Redefining Medical Care
How the Changing Health Care Paradigm Helps Patients
It’s a new year with a new president and the potential for a new health care system for the nation. These days conventional mainstream medicine is mainly driven by what health care insurance companies will cover or not in terms of dollars and cents; but the changing system may be good news for patients.
While conventionally trained doctors still may resist the healing potential of other modalities that don’t conform to Western medicine norms in the same way as medication and surgery, a slowly increasing number of physicians are opening up to the fact that more patients are seeking and are increasingly knowledgeable about other solutions. And this integrative paradigm is a win-win for patients and physicians.
“Much of the public wants a more integrative approach, such as talking about diet and nutrition, should I take this supplement, and how I canI reduce my reliance on drugs and medication?,” says Kenneth Hoffman, medical director at Brookfield’s Sophia Natural Health Center, who has studied Asian therapies and Western medicine. “Many more conventional doctors are now able to counsel patients on integrative therapies.”
Although medication and surgery certainly have their place and may be necessary with various medical ailments, many patients want to rely less on medications if and where possible, Hoffman adds.
Some patients may also tend to seek out alternatives in frustration because Western medicine either failed them, or at least did not treat their illnesses but instead just masked the symptoms for a period of time.
“I don’t agree with this [Western medical] system—basically it’s a very dysfunctional system,” says Dr. Tatiana Fleischman. She just opened a clinic in Stamford, but received her initial medical training in Russia, her homeland. “Many times, doctors are spending just minutes with patients during appointments. The advances of science and especially pharmacology have shifted many doctor-patient interactions, to drive-through medicine where the doctors only have enough time to quickly evaluate symptoms and prescribe a pill that is supposed to quickly make them go away. This has become dissatisfying for patients and doctors. Integrative medicine offers an alternative. Being a doctor in the integrative paradigm means to me: being a healer, a patient advocate and a guide to better health and true wellness.”
Fleischman does not consider herself anti-Western medicine, but instead believes some problems can be healed more naturally and without medication. In Russia, she worked as a physician in an area called Novokuznetsk, near mountains nicknamed the “Siberian Switzerland” on the border of Mongolia.
She noticed that the indigenous peoples living there, called Shors and Altay, were more attuned to the healing powers of the natural environment, such as a healthy diet without processed foods. “Their lifestyles and diets were healthier than those of the residents of polluted urban centers nearby,” Fleischman recalls. “I think that experience kept me open-minded toward different healing practices despite me formally receiving conventional medical education and training.”
Time & Money Implications
In health care, as in any industry, markers of efficiency and productivity are frequently factored into decision-making at the macro level. Health care spending is expected to reach $4.3 trillion in 2017, according to Centers for Medicare and Medicaid Services reports.
Non-conventional physicians, such as Fleischman, agree the Western medical system is overbooked with less time for patients during appointments. Sometimes, they spend more time looking at a computer or reviewing a patient’s medical history, instead of really listening to the patient’s needs or ills that day. It’s very important in a patient’s healing process to give them attention and empathy, Fleischman explains.
But health insurance drives much of what patients can and can’t do when it comes to solutions. And that presents a challenge for people who would prefer an integrative approach because insurance companies haven’t yet caught up with the value of providing integrative care for their clients. Hoffman illustrates the point with the case of a patient who was pre-diabetic but his insurance company wouldn’t cover nutritional counseling to help him from becoming diabetic. Only when he was diabetic, would insurance cover nutritional counseling. “It’s backward,” Hoffman says.
Dr. Tamara Sachs of New Milford uses functional medicine in her practice. Functional medicine is a growing sub-specialty for conventional physicians interested in taking a different approach. Like naturopathy, functional medicine prevents and treats chronic illness by seeking to address the underlying root causes rather than the symptoms. She explains that U.S. health insurance companies don’t include the word “inflammation” as a code that would be covered in the International Classification of Diseases (ICD). The classification is the standard diagnostic tool that doctors use to state what is wrong with a patient and how insurance companies should pay for it. “They still don’t have a code for systemic inflammation, which is the underlying cause of every disease we have. And I can’t be reimbursed for it. …They are completely out of touch with what we do. Functional medicine cannot [and should not] become just the medicine of the rich.”
Dr. Vicki Blumberg, an internist and primary care doctor in Ridgefield, spends up to an hour with each patient during an office visit. She now treats several patients with autoimmune and chronic infectious diseases, which she says are likely an overreaction of the immune system. These patients often come to her after undergoing multiple courses of antibiotics that did not work.
“One patient with Lyme disease was almost intermittently bedridden for a year and a half,” Blumberg recalls. She started treating him with low-dose immunotherapy, or LDI, first discovered in England in the 1960s and then brought to the U.S. in the 1990s. Her patient was nearly cured. “He’s nearly symptom-free aside from needing a dose or two at a higher amount,” she says. “He isn’t seeking Western medicine for his chronic Lyme anymore.”
It can take time to feel better using a non-conventional approach. Blumberg suggests to her patients to give it a year to see if it’s really working, which she finds is necessary, especially for eczema and allergies.
Patients who want more than medication and surgery treatment plans are also visiting chiropractors with advanced training, such as Associates in Family Chiropractic and Natural Health Care’s Dr. Mark Joachim in Norwalk. “They are not going to the MD as their first source for treatment because they know it would eventually mean medication,” Joachim says. “They want to use medication as a last resort.”
Some patients are in a gray area in terms of conventional measures, where they are not feeling well because of nutrition or because of back pain. They haven’t responded to medication or physical therapy, yet they are not bad enough for surgery. “That’s where we can come in and can restore normal joint function and teach them stretches,” Joachim says.
“Let’s take headaches,” he gives as an example. “Some people will live on Advil every day because it gets rid of the head pain. But what is causing the head pain? You can have misalignment in the neck, which is irritating the nerve that wraps around the skull; that also causes the muscles of the neck and shoulders to tense up. You have joints in your spine and if those joints aren’t lining up properly and moving the way they should, over time it can irritate the nerves and cause pain. Or people could get headaches from not eating properly.”
Collaborative Medical Care
But medical doctors’ gap in knowledge about alternative therapies still creates a hole and challenge for patients. Joachim says many conventional doctors still don’t know what integrative physicians do and that can create a mutual antagonism. An ideal situation would be a partnership where primary care doctors and other conventionally trained physicians would refer patients who suffer from various chronic conditions—such as hypertension, gastrointestinal issues and tick-borne illnesses—to non-traditional physicians to find a solution.
“In an ideal world, we would work together in a symbiotic relationship as equals,” Hoffman muses. “A patient would not need a referral, and a patient can see me as a first line of any health problem. If a patient needs medication or needs to have further evaluation from a specialist—such as to treat cancer—we can happily refer them to our conventional colleagues to consider a disease consult. I’d work together with them and we’d have an open dialogue to evaluate and treat the patient.”
Joachim adds that prevention is key as patients might think they are healthy when they don’t have symptoms. “What we have now is sickness care,” he says. “We encourage people to be more proactive to take care of themselves, and hopefully not end up with a disease or chronic issue.”
Priding herself on being a teacher, Sachs teaches patients how their own body works and how to navigate the sometimes “crazy” medical system. “It’s my job to find that line where this is not healable by just herbs and resting, and that’s when you might need medication or even need the hospital,” she adds.
Over time, Sachs says, the system will change because patients will demand the more natural and integrative approach to medicine. “It will take a patient revolt. It will be driven by patients who will consistently demand more information about supplements, and more information about nutrition, and about what other options they have. That’s what’s happening now. I’d like to see functional medicine be called good medicine. That’s what it is.”
Angela Pascopella is a 26-year journalism veteran and frequent contributor to Natural Awakenings. She resides in Fairfield County and is the editor of a national, monthly trade publication.
Choosing a Physician: Conventional or Integrative
To find the best conventional doctors, some integrative physicians suggest patients should call the local hospital. Talk to the head nurse in the intensive care unit or emergency room. “They are a great resource for the best physicians—how they work under stress and their own medical styles,” Blumberg says.
Fleischman says a doctor should be caring, knowledgeable, easy to talk to and affordable. “An integrative doctor is essentially a primary care physician but with an expanded bag of tools and options whose role is to get to know the patient very well and guide him or her to wellness,” she explains.
Most allopathic physicians don’t know about LDI, according to Blumberg, but social media and the internet have made it easier for physicians of all kinds to connect and educate each other, raising the bar for all. For example, pioneer physicians Drs. W.A. Shrader and Ty R. Vincent are making themselves more available via social media—including on Facebook—to patients and other physicians. Doctors are using YouTube videos to help patients who don’t have the time or access to get to a doctor’s office miles away or in another state. “They want to teach each other,” says Blumberg. “We want to share experiences.”
Sachs recommends people look at testimonials online and consider the reputation of the doctor’s medical school. “Honestly, there are some very talented healers out there. People should assemble a team of people to help them. A red flag is a practitioner who is exclusionary… a good healer is always respectful and can communicate with you.”Edit ModuleShow Tags