Take a quick glance inside the West Vancouver office of Anita Tannis and you know she is no normal family doctor. Instead of a hard examining table covered with paper, there is a massage table wrapped in fabric with an African print. On the walls: beautiful, black-and-white photos of children, a colourful, beaded quilt and a stick drawing by her six-year-old daughter, Signe. On a side table sits a Tibetan singing bowl and a white marble acupuncture model, a miniature human body covered with black dots to reveal the acupressure points.
It is an unlikely space for a medical doctor, but to Tannis, it makes perfect sense. She is at the forefront of a movement to integrate conventional with alternative medicine. And although she is one of only a few dozen doctors doing this across Canada, she believes people are hungry for this approach. When necessary, she will use medication, but often in conjunction with treatments like naturopathy, homeopathy or acupuncture.
“I’m quite cautious if someone comes in with symptoms that could signal a serious medical condition like cancer or inflammatory bowels,” says Tannis, a petite, soft-spoken woman with shoulder-length blond hair and a ready smile. “I like to get a conventional medical diagnosis before we start doing alternative therapies.”
Tannis always knew she wanted to be a different kind of doctor. Studying medicine at Hamilton’s McMaster University in the late 1980s, she started to see how medications could be overprescribed, and became interested in other kinds of healing. With a mother who was a dentist and a grandmother who was a midwife and healer, Tannis believes she is the natural evolution of her background.
After graduating from medical school, she moved to Vancouver and joined the practice of two doctors who were integrating Western and alternative medicine. What she saw impressed her. One woman who was overweight and had several digestive problems was put on a gluten-free diet; not only did she lose weight, she lost her seasonal allergies. To Tannis, it made perfect sense: Take away what is assaulting the body, and it can relax and heal. Another woman, who said she was allergic to antibiotics, recovered from pneumonia with just vitamin B injections and what Tannis calls self-care — rest, good nutrition and patience.
The patients at this clinic were already wary of doctors, and Tannis began to ask the patients what they did that was helping. They told her about herbalists and faith healers and naturopaths, and Tannis took it upon herself to go see them. She admits she got sucked in a few times — buying herbs that turned out to be of poor quality, for example. But she learned what worked and what made a difference.
In 1996, she took a year off and went to work in the mountains of Nepal with the Himalayan Rescue Association for hikers en route to Mount Everest. Helping those with altitude sickness, she gained new respect for what conventional drugs can do. When she returned to Vancouver, she joined the Centre for Integrated Healing, where doctors combine conventional and alternative medicine for cancer patients. It was a profound experience for Tannis. “The patients were so keen to get better, and they were willing to do whatever it took and to make changes, which the average joe isn’t always motivated to do.”
After all, as she points out, alternative therapies demand more of patients — and of doctors. For a busy GP, it’s quicker to write a prescription than to sit down with a patient and talk to him about how his body works and what he might have done last week that affected his health. For a patient, it’s easier to just take an antibiotic, rather than take time off work, postpone all his activities, examine the potential reasons for his illness and take time to rest.
But the effort, says Tannis, is worth it. What she has seen in her patients is that, even if they don’t feel better, they feel more in control and involved in their own care. In turn, she believes, this leads to wiser choices.
That is exactly the focus of the medical practice she opened two years ago in Dundarave, a small community near the beach, just outside Vancouver. She wants to help her patients — including many parents and kids — understand the full spectrum of choices available to them.
“There’s a lot of information out there, but not a lot of wisdom,” says Tannis. “My patients come in with a lot of facts, but they don’t know how to put it all together. Sometimes, they’ve already seen a Chinese medical doctor or a naturo-path and they’re getting conflicting information. I try to help them interpret and understand it all.”
She saw a woman recently who had been told by her doctor that she was depressed and should be on antidepressants. Her naturopath said her liver was toxic and that antidepressants would make it worse; she needed a liver detox. When Tannis saw her, she diagnosed perimenopause and she explained the role of the liver in making perimenopausal symptoms worse and how those symptoms can look like depression. She prescribed progesterone, plus herbal supplements to help manage the woman’s adrenal glands and her stress, and she recommended added exercise and a healthy diet with limited sugar and processed foods.
In another recent case, Tannis made a Sunday morning house call to check out her neighbours’ ailing two-year-old. She listened to the toddler’s chest and looked at his ears, ruling out pneumonia, bronchitis and tonsillitis. But one of his ears was a little red, suggesting an infection. She reassured the worried parents that it would probably settle on its own and recommended ibuprofen. She uses that a lot for coughs, colds and earaches; the anti-inflammatory helps passages open up.
Tannis also prescribed homeopathic remedies: coryzalia to help with the toddler’s cough, runny nose and sore throat, and homeopathic belladonna for its anti-inflammatory effect. If he got worse, she told the parents, she’d prescribe antibiotics (as well as probiotics to counter the effects on the body’s bacterial balance). He got better without them.
“The reality is,” says Tannis, “there’s a place for both conventional and alternative medicine. If my child has meningitis, for example, I want an IV and the best hospital. I wouldn’t mess around. For me, it’s about finding the best of both worlds.”
Often food is the best medicine, Tannis says. “I use a lot of vitamin D, blue-green algae, cod liver oil and probiotics.” Treating a three-year-old with bad eczema, Tannis gave the boy an omega-3 fatty acid supplement and asked his mother to eliminate all dairy and citrus from his diet. Within five days, there was a noticeable improvement, with the affected areas of his skin becoming less red and itchy.
Tannis often refers her patients to nutritionists, herbalists, naturopaths or chiropractors. When she recommends acupuncture, if it’s just a minor treatment, she may do it herself. A certified acupuncturist, she polished her skills studying with Steven Aung, a pioneer in the integration of Western, traditional Chinese and alternative medicine.
Aung, a doctor of Chinese medicine originally from Burma, came to Canada in the 1970s for post-graduate training in family and geriatric medicine. Based in Edmonton, he developed the first Canadian certificate program in medical acupuncture. That’s where Tannis headed to study, one weekend a month for almost a year, to further her acupuncture skills.
At home she would use her daughter to practise acupressure, finding and massaging the pressure points on Signe’s lean body. “She loved it,” says Tannis.
For six-year-old Signe, the lesson stuck. On a recent car ride, she turned to her mother, sitting beside her in the back seat, and said, “Let’s play doll. My baby is sick.”
“What does the baby have?” asked Tannis.
“A tummy ache,” replied Signe.
“OK, let’s take her to the hospital,” said Tannis.
“No, Mommy. Let’s find her points.”
“Children really respond to acupressure and touch,” says Tannis. She has used it on kids with stuttering, fever, immune dysfunction or diarrhea.
So how does the medical establishment regard practitioners like Tannis, who are breaking new ground — even implicitly criticizing conventional approaches?
Tannis says the climate, formerly one of witch-hunting, has turned around. She has never experienced any opposition to her integrative approach, and often gets referrals from doctors whose patients are eager to try new things.
Aung, for his part, has observed a sea change in how the Western medical community views alternative therapies. Back in the 1970s, he says, the medical establishment was resistant to integration; many doctors had heard about natural healing and acupuncture, but had never seen it. “It was so new and they didn’t know much about it,” he says. Today Aung has a private practice in Edmonton where he sees many children. “They are very responsive to natural healing,” he says. “Children’s bodies are like brand new cars. It’s much easier to repair them than an old truck.”
In the past two decades, Tannis has seen her own integrative approach transform dramatically. When she started in 1992, if a patient came in to renew his prescription for stomach acid medicine, she would have just written it up. But now, she will ask if the drug is working and if it’s not, she will put him on digestive enzymes. She will offer more options and information.
She tries to be open to whatever therapies her patients want to explore, but admits there are some things she doesn’t know about and so can’t recommend. A lack of scientific research on alternative treatments doesn’t make it easier. She admits to getting excited when she sees good research on alternative treatments, but also believes you don’t always need formal evidence. “If someone has a cold and he wants to take echinacea, the chances that he’ll have problems are low, and the chances he’ll get better are good.”
Tannis’s friends are lucky. Not only will she do house calls, she’ll freely discuss things like immunization and flu shots. (She didn’t get the H1N1 shot, if you’re wondering, but she’s not a disbeliever. She thinks there’s a place for immunizations but that we tend to over-immunize and it would be better to put more effort into creating stronger, healthier bodies through lifestyle and nutrition.)
Tiffany Erdman and her family are patients of Tannis. When either of her two kids has had an ear infection, Erdman says, “instead of automatically putting them on antibiotics, she’ll wait and watch it for a couple days. Usually, it has subsided on its own, with some Motrin to control the fever and pain, but when it’s bad, she’ll prescribe the medication.”
Erdman says she didn’t seek out a doctor who was open to alternative medicine, but she feels grateful for what she’s learned from Tannis. “A lot of what she has taught me is common sense,” she says. “She’s shown me how to look beyond the ear infection to my kids’ general demeanour when they’re sick. She treats the whole child, not just the symptoms. She has taught me to trust my instincts as a parent.”
Tannis believes that most of the things that take people to the doctor can be managed with better lifestyle and nutrition. Obviously, there are serious diseases and medical issues that go beyond that. But she maintains the important things are simple: getting enough sleep and exercise, and eating more healthy food like fruits, vegetables, whole grains, nuts and seeds, and less of the processed foods like sugar and white flour. “Most people have a hard time doing those things,” she says.
She has also learned that integration, in its truest sense, doesn’t just mean combining different treatments and approaches. It means helping patients with their minds, bodies and spirits, not just the small problems that bring them into the office.
Bookmarks on the doctor's laptop
Family physician Anita Tannis likes these online sources for information on alternative and complementary medicine:
• acupuncture.com Basics on acupuncture and herbal treatments, aimed at patients and students of Traditional Chinese Medicine.
• drweil.com Advice from Andrew Weil, MD, integrative physician, professor and innovator.
• herbalgram.org Excellent resource on herbal medicines.
• holisticprimarycare.net News and issues from the magazine Holistic Primary Care.
• nccam.nih.gov Fact sheets and research from the National Center for Complementary and Alternative Medicine, under the US National Institutes of Health.
• ewg.org Environmental Working Group site, with well-researched information on health and environmental issues.