Episode 3 – Dr. Ivy Branin

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Clay: Alright, hello.  This is Clay Cockrell with the Online Counselling Podcast.  Welcome and today, we’ve got a very exciting guest,
Dr. Ivy Branin, who is a naturopathic doctor and the owner of Simplicity Health Associates.  She’s located here in New York City and having offices in South Jersey, but what’s more interesting for us is that she sees clients online, so she’s working with people all over the world.  While normally we work and investigate therapists on this podcast, people working in mental health, I thought it would be important to talk with someone else who is doing a different version of telemedicine.  With no further ado, Dr. Ivy Branin, thank you so much for being with us.

Ivy: You’re welcome, Clay, and this is a pleasure to have me, yes.

Clay: Tell me, we first met, you were a guest at our BNI meeting and now, you’re an official member.

Ivy: Yes, that’s true.

Clay: For those of you listening who don’t know, BNI is Business Networking International and it is a great place for people with a small practice or even a large practice to go and meet referral sources and grow your business together.  We’ll some links in the show notes afterward about BNI.  Dr. Ivy, tell us a little bit about your history, what you do, and what brought you to naturopathic medicine?

Ivy: Sure, sure.  My background is I was a biochemical engineer and I worked for two pharmaceutical companies, one major and one more of a biotech.  It was just one of those things.  I kind of knew deep down inside that I wanted to do something differently.  I wasn’t sure what that was.  I considered going back, going to law school, going to property law.  I thought about also getting my MBA, thought about also getting maybe my PhD in Mathematics and then basically, it was a neighbor of mine who introduced me to homeopathy and really sparked my interest.

It sounded like something that I really, really wanted to do so I actually found this homeopath out in California who had gone to MIT, had been an electrical engineer.  After talking to her for about an hour, she said, “You’re young.  You’re single.”  I was 25 at that time.  She said, “Rather than go into homeopathy just basically doing this weekend courses once a month, why don’t you do the change and go into naturopathy,” which is what I ended up choosing and I’m very, very happy with that decision.  It was definitely a journey going back to school and kind of almost serve like a leap of faith of basically abandoning a career with great benefits and stability, but it was definitely a really good decision.

Clay: Good, so being out on your own, having your own practice, a small business essentially, it’s a good a decision.

Ivy: Yes.  Oh, absolutely.

Clay: Okay.  How long have you had your own practice?

Ivy: Sure.  I’ve been in practice actually this month, October, is my four-year anniversary and I really just started right out of school.  As soon as I graduated, I basically was ready to put the shackle up on the door.

Clay: Congratulations on the four years.

Ivy: Thank you.

Clay: That’s an accomplishment.  I imagined the growth process through that time has just continued to grow.  Did you just hit the ground with full success as soon as you put your shingle out?

Ivy: I don’t think anyone has that, but I will say I feel that it was successful in the sense that I did actually have a patient that first month.  A lot of practices, even a conventional doctor’s practice could be quite slow in the beginning.  I have my first patient that month.  I had my second patient November and then I did also have the good fortune, my mother’s friend worked for the Atlantic City Press and she published an article about me in November.  Literally the next day, I had 10 new patients.  I’ve never had anything that was that successful in advertising or marketing.  That was quite incredible.

Clay: That is just a testament to getting media on.

Ivy: Right, yes, exactly.

Clay: Something that I found really interesting with you is the number of languages you speak.  Let’s talk about that.

Ivy: I am a polyglot, as we say.  When I was in undergrad, French was my minor and I’ve actually started speaking French at age 8.  I did the study abroad in Paris and then also while I was an undergrad, I also took a lot of German.  Actually again because I was an engineering major, I feel like language has really helped me to survive engineer school.  We used to kind of breaking it up and then also after I graduated from my undergrad, I decided to spend three months in Japan learning Japanese and then when I came back to the east coast, continued my Japanese studies at the Japan Society.  I’m a big lover of language.  I studied a tiny, tiny bit of Italian, but I don’t include that in my list of languages that I speak, though.

Clay: That’s fascinating.  Now, has that helped you in your outreach to a global audience and treating patients of varying cultures and different languages?

Ivy: Well, I’ve never actually had a visit in a different language, but I definitely have had some patients of those different backgrounds.  It has helped me at least sort of relate that to them on a different level.  Sometimes, we all speak in the other language, but for the most part, we’re just speaking in English.  I feel like also especially, I do have a really big or real strong connection to France and French culture.  That has helped me sort of expand basically my patient market and I’m involved with a lot of different French organizations and then I also go to France every year.

Clay: I think this is an area of growth for you, Ivy, to put that out there, but certainly connecting with expats, I’m assuming, as a marketing ploy.

Ivy: Yes, yes.

Clay: Tell me a little bit about when did you begin taking your practice to telemedicine and what that was like for you.

Ivy: Sure.  It was something, I mean, I always had that as an option on my website, but it was never really something I was actively necessarily promoting and actually, it was a couple of things.  It sort of happened a little bit organically with some of my patients.  I have the two offices, one in Manhattan the West Village, and then I have the other one in South Jersey.  I think it was actually, people was like, I don’t know, my eighth or ninth patient, a Graves’ disease patient, she was from Jersey but she’s a little bit far from both of my offices.

She did see me face to face once on the premise that we would continue via telephone and so we worked together for, gosh, I think over a year because Graves is a pretty challenging condition, but at the end of our work together, her labs, everything, her symptom picture, all were normal, so she actually ended up referring one of her neighbors to me, her neighbors having challenge with their son.  Similar thing, the son came in to see me the one time and then proceeded to then work with him virtually.  It was more just like kind of just things sort of worked out that way in some cases.  In another case actually, a BNI member of a different BNI chapter, she became a patient….

Clay: At that point, we were cut off because of technology.  We’ve got Dr. Ivy back, but I think I’ll just leave this into the recording because sometimes, this happens during a session, during a consultation, and technology gets in the way.  Has that been your experience?

Ivy: I have.  Yes, it definitely has happened.  I actually don’t use Skype as much as I do use telephone.  For some reason, some of my patients are not very tech savvy, which is okay.  I do remember specifically when I was in France, I had definitely some technical difficulties at pretty much almost consistently with most patients.  It would drop out between somewhere during the visit.  Fortunately, one of my patients, I wouldn’t say necessarily that we have a casual relationship but I know her from other things.  It wasn’t that hard to just basically text her the rest of what I was talking about because it happened, it was like towards the end when I was giving her the recommendations that I wanted her to follow.

Clay: I think that you got to be careful with the technology, making sure that you’ve got a good connection and most, if not all, of the patients that I’ve worked with understand that these things happen and they kind of roll with it.  It really hasn’t been a hindrance.  I remember when I was traveling in Rome, Aruba, and I’ve done sessions while in London, sometimes, the connection is great, but then sometimes, it kind of gets in the way.

Ivy: Right.

Clay: But they typically roll with it.  You bring up a good issue of you’re doing telephone work.  You do some Skype.  Is there another platform?  There are people, they are doing Facetime or Google Hangouts, and then there are some more HIPAA compliant places.  What are the platforms maybe you use?

Ivy: I’m pretty basic.  It is basically Skype, phone.  I do have Facetime capability.  Nobody has done that.  One of the things I did discover, so when I was in France this summer and I said before that a lot of my patients are not very tech savvy so they really insisted on doing the phone sessions.  Fortunately, I do have a pretty good international phone.  My phone is T-Mobile so I have unlimited text and the calls are not that expensive.  They are 20¢ a minute, but when I got my first phone bill, I was like, “I have to do something a little bit different.”  It wasn’t terrible but I was like, “This is not really a good idea.”

I did remember that there is a service called Talkatone, which is an app you can download either on your iPad or your iPhone and basically, it just uses your wifi.  It does give you a different phone number, so basically, if you have some patients, you just tell them the new number to call and it worked really, really well, and then that is completely free.  I think you can also use WhatsApp as a phone as well.  I’ve only used it as a texting service so I don’t know how that works, but that might be another possibility.

Clay: In Europe?

Ivy: Yeah, yeah.  WhatsApp is really big.

Clay: Before we were difficultly cut off, you were talking about how your practice started and I’m hearing that a lot from other therapists that they maybe had the option on their website, I can do online,” but not many people took them up on it.

Ivy: Right.

Clay: But then gradually maybe an existing client was traveling, it gradually became a part of their practice slowly.  That’s happened to you as well?

Ivy: Yeah.  It’s definitely been this gradual process.  It has either been, some patients again who are way too far away, like, I think I don’t know at what point I was cut off, but having one patient, she had a sister that she wanted me to see and she’s in Colorado.  Obviously, we’re going to be doing phone consultations or Skype consultations.  I had another patient and then some patients actually, it kind of baffles me.

They have just elected to do virtual even though they live in Manhattan or Brooklyn which is really, really kind of funny, or also I find because I don’t see a lot of pediatrics in my practice, but I do occasionally, especially with the really young kids like under 3 or 4, it’s a lot easier for parents actually just to do it virtually rather than bringing them into the office and also because for the most part when I’m working especially at that age, not that the child’s not going to benefit during the visit because I’m basically just talking to the parent anyway.  It is a lot easier in those cases.

I’ve seen lots and lots of different conditions and I’ve worked with a lot of people, but I definitely do have main areas of focus or areas where I’ve enjoyed working or have a lot of success.  The first being I see a lot of women’s condition so I work a lot with women with PMS, menopause.  I see a lot of cervical dysplasia and HPV, and that’s actually something that I can really work with virtually.  In fact, I just had a new patient start with me last week.  She’s all the way up in, I think she’s in Poughkeepsie, somewhere far up north.  I’m helping her get a normal PAP.

I also work a lot with fertility, any kind of fibroids, ovarian cysts, and then other things, lots of depression/anxiety patients, usually patients looking to wean off medication.  I see a lot of gastrointestinal problems specifically GERD, IBS, even things like Crohn’s and ulcer, colitis.  Another area that I also have a lot of success with is skin, dermatological issues specifically acne.   I see a lot of both high school students, adolescents with acne and then I see more of the adult onset acne that some people might not be that aware of or familiar with and also eczema.

Clay: Your approach in all of this is to treat in a natural way.

Ivy: Exactly.

Clay: Herbs, vitamins, and in passing, I heard you speaking today earlier about it’s really diet so much of what you put into your body, the fuel that you put into your body is going to affect whatever kind of disease or discomfort you might be in.

Ivy: Yeah, that’s absolutely true and everyone is kind of surprised because a lot of times people come in and they are like, “Oh, I’m a healthy eater,” and it really is very patient specific, so what could be a healthy diet for one person could be not healthy for somebody else.  It’s not even sometimes just about the foods you eat but how much you eat of a certain food, when you’re eating certain foods, other sometimes like underlying digestive issues that can affect the stimulation of nutrients.  There are a lot of things to consider, but always, everyone is going to have some type of dietary change.  In fact actually even with one of my consults yesterday, I was just actually adding additional meal.  I was like, “You need to choose just eating something really, really early in the morning and then late at night.”  I was like, “No, we need to balance your blood sugar.  You need to have at least one more meal.”

Clay: This is what has fascinated me.  I think it would be interesting to the listeners is that you’re talking about a lot of science stuff, physical things.  What is the difficulty of working with somebody online?  I’m thinking of pulse, blood pressure, and temperature.  How do you get labs done with somebody who is living in Colorado and you’re so far away?  Is that an impediment in your practice online?

Ivy: Actually, absolutely not.  I think it also depends on, I don’t know if I talked about this at all this morning, but with naturopathic medicine, it really depends on what state you practice in.  Here in New York, both New York and New Jersey where I’m based out of, I have a license in Vermont.  We actually are not permitted to be doing any sort of physical evaluations.  I shouldn’t be taking anybody’s pulses, temperature, or anything like that.  There’s definitely like if I have a skin patient, it’s a good idea to actually see the skin, requesting something like photos and then as far as lab work, I don’t order any direct lab work.

I have all my patients follow up with either their general practitioner, their family practice doctor, or whatever specialist they are working with.  As far as getting those labs in, it’s pretty simple.  Most doctors will either email me a PDF copy, an electronic copy of their lab records or a lot of times, most of these doctors now work with patient portal.  The patient themselves will download the labs and send them to me.  Actually, this patient that I started working with last week, for some reason, I heard the doctor didn’t have an email address.  I don’t know.  I kind of find that hard to believe.  Her doctor just sent me a huge 100-page package to my office.

Clay: Okay.  Yeah, there are all levels.  You bring up a point with the regulatory.  A lot of therapists are concerned and there’s a lot of debate right now that if you’re licensed in, let’s say, for New York and you have a client in Mississippi, are you able to see that client and are there any regulatory difficulties and licensure difficulties for your field?

Ivy: That actually is a good question because to be honest, I really think it definitely depends on the state because again, I’m actually working in unlicensed territory, which is like both kind of gives me the green light to almost do, I won’t say it gives me the green light to practice however I want, but it kind of does, but I also know from, for example, in Canada where naturopaths are licensed.  They are not allowed to do telemedicine.  I’m assuming that out in Washington, that’s where I got my degree, I remember there was a couple of docs doing phone consults and things with their patients, so I’m assuming that it’s legal to do it there.  I don’t know if there are any rules or regulations.

I think the biggest barriers might be is if you are in a licensed state, looking at what is in your license and what you’re allowed to do and what you’re not allowed to do.  Here in New York and New Jersey, because we aren’t considered licensed professionals even though all of us here usually have our licenses in another state, I don’t think we have the same restriction.

Clay: I see.  For your industry as well, you’re developing state to state licenses.

Ivy: Right.

Clay: There’s no national blanket.  This is how we handle things and of course certainly not an international blanket.

Ivy: Oh yeah, not at all.  I mean, really very state to state.  For example, somewhere like Washington and Oregon where they have a really broad scope of practice.  Naturopaths can even perform minor surgeries.  They can prescribe most pharmaceutical drugs.  They can act as your primary care physician and then you go over the state line over into Connecticut where they do have licensure.  They are not allowed to perform minor surgeries and they are not allowed to prescribe.  I think they might have some prescriptor rights with antibiotics, but I think that’s about it.  They can take insurance and order labs and things like that, but they are definitely a lot more restricted than, say, Washington or Oregon.

Clay: Alright.  It’s just interesting to hear from another field that is growing along and being affected by this new technology as well.  Do you know of other people in your industry that are online and offering services through web cam or telephone?

Ivy: Oh yeah, absolutely.  Actually, one of my colleagues, I think I might have told you about her.  She actually moved to London about, I want to say, two years ago and she used to practice her in New York.  Before she even knew, she was going more and more virtual and now, I thought she’s 100% virtual but I think she’s now starting to see some face to face clients, but for a long time, she was just completely virtual.  She also had twins so I think that was like another factor.

Another one of my colleagues, I should have talked to her more.  I saw her on Sunday.  She does a lot of corporate wellness but she also had a baby, and I think she even does something even like, I don’t know if she’s just texting or emailing.  It’s something a little bit different then there’s this other naturopath who is also just worked virtually who was first based in Austin then moved to Brooklyn.  I don’t know if she’s still here.  I’ve never actually met her, but yeah, absolutely.

Clay: What about for you, the benefits that working virtually for you as a person and as a practitioner and I know for myself to be able to travel.  I think we both have a little bit of a travel bug and the convenience factor.  Talk to me a little bit about how this has impacted you in a beneficial way or that you see it to impact you as it grows.

Ivy: It definitely has so many benefits.  One, again, because I do love to travel and I actually love working.  I actually don’t necessarily want to go on vacation.  I just sometimes need a change of scenery, giving me that flexibility.  Also as you know because you live in New York City, office space is very, very expensive.  I happen to be in a really good situation.  I share an office with actually three other naturopaths, but at the same time because I share it with them, my space time there is quite limited.  This also gives me more flexibility and when I can see patients, before I actually left for France, I was seriously considering adding this second location in SoHo.  I was really like excited about it.

I love the space, but because I actually did so well virtually when I was in France, I was actually really surprised. I was like, “Maybe I need to put more energy in the virtual.  Do I want to spend like another $500-$1,000 a month and everything like this?”  It definitely like cutting down on overhead, so I’m basically just spending this amount of money on this office space, flexibility in traveling.

Clay: Yeah.  It makes financial sense, I think, like you and I think for me as well to grow a virtual practice on the side slowly until it almost takes over and the benefits behind it are immense.  Are there any marketing tips that you found helpful that you might want to pass along and giving the name out about your services?

Ivy: As far as in virtual or just in general?

Clay: I suppose both.

Ivy: Yeah.  One of the things too because I do have the two offices and the one office I only go down to once a month, sometimes, having the virtual has been useful in that some of these patients, it seems like every time they want to come and see me, it’s like I’ve just gone down or it doesn’t work out, but they are still really wanting my services so they are open to doing the virtual.  Another thing that I have also been working on because again, I do want to increase my virtual market, and I guess it also depends on what kind of services you’re offering and life insurance and things like that, but I do offer special packages for my phone consults.

My virtual consults are the same price as my regular consults, but I do offer like a three-package session so that can also make it more attractive when somebody is deciding whether or not they want to be virtual with me or face to face, and then as far as marketing goes, I think anyone starting out should get a newsletter together, especially with something either like therapy.  We don’t have something to give them right away but it’s a good way to continuously get on that person’s mind.  Sometimes people, they will meet me or they will call.

They are interested in making appointment but they are just not ready yet and they might be on my newsletter for six months to a year and then they are ready to make that call, or maybe they are not ready to make that call but they convinced somebody else to make that call, or even having some patients after maybe a couple of sessions, they fall off but they keep getting my newsletter and then they are reminded to come back.  I feel like that’s been really helpful.

Clay: Yeah, I would echo that and they say this over and over.  You want to put out a good quality free content and it will come back to you.  There was somebody who came in last week that said she had gotten a newsletter from me and put my website on a Sticky, on her computer, and kept it there for three years saying, “One day, I’m going to get ready to call and when I call, I want to call this guy.”  She read my blog and she followed me.  One day, she was ready and there I was on the Sticky.  You never know how long it’s going to take for people, but our job, I think, is to continue to put ourselves out there on a regular basis.

Ivy: Oh, you have to.  You always have to be putting yourself out there in some way and I think one of the hard things especially when you first start in practice is you don’t know what’s going to work and some things, just because it didn’t seem to work very quickly doesn’t mean it’s not a success.  In fact, actually like this week, I just had this new patient.  She came to one of my talks almost two years ago, so you really don’t know.  You can be like, “Gosh, I gave this talk.  I didn’t get that big rush of patients I thought I was going to get,” but seriously, you never know.

It’s actually funny because actually, this past Monday, it was also even a testament to BNI.  Somebody from my old BNI group introduced me to this real estate person from another BNI group.  I was like, whatever.  I went out and had coffee with him.  It might have been a year and a half or even two years ago.  I guess somebody had posted something on Facebook that they needed a naturopath.  He remembered me and so I got this other patient.

Clay: Yeah.  Again, for people listening, look into BNI.  It is a wonderful way just to teach you how to network and it’s going to surrounded by people like Dr. Ivy who I’ve learned from.

Ivy: Oh, thank you.

Clay: Absolutely.  For the mental health professionals who are the primary audience, I will highly recommend her.  I’ve referred several patients to her who wanted to get off their psychiatric medication, more like effects or post effects.  They want to have a healthy alternative to some of their mood, antidepressant medications.  She’s wonderful with them, highly effective.  Please get in touch with her, which you can at simplicityhealthassociates.com, is that right?

Ivy: Yes, that’s correct.

Clay: Alright, I’m going to put all that in the show notes.  I think that’s about all the time we have, but doctor, I can’t thank you so much.  It sounds like you’re outside enjoying the beautiful weather today.

Ivy: I am.  I am in Central Park.

Clay: Oh, that’s nice a nice stomping ground.

Ivy: Yes.

Clay: Again, thank you so much for spending some time with us and I look forward to talking with you more.

Ivy: Of course, yes.  Have a wonderful day.  Thank you so much, Clay.