In an ideal world, yoga therapists would not be working in isolation. They would be aware of all of their patients' medical diagnoses, medications, and other therapeutic interventions. They would be informed of any changes that might affect the yogic practices they prescribe. And, of course, other health care professionals, including physicians, would be interested in the yogic intervention and the results you and your clients observe.
So far, we are not living in an ideal world. Most physicians know little about yoga, or they suffer from misconceptions about it. Some consider yoga to be mystical hocus-pocus with little basis in science. Most doctors do not realize that yoga therapy is not the same thing as taking a yoga class. Others think that yoga is nothing more than asana. Some lump all styles of yoga together, despite the enormous differences between them. Even more open-minded health care professionals may not realize that yoga is much more than just a good way to relax.
Getting Patients Involved in the Communication
Most physicians are very busy, and they can be difficult, if not impossible, to reach on the phone. Some have little interest in speaking with a yoga therapist or other practitioners of alternative or complementary healing systems. This situation is likely to change in coming years, as yoga therapy moves into the mainstream of the healing professions. In the meantime, involving your students in the communication is probably the best way to learn what you need to know about them, as well as the best way to increase their physicians' understanding of what you are doing.
If there are any questions about whether the practice you wish to pursue is appropriate, ask your student to briefly outline for the doctor what is being proposed (or what you are already doing). It can be helpful if the student brings a book with pictures of the poses or practices in question. Keep in mind that many physicians may not be able to accurately judge what's safe and what's not and, when ignorant, sometimes err too much on the side of caution. However, there are times when a physician will alert you to contraindications you might not otherwise have thought of, which can help you plan your student's practice.
In order to do your job effectively and safely, you need to be aware of your students' medical circumstances. Keep in mind that this is privileged information, not to be shared with anyone without your students' approval. Don't talk about confidential matters where you might be overheard. Written notes should be stored in a secure location.
Also keep in mind that, because of their concerns about privacy, some students will simply not tell you everything that might be helpful to know. They might not want to inform you if they are HIV-positive or taking an antidepressant. Also, consider that millions of people have conditions such as high blood pressure or diabetes but do not know it. Even if they are aware, the conditions may not be adequately controlled, or they may have stopped taking prescribed medication (which, again, they may not tell you). There's not much you can do in these circumstances other than to simply monitor the students the best you can, using the tools you've got.
Talking to Doctors about Yoga and Yoga Therapy
If you do have the opportunity to communicate directly with physicians—in writing or in conversation—there are a few things to keep in mind. First, be succinct. Doctors are under tremendous time pressure, and if you waste their time, you may not get another chance. Second, try not to set off their "woo-woo" alarms. Unless you're dealing with one of the increasing number of health care professionals who also practice yoga, don't talk about prana, the chakras, or liberation, or you'll risk turning them off. Instead, stick to the anatomical and physiological world physicians understand. If you're aware of scientific research on yoga that's relevant to the patient you're discussing, offer to share it (or at least the reference)—or include it in the paperwork when you're exchanging information.
Finally, stress the complementary nature of yoga therapy. Yoga is not in competition with medical care. Indeed, yoga therapy, properly applied, can make almost any conventional care even more effective. Patients may be able to get away with smaller doses of drugs, for example, saving money and reducing the risk of side effects. And emphasize that, unlike many alternative therapies, from herbs to vitamins, yoga is unlikely to interact adversely with any medical treatment.
Dr. Timothy McCall is a board-certified internist, Yoga Journal's Medical Editor, and the author of the forthcoming book Yoga as Medicine: The Yogic Prescription for Health and Healing (Bantam Dell, summer 2007). He can be found on the Web at www.DrMcCall.com.