Finding a holistic doctor isn’t easy with the state of American healthcare today, but with a little effort, you can track the good ones down.
Let’s start with a list of facts.
- Nearly 1 in 2 American adults live with at least one chronic illness.
- 75% of all health care dollars are spent on patients with one or more chronic conditions, many of which can be prevented, including diabetes, obesity, heart disease, lung disease, high blood pressure, and cancer.
- The United States is the only wealthy, industrialized nation that does not have a universal health care system.
- The United States spends about $8,000 per person on health care, 50% higher than the closest industrialized country.
- 17% of children and adolescents are obese—triple the rate from just one generation ago!
- 68% of adults over 20 are obese or overweight.
- Life expectancy at birth in the United States is an estimated 78.49 years, ranking 50th globally.
- There are about 100,000 deaths due to medical errors and drug reactions per year.
- The United States spent more than 17% of its GDP on health care, higher than any other developed nation.
- Hospital care, physician, and other clinical services make up about 51% of all health spending.
- Prescription drugs only make up about 10% of all health spending ($259B).
- Of the $2.2 trillion in personal health care expenditures, Medicare and Medicaid finance $525B and $400B respectively, or more than 40% of health care.
- Private health insurance finances around $850B of personal health care expenditures (38%).
- Consumers finance only about $300B out-of-pocket (less than 15%).
- Around 30% of all health care spending in the U.S. or more than $750 billion per year is wasted.
- Seniors account for 36% of total costs, at $1.01 trillion, but are only 13% of the U.S. population.
- The vast majority of patients (90 percent) want to self-manage their healthcare leveraging technology, such as accessing medical information, refilling prescriptions and booking appointments online.
- 76% of Fortune 50 companies are in the health industry or have a health division.
What does all this mean? Big medicine and big business controls America’s healthcare and they’re getting richer, while we’re getting sicker, fatter, and spending more in insurance premiums and tax dollars.
Big Money Ruling All Decisions
This list is only a tip of the iceberg. It doesn’t get into manipulated research, lack of evidence for effectiveness on many procedures like stents for cardiovascular disease or the over-use of mammograms, or any number of other questionable medical interventions. It doesn’t give insights into how doctors are controlled by insurance companies and hospitals.
Doctors have themselves become victims of corporate healthcare. They are faced with enormous constraints on how they can practice medicine, and strapped by perverse demands on their time ruled by reimbursement schemes that shorten patient visits, rush doctors and nurses, while the medical corporations rake in big profits.
Changes on the Horizon?
We can only hope for a new paradigm to supersede the current aberrant one, but it doesn’t look like that will happen any time soon. An alternative paradigm has already emerged, but it’s wonky and incomplete.
Licensed primary health care practitioners, including chiropractors, naturopaths, acupuncturists and doctors of oriental medicine are gaining in numbers. But these professions in America are in their infancy. Because of increasing interest in natural health care, college enrollment has mushroomed. The result is that the majority of practitioners have less than ten years of experience. That’s not enough to be of serious help to very sick people.
Patients are finding this out, and getting as good advice from the health food store or on the Internet, as from their holistic doctor. That’s not a good thing. It means that neither knows much about health, and very little about disease. It’s not easy to find the right doctor. You have to hold your holistic doctors to the same high standards as you would you MD or DO.
Holistic Doctors Largely Inexperienced
In fact, among the holistic professions, there are very little professional standards. There is little research, and PhDs and MDs do the majority of what research is taking place. DCs, NDs, DOMs/OMDs, and LAcs are not allowed teaching posts at medical schools, have no hospital privileges, no residency programs, and very few states require post-graduate internships.
I teach selected courses at NOVA Southeastern University and the University of Miami Miller School of Medicine, but they have avoided granting me even visiting professor status. I also wrote the policy and procedures for Scripps Memorial Hospital and Health South, but very few alternative practitioners work in hospitals and none have been granted admitting privileges. That means they learn theory, get a minimum of supervised clinical experience as students with patients that have minor ailments, and start practicing as soon as they graduate and pass state licensing exams. That’s not enough training to become a skilled practitioner.
What’s crucial to your health is the you actively prevent sickness, as much as possible, and if you do become a patient, find the right doctor and insist on maintaining control of the diagnostic and therapeutic process.
How To Find The Right Doctor
It is difficult to say exactly what makes the “right” doctor, but it’s definitely one who helps you get better. Dr. Vasant Lad, one of my mentors, once told me an old Ayurvedic medicine aphorism: “If the doctor doesn’t find the right medicine, the patient will find the right doctor.”
The second best doc¬tor is one who doesn’t make you worse, and refers you to the right doctor. The third best is one who makes you feel better by managing your symptoms, but is not able to actually resolve your condition, and consults with a good doctor to solve your health concerns.
If you are reasonably healthy and are going for regular physical exams, need an acupuncturist to treat a knee strain, or a chiropractor to work on a stiff neck, you need only to find the doctor who provides you with the best service for the most reasonable fee. That’s largely a matter of shopping the phone book or your insurance company’s physician directory, getting a recommendation from your neighbor, or calling a referral service. It’s the wrong approach, however, when looking for a doctor who specializes in anti-aging and longevity medicine, or who knows how to treat chronic disease.
Prolonging your health, treating chronic dis¬eases, and addressing the conditions that arise due to aging, are serious matters. For these, you need the best doctor available—one who is knowledgeable about your specific condition and individual needs, and has the time and willingness to work with you. You need a person you can trust and develop a professional rapport with over several years.
A Few Tips to Help In Your Search
Though there is no guarantee that you will chose the right doctor on the first try, here are a few rules you can apply when looking for the right doctor.
Interview Carefully: At your first visit or interview, consider asking a few questions. Ask if the doctor has had a similar condition. What made her choose this area to specialize in? Doctors see many patients day after day and an astute physician knows who gets better and what medications and therapies tend to work better than others. Ask what her success rate is. Is she comfortable working as part of a team with alternative medicine practitioners? Remember, you want to know what her clinical success rate is, and not the statistics from research studies that were not per¬formed on you.
Show Respect: Keep in mind that the healing profession is very stressful. Do not be overly demanding or confrontational with your doctor. If she turns out to be the right doctor, you want her to think of you as an intelligent, informed, and concerned person—a proactive patient who will cooperate, rather than a difficult and stubborn patient who asks endless questions that waste time. Be on time for your visits. Be patient and under¬standing if your doctor is late. If she is consistently late, inform her that your time is as valuable as hers and you expect to be treated with consideration.
Don’t Assume Your Doctor Knows Everything: Many people make the mistake, based upon the medical myth that doctors are akin to deity, of thinking that their doctor knows everything. After all, a doctor is just another person like you. If you get nervous with the doc¬tor and later remember questions you wanted to ask, prepare a short list before you go in for your next visit. Don’t bring in a page of questions. Don’t make it a habit of calling after your visit to ask questions that would have been much better answered while you were there. Both of these annoy and frustrate doctors.
Listen Carefully: When you ask questions, listen to your doctor’s answers carefully. Ask him to write instructions down for you if you have a hard time remembering details. In my practice, being used to the memory loss and concentration difficulties many patients have with chronic illness and during aging, I explain the reasons for my treatments, summarize them, and write them down for the patient. In complex cases, I type out a summary and email it to the patient.
Reveal Information: It is important to have a relationship with your doctor that is open and frank, with respect on your end and empathy on hers. Do not withhold information about other treatments, self-prescribed medications, or other therapies you are doing. If your medical doctor is opposed to alternative therapies, inquire on what grounds she bases this opinion. If her answer does not satisfy you, look for another doctor.
The same holds true for alternative medicine practitioners. If he is against allopathic medicine, you will find it difficult to communicate effectively on issues that involve medical intervention and drug therapy, and if you need a referral or are faced with a medical emergency, you will be unsupported.
If stress plays a key role in your illness, make sure you reveal this to your doctor, but don’t expect her to listen to your personal problems for the whole of your visit. Save that for your therapist or psychologist.
Keep Your Doctor Informed: Tell her what you’re doing to manage your condition and support your health, but don’t overwhelm her with every detail about every acupuncture session or what the clerk in the health food store told you last week. It’s a good idea to write out all the supplements you are taking so there is a copy in your file; update it periodically.
Likewise, keep your alternative practitioner advised on what drugs you are taking, but don’t expect him to answer questions on prescription medications that your medical doctor has ordered. Ask the nurse, the prescribing medical doctor, or the dispensing pharmacist questions concerning pharmaceutical drugs. Don’t expect your medical doctor to know everything about vitamins. Save those questions for your naturopath or nutritionist.
It’s acceptable to provide your doctor with literature and information that you are reading. Don’t overwhelm him with books, however, and especially do not confront him with marketing pieces from nutritional companies advertising the latest cure for whatever ails you. Select sources that are related to your condition and make copies of parts of articles or highlight a paragraph or two that you think he might find interesting or that you would like him to comment on. Remember, you are there to access the doctor’s expertise and not to confuse the issues of your case with extraneous information.
The Right Doctor’s Good Judgment
Good clinical judgment reflects wisdom, not just information. You get information from the Internet or marketing materials about a nutritional supplement; you don’t get clinical experience or medical wisdom. What you expect from the right doctor is the distillation of collected clinical anecdotes of a lifetime practicing medicine. It reflects your doctor’s skillfulness in teasing out biological secrets from the body.
Good clinical judgment tends to improve health outcomes. The right doctor’s patients get diagnosed faster, have improved recovery from therapies and surgery, respond better to drugs and supplements, are healthier, happier, and live longer. Sound too good to be true? Good doctors are out there, and they’re waiting for you to find them.
You need a doctor when your own capacity to cope with illness is exceeded by the virulence of the disease, and when you’re confused about a chronic condition. Usually a well-trained, ethical and experienced doctor will do. But, you should find the right doctor for the sake of her clinical judgment, as it relates to you, and develop a doctor-patient relationship over a long period of time—often for the rest of your life, or your doctor’s.
The bottom line is that a good doctor instills confidence on the first visit that gets better with time. Over time, confidence fosters trust. They’re not infallible, but getting it mostly right most of the time is pretty darn good when it comes to the complicated process of assessing and treating chronic disease.
On Self-Care and Second Opinions
There is massive competition among different therapeutic methods, all contending for the same health care dollar. Unless you have a referral from a trusted source, approach your medical care as you would any other business arrangement, adequately prepared and with thoughtfulness.
If you want to work preventively, consider the option of “guided self-care” where you work with a natural medicine-oriented physician to order lab tests and monitor your progress. I call this the “doctor-patient-partnership.” About fifteen percent of my practice is made up of proactive healthy people who do annual testing to monitor their health status, and check in with me from time to time if they have a question on health. These people seek optimal personal wellness and longevity, but need a good partner.
At some point, you may need an objective second, or third or fourth, opinion, which can be invaluable in a long-term program to manage chronic disease. Do not hesitate to seek another opinion if you or your doctor are feeling con¬fused or you do not think you are making sufficient progress.
Dr. Bernard Jensen, another of my mentors, had a sign above his office door, which I copied and put above mine. It says: “You’re looking for a good doctor. I’m looking for a good patient.”
The right doctor can be an invaluable asset on your personal road to wellness.