Dr. Jordan Robertson, ND
Episode Summary
What does evidence-based naturopathic medicine actually mean—and can naturopathic doctors use medications, lifestyle medicine and integrative care together without abandoning the principles of their profession?
In this episode of Girls Gone Wellness, Jeanette and Victoria sit down with Dr. Jordan Robertson, ND, naturopathic doctor, educator and founder of the Confident Clinician, for a detailed conversation about evidence-based medicine, naturopathic medicine, integrative healthcare, standards of care, practitioner bias, the placebo effect and diagnostic delay. They explore how naturopathic medicine can evolve alongside scientific evidence while still offering the longer appointments, behaviour-change support and individualized care that attract many patients to the profession.
Jordan discusses her own experience entering naturopathic medicine with a background in critical appraisal and evidence-based medicine, including the challenge of reconciling what she learned in school with changing clinical research. She explains why naturopathic medicine historically developed an oppositional relationship with conventional medicine and why she believes the future of integrative medicine requires moving away from the idea that patients must choose between “natural” treatments and pharmaceutical treatment.
The episode also asks a fundamental question: what counts as evidence? Jordan explains that evidence-based medicine is not simply finding one randomized controlled trial (RCT) that supports an intervention. Instead, clinicians have to consider the broader hierarchy and body of evidence, how consistently findings have been reproduced, the strength of the available research, clinical expertise and the circumstances of the individual patient. Clinical experience can contribute useful information, particularly when research is limited, but it should not automatically outweigh large bodies of stronger evidence.
Several real-world examples are discussed, including statins, selective serotonin reuptake inhibitors (SSRIs), hormonal birth control, endometriosis, diabetes, Hashimoto’s disease and iodine supplementation. Jordan and the GGW hosts discuss why something being described as “natural” or relatively safe does not necessarily make it the best treatment. Delaying an effective treatment in favour of an intervention with little evidence can itself cause harm, particularly when untreated disease can progress.
The conversation also examines practitioner bias and shared decision-making. Jordan argues that clinicians can influence patients simply through the language they use—for example, describing a medication as “toxic”—and that healthcare providers should be aware of how their own beliefs affect the options they present.
Jeanette, Victoria and Jordan then explore the placebo effect and what Jordan describes as a possible “provider effect”: the impact of feeling heard, having longer appointments, receiving accountability, working closely with a practitioner and getting support with behaviour change. Rather than attributing every improvement to a supplement or treatment itself, Jordan discusses why the therapeutic relationship may be an important part of healthcare outcomes.
Finally, the episode explores why naturopathic medicine may benefit from clearer standards of care, why clinicians need to be willing to change their minds when research changes, and why professional identity can make that difficult. Jordan shares the story behind the Confident Clinician, an evidence-based integrative medicine resource designed to help practitioners access current research, clinical recommendations, dosing information and ongoing professional support.
The overarching message is that evidence-based healthcare is not about choosing sides. It is about continually updating what we know, recognizing uncertainty, weighing evidence appropriately and using the best available tools to help the individual patient in front of us.
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What is evidence-based medicine?
Evidence-based medicine is an approach to healthcare that weighs the best available research rather than relying solely on tradition, authority or an individual practitioner's experience. In the episode, Dr. Jordan Robertson explains that evidence should be considered as a body or hierarchy rather than treating one study as definitive proof of a claim.
What does evidence-based naturopathic medicine mean?
Evidence-based naturopathic medicine applies current scientific evidence to naturopathic and integrative care while still considering the individual patient's circumstances. Jordan argues that naturopathic doctors can use evidence-supported nutrition, lifestyle interventions, supplements and behaviour-change strategies while also recognizing when medications or conventional medical treatments are appropriate.
Does clinical experience count as medical evidence?
Yes, clinical experience can contribute to evidence-based decision-making, but it needs to be weighted appropriately. Jordan explains that a practitioner's experience with 100 patients should not automatically outweigh high-quality research involving hundreds of thousands of patients when that stronger evidence exists.
Is one randomized controlled trial enough to prove that a treatment works?
No. One randomized controlled trial (RCT) is one piece of a much larger evidence base. Jordan describes evidence-based medicine as looking for a broader movement in the scientific literature toward a clearer understanding rather than allowing a single favourable study to overturn an established body of evidence.
Can naturopathic medicine and conventional medicine be used together?
Yes. A central theme of the episode is that naturopathic medicine and conventional medicine do not have to be opposing systems. Jordan discusses combining the strengths of pharmaceutical treatment and specialist care with nutrition, lifestyle change, patient education, accountability and longer-term health coaching.
Are medications incompatible with naturopathic medicine?
No. Jordan specifically challenges the idea that recommending an SSRI, statin, hormonal contraceptive or another evidence-supported medication makes someone less of a naturopathic doctor. The episode argues that the appropriate question is which available treatment options have the best balance of evidence, benefits, risks and fit for the individual patient.
Can a treatment cause harm even if the treatment itself is relatively harmless?
Yes. Delaying an effective treatment can cause harm even when the alternative intervention itself has few direct risks. Jordan uses diabetes as an example: delaying appropriate treatment while disease progresses may increase the risk of complications such as microvascular damage.
Why does diagnostic delay matter in chronic disease?
Diagnostic and treatment delays can worsen health outcomes and may also erode a patient's trust in healthcare. Jordan discusses endometriosis as an example of a condition where patients may spend years seeking answers, which can influence how willing they are to trust treatment recommendations once they finally receive a diagnosis.
Can practitioner bias influence a patient's medical decisions?
Yes. Healthcare providers can influence how patients perceive different treatment options through their tone, language and personal beliefs. The episode discusses how describing a medication as “toxic” or presenting one treatment option negatively can make genuine shared decision-making more difficult.
Are natural treatments automatically safer than medications?
No. “Natural” does not automatically mean harmless, appropriate or evidence-based. Victoria and Jordan discuss the example of excessive iodine intake in people with Hashimoto's disease and emphasize that naturopathic interventions should be held to the same standards of safety and evidence as other healthcare treatments.
What is the placebo effect in healthcare?
The placebo effect describes improvement that occurs in the absence of a specific active treatment effect, but Jordan argues that this category may include several different influences. These can include expectations, support, the patient-practitioner relationship, motivation and changes in behaviour that occur during care.
What is the “provider effect”?
The “provider effect” is Jordan's description of the possible health impact of having a healthcare provider who listens, cares, provides accountability and actively supports behaviour change. She suggests that some improvements commonly labelled as placebo effects may eventually be better understood as effects related to the therapeutic relationship and healthcare environment.
What does an evidence-based naturopathic doctor offer that may be different from a medical doctor?
Jordan emphasizes time, accountability, individualized follow-up and behaviour-change support as important differences in the naturopathic model. The medical and naturopathic clinicians may sometimes agree on the treatment itself—for example, medication or a Mediterranean-style diet—but a naturopathic doctor may have more time to help a patient understand and consistently implement the plan.
Why are standards of care important in naturopathic medicine?
Standards of care can help reduce large differences in treatment quality between practitioners. Jordan argues that individualized medicine should mean individualizing care for the patient, not allowing every practitioner to choose treatments solely according to personal preferences or favourite therapies.
Why is changing your mind important in evidence-based healthcare?
Changing your mind is a normal part of science because medical knowledge continually evolves. Jordan discusses how clinicians can become attached to a particular diagnosis, treatment philosophy or professional identity, making it harder to abandon an idea when newer evidence no longer supports it.
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This transcript has been edited for clarity and readability while preserving the substance of the conversation.
Victoria
Welcome to Girls Gone Wellness, Dr. Robertson.
Jordan Robertson
Thank you so much for having me.
Victoria
We are so excited to have you on our podcast today.
Before Jeanette and I even had the idea of creating this podcast, we would actually listen to your podcast, Women's Health Unplugged. We would literally send two- to three-minute voice notes back and forth to each other saying, "Did you know this? I had no idea. This is not what we were taught."
For us, it was a really big moment that allowed us to start asking more questions in and around naturopathic care and integrative medicine as well. That's really what inspired us to start this podcast.
So we're very grateful to have you here.
Jordan Robertson
That's so kind. I'm so happy.
I love seeing that baton get passed to people who are excited and inspired and ready to influence their own audience of listeners.
I'm so excited to be here and be on the other side of the mic.
Jeanette
I was talking to Vic beforehand, and as students, we're seeing firsthand how misinformation in this space—and especially online—is really seeping into our education and affecting the next generation of NDs.
When we interviewed Dr. Kim Bretz, she even mentioned that there are still gaps in education today and protocols we're still being taught that have already been phased out of clinical practice.
We still have a long way to go, but this is why we wanted to create this podcast and help bridge that gap between evidence-based naturopathic doctors, students and the next generation.
Jordan Robertson
I love it.
Victoria
So, Dr. Robertson, let's start with you telling us a little bit about how you got into naturopathic medicine.
Jordan Robertson
Okay. It's a long story, but I'll try to keep it short.
First of all, just call me Jordan. That's way better for everyone.
Victoria
Okay.
Jordan Robertson
Jordan is good. I'll lead with that.
I always say that going into naturopathic medicine was the most rash decision I ever made in my career.
There are lots of layers to why I chose it, from being ready to move on from my undergrad to looking for something within my fields of interest, which were exercise, nutrition and things like that.
I had also watched family members struggle in the conventional healthcare model, and I was interested in being outside of OHIP.
My partner at the time was a dentist—my partner is no longer a dentist—and we were both purposely pursuing health professions outside of OHIP so that we could make more autonomous decisions about how we ran our practices.
That's how I started.
But I came from a background of critical appraisal, evidence-based medicine and inquiry-based learning, so it was a hard transition for me to make from that environment into the naturopathic schooling environment.
Try as I might while I was there as a student, I tried to influence the way we incorporated new knowledge into the curriculum and things like that.
But that's how I got started in the first place. It was this marriage of things I was interested in and a healthcare model I was interested in.
I was excited by the research and evidence for integrative medicine, even though that was maybe clouded over during my time at the actual school.
Jeanette
I have kind of a similar story.
I did my undergrad in neuroscience, so coming from that program into naturopathic medical school was a big jump for me. There was a lot of relearning I had to do in first year.
My brain is very logical, and I need to know how and why things are done. So it was definitely difficult in first year trying to relearn some of these different things.
When you were applying to naturopathic medical school, what was your perception of naturopathic medicine before you got to school? What was it like when you were in school? And how has that changed over the course of your career?
Jordan Robertson
That's a really good question.
I didn't know a lot about it before I went, truthfully. That's why I would say it was one of the most non-evidence-based decisions I ever made. I was like, "This sounds great. I'm going to throw all my chips in that basket over there."
I toured the school and shadowed an ND I knew personally at the time.
It seemed cool that they got to spend more time with their patients. The things they were talking about were interesting.
At the time, I suffered from migraines myself and found some benefit from seeing an ND.
So I jumped in without really thinking that much about what was going to happen afterward, truthfully. I just assumed I'd be fine coming out the other side from a business perspective. I didn't really think about it as a career. I was just the perennial student who was like, "Okay, well, this is the next thing I do."
While you're there, you're pretty insular in that school. You don't get a lot of outside experience. A lot of the people leading at the school have either always led at the school or came up through the residency and academic system.
You don't get a lot of outside conversations happening until you leave.
Funnily enough, while I was a student, the person I had shadowed left the profession.
That was like, "Oh, wait a minute. What?"
I had based part of my decision on watching this other person's career, and they were like, "I've had it. I can't make it as an ND," and left the profession while I was in school.
I was like, "Well, shit. Hopefully that doesn't happen to me."
When I left, I didn't have any other choice but for it to be fine.
I'm not saying people have a choice for it not to be fine, but the way I approached it was that I didn't have a Plan B in my work or my life. I had to make it work as a profession when I graduated.
I'm still so grateful for what I know and for being an ND. Honestly, if I had a do-over, it's not like I would go back and do it differently.
I still think what we can do is so amazing and has so much potential. That information just hasn't necessarily made it to the grassroots level.
As students, you're almost having to relearn what it is to be an ND when you graduate instead of getting those building blocks right from the beginning.
Jeanette
That last point you made is something I was going to touch on as well.
When you're in school for those four years, you're learning a certain subset of subjects and ways of thinking. Then once you get out, you're left thinking, "Oh, these ways of thinking may not work for me. I have to relearn."
You've mentioned before on Instagram—and I love your new set of Reels, by the way—that people will comment or DM you saying you're not a "real naturopathic doctor" because you challenge the narrative a lot of the time.
What do you think people mean when they say that to you? And why do you think there's a negative connotation behind that in the first place?
Jordan Robertson
I've thought a lot about this.
I think we're scarred a little bit as a profession from a time when there wasn't a lot of evidence for what we did.
Twenty or 30 years ago, NDs put people on healthy diets, talked to them, listened to them, sometimes gave supplements, and people got better. We didn't have a lot of evidence for why that was.
I think we became connected to this idea that because there wasn't funding, evidence or interest in what we were doing, and yet we were having this profound impact on patients' lives, we needed to take a contrarian stand against conventional medicine.
It became, "If they would just use these tools, they could help their patients too. There must be a conspiracy against health. There must be a disinterest in really helping patients get better."
The reality is that we were lacking evidence for some of what we did, and that more industrial model of healthcare isn't built to do what we do.
It's not that our tools are the only tools and we should shun their tools. It's not that conventional providers don't care about their patients. They simply don't necessarily have the infrastructure to do what we do.
But we took this path as a profession where it became more attractive to be oppositional to conventional care.
That meant we divorced ourselves from options on that side of the fence. We made ourselves feel that if we offered or suggested any of those options, we were going against all of our values and beliefs as a profession.
Now, the evidence is strong for some of the things we do.
There are some things we need to let go of, and that's a whole other conversation: how do we stop doing things that we've learned have no evidence?
But now we have a lot of evidence for some of what we do, and we also have a lot of evidence for pharmacotherapy.
To come together and imply that both of those things might be done at the same time in the same patient by different professionals apparently feels novel—or historically was novel—for our profession.
I do think the tides are changing.
When people suggest I'm bastardizing our profession because I suggest that someone take an SSRI, I think they're coming from that very hurt place where we as a profession were undervalued.
We felt like we had to be super oppositional in order to make waves in healthcare.
Now they're crying for us to be part of healthcare.
When you see someone who's willing to hang out on both sides of the fence, that can feel very threatening because it's threatening the identity of what people think naturopathic medicine is.
Instead, we need to become comfortable with an identity that sees the duality of needing both what we do and what conventional medicine has to offer.
Victoria
Absolutely.
Jeanette and I always laugh that we're still perfecting our sales pitch for what naturopathic medicine is.
When people ask what we do, I always feel like I need to be ready to defend myself.
Often I'm met with, "Oh, I really believe in what you do," or, "I can't stand drugs. I love what you're doing."
And I'm like, how do I explain to people that the beautiful part of naturopathic medicine is that we have so many amazing tools that we can work with alongside and in conjunction with conventional care?
That's really where we can see good health outcomes.
It doesn't have to be this "alternative medicine" people have described for so long.
That's where I get stuck.
Jordan Robertson
I know.
It's interesting because if we helped people understand what they actually want out of healthcare—are you happy with how much time you have with your doctor? Not really. What do you want? Well, I want to be better.
We haven't done a good job helping people understand that cognitive dissonance.
You want to be better, but what if the thing that makes you better is medication? What if that's the case?
Then what are you going to do?
Often we have these conversations with people who are generally well or who've been traumatized by their medical experiences.
But as a practitioner, we're not supposed to get down into the emotion of all of that decision-making. We're supposed to show up with an unbiased buffet of options for patients.
Some of those options we help them with, and some of them someone else helps them with.
That's not generally how we've approached decision-making in integrative medicine.
A practitioner's belief system can become wrapped up in their identity, and that influences how they present options to patients.
There's no doubt that patients can then feel shame if they choose the other option.
If your doctor says, "Don't use that. It's toxic," that's influential because that person is sitting in a position of power.
They've allowed their bias and beliefs to creep into how they present the options.
They're still options.
Sometimes one works better than the other. Sometimes it's us, and sometimes it's them.
Victoria
Absolutely.
We're seeing this in clinic too, which is a great thing.
We'll have patients say, "My medical doctor wants me to take a statin, but I wanted to talk to you first."
It's an amazing place for us to be able to say, "Yeah, I can see why your medical doctor wants you to take a statin. Here are the reasons why this is something that could help you long term."
We're being met, at least in my experience, with a lot of, "Oh, I didn't know that."
I think part of that is because we have more time to spend with people.
But people who've experienced trauma in the conventional system are looking to us to answer these questions.
That's why it's so important that evidence is a priority in our careers instead of me saying, "Don't take a statin. It's so bad for you. Just take red yeast rice instead."
Then we're putting that patient in a potentially dangerous position.
Jordan Robertson
Yeah.
There are some interesting ideas around how long it takes people to get solutions and feel listened to.
The longer it takes someone to finally meet a practitioner they connect with, the less likely they may be to accept the solutions they're given.
Endometriosis is where I've spent a lot of time looking at this.
Let's say it takes an endometriosis patient 12 years to get diagnosed and understood. Finally, we happily give them that stamp saying, "Yes, you finally have endometriosis."
Even if we then present them with a treatment option that's a 10 out of 10 for them, they may be less likely to take it because their trust in medicine has been eroded over those years.
Patients can struggle to make what we'd put in air quotes as the "right" decision based on what their medical experience has been.
Now, if you put a practitioner on top of that who says, "Oh God, don't take hormonal birth control. That's the devil," we've really complicated things.
That patient's trauma is already making it hard for them to trust anybody.
If we're lacing that with conspiracy, ideas and beliefs from our own profession, that's where the harm really comes in.
Now that patient may move even farther away from making what, on paper, could be the right decision because their provider is influencing how they feel about those options.
That breaks my heart.
That's not okay to me.
What also breaks my heart is that the provider may not even know they're presenting information in a biased, non-evidence-based way because all they're doing is repeating what was taught to them.
Victoria
Absolutely.
Have you always put such an emphasis on evidence in your practice, right from when you graduated and started clinical practice?
Jordan Robertson
You know what? I've had to look back at my charts.
When I retired, I had to give all my charts to my associates, and that was embarrassing.
It's literally like letting someone look in your underwear drawer and you're like, "I meant to throw those out. Those ones? No one's supposed to look at those ones. I never wear those, I promise."
That's what it felt like giving my charts to other people because they were going back to 2009 and looking at what my treatment plans were.
Were there things in there that now make me cringe? Sure.
But I also hope that in 10 years, the things that are in our charts right now make us cringe because, in theory, we should be changing all the time.
Did I keep doing some practices I'd learned in school when I graduated? For sure.
There were things that crept into my first couple years of practice that were not evidence-based, and I take full responsibility for that.
I always tell the story of wheeling my course notes to a dumpster in a shopping cart before I moved out of Toronto because I didn't want to move them to Burlington.
I also thought, "I have enough research skills. I actually don't need these."
The only thing I didn't throw out was my TCM notes because I thought, "I don't know. This feels like an ancient scroll. I shouldn't throw this out."
But I threw out everything else.
In theory, I should be able to find this information if it's accurate.
There were definitely terms around things like "hormone imbalance" that stayed in my brain for a little while when I first graduated.
It was a very simplified way of explaining why people felt the way they felt.
It wasn't until I did some deep diving into the content that I realized, "Oh shit. No wonder my referral letters suck."
They weren't speaking the language of the MDs I was asking for support from.
That really changed how I approached care in general.
It's part of why I developed the Confident Clinician.
I was like, "So it's my job to create the standards of care for our entire profession because we don't have them?"
Not only was I doing this in my office, but someone two kilometres away was also doing it for their patients.
I thought it wasn't fair that we had nowhere to go that created a unified position or resource around how we support patients.
That's where the Confident Clinician came from: my annoyance that I didn't have a resource I could look at.
Victoria
We're going to talk about the Confident Clinician and standards of care in just a minute because I have so many questions.
But first, the term "evidence-based" is thrown around now more often than ever, and then it's often followed by things that aren't evidence-based.
People will say, "I have this evidence-based homeopathic protocol," and I'm like, "Do you? I've never heard of that. Show me."
So what is evidence-based medicine? What actually constitutes evidence?
Jordan Robertson
That's a really good example.
When we use the word evidence-based, people can also get their backs up and say, "Are you saying that my experience is meaningless? I've been practising for 40 years. That means nothing to you?"
No. That's not actually the case.
The idea behind evidence-based medicine is that we're rejecting the idea that we simply learn everything from our elders.
That's actually partly how it was born.
During grand rounds and reviews in hospitals, people realized older physicians were telling newer physicians what they themselves had done, rather than necessarily incorporating how science and medicine had updated.
They weren't always able to pivot and change how they educated students.
The idea was that we can't rely solely on expertise to keep up with changing medicine.
Evidence-based medicine is a system where we're looking at hierarchies and various levels of evidence.
There's also context.
If someone is on their deathbed and we have no other options, we may be much more willing to throw the kitchen sink of non-evidence-based things at them.
We're not as willing to do that when somebody has a very treatable illness for which we have tried-and-true solutions—or we shouldn't be.
So "evidence-based" is actually dynamic.
It's not about having one study that says something. It's not even necessarily about having five studies that say something.
It's about having movement within a body of literature toward a concept of truth, even though we never really arrive at absolute truth in science.
We're gaining clarity over and over as the years progress.
One paper doesn't shift an entire ocean that's moving in one direction.
Someone's clinical experience can start to weigh in when we don't have a lot of literature on something.
But if someone has treated 100 patients with hypothyroidism and we have studies involving hundreds of thousands of patients, that evidence starts to sit differently on the evidence-weighting scale.
We're not great at holding multiple pieces of truth at the same time. We tend to think in black and white.
We're like, "This is right and this is wrong. If you're saying this, then you're saying no to that."
But they're all in there as part of the evidence.
What our brains have to do is weight them based on the level of evidence and decide how much emphasis we're going to put on one piece of information versus another.
That's what evidence-based care is.
Sometimes we use that term as a proxy for one study in rabbits.
Or we say someone's clinical experience is evidence. I'm not saying it's not, but it's one thing within a body of literature that we should also have consulted.
Jeanette
That's such a good point.
A common argument I hear in clinic is, "Chinese medicine or TCM has been around for thousands of years, but this one randomized controlled trial was only four weeks."
It's interesting how people place emphasis on certain things.
Maybe it's partly that bias you were talking about earlier.
Jordan Robertson
And it's not that those things aren't helpful.
There are absolutely limitations to our biomedical approach to research. Nutrition is a great example. Nutrition is very difficult to fit neatly into the biomedical research model.
But the argument is that we do have evidence for some things.
Where we place thousands of years of TCM in that evidence hierarchy may be up for discussion.
Do we put it at the top of the triangle and say, "This is the most important thing we've ever learned about eczema, so we're going there"?
Or do we recognize that it falls somewhere else in the hierarchy when we have strong evidence for other interventions?
That's hard because that TCM practitioner may have identified their professional identity around that particular system.
Instead of saying, "I am part of a system that treats eczema," it can become, "This is the only way to treat eczema."
A more collaborative approach is much more evidence-based because then patients can make a more educated decision about what they're doing.
Jeanette
Earlier you touched on standards of care.
Why do you think there aren't standards of care for naturopathic medicine, and do you think there should be standards of care for naturopathic doctors?
Jordan Robertson
As a regulated health profession, it shouldn't be a gamble for patients what kind of treatment they receive based on who they happen to see.
If we wanted it to be the Wild West and didn't want to be regulated, then it's buyer beware.
But if we're going to stand together as a regulated health profession, if someone's favourite herb is turmeric but turmeric isn't actually the best choice for what the patient has, I don't think it should be up to the patient to sort out whether they're seeing the right practitioner.
There should be a standard applied across the profession.
We have this idea of individualized care.
One of my longtime friends and favourite people used to say, "When did we get so mixed up that the individual in that statement became the practitioner and not the patient?"
Individualized medicine has somehow given us this idea that each practitioner gets to practise as an individual.
That's not what it's about.
It's about the patient being treated as an individual.
If we have tried-and-true, evidence-based strategies for how to support that patient, why should the patient have to gamble on who they see?
I don't think that's fair.
Part of why we don't have standards of care is that we've carried along a lot of traditions in our profession that really need to die.
I think we've done that to keep the peace rather than taking a progressive, leadership-based stance on where we want the profession to go.
We don't want to make anybody mad, but as a consequence, we've held ourselves back.
I think the way forward is for practitioners to have somewhere to go that shows them how to deliver the standard of care so they can show up confidently with their patients.
Then we as a profession can rise to the occasion instead of being held back by longstanding traditions that need to be let go.
Here's a perspective I find really helpful for practitioners who are listening.
If conventional medicine behaved the way we did, how would we feel about it?
If they had a practice from hundreds of years ago that we now knew didn't work and potentially caused harm, what would we expect them to do as a group?
We'd expect it to come out of the curriculum. We'd expect it to come out of their standards of care. We would expect consequences if people continued to do it.
Yet in our profession, we carry along things that may have no effect and potentially cause harm. We still teach them. We write exams on them. We endorse them. We offer continuing education about them.
Then somehow we try to keep the peace rather than take a leadership stance and say, "We don't do this anymore."
How great would our profession be if we actually took a stand on some of those pieces?
We wouldn't tolerate it if conventional medicine did the same thing.
Was that too much of a rant?
Victoria
No, absolutely not. I love a rant. I always appreciate it.
I think there's also this idea in naturopathic care that if we prescribe something without evidence—or even with evidence against it—it's harmless because it's natural.
That's also completely untrue.
Jeanette and I were recently talking about prescribing excessive iodine to patients with Hashimoto's disease.
I'm in the thyroid space, and I still see people in clinic taking eight capsules of a thyroid-support complex despite having Hashimoto's disease.
We have evidence suggesting that excessive iodine can potentially be harmful in Hashimoto's disease, yet people do it because it's something we've done for a really long time.
We've accepted this idea that iodine is always good for the thyroid.
Even though we now have evidence suggesting it may not be the best or safest option for certain patients, we let it slide.
If a conventional doctor did the equivalent, we'd all be up in arms.
Jordan Robertson
One hundred percent.
We'd be saying, "Where did you get that pen from the drug company whose medication you keep prescribing even though it isn't effective?"
We'd hang them out to dry if that's how they behaved.
You bring up a good point: just because something is safe—or perceived as safe—doesn't mean we shouldn't apply the same level of evidence.
We know so much now about the impact of diagnostic delay on chronic disease.
The moment a patient develops diabetes, if we don't address that, we've got the potential for microvascular damage.
The other thing we know from a diagnostic-delay perspective is that we often make the claim that just because something is safe, it's okay and it doesn't matter if the effect size is low or if we don't have good evidence for it.
But we have so much evidence that delaying the right treatment can cause harm.
It's not enough to say, "The thing I'm doing isn't causing harm."
You can also cause harm by diverting someone away from the thing they should be doing.
If we avoid appropriately treating a newly diagnosed patient with diabetes with medication that could help them and delay that in favour of something else—even if that other thing itself is harmless—we may be putting that person at risk for microvascular damage and other complications of diabetes.
So it's not just about each individual intervention being safe or unsafe. It's about the person's entire care structure.
When we delay evidence-based treatment in favour of something that's supposedly harmless, we can still potentially cause harm.
Jeanette
Something I wanted to talk about that's on the same page is the placebo effect.
We hear a lot that if people are feeling better, that's good enough. Even if it's placebo, they're feeling better, so that's good.
Do you think placebo is enough?
Or do we need treatments that create objective changes—blood work, measurable results and things like that?
How much weight does the placebo effect have?
Jordan Robertson
The poor placebo effect.
I like the placebo effect, but there's a right place and right time for it.
I think we're just starting to scratch the surface on understanding how someone's mindset or their relationship with their provider impacts their progress.
We're just beginning to understand what those things do to someone's long-term health.
This is just my prediction and guess, but I think in 20 years we're going to say, "You know what? We kept calling this a placebo effect. There's a provider effect."
If someone loves you, sits across from you at the table and deeply cares about you getting better, you get better.
I think we're going to understand that side of the nervous system, motivation and compassion much more in 20 years.
But right now, anytime we're not giving active treatment, we tend to lump all those people together and call it the placebo effect.
What I don't like is giving someone an agent, having them get better, thinking it's probably the placebo effect and then continuing to give them that thing as though the agent itself is responsible.
That's where I have more of a problem.
We need to call it what it is.
It's not necessarily the homeopathic pellet.
Maybe you talked to that person for an hour and helped them deal with their stress. They may feel better for that reason.
If we keep pretending it's the agent, we're removing power from that patient.
Patients can benefit from learning about the impact of their nervous system on their own treatment course.
If we make them feel like this little lactose pellet is the thing that saved the day, they're always going to feel like the solution is outside of themselves when a lot of that solution is inside themselves.
Now who's talking woo-woo?
It is in them. You have to coach them to change and improve.
You don't necessarily need the pellet.
If we're focusing on the external agent, we're potentially disempowering that patient from taking control of their health.
Victoria
I've never heard it described that way—the provider effect—and I really like that.
It's true. We have this amazing opportunity to really get to know our patients, which I think is part of what sets us apart.
Jordan Robertson
Even a text-message reminder.
It's hard in research studies because we want people to comply, but getting people to comply in research without ever talking to them is very difficult.
Then we invariably give them some kind of support.
The control group gets a pamphlet about the Mediterranean diet, but we text them twice a week to see if they read it.
We're contacting that person. They have provider time.
Or we give one group a supplement and the other group meets with a dietitian once a week for 12 weeks.
I'd get better if I met with a dietitian once a week for 12 weeks.
It's really hard to remove that access point from research and from what we do.
We can't say, "I'm going to give you this thing, but I'm going to be mean about it, and then we'll know for sure if it was the turmeric."
We can't completely separate those things.
When I think about where our education is lacking, it's in the coaching side of what we do.
We really underestimate how important relationship-based care is with our patients.
We're making it about this external agent we give when I think so much of what makes them better is that they have you as a provider.
Victoria
That probably answers my next question, but for listeners who are wondering what sets an evidence-based naturopathic doctor apart from just going to their medical doctor—the medical doctor is publicly funded, while an evidence-based naturopathic doctor might not be giving me homeopathy and all of those "alternatives"—what sets us apart?
Why would someone still want to see us as well?
Jordan Robertson
Time. Provider time.
People would pay to see their doctor longer.
If that's something of value to you, that's a difference.
Accountability is another thing that's really hard to extract from conventional healthcare.
I was talking to my parents this weekend. My dad has an upcoming appointment and doesn't know why he has it. He can't actually contact a human to figure out if he's supposed to have the appointment or not.
He's just going to go. He doesn't even know who it's with.
That's his experience of being in the conventional system.
There often isn't anything that holds people accountable to behaviour change.
There isn't always something that helps you navigate life's ups and downs because you're having three to six months between appointments.
No one is necessarily helping you navigate tax season, report-card season or a busy period at work with your health.
There's almost this assumption that none of those things are influencing your health.
The only thing you need is a prescription renewal.
That's so far from the truth.
The prescription is almost the cherry on top of real health change.
When you work with a provider outside that model, you can customize your healthcare experience.
You can go as often as you need. You can talk as long as you need. You can ask all the questions you want instead of having half a question when you see your specialist.
It's a completely different focus.
It puts you as the agent of change in your healthcare, and that person becomes your Yoda helping you navigate your health journey.
In theory, the answers may not even be that different.
Your specialist still thinks you should eat the Mediterranean diet.
Do they know how to help you actually do that? Maybe not.
Do they have time to talk about it? Often not.
To implement those things, you need someone who can help you with behaviour change.
That's honestly what we do best.
Victoria
That's what's so special about having a medical doctor and a naturopathic doctor who are open to working alongside each other.
Instead of this opposition all the time or the ego of, "I'm better than you. I have a better way of doing this," imagine what we can do for people's health if we can work together and get on the same page.
Jordan Robertson
Absolutely. I'd love that.
High-five, hand off, go see them.
Renew the prescriptions or whatever you need on that side, then come over here and let's talk about how you're actually going to take them.
That's a whole other thing.
My medication-adherence coaching is top-notch.
If you're not taking your drugs, I will help you figure out how to take your drugs.
Then we can also address the rest of the behaviour change required so that you don't keep progressing down that trajectory.
If we just medicate people, we still have an expectation that disease can progress.
There are no drugs where we give them and then never have to worry about the condition again.
We need both.
If your diabetes is well managed on first-line therapy for five years, treatment still may need to change over time.
Wouldn't it be more empowering if during those five years we made you feel that what you do also makes a difference?
That's where we can make change.
Victoria
Absolutely.
I want to shift the conversation a little bit.
We see all the time on social media—and unfortunately even with trained medical professionals—that it's really hard for people to change their minds.
It's hard for people to admit they may have been wrong about something.
I feel like you're such an expert in this.
How do we create more curiosity and become lifelong learners in this field? How do we become okay with changing our minds?
Jordan Robertson
It's funny because in so many areas of science, changing your mind is celebrated.
Finding something new is celebrated. Scientists are on this relentless pursuit of the new and getting rid of the old, or reaffirming something we thought we knew.
That's what science is.
Somehow in medicine, we've divorced ourselves from that.
I don't know if it's ego, identity or something else.
But you have to be in a culture of mind-changing in order to try it on.
For many practitioners, it isn't safe for them to change their minds.
I've tried really hard to approach this from a compassionate leadership perspective when I work with clinicians.
I can say, "No, adrenal fatigue isn't a thing."
That's easy for me to say. I didn't build an entire business and identity around it or write a book about it.
A lot of people have identified as the person who believes the thing.
Now the thing isn't true.
That's awfully scary for them.
As a profession, if we showed up as doctors rather than "the plant-based pediatrician" or whatever identity we've created, we might create less risk around changing our minds.
Otherwise, you've backed yourself into a corner where you have to defend your stance to the death because you've built your entire identity around it.
For many clinicians, it can feel flat-out unsafe to admit they're wrong.
One of my goals is to create a culture where changing your mind is embraced.
We shouldn't think we're going to get struck by lightning if we admit that we said something wrong to patients five years ago.
As a community, we need to embrace change.
We also have to model it.
People in leadership positions need to change their minds publicly.
I shared on social media the other day that I had a colleague reach out saying they'd once heard me say something they thought was incorrect and, for the last four years, hadn't listened to anything I'd said.
I thought, "That's awfully narrow-minded."
This person is in a position of power and leadership.
If our leaders and the people driving the ship are unwilling to be curious, change their minds or have dialogue, we're doomed.
We need to be more vulnerable with each other.
We need to be more vulnerable as a profession and say that we're moving forward.
We also need to take a leadership stance on things we do that aren't evidence-based.
I built my whole identity around changing my mind, so it's very easy for me.
Jeanette
I'd love to switch gears and talk about the Confident Clinician because I think it's such an amazing thing you've created.
It was so needed and has literally changed the game.
Why did you create it, and what is it?
Jordan Robertson
Like I said earlier, it broke my heart that every single clinician was waging this war in their own office.
It kept me up at night thinking that we had thousands of practitioners working after hours trying to figure out the best treatment for asthma because they suddenly had a patient with asthma.
They had nowhere to go to find that information.
Part of how we learn as clinicians isn't just by looking at resources. There's tremendous value in thinking you know the right answer and then being able to compare it against what your peers are doing.
None of that was celebrated in our industry.
We clutched our protocols to our chests. It was a secret what we did with our patients.
Maybe you had one friend you'd text and say, "Oh shit, I just saw somebody with asthma. Do you remember what they said in third-year nutrition?"
There wasn't a culture of, "Let's fact-check. Let's make sure we're moving forward. Let's see if we're all doing the right thing. Where can I ask questions or get mentorship?"
There wasn't enough of that.
It was sad to me.
How could we as a profession make a go of it if we're demanding hours and hours of unpaid labour from each practitioner alone in their office, and we don't even know if they arrive at the right answer because they have no way to check?
So we started the Confident Clinician.
Honestly, it started as a beta, fun little thing.
I had clinicians who wanted to learn to be more evidence-based. We literally gave them a Zoom link, and we'd hang out on Zoom twice a month.
That's how it started.
Now it's evolved into a full-scale integrative medicine database.
You can search across hundreds of medical topics and get up-to-date evidence-based information, concise dosages, magnitude of effect, references and the things you need to show up confidently with your patient.
There's also support to become a better prescriber—the coaching and behaviour-change support—so that the term "Confident Clinician" can actually become more accurate.
I was telling someone about the program the other day, and they said, "So it really helps them become more confident. What did you call it?"
I was like, "Well, let me tell you."
That's the purpose.
I think clinicians can thrive if they have more support.
They can also gain hundreds of hours a year back by delegating that research task they frankly don't have time for and may not be particularly good at to a research team that's dying to share what the literature says.
Then they can plug that information into practice and become better clinicians.
Jeanette
As a fourth-year student, I feel so grateful that this database exists.
I know when I'm first starting in practice, it's going to save me a lot of time.
To end the episode, Vic and I are fourth-year students. We're in our clinic year and finishing school.
If you could give one piece of advice to current naturopathic medical students or new graduates who want to be more evidence-based or who might be struggling with the current education, what would it be?
Jordan Robertson
The big thing is: don't give up.
That community is so small, and you don't even know what's possible from inside those walls.
During that time, experiment with what you're good at and what you're interested in.
I always make people laugh when I say, "I was on the peds shift, guys."
What you do in school has no bearing on what you do in life.
Try on those experiences. Swear off treating pediatrics if you need to.
It doesn't define you.
What defines you is your willingness to show up, work hard and take experiences as they come.
You can gain so much from having that mindset when you leave school.
You don't have it all figured out when you're graduating.
You might not even have it all figured out two years later.
But that relentless pursuit of finding your way is so important.
You can probably look around at your colleagues right now and see who is going to do great, who's going to be successful and who has that never-ending curiosity.
I think that's one of the most important things to graduate with.
You can look up everything you learned in school.
Those multiple-choice tests don't matter.
You can look up every single thing.
Come away with inspiration, curiosity, maybe some connections and an understanding that there's a whole other world outside that school that you haven't even seen yet.
Victoria
I love that. That's such good advice.
Jordan, we're so grateful to have had the opportunity to speak with you today.
Where can our listeners find more about you, and how can our colleagues join the Confident Clinician?
Jordan Robertson
We only open the Confident Clinician twice a year.
We create some pressure for you to join during those two weeks.
We're open in July, and the best way to get connected is at confidentclinicianclub.com. It has information about what the program entails, how to join and everything else.
I hang out on Instagram sporadically. That's a great place to connect if you want to learn more about me personally.
The Confident Clinician also has its own Instagram.
That's really where to find the meat of that information.
What people can expect when they join the Confident Clinician is a bit of a drinking-from-a-fire-hose experience because there's never been anything quite like what we offer for our profession.
The moment you get in there, your brain will explode.
But we promise to help it be a controlled explosion and that it will help you immensely in your work.
It's a whole other world outside school.
When you join that community and see what's possible, I think it's very inspiring for new graduates.
Victoria
You failed to mention that you also have some world-class memes on your Instagram, so everybody should really follow you there.
Jordan Robertson
Come for the memes, stay for the evidence-based medicine.
That's my Instagram in a nutshell.
Victoria
Exactly.
Like I said, we're so grateful to have had you on the podcast today.
We look forward to speaking with you again soon and staying in touch.
Thanks so much.
Jordan Robertson
Thank you for having me, and good luck with everything you guys are doing.
I think you're awesome.
Like I said, I'm super happy to see that baton get passed to inspired, excited practitioners because you can carry forward all the things that practitioners who came before you have started.
I'm so happy to see you carry those pieces forward and give people a great place to learn information.
Thanks so much for having me.
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After years of building healthcare businesses, leading teams, and working alongside founders, I've become fascinated by one question:
Why do some leaders continue to grow while others plateau?
That question has shaped the evolution of my work.
Throughout my undergraduate education, I was fortunate to receive extensive training in leadership, personal development, and human behaviour at a time when those lessons had a lasting impact on how I think, communicate, and lead.
What I've come to realize is that most healthcare professionals never receive that kind of education.
We're taught how to become exceptional clinicians, but very few of us are taught how to lead people, navigate uncertainty, make difficult decisions, or build organizations that can grow beyond us.
As I built businesses, led teams, and worked alongside founders, I saw this gap repeatedly.
It wasn't a lack of expertise holding people back. It was the leadership skills needed to support the next stage of growth.
That realization became the foundation of the work I do today.