BRATTLEBORO — There are two kinds of people in the world: those who dream big and go for it, and those who don't.
And when the big dream is so full of love and compassion and a desire to give, we - all of us - are all the better for that dreamer's just going for it.
I approached my chat with Dr. Samantha Eagle having done enough research to build a bit of foundation on what she and Biologic Healthcare are all about, but not so much that I'd miss the opportunity to go for it myself as an interviewer.
According to the American Association of Naturopathic Physicians (naturopathic.org), “Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals' inherent self-healing process. The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods.”
I arrived at the Merchants Bank building, arguably one of downtown Brattleboro's finest - both in terms of its architectural design and its site near the river - and stepped off the elevator to a third-floor space so calming, so lovely and with one of the best views in all of downtown. The perfect shade of sage green on the walls lent a quiet and at the same time an air of professionalism and caring.
Dr. Sam and I talked and talked. Hey, what else would two Long Islanders do upon discovering each other? It was delightful and - well, I came out of the experience vowing to take better care of myself. She'd done her job!
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Jerry Goldberg: Before we jump in, doctor, I saw on the kiosk outside the building that you provide “Primary & Specialty Healthcare for the Whole Family.” Please give us the 30-second “elevator speech” about Biologic Healthcare. What is it?
Samantha Eagle: Well, we're a primary-care family practice. Our team of practitioners offers patients an informed, sustainable foundation for their optimal wellness by providing integrative disciplines such as naturopathic, lifestyle, functional, chiropractic, preventive and conventional medicine.
J.G.: Thanks. So tell us - how did you and I come to be sitting together on this fine day?
S.E.: O.K., here goes! I grew up in Stony Brook, N.Y. on the north shore of Long Island. When I was 14, my parents saw that I didn't seem challenged - to say the least - by school. We had a kind of open campus, so I was able to skip classes and missed more than I should have.
My passion was learning about the social impact of hunger, poverty, and homelessness. I volunteered with a local organic farmer, who'd created a “no questions asked” food bank. So there I was in the early '90s, heading for the farms, while most of my friends were hanging out in shopping malls. Believe me, Long Island has a lot of those!
J.G.: Where were your mom and dad through all this?
S.E.: When they saw that I was getting straight As despite my spotty attendance in classes, they began looking for alternative education for me.
We found the Putney School - which was my entrée to southern Vermont. I did their summer arts program, and when it was over and we were on the way back to the Island, I asked my parents if they'd be OK about my transferring there. They were.
That was 1992. I was 15 years old, and I entered the Putney School as a junior. Because I'd been taking high-school-level courses and New York State's Board of Regents Examinations and getting credit for them, halfway through the school year my parents were informed that I had enough credits to graduate at the end of my junior year, which I did.
It was 1993. I was 16 years old and applying to colleges. The University of Vermont accepted me, and I started off majoring in biology because of my love of agriculture and botany - and all things science.
J.G.: Where did this “love of [...] all things science” come from?
S.E.: My family. My father was a pathologist at SUNY-Stony Brook for 40 years. My mother had a background in hematology and genetics.
While at UVM, I widened my focus and changed my major. I graduated in three years with a degree in sociology and women's studies.
I was 19, very interested in counseling - again, those social services - and applied to Boston University's School of Social Work and Public Health. They accepted me, and I moved to Boston. However, because my track had been so fast, I decided to take a year to work and “season” a bit before starting my grad work at B.U.
J.G.: And how were your folks about their 19-year-old living in Boston and not yet attending school?
S.E.: By then, my parents knew they had a pretty determined daughter.
For my UVM independent study, I trained with the Women's Rape Crisis Center [now Hope Works] and Women Helping Battered Women [now Steps to End Domestic Violence] and took advantage of several extracurricular training and volunteer opportunities offered in Burlington.
So using this background in women's health, I started counseling and doing crisis intervention.
J.G.: How does a 19-year-old market herself as a credible practitioner to people in dire need?
S.E.: Fortunately, I was confident in what I was doing, and I did have the bona fides, so most clients had no idea how old I was. When I'd show up at a facility, I came with degree, credentials, and background. It also didn't hurt that I'd been 5'10” since I was about 14!
J.G.: Then, another transition - this time from social work to medicine. How did that come about?
S.E.: An emergency erupted at a center where I was counseling, and I jumped in to help with the initial triage of an individual who was in acute distress.
During the debriefing with the medical team, one attending physician said to me, “That was fantastic. You didn't even hesitate. Most people don't have their wits about them when faced with a situation like this if they haven't been through all the right training, but you did. Why are you going to be a counselor? You must go into medicine!”
J.G.: What good marks - and from a doctor!
S.E.: Again, I grew up around doctors, so when I heard that, something clicked. So I decided to pursue medicine instead. I moved back with my family and enrolled in SUNY Stony Brook's post-baccalaureate pre-med program.
Eventually, I was hired by Disabled Student Services to shadow a third- and then a fourth-year student with hearing issues on medical rotations. It was then that I began to question whether I was preparing for the right type of medicine. But I'd already applied and was starting to hear from the medical schools about interviews.
Then one day, while on the pediatric rotation with the student I was note-taking for, there was a discussion about a young patient being treated for chronic otitis media - a pretty severe ear infection. I remember noticing that the young man was drinking from a container of milk and was all stuffy and sniffling.
At the debriefing, I asked if anybody had thought about food allergies or sensitivities as possibly pertinent to the child's chronic mucus production.
J.G.: Funny, I thought that myself.
S.E.: Well, the attending physician didn't - and I was told in no uncertain terms that if I thought that food sensitivities had anything to do with chronic otitis media, I was sadly mistaken.
Totally rattled, I called my parents. I told them about what happened and that I wasn't sure I was on the right track. And my pathologist father said, “I've spent the better part of 50 years looking at the end stage of disease that can often be prevented. I would love for you to look into doing something else.”
That very day, a postcard came from the University of Bridgeport College of Naturopathic Medicine announcing the graduation of their first class at the end of that year. I applied and a few months later I started naturopathic medical school.
J.G.: O.K., fast forward. You've finished med school and are ready to get going. Your introduction to southeastern Vermont had been the Putney School, but that didn't mean you had to come back here. Why did you?
S.E.: Well, I was in Connecticut. By that point, I'd married and had two children, so for the first time it wasn't just about me. When thinking about where I could raise my kids with a consciousness - and with some of my fondest memories being my own young times in southern Vermont - I kept coming back to thoughts of here. And we came.
J.G.: And you've found that to have been a wise choice? that Brattleboro has lived up to expectations?
S.E.: Interesting question. I feel very fortunate that I grew up on eastern Long Island, where there were still organic farms and mom-and-pop shops, but where one could also hop on a train and get to New York City. My experience of Brattleboro is much the same: that you can be in an absolutely beautiful place and yet there's still accessibility.
Think of the number of people who come to and through Brattleboro because of our location, who bring culture and art and music and entertainment. I've always identified with this area.
So I asked myself: Where do I want to raise my kids? And the answer was that Brattleboro hit all the nails on the head - for them and for me.
J.G.: Eden?
S.E.: Absolutely not. There are challenges.
I think after the initial glow, one learns about living in a community that has considerable socioeconomic diversity. But I'm very grateful that my children get to see that.
I'm grateful that although we may not have the ethnic diversity that they'd see in some major cities, there's at least awareness of difference - and an open-mindedness.
J.G.: How does that affect what you do here?
S.E.: When I first moved up, although there were just a couple naturopathic physicians around, there was a sense of openness to at least the idea of the naturopathic approaches to healing.
I hope that, through the success of Biologic, we've broken down further some of the misconceptions about what naturopathic physicians are trained to do, how we can complement more traditional approaches, and how we can be complemented by them.
J.G.: After all, medicine is fundamentally about helping people, isn't it?
S.E.: When I look at being a doctor and where I could do that most effectively, it's in small communities. Our word “doctor” comes from the Latin “docere,” which means “to teach” - and I take that job very seriously.
When patients come to Biologic, they're getting an education - they're sort of majoring in themselves. What I'm doing is not rocket science or brain surgery. I take the information I have and find a way to teach my patients about their condition, to teach them a way of doing something better - a way that actually makes more sense than some of the other options they've been provided.
J.G.: I read in your literature about patient-centered medicine.
S.E.: That's absolutely what this is about. When I look at the economics, I see where naturopaths and functional medicine providers fit in. We focus on therapeutic lifestyle changes - behavioral interventions - and put the patient at the center of that. We get to know you - your obstacles, your goals, your motivation - and finally, what problems arise for you. And we dissect all that.
Again, maybe that's not brain surgery, but it surely is good medicine.
This isn't to say that there aren't traditional practitioners providing this approach to wellness. Many do. But others will say that while of course that will work they have neither the time nor the financial incentive. That's why our system of traditional medicine isn't sustainable.
I want to show that Biologic Healthcare, as a patient-centered medical home, can assess the risk of our patient population and keeping their needs and their wants at the center, move them toward more optimal health and away from the health risks.
And that's what's good for our community - and our state.
J.G.: Am I safe in assuming that you didn't have any formal business training?
S.E.: I went to naturopathic medical school, and believe me, they didn't teach us how to run a business.
J.G.: So much focus in health care today is on insurance - on time being money. Most medical practitioners have to learn this stuff on the job.
S.E.: At Biologic, we spend a lot of time with our patients - much more time than patients usually are given in traditional-medicine settings. Making that work within a traditional insurance-based model is very challenging.
I've heard from other providers that, of course, you spend more time. But they don't realize that we're accepting the same insurance that traditional practitioners are. At times, this practice has a population that's over 60 percent Medicaid, yet the lights are still on, we're still functioning, and we're still spending time with - and still educating - our patients.
J.G.: Maybe the first lesson to learn about starting a business is to be in love with it, which you so obviously are. And the second is to be in love with where it'll be located.
So tell me more about the Green Mountain State and its role as a partner.
S.E.: Vermont is way ahead on this one. About a year or so after I started my practice, the state passed a law that made it mandatory for all Vermont insurances to cover naturopathic physicians as primary-care providers. I was very lucky to have come to Vermont knowing that this was going to happen.
Once the mandatory coverage law passed, I was one of probably the first 30 naturopaths in the state to go through the credentialing process.
Transitioning from running a cash-based business to becoming a participant in a much-larger insurance network that I'd had neither training for nor an understanding of was scary. But it was also exciting, because with the stroke of a pen, people had access to me and I to them in a way we never saw before.
After we go through a patient's medical history and do a physical exam, we have probably some of the most important conversations these folks have ever had, about the truth of how they've been treating themselves: what they eat, how they treat their bodies, and how their habits affect them and their families. These are frank discussions, believe me.
I began meeting patients at the supermarket and shopping with them, creating meal plans based on what they had access to. And I brought on a nutritionist to make sure that every patient who walked in these doors gets nutritional counseling.
J.G.: How many patients do you have right now?
S.E.: We're up to 3,000 active patients. That's amazing! We get referrals from other specialists. Patients come from all over New England to see us. It's resonating. Hey, we wouldn't have grown this much in the past 10 years if we didn't resonate.
J.G.: How has it changed for you?
S.E.: It's improving. There's more understanding and more acceptance.
When I first came here, I did a lot of apologizing and explaining. Now I come from a place of being proud of what I am and what I do: treating the underlying etiology.
It's about building relationships - partnerships - with patients. It has to be a partnership for me to say, ”O.K., just because you have a headache doesn't mean you have an aspirin deficiency. My job is to figure out why you keep getting those headaches.”
We'll have that conversation not in an examining room but in my office - where they actually can relax and just talk. That to me is where the true healing takes place. It starts when someone walks through this door into my office.
J.G.: So, what about the broader field of health care? There are new realities.
S.E.: The business has changed over the past 10 years because medicine has changed. Requirements have changed; we're going from paper to electronic charts. The administration and documentation take a lot more time today.
I also think my comfort level and my expertise within the practice have also changed. I've had to face new challenges.
For example, right after naturopaths became credentialed as primary-care physicians, Blue Cross Blue Shield audited the practice. It was grueling - yet we managed it.
I learned from that exercise where, as a provider, I fit into the economics of the health-care business. So I set out to learn the health-care economics. There's that on-the-job training again!
J.G.: One of the great “doctors of branding” and a personal hero, Seth Godin, asks a seminal question: Is the story that's going around about your enterprise the story that you want to have going around?
S.E.: Wow. Perhaps I don't know what the story is anymore. I don't know what that perception is anymore. I hear good things, but I also know that people aren't likely to tell me bad things that might be going around.
I'd say that our success - because I do very little advertising now - comes largely from word of mouth. I suppose that's a good thing. A good story, right?
J.G.: O.K., you're at some social event, and somebody says, “We've been thinking of moving out of where we are and starting a business. This area looks interesting. Should we come up here?” What would you advise them?
S.E.: I'd ask what they're looking for, why they're looking to move, what it is about where they are that....
J.G.: Sort of remind them that the grass is always greener....
S.E.: Yes, kind of. I've certainly moved a lot of people through the process of relocating here.
But I'm also realistic. Brattleboro is a funky town - which, by the way, is how my mother from Long Island describes it. Don't come here and expect to be out at the restaurant at 9:30 or 10 at night and have tons of nonstop entertainment options. Downtown quiets down pretty early.
But if you want to get good food and go to a movie and browse through a locally owned shop that's not a big-box store and be part of your community, then, sure, come to Brattleboro.
J.G.: Well put. I especially like the part about being part of the community. That's so much about what this area is about.
S.E.: I met a woman recently who conducts wellness retreats, and she's looking at southern Vermont as a site for one. She didn't have much time, and serendipitously I was able to take a chunk of the day to show her around. I got to see our area through her eyes.
She's from Los Angeles - all that energy and growth - and remarked that Brattleboro seemed to be full of potential.
I saw what she saw that day: that Brattleboro is a bundle of energy and potential trying to figure out when to sprout and how to sprout - how to push up through some pretty tough rocks and perhaps some concrete, too.
J.G.: I heard something about you building a building on Flat Street?
S.E.: Prior to moving back to this area, knowing that I wanted to root here for the long term, I looked around for a site for a building I'd been dreaming about. I saw a space that had been the old hometown auto-body shop or store, actually. The structure dated back to the 1880s and had completely broken down. Anyway, I bought the land.
J.G.: I do remember seeing the Biologic sign there, along with some architectural plans. I couldn't quite figure it out.
S.E.: You're not alone. People have asked me about it for years. Well, I've gone through a long process - years of development - to design a six-story, LEED-certified, mixed- use commercial space.
J.G.: Pretty enterprising for a doctor with a growing multi-practitioner practice and a couple of children in school. Why did you want to do that?
S.E.: Something needs to shift in Brattleboro. I want to do what I can to help revitalize this town - and Flat Street is in need of quite a bit of TLC and could be something of a catalyst.
But right now, I'm concentrating on the practice and where we're located.
J.G.: Tell me more.
S.E.: We have eight people on staff and a great spot on Main Street. I just hired a third chiropractic physician. I'm looking to bring in a women's-health nurse practitioner, an acupuncturist, and a massage therapist.
The area in and around Brattleboro has a wonderfully diverse healing community, and I want to continue to complement them, just as I see that the medical doctors at the hospital complement what we do - not the other way around. What we do is not alternative.
J.G.: Very ambitious. Very exciting. Looks like you and Biologic Healthcare are pushing up through those tough rocks. It's a lot of work.
S.E.: Right. I work a lot - and I love it. I love it because we're doing good things, inspiring people to work on themselves so that they can then work for themselves and their families.
Hey, it's about feeling better so that you can have a more vital presence in every day you're given.
I love Vermont. With 630,000 citizens, it's a manageable entity - like a large corporation. If only we could manage it that way from a health perspective and give Vermonters the tools they need.
I believe that people at their core want to do better. I also believe that when they know better they will do better.