ND Alumna Describes Building a Practice from Scratch

Emily Colwell

Emily Colwell, MSSW, ND, graduated from Bastyr University in 2006 with a head full of knowledge, a heart bursting to heal and a pressing need to earn some money. It's a familiar story for many graduates. She spent a year building a patient base as a resident at Bastyr Center for Natural Health, then launched her own practice, Waterleaf Naturopathic Medicine, right on the Burke-Gilman Trail in Seattle's University District.

Three years in, she's got a full calendar of patients, a new business partner and a 10-month-old daughter at home. She spoke to us about building a private practice fresh out of school.

You were fortunate enough to land a competitive residency at Bastyr Center for Natural Health after graduation. What was that like?

Amazing, intense, exhausting. I was slammed with patients all the time, which was stressful, but also a fast learning curve. At first, I just hoped the patients didn't know how nervous I was. Then I realized I did, actually, have a clue. I was figuring things out.

I was also teaching student clinicians, which was strange, because some of them were classmates the year before. But I learned through teaching and came to realize I knew more than I thought I did.

How did you decide to start your own practice? Was that your plan all along?

As part of the residency, I saw patients alone through Bastyr Center’s Practitioner Care shifts. So I started building a base of patients that way. I discovered that I like having the freedom to direct myself, and I could just feel that it was time to go out on my own. So when this space opened up three years ago, I went for it.

What's it like owning a small business?

All of a sudden I was in charge of these things that I had not been managing at the clinic — scheduling, billing, office systems. I'm not a natural at these things. I can do them now, but I've had to learn them step by step.

QuickBooks accounting software is a lifesaver for bookkeeping. I use a great online scheduling system that lets patients go online and make appointments themselves. Hiring an office manager was a huge help. At the beginning, nobody has an office manager, which is not a bad thing, because it means you have to learn how to do things.

What's it like having patients who depend on you?

With a lot of patients it's pretty clear what they need. There are others with conditions that push me more and require me to research more to figure it out. Then I start mastering those issues, and new ones come along. So every time I get to that place where I feel more confident treating a particular condition, I'm challenged again. When younger colleagues call looking for advice and I start spouting stuff off, I'll stop and realize, gosh, I've learned a lot in these last five years. I'm not always aware of it, but it's a nice feeling when I am.

What's been important for retaining patients or for having them recommend you to others?

It's all about relationships. I was a social worker for almost 10 years before coming to Bastyr, so building relationships and asking patients about their lives came naturally to me. I think that makes them feel heard. Counseling is always an important part of my practice. I'm always listening for the psycho-spiritual piece, along with the physical/medical piece. I use botanicals and homeopathy and nutrition, too, and sometimes prescription medication, but emotion is almost always a factor, even though it may not be what patients come in thinking about.

It sounds like you're using the "doctor as teacher" model.

I tell patients that our bodies use symptoms to communicate with us. Our bodies don't use English, so we have to translate. Sometimes when symptoms get louder and louder, it's because our bodies are trying to get our attention. Almost always there's a lifestyle piece relating to stress and how we live. Unless that gets addressed, the physical symptoms are going to keep returning.

In the allopathic world, the focus is often about stopping the body from showing symptoms, instead of listening to what it's trying to tell us. When my patients start learning to listen, they'll email or call to tell me about a reaction. I'll tell them "Reduce your dosage, or let's do something else, and we'll see what your body tells us." It's almost like they start to have a relationship with their body, which is how it should be.