strengthen your energy, basically.”
Homeopathic medicine has long been controversial. It’s based on an idea known as “like cures like,” which means if you give somebody a dose of a substance — such as a plant or a mineral — that can cause the symptoms of their illness, it can, in theory, cure that illness if the substance has been diluted so much that it’s essentially no longer in the dose.
“We believe that there is a memory left in the solution. You might call it a memory. You might call it energy,” Aurigemma says. “Each substance in nature has a certain set of characteristics. And when a patient comes who matches the physical, mental and emotional symptoms that a remedy produces — that medicine may heal the person’s problem.”
Critics say those ideas are nonsense, and that study after study has failed to find any evidence that homeopathy works.
“Homeopathy is an excellent example of the purest form of pseudoscience,” says Steven Novella, a neurologist at Yale and executive editor of the website Science-Based Medicine. “These are principles that are not based upon science.”
Novella thinks consumers are wasting their money on homeopathic remedies. The cost of such treatments vary, with some over-the-counter products costing less than $10.
Some of the costs, such as visits to doctors and the therapies they prescribe, may be covered by insurance. But Novella says with so many people using homeopathic remedies, the costs add up.
There’s also some concern that homeopathic remedies could be dangerous if they’re contaminated or not completely diluted, or even if they simply don’t work.
Somebody who’s having an acute asthma attack, for example, who takes a homeopathic asthma remedy, “may very well die of their acute asthma attack because they were relying on a completely inert and ineffective treatment,” Novella says.
For years, critics like Novella have been asking the FDA to regulate homeopathy more aggressively. The FDA’s decision to revisit the issue now was motivated by several factors, including the growing popularity of homeopathic remedies and the length of time that has passed since the agency last considered the issue.
The FDA is also concerned about the quality of remedies, according to Cynthia Schnedar, director of the FDA’s Center for Drug Evaluation and Research Office of Compliance. The agency has issued a series of warnings about individual homeopathic products in recent years, including one that involved tablets being sold to alleviate teething pain in babies.
“So we thought it was time to take another look at our policy,” Schnedar says.
The FDA’s decision to examine the issue is making homeopathic practitioners like Aurigemma and their patients nervous. “It would be a terrible loss to this country if they were to do something drastic,” he says.
He also disputes claims that homeopathy doesn’t work and is unsafe.
“There’s no question that it helps patients. I have too many files on too many patients that have shown improvements,” Aurigemma says, although he acknowledges some homeopathic products sold over the counter make misleading claims.
Companies that make homeopathic remedies defend their products as well.
“Homeopathic medicines have a very long history of safety,” says Mark Land, vice president of operations and regulatory affairs for Boiron USA, which makes homeopathic products. “One of the hallmarks of homeopathic medicines is safety,” says Land, who is also president of the American Association of Homeopathic Pharmacists.
“The potential risk [of greater FDA regulation] to consumers is if any change in regulation were to limit access to these products,” says Land.
That’s what worries Resnick. She says homeopathic remedies have helped alleviate a long list of health problems she’s experienced over the years. “Why would they want to take that away from us?” she says. “Let us have the freedom to decide what works the best for us.”
The FDA says this week’s hearing is just a chance to start gathering information to decide what — if anything — the agency should do about homeopathy.
For full story see: http://www.npr.org/blogs/health/2015/04/20/398806514/fda-ponders-whether-homeopathy-is-medicine
I appreciate the message of this article, however it lacks a definition of post dates safety. Questions we could be asking; what are more natural methods to support induction? Should we wait 43 weeks? How often do we monitor placental health? Birth is a complex journey and in our culture of unacknowledged emotions and mental states, it is no wonder we are resistant to surrender to the birth powers. By KJ DELL’ANTONIA
A new report from the Childbirth Connection; a program of the National Partnership for Women and Families, stops short of recommending home births in the United States, but does challenge the same issue addressed by Britain’s health service: Many hospitals approach childbirth from the premise that “more technology is better,” while significant research shows that less intervention is safer and healthier in most cases.
“If overtreatment is defined as instances in which an individual may have fared as well or better with less or perhaps no intervention,” the report states in its forward, “then modern obstetric care has landed in a deep quagmire. Navigating out of that territory will be challenging.”
Dr. Sarah Buckley, who collected and interpreted the research and wrote the report, suggests within it a number of ways of escaping that quagmire, all based on the premise that the hormonal physiology of childbirth nearly always works best when it is left to work at its own speed. The benefits of the natural process, her synthesis of the research suggests, go far beyond what we had previously understood; preparing mother and baby for birth through hormonal changes up to and during the labor and birth process.
Hospitals and clinicians should wait for labor to begin on its own, encourage and support women laboring at home during early labor, and have patience with women in labor in their facilities rather than using interventions to speed up the process. Women, too, should be patient, trust their bodies to work through the process and “stay calm and relaxed” (frustrating advice for many women, but advice that might be more easily heard and heeded in an atmosphere less stressful than that of many maternity wards).
“It’s important for both clinicians and women to understand that common interventions, that we have come to view quite casually, are actually quite consequential,” said Carol Sakala, director of Childbirth Connection Programs at the National Partnership for Women & Families.
“Our current high rates of intervention are not serving women well,” she said. “But the community is really moving in the right direction. Professional societies are breaking with the past,” and talking publicly about the overuse of cesarean sections, the need to avoid constant fetal monitoring, and not permitting elective inductions or cesareans. “We are hopeful that the timing of this report will support that change.”
HARRISBURG, Pa. — BETSY came to Dr. Martin for a second — or rather, a sixth — opinion. Over a year, she had seen five other physicians for a “rapid heartbeat” and “feeling stressed.” After extensive testing, she had finally been referred for psychological counseling for an anxiety disorder.
The careful history Dr. Martin took revealed that Betsy was taking an over-the-counter weight loss product that contained ephedrine. (I have changed their names for privacy’s sake.) When she stopped taking the remedy, her symptoms also stopped. Asked why she hadn’t mentioned this information before, she said she’d “never been asked.” Until then, her providers would sooner order tests than take the time to talk with her about the problem.
Betsy’s case was fortunate; poor communication often has much worse consequences. A review of reports by the Joint Commission, a nonprofit that provides accreditation to health care organizations, found that communication failure (rather than a provider’s lack of technical skill) was at the root of over 70 percent of serious adverse health outcomes in hospitals.
A doctor’s ability to explain, listen and empathize has a profound impact on a patient’s care. Yet, as one survey found, two out of every three patients are discharged from the hospital without even knowing their diagnosis. Another study discovered that in over 60 percent of cases, patients misunderstood directions after a visit to their doctor’s office. And on average, physicians wait just 18 seconds before interrupting patients’ narratives of their symptoms. Evidently, we have a long way to go.
Three years ago, my colleagues and I started a program in Harrisburg designed to improve doctors’ communication with their patients. This large urban hospital system serves a city with a population of about 50,000, together with the surrounding metropolitan area of more than 550,000 people.
The hospital faces particular challenges: The city has a high poverty rate (32 percent, compared with the state average of 13 percent), and the metro area has a high rate of childhood obesity. Over all, nearly a third of people around Harrisburg are uninsured, compared with about one in 10 for the rest of Pennsylvania.
Our project started with a simple baseline assessment of how we as doctors communicated with our patients. Observation soon revealed that physicians introduced themselves on only about one in four occasions. And without an introduction, it’s no surprise that patients could correctly identify their physician only about a quarter of the time.
Brief, rushed physician encounters were common, with limited opportunity for questions. A lack of empathy was often apparent: In one instance, after a tearful patient had related the recent death of a loved one, the physician’s next sentence was: “How is your abdominal pain?”
We developed a physician-training program, which involved mock patient interviews and assessment from the actor role-playing the patient. Over 250 physicians were trained using this technique. We also arranged for a “physician coach” to sit in on real patient interviews and provide feedback.
Over the next two years, patient satisfaction with doctors, as measured by a standard questionnaire, moved the hospital’s predicted score up in national rankings by a remarkable 40 percentile points. Several studies have found a correlation between higher patient satisfaction scores and better health outcomes. In one, published in The New England Journal of Medicine, Harvard health policy researchers reported that higher patient satisfaction was associated with improved outcomes for several diseases, including heart attacks, heart failure and pneumonia.
The need to train and test physicians in “interpersonal and communication skills” was formally recognized only relatively recently, in 1999, when the American Board of Medical Specialties made them one of physicians’ key competencies. Although medical schools and residency programs then began to train and test students on these skills, once physicians have completed training, they are seldom evaluated on them. And doctors trained before the mid-1990s have rarely, if ever, been evaluated at all.
I realize that many colleagues may see methods like ours as too intrusive on their clinical practice and may say that they don’t have the time. But we need to move away from the perception that social skills and better communication are a kind of optional extra for doctors. A good bedside manner is simply good medicine.
A passionate diabetes specialist told me how she sat down with a patient to understand why he was not using his diabetes medications regularly, despite numerous hospital admissions for complications.
“I can’t continue to do this anymore,” he told her, on the verge of tears. “I’ve just given up.”
She placed a hand on his shoulder and just sat with him. After a pause, she said: “You have a heart that still beats, and legs you can still walk on — many of my patients don’t have that privilege.”
Five years later, recalling this episode, her patient credits her with inspiring him to take better care of himself. The entire encounter took less than five minutes.