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Janine Blackman, MD/PhD
Speaker, Practitioner, Advocate


About Janine A. Blackman, MD/PhD

Medical Director & Founder
The Center for Nutrition and Lifestyle Medicine

Once Central Plaza, Suite 1205
11300 Rockville Pike,
North Bethesda, MD 20852
(301) 230-2530
(866) 546-0777
Adjunct Faculty, Georgetown Univeristy Medical Center (2008)



Travel/Directions page


Special Interests:  Dr. Blackman has particular interest in applying Integrative Medicine to helping people with chronic health conditions such as fibromyalgia (FM); fatigue; complex bowel disorders such as irritable bowel, Crohn's disease, Ulcerative Colitis; diabetes; high cholesterol; and women's health issues including PMS, menopause symptoms, and osteoporosis.

 
Board Certified:   Family Practice

Medical Degree:  University of Maryland School of Medicine, Baltimore, MD

Graduate Degree:  PhD, Epidemiology, University of Maryland School of Medicine, Baltimore, MD

Internship and Residency:  Department of Family Practice, Franklin Square Hospital Center, Baltimore, MD

Fellowship:  Integrative Medicine, University of Maryland Center for Integrative Medicine

Academic Appointments: Assistant Professor, Family Medicine


Awards:
ISPE-Pharmacoepidemiology & Drug Safety (PDS) Prize to authors of the best papers published, 2002:
Janine A. Blackman, MD, PhD. 
Estrogen Replacement Therapy and Risk of Lung Cancer
Volume 11 Issue 7:561-7, Oct-Nov. 2002.
Co-authors: Coogan, Rosenberg,  Strom,  Zauber, Palmer, Langenberg,  Shapiro.


Other:  
Dr. Janine Blackman is an Integrative Medicine physician. Previous to co-founding and directing The Center for Nutrition & Lifestyle Medcine practice, she served as the Medical Director of University of Maryland Integrative Medicine, LLC.  She provides Integrative Medicine Consultations for advice on optimal wellness, and for management of chronic conditions. Dr. Blackman is committed to helping people on their journey for improved physical and spiritual health, and to providing a caring and compassionate environment.  She takes account of the whole person (body, mind, and spirit), and makes use of all appropriate therapies, both conventional and alternative. Dr. Blackman's interest in nutrition began at a young age while in college, and continues in her clinical practice today.  She has taken several courses in nutrition and on the use of nutritional supplements for improving health.

Dr. Blackman's interest in Integrative Medicine began during her residency training in family practice when she became aware that while conventional allopathic medicine can be very good at treating acute illnesses or traumatic injuries, it also has many limitations for treating serious chronic conditions.  In her journey to learn new methods for helping people with chronic conditions, she has studied various mind-body techniques and acupuncture, and gained experience directing a team of alternative practitioners at University of Maryland Integrative Medicine.   She strongly agrees with the philosophy utilizing natural methods to restore the body to balance and promote healing, and prescribes western medicines and surgeries only when more natural approaches have been inadequate.
 
Another important aspect of Integrative Medicine that Dr. Blackman likes to emphasize is the value of establishing a therapeutic relationship with each patient.  "When I have spent an hour or longer listening to a new patient tell their story, and this person feels heard and validated for the first time in their life, then our time together can be very healing.  Similarly, when I have worked with a patient for several months, and have helped them learn to listen to their own body's signals about optimal nutrition and mindfulness techniques, then they are further empowered and on the road to healing."

In her practice at The Center for Nutrition & Lifestyle Medicine, Dr. Blackman offers individualized treatment and programs for weight loss, chronic illness, being over stressed. In addition to her clinical practice and role as Medical Director, Dr. Blackman also lectures frequently at local and national conferences on Integrative Medicine approaches to fibromylagia, arthritis, inflammatory bowel disease, women's health, nutrition, and the use of dietary supplements.

The Return of Soul to Medicine and The Role of the Integrative Physician

Based on presentation by Janine Blackman, MD, PhD, to the
Nova CFS/FMS Support Group
Mason Governmental Center
Annandale, VA
 October 21, 2006

Notes by Elly Brosius, MS
Contact information updated 11/2008

See Photo Gallery for a photo from this event.

Dr. Blackman came to our group's attention in 2004 while at Kernan Hospital in Baltimore, treating some of our members at The Center for Integrative Medicine at University of Maryland School of Medicine. Since, she resigned from that position in order to be the Medical Director of  first, an  eastern and western medicine integrative medicine clinic which for a time focused solely on CFS and FM, and in 2009 to be Medical Director of The Center for Nutrition and Lifestyle Medicine. Elly first met Dr. Blackman at at CFIDS Lobby Days 2005. Dr. Blackman was on the Maryland team, speaking up within the halls of Congress on behalf of people with CFS. This October 21, 2006, meeting marked the first time she spoke to our group. 

How She came to Medicine

Dr. Blackman introduced herself and told us a little about herself. Medicine is her second career, after being an engineer. She was attracted to medicine to study health and found the work of Larry Dossey. MD, and others who have a holistic, health approach inviting. She was intrigued by studies that showed prayer could affect health. She quickly found out that US medicine is mostly diseased based and not health based. She wanted to talk to people up front about what health is and how to maintain it, not wait for them to get sick before interventions began. Somehow, she found the inspiration to complete her training in spite of the disease model of medicine being taught, but she always figured she would remain in academic medicine. Her double degree in family practice and epidemiology is suited for just that. Instead, she now finds herself in private practice, working directly with patients. She offers the services of a physician who has embraced and embodied the role of a truly integrative physician, respecting patients preferences and making available a wide choice of healing modalities, encouraging patients to examine and heal their inner world, thereby returning some soul to practicing medicine.

"When people come to see me, they are already outside the box."  - Janine Blackman, MD, PhD

Since there is often no insurance coverage for supplements, certain tests, the FM/CFS program, Dr. Blackman's patient's tend motivated and already committed to the concepts of integrative care. While an excellent family practice doctor with impressive credentials, she receives almost no referrals from other physicians! They don't know whether to trust this integrative stuff, even though it is also evidence based medicine. Both she and the patient bring extra motivation to create this special space of care and respect. And that's what you need when things don't go as expected.  Dedication, patience, and persistence are key to unraveling the complexity and finding a new direction for successful treatment.


What is Integrative Medicine?

Dr. Blackman brought 4 handouts for us. We started by going over the first one, a definition of Integrative Medicine. It is grounded in the healing relationship — practitioners and patients sharing information as well as compassion as they seek ways to achieve optimal health together. It draws upon many traditions and treatments and includes prevention as an important component. Its seeks to return the soul to medicine, with care focusing on healing the whole person and addressing a person’s physical self, a person's mental and emotional state, a person's community, and a person's personal connection to the transcendent. More soul for a new role as whole.

Dr. Blackman noted that the term Integrative Medicine may or may not last. It seems to be a needed name for now. Its not particularly descriptive. Maybe the evolution of medicine in the west will be such one can get this encompassing approach everywhere and the word Integrative will be dropped.

How she works as an Integrative Doctor

 Next, our speaker took us through handout 2: how I work as an integrative physician. Dr. Blackman stays mindful of the patient’s goals, she remains respectful of a patient’s desire to use or avoid conventional medical options, and she tries to identify new areas in which the patient may improve his or her health. Enhancing nutritional intake is one important area and we detoured to handout 3– Ten Simple Nutritional Principles & Vitality Foods.

The nutrition handout is for individuals with a high level of digestive and food preparation functioning. Dr. Blackman noted for a person with CFS/FM, the first suggestion "Eat > 4 cups of colorful produce daily", is probably a horrific thought and would make one feel terrible! Our digestion is too weak and needs help and healing before it could handle processing all those veggies. She went into detail about the quality of grains available to us even in health food stores being so poor, that unless you are the most careful of shoppers and follow good preparation techniques, eating grains is probably not as helpful as you might guess from all the advice out there. Dr. Blackman mentioned here about phrasing things, doing things in the form of the positive with the example being to focus on what can be added to a diet instead of what can't eat anymore. She encourages the planning and readiness of healthy snacks (small amounts of very dark chocolate made the list) to help make a shift to eating differently.

She talked quite a bit about the benefits of Cod Liver Oil for its Vitamin A and Vitamin D and some omega 3 fatty acids. These are so important and so difficult to get in one's diet otherwise, especially A & D if limiting animal products. Vegetarian multis will not have vitamins A and D. A good brand of cod liver oil she mentioned is Green Pasture Blue Ice. She recommends the liquid over the capsule for cod liver oil because you call tell more easily if the oil has gone rancid. If using soft gel caps for any oil based supplement, she recommended puncturing and smelling one capsule of each bottle you open to verify that the product inside is still fresh. Dr. Blackman uses other nutritional supplements to help her patients. The cod liver oil is the only non-plant based supplement she recommends. She talked about the importance of supplement quality and offers professional grade nutritional products in her practice. Other good brands for cod liver oil that came up are Nordic Naturals and Carlson.

Continuing along with Handout 2, Dr. Blackman talked about offering ‘state of the art’ laboratory screening including newer conventional lab tests, including vitamin levels  and “Functional Medicine” testing for interested patients for whom it may help. Tests can pick up imbalances and excesses and deficiencies and more.

Dr. Blackman feels it important to challenge patients to live a full and balanced life. For example, she may ask one to examine if they having been taking large quantities of supplements for a very long time for deficiencies or to compensate for a non-healthy lifestyle. She'll explore with patients how there  isn’t a pill (or vitamin or herb) for every problem.  She encourages  looking inward at how we are living, often necessary for the big health issues. She helps to uncover the sources of problems and works to facilitate healing of the core issues. There is more to do than simply prescribing therapies to mask problems.

People have often sought out stimulants for short term coping or as a long term strategy, thinking it is a good thing. At best, she said, one gets only temporary help. At worst, they can "squeeze out the last bit of energy you have." Her program is designed to support people and nourish them while they stop the push crash cycle and practice a new way of being.
Dr. Blackman reminded us our physical bodies need loving relationships and various interests and passions. We were not born to simply eat, sleep, and work.... we need play!

"Play is our primary nutrition. The food is secondary."

"Remember when play was more important than food? she asked. Remember when your Mom would call you in for dinner and you didn't want to stop what you were doing because it was so fun. You didn't care if you ate." Immersing yourself totally in something that brings you that much satisfaction - that is a kind of nourishment as important as food, more important than food. She asks patients to cultivate mental, emotional, intellectual Nourishment, to play once again. Its good and important self care. Find it through joy-filled activities, art, meditation, journal writing, reading on a new subject. Even while ill, especially because one is ill, play is a vital strategy for healing.

We talked about the importance of touch. And even if it is a pedicure, pampering touch can be quite an important connection/ interaction. A massage is good for some, but she cautioned many with fibro don't feel with massage. We talked about making appointments such as for a massage may make us get to that event so we can relax and feel cared for. If we plan something at home, it is easily and often brushed off. Find a way to regularly do things that recharge you. Hmmm, maybe weekly visits to the hair salon by the older ladies in my past was never about hair, but about community, touch, connection.

Applying an Integrative Approach in a CFS/FM Program, the Physician's Role

Because there are long term weaknesses, imbalances, acute and chronic stresses, food and other sensitivities, and more individual variables, an integrative program for people with CFS and FMS needs great flexibility. The structure is important, too. It takes commitment on the part of the provider and the patient to make it through the rough spots. Dr. Blackman talked about creating a team feeling, a family, giving you support as you attempt healing in her clinical program.

Dr. Blackman's 4th handout is The Role of the Physician [in integrative programs].  The clinic's mission, the reason it has come into being, is to provide an integrated approach to the treatment of fibromyalgia and chronic fatigue syndrome to ensure that the maximum chance of the patient's recovery is possible, and for that recovery to be sustainable without the need for further care.  I have been a witness to the clinic's formation and it is impressive in its design for and dedication to CFS and FMS (and M.E.) patients. I have been inspired by the successes of those who have completed work with the practitioners of this holistic program.

[NOTE: Late 2008 update: Both the The Gilbert Clinic which Dr. Blackman has left and her new clinic in the same location, The Center for Nutrition and Lifestyle Medicine, offer programs of shorter duration now, and not just specific to CFS/FM. Participation is not required to see the practitioners in thier private practices.For more information, call (301) 230-2530.]

A restoration of heath includes physical, mental, emotional Nourishment & Rebuilding; Regulating & Rebalancing the nervous & endocrine system; Clearing Obstacles ("Detox" and much more); and Awakening Your Healing Energy which involves identifying unrecognized and unresolved stressors.

Following a pathway that is is not linear , the is guiding people along a transformative path from
"An Extreme State of Exhaustion"   →   →  to  →   →  "A Sustainable Restoration of Health & Resiliency."
It requires an individualized treatment approach to help patients with Cleansing and Regulating, Building and Nourishing, and Maintenance and Transition to Health. It takes a multi-directional and synergistic approach to facilitate a mind-body through this transformation.

We spent some time talking about unrecognized stressors as being very important. If we could recognize them, we would do something about them. Sometimes it takes someone with special training and gifts to help people see the strain they are under from what is eluding them about themselves. Dr. Blackman has witnessed that even if people have done 10 years of therapy and thought they covered everything, they tend to have breakthroughs in just a few sessions with Anita Bains. Ms. Bains teaches techniques, mainstream and CAM, that grant access to where those undiscovered stressors are and begin relieving them. We all have stress that is  unrecognized. But when you are ill, you have less spare energy to spend on it or the drain from denying it. Ms. Bains also helps people find a therapist close to home, because healing often requires more and more talking. She gives you questions and strategies for interviewing them and choosing a good one. I noted that I go to pastoral counselor, stress management therapist, and nutritionist Sam Makoul in Herndon, VA.

The role of the physician for chronic illness patients interested in programs includes screening potential patients, confirming diagnoses and looking for missed ones, communicating with primary care physician as requested, optimizing medications -- weaning from drugs only as patients improve, nutritional teaching (food and supplements), optimizing sleep and exercise, and teaching life-long optimal health planning.

For Clearing Obstacles, the removal of processed foods, stimulants, alcohol, emotional stress, vigorous exercise, and disempowering & limiting thinking is encouraged and supported. There is ZERO prescribing of anything to force detoxing. Instead, the body is allowed to do it on its own. It can do it better given the chance! People with exhaustive, painful illness do not have the strength to handle detoxing fast or by force. Medications are adjusted as people improve and weaning off occurs as is medically appropriate and tolerated. See handout 4 for specific examples. 

The physician's role in Physical, Mental & Emotional Nourishment & Rebuilding is to support good nutrition, improve digestion & absorption, optimize medications so herbal therapy can improve function of the GI tract and clear old waste, encourage clients to eat slowly, calmly and at regular intervals, provide whole food nutritional supplements, optimize a patient's sleep. Sleep is a priority in this program. The physician also encourages Gentle Movement such as gentle yoga or stretching daily, gentle walking and avoiding exercise that "breaks a sweat" until told otherwise (late in Phase II). Exercise is greatly discouraged at the beginning since people are just too tired. There is no energy return for that energy spent. The physician also encourages emotional nourishment (remembering when play was more important than food), love and loving touch, and intellectual or mental nourishment.

Discussion Highlights

Dr. Blackman talked about the process of shifting people's  current medications to different, temporary ones, to allow the other part of the treatment to be more effective and to regulate people's sleep patterns. The ultimate goal is to withdraw from medications and other treatments only when full health has been restored, and she has seen that happen repeatedly in people. She had just completed some research looking at case files for the last few years (she is an also epidemiologist) and the news was good for people with CFS and FM.

Dr. Blackman has observed resistance not in people's willingness to take a drug or make a change to shift to a new pattern, but in their resisting finding out what might have led to abnormal patterns such as a turned around sleep pattern. If you are sleeping in the day and up at night, she encourages finding out what about night is appealing - is it being alone? the quiet?... ? Complex chronic illness patients need significant medical, medicinal, emotional, and other kinds of support to get all the body systems and the mind-body-spirit all in harmony again. And although she is the physician, she considers her self a participant in the team, not its leader. Everyone, including the patient, has valuable input and work to do in the healing process.

As always, the money and accessibility issue came up. Programs can be expensive. However, there is a large amount of individualized attention, services, materials and products included. Its a great value, especially compared to what else is out there and also expensive. People need to be functioning enough to travel to the clinic, to sit up to take the workshops, to have the ability to pay. We discussed how frustrating it is for patients who can't do the program who want to and for Dr. Blackman to know she can't help everyone who wants it whether it be because they are too bedridden or on limited income. She also noted that many of the people she has treated have come from far away, Chicago or Washington State, adding flights and hotels to their expense.


We thanked Dr. Blackman for her time and sharing her wisdom and experience. She stayed another 1/2 hour to answer questions afterward. The room had been very cold, so several people had to leave to go warm up or we might have even stayed longer! It was a great meeting.

[Note, as of 10/08, you do NOT have to do a program to see Dr. Blackman in her privated practice. Her new practice, The Center for Nutrition & Lifestyle Medicine offers different programs for health restoration (a beginning of really learning how to take care of yourself), nutrition, weight loss. These programs are 4 months or less, and not just specific to CFS/FM. For more information, call (301) 230-2530.]


Meeting Handouts from Dr. Janine Blackman, Text & PDF

 1.  
Integrative Medicine –  much more
than simply Complementary or Alternative Medicine
 		 PDF
 2.  
How I work as an Integrative Physician
 		  
 3.  
Ten Simple Nutrition Principles & Vitality Foods
 		  
 4.
Role of the Integrative Physician in
The Gilbert Clinic Program (Fibromyalgia & CFS)
  


Web Links for Janine Blackman, MD/PhD
Family Practice, Integrative Medicine, Epidemiology.


Who and where on the web is Dr. Blackman:
On this site / CFSupport: Articles/video by, quoting, or mentioning Dr. Blackman:

A Few Speaking Engagements
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Updated November 13, 2008
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