The Business of Medicine: Doctors, Diet, and Common Sense
One of the things I personally struggle with, with regard to the Paleo Movement, is how to most effectively spread this message of health and empower people to draw their own conclusions. Sometimes I think the Paleo Movement as a whole vilifies physicians, whereas physicians need to be our allies. On the flip side, modern society puts physicians in the position of omniscient demigods, which clearly they are not. Physicians are also fallible, and some are better than others… Just like any other career choice. Not every professional is created equally or motivated by the same ethical standard. You have to work hard to find the best physician.
Recently, I had the pleasure of speaking with a number of medical practitioners, and those conversations echoed past conversations I’ve had with many types of doctors. It brought my train of thought full circle and reminded me of my place in the grand scheme, giving me purpose… and purpose is an important motivator.
I have a very unique perspective on where Western Medicine meets traditional (Eastern/Holistic, etc.) medicine. I sometimes forget that when I put a thought out in cyberspace people don’t know the context from which it came. In this case, I think it’s important to note that my background is relevant. Originally, I went to college majoring in Biology, pre-med, with a minor emphasis on psychology.
From the time I was a child, all I ever wanted to do was practice medicine and save lives. During high school, I was lucky enough to have a mentor who was not just a practicing physician, but a leading researcher. His advice to me was that before I went to medical school, I needed to understand the business of medicine.
He taught me to manage every aspect of his practice. During college, I moved to working for the University Medical Center under the direction of 3 very accomplished vascular surgeons. One thing I’ve been excellent at in my life is seeking out, meeting and developing lasting relationships with people that were not only successful in their fields but willing to be friends and mentors.
So, how does a person with all of the right motivation, dedication and support NOT become a doctor? Well, all that exposure to the “industry” of medicine taught me that practitioners were limited in the scope that they could actually do their jobs. Primarily by insurance companies who ultimately are the deciding body on patient care. This made me very disenchanted with medicine and ultimately was the deciding factor for making a major life change right at the end of my collegiate career.
Despite changing career paths, my passion for nutrition, psychology, biology, anthropology and the entire human condition did not wane. For over 12 years I pursued another path, yet this desire to change lives never left me. Throughout this time I developed amazing relationships with other physicians and set out to gauge how others felt about insurance, pharmaceutics and other factors that were limiting to them professionally.
When I moved toward a Paleo Lifestyle, not only did it kindle that flame of passion for these topics, but also introduced me to a more holistic and evolutionary solution for many of these modern problems. These discussions continued. The cogs in my brain working and trying to figure out how the pieces could fit together for me, personally, in a realistic way.
There are days when it seems like the solutions to so many of mankind’s problems are within grasp, and yet are still so far away. Being surrounded by other people searching wholeheartedly for ways to help re-educate society, solve problems, create opportunity and collaborate is not only gratifying but reaffirms so much of what I’ve been contemplating.
These ongoing discussions reminded me that one of the problems echoed by other practitioners as we’ve discussed the topics of nutrition, autoimmune disease, the obesity epidemic, chronic prescribing, and a myriad of other ever-present challenges we face include a lack of education, motivation and time.
Now, this sounds terrible, I realize. You may say “Hey, my doctor had lots of schools, how can you call them uneducated!” Let me start by saying that I have a heartfelt respect for medical practitioners and this is not to challenge individuals— it is to point out three things:
1. The system is broken
2. Physicians need other professionals as nutritional advocates; wellness coaches, fitness & nutrition professionals, holistic and Ancestral Health partners.
3. As patients of medical professionals, we need to understand their limitations and not expect them to advise us on all things, that means taking responsibility for our own research, our own information, and ultimately our own choices!
Here’s How The Basic Business of Medicine System Works:
First: You choose a provider based not on their education, skill set, belief system or any other tangible quality (usually), but instead by which provider in your area is covered by your insurance program.
Second: You schedule a physical or appointment with your new physician, many times having to wait for weeks or months for availability, or else scheduling an urgent appointment when symptoms are at their worst.
Third: In order for your doctor to make a sufficient amount of money to pay for the plethora of student loans he or she took out for school, etc. and to cover their cost of liability insurance for treating you and their other patients, yet for them to accept the discounted prices your insurance will pay them (and even less than Medicare/Medicaid pays them) they schedule 30-40 patients per 8 hour day.
Let’s just assume that they see patients 7 hours with a 1-hour lunch and schedule 30 patients. At most, you have an opportunity to spend 14 minutes with your practitioner. That’s assuming that they have no medical emergencies that take longer than the allotted amount of time. That’s the BEST case. That means that in 14 minutes you and your doctor have to take a complete medical history and discuss every aspect of your physical, mental & emotional health (because we can all agree that they are inter-related). Yet, inevitably in that little time, something gets missed.
So, an appointment should go a little something like this instead:
1. In that appointment, you need to be prepared with every symptom, every question, and every concern to maximize your 14 minutes.
2. Your physician needs to decide how to treat what ails you by prioritizing – symptoms get treated first, providing temporary relief over long term management, and often leaving underlying problems undiscovered, or unresolved.
3. Your physician also is inundated with information not from holistic resources but from pharmaceutical research, leading to more opportunity for prescriptions that satisfy your desire for symptom relief, their limited time, the resources all parties involved have. Unfortunately, this is putting a band-aid on a gaping wound, versus a long-term plan of care. Not to mention, even prescriptions are dictated by what’s covered by your insurer, not what’s most effective for you.
4. This is not to fault the physician, your physician may fully intend to follow up with you, spending more time, through additional visits, more frequently, and following you to provide a better course of care. However, let’s face it, taking off work weekly to treat an ongoing problem is much harder than taking off work when symptoms are at their worst and you are in need of an immediate solution (pain management, antibiotic treatment, etc.)
How many of you can relate to this series of events? I’m quite certain we’ve all been here.
In addition, most medical professionals have been education overloaded with very specific information pertaining to their specialty or subspecialties, while leaving many aspects of the human system merely skimmed upon. There is, after all, only so much time to cover as vast of a subject as medicine before their educational program ends. Any physician will tell you that nutrition is not given a place of priority in the education system.
In a perfect world, you would choose your primary care physician or specialist based on their experience, a face-to-face interview, and a discussion regarding their methodology and beliefs. Sadly, that’s not normally the case.
Next, your physician would have time to see you and be fairly compensated to do so, which provides mutual benefit to both the patient and the practitioner (for whom this IS a business and they’ve worked very hard to earn their right to practice).
Finally, your physician would be able to develop a care plan that created a long-term course of action treating both the symptoms in a temporary way, and the root cause effectively over a longer term. They would educate you and be a part of your professional team.
Here is the thing, we’ve already seen through that, in reality, your physician is limited in their scope because it’s just simply not an ideal world, at least, not yet. Today during my discussion, several physicians commented that people needed to understand that your doctor is not the bottom line or final opinion. They repeatedly mentioned that patients really did need to apply their own research and thought into choosing a care plan and discussing options with their doctors.
However, this is absolutely contradictory to the information I received when I asked patients how their doctors felt about their dietary changes. Patients told me over and over again, that their doctors were unsupportive, were angry even that they brought their own research to the appointment to discuss, or that they were agitated when they received questions from patients, etc.
There is a very real breakdown of communication between the medical community and their patients. In my personal opinion, it has to do with the lack of time and enormous caseload of doctors as much as it has to do with the underlying belief by the patient that their doctor always knows best and thereby refuses to question the person whom they perceive has authority.
Time and time again when I ask people if they mentioned a particular secondary symptom or condition to their physician they say no. This isn’t being fair to you, your body or your doctor. You cannot withhold vital information and expect to get help. This is where common sense comes in handy.
My own doctor once said to me, “Leanna, no one knows your body better than you, you will always know when something isn’t right and you need to always act on that.” For me, that’s a sign of an excellent doctor and a team member I’m glad to have.
This is where I believe health coaches, holistic practitioners and nutrition therapists need to provide the missing link. By working WITH instead of against the physician, we can provide comprehensive care that truly impacts the lives of the patient or consumer in a very profound way. We can do this by creating a team environment or template.
I have a very unique relationship with a practitioner that refers clients to me, it’s the most effective way to work as a team. The patient is under supervised medical care, but through coaching pursues a healthier lifestyle, is educated on alternatives and simple changes in either nutrition, movement or overall lifestyle that can effectively improve their health. The patient receives more time, more consideration and more respect.
The team approach is a win-win scenario.
I only hope that more consumers will demand it, and become advocates for themselves. Also, more Ancestral Health, Private practice physicians, Holistic practitioners, and Health & Wellness professionals will reach across the tables to create more collaborative efforts and innovate for change.
So What Do You Take Away From This?
1. QUESTION EVERYTHING
2. INTERVIEW doctors and choose the best one for YOU
3. Get many opinions
4. RESEARCH yourself!
5. CREATE YOUR TEAM:
I talk a lot about your professional team, I believe everyone should have a team. Your team is comprised of all the individuals in specialized fields that you need to provide you education, counsel & mentorship. This includes but is not limited to: your financial professional, realtor, legal counsel, mortgage lender, physician(s)/dentist(s) and anyone else whose advice, education and expertise you rely on.
Your team includes people you have developed relationships and mutual respect with. Each of these people should be chosen with care and be lifelong trusted advisors who are loyal to you and to whom you are loyal. This team provides you with specialized information and opinion in their area of expertise for you to consider, weigh and draw your own conclusions from.
Ultimately it’s your body, your health, your family… your responsibility.
If you are having trouble locating a physician or practitioner in your area, I encourage you to look through databases such as Paleo Physicians Network and the Institute of Functional Medicine. Also, we found our new dentist through the International Academy of Oral Medicine and Toxicology (IAOMT).
I’d love to hear from you! I am presently speaking with people about both their positive and negative experiences with their family physicians and specialists. Specifically, how do you approach discussing and understanding the paleo approach as a treatment for chronic conditions, or if and why you’ve avoided the discussion of nutrition as a form of treatment?
If you’d like to share your story with me, please email me at firstname.lastname@example.org