Dr Sanjay Mohan Ram
Dr Dorothy Fairly: So just a really general question to start, what brought you to naturopathic medicine in the first place?
Dr Sanjay Mohan Ram: I was going into mainstream medicine so I applied for UBC, all the medical schools. But the med school professors that I was working with in UBC, said that I was more suited to naturopathic medicine because I was more of a people person.
I didn’t even know what naturopathic medicine was or that it even existed, I had to ask friends what it was, why it was different, and applied. Having asked my parents actually, they said I came from a line of physicians it just skipped few generations. They [my ancestors] actually practiced aerobatic medicine, homeopathic and mainstream medicine in India. My parents had just never told me that, I was actually following in the footsteps of family before me.
DF: So once you were accepted, how was your experience at Boucher?
SM: It was tough, definitely. You’re not only learning what medical doctors do, plus naturopathic medicine, plus Boucher wasn’t accredited yet. The growing pains of building the school, changing and morphing and helping create the syllabus as we went along. That along with not knowing when we could write our board exams, which we ended up writing both of our exams back to back, I would say made it quite stressful.
DF: You mentioned growing pains, what would you say was the most difficult part of that process for you?
SM: I think, for one; it was not having the support of the profession (initially), because a lot of NDs said the school was not accredited so they never believed it would work. But there were some in the profession who believed in it and were helping it grow, change and teaching at the school. Many of the teachers we had were a lot of the older docs who had an infinite amount of wisdom. Secondly, the boards. I mean, even if we hadn’t be able to write them in BC, we could have written them in Washington State because Bastyr was willing to allow us to write them. So it was more the fact of the unknown and having to build a syllabus, getting professors in and getting the profession to recognize the school and achieve that accreditation was my fear.
DF: So you actually helped create the syllabus throughout your four years?
SM: Yeah. Dr. Dave Scotton was the main person, obviously, along with all of these other old school docs like Dr. McKinney, Dr. Braven Rayne, I mean they helped morph that syllabus based on what Bastyr, CCNM or NCNM had done. So they could follow their syllabus, but then it was a matter of making it unique to what Boucher could offer, because we were small classes. And it’s always meant to be small classes at Boucher, never a large class. I think that was the challenge of it. How do you create a syllabus for a smaller group where you have a lot more interaction with the professor and less in terms of facilities. I mean we didn’t have labs, we had to go to Saskatchewan for our cadaver dissection, so little things like that we didn’t have which was another growing pain.
DF: Wow. I did not know that. So what about the process of accreditation, while it was happening, did you feel its impact?
SM: I don’t think we felt the impact of it per say, it was just the not knowing what was going to come out of it. Plus when we first started we were attached to the massage school and then it split into two separate entities. So that in itself was also stressful. But the accreditation process I don’t think we felt it as much as Dr. Scotton would have, or the other professors, because they were being scrutinized by various boards with a microscope to ensure that the curriculum is up to the standards that are required by other post-secondary institutions. So at least I didn’t feel this stress of it, for us [the students] it was just the unknown, not knowing if we would actually have our diploma at the end of it.
DF: Did it have much of an impact on you, the day you actually learned that you would be accredited?
SM: Yes. I remember driving to the school for the big announcement that we would be accredited and I think it was the December we graduated, because the school year went from January to December, and December is when we found out. Then we wrote boards in February the following year.
DF: Moving on from that, what has helped you in developing your practice? Were there certain mentors?
SM: For me, I mean when we were going to school, our mentors were those who took us a preceptors, like you [Dr. Fairly] did, Dr. Martin Kwok, Dr. Kelly Farnsworth, so there were several people who were willing to take us on as preceptors. I think those became our mentors and they were more than happy to help us with setting up our practices or even joining their own. Like Dr. Fujibiashi joined with Dr. Lorne Swetlikoff because she has precepted with him, whereas I joined Dr. Farnsworth’s clinic. So for me the support was the physicians that were already in practice, Dr. Bayley was another big one. He supported me (stood up for me really) when I decided to join the CNPBC board. I became the youngest on the board but he vouched for me at the AGM, and hence I got on. It was all these other docs that helped us, even after we graduated if we needed any information on testing or protocols or whatever we might need.
DF: In starting up was there anything you did that you think now was maybe a mistake?
SM: I don’t know if anything was a mistake, because every experience is going to be a learning experience. I mean before I ended up at Crossroads I went through three failed practices, so for me it was learning from that. You know you don’t have a crystal ball that tells you if it’s going to work at this practice or it’s not, but with each practice, it was a different learning experience, a different outcome or different reasons why the practice closed and I had to move on to a different job. I don’t think there was anything that I regret, or looked back as though it was a waste of time. Maybe one of the things was, and I mean it has its positives and negatives, working for a businessman. Two of the practices I joined were business people running the practice, as a business. So in terms of medical support it’s not as great because there’s a bottom line they’re looking to achieve, and it was all about the profit regardless of patient care. That maybe would have been one of them [a mistake], but at the same time there are many practices that are run by business people and they’re very successful.
DF: So what is it about Crossroads that works for you?
SM: Multidisciplinary. We have 11 clinics in one here, it’s the whole gamut. So we can talk openly with the medical doctors or the physio and massage therapists and refer patients back and forth. I think that’s worked really well.
DF: What about your practice itself, do you have any particular focuses?
SM: The two that ended up being a focus for me were hormones (regardless of gender), and the other one is adjunctive cancer care. So supporting patients through radiation or chemo, helping patients through fertility, menopause, and PMS symptoms. Whether it’s using herbs or IV treatments or using bio identical hormones. But those two main areas are the ones that I’ve settled into.
DF: Is that different from what you thought you might have done?
SM: I wouldn’t have thought of that. I mean cancer is an area that holds clinical interest, perhaps, because my mother died of cancer. But I remember preceptoring with Dr. Jim Chan (ages ago) and he practiced solely in naturopathic cancer care. It’s honestly a very depressing field, so I never thought I would end up in it, but it just happen the patients that I attracted were that subset. When I did the A4M (the American Academy of Anti-aging medicine), they offered all of the bio identical hormone courses, so I went with Dr. Coe (who graduated the year after me), and we’ve been going to those conferences for year now. So I think it was interesting to deal with hormones.
DF: So getting back to the CNPBC, what was it that made you want to be on the board?
SM: For me, I’ve always been one who wants to make a difference. A lot of the members who were on the board were of the older population, so I thought being the new generation of naturopathic physicians, I would be the one to lead that way in making changes. We were thinking of prescriptive rights at that time, so this was in 2004 when I joined the board and it was just about wanting to get involved in the new things that were developing in our profession, and give some insight to it. I’m a stickler for rules and regulations so to me the college was the natural fit.
DF: And how was the experience?
SM: It was good. It was challenging because of all the things the college was attempting to do with prescriptive rights, HPA or the ethics. A lot of changes were happening and it was a huge learning curve having never been in politics before, jumping in and not being in practice for very long, just having the basic knowledge of naturopathic medicine. But now this whole new world of lobbying and changing policies, it was a lot of reading and learning new things that I would not have even considered.
DF: Now you teach at Boucher, what was the inspiration to get involved there?
SM: I’ve always loved teaching. And because I’m fortunate enough to teach them the academic portion for two years and then the clinical portion for two years. So I get to see them through the four years of their education, and I believe I’m the only one who gets to do that. I find it very satisfying to see them change and grow through the program that we [my original class] did a long time ago, and see how it’s changed for the better. Seeing different doctors come in and teach different modalities and subjects and giving the students a greater exposure. Seeing that change over ten years of teaching is quite satisfying as well.
DF: So what about the expanded scope of practice, has that impacted your practice in any way?
SM: Definitely. Especially with prescriptive rights, being able to prescribe things such as antibiotics, bio identical hormones or antidepressants that a patient requires. Being able to monitor them through the progress, they don’t necessarily having to wait to get in to see their GP, we take over as primary care physicians, I think that’s a big help. It’s about being able to manage the patients, so if they’re on an antibiotic what can we do that’s naturopathic to assist them. So I think having access to those things that we didn’t have before, has been a huge help to the practice.
DF: Any final thoughts?
SM: I don’t know. Ten years I look back and it’s like a flash, it doesn’t feel like ten years until we had that reunion at the NorthWest. It doesn’t feel real. Last weekend I did the bio identical hormone course for the first time here in Vancouver, and pharmacists were coming up to me and introducing themselves to me because they had heard of my reputation of treating (after quite a few years now), asking me if I teach as well. I was able to say “yes”, there’s about three rows of students behind me. To actually be able to vocalize that, there were 200 delegates at this event, of whom about 40 were my students. In a way it feels satisfying that I introduced them to anti-aging medicine, but the other part of that is I feel old. [Laughs]