Community Spotlight: A Conversation with Dr. Michael E. Doyle on Integrative Medicine
Michael E. Doyle, MD is a board certified medical doctor, with degrees from Cornell and Georgetown, who is committed to offering his patients the safest and most effective care possible. Dr. Doyle believes that when conventional medical approaches are unsafe or ineffective, it is his job to find better “alternative” approaches to restoring and maintaining health. His unique expertise in nutrition and natural hormone therapies has attracted patients throughout the New York metro area and from across the country.
You started out as a conventional MD. What led you to transition your practice to integrative and natural medicine?
My transition from strictly conventional medicine to an integrative approach was really a matter of me getting back to my core beliefs. My mother had a great influence on me by passing along her interest in natural nutrition. My extended family has contained many doctors including my grandfather, two uncles and two cousins. So I grew up with a keen interest in health and medicine, but I was always a bit of a skeptic. As a teenager, I experimented with various natural remedies and often found fault with the conventional medicine that I saw being practiced. Even my college applications referred to alternative health approaches, and my essay was written about the dangers of some medical treatments. Eventually, my cousin the surgeon had a long talk with me and helped convince me that the best way to achieve my goals was by going to medical school.
I learned a great deal in medical school and residency, but I was never fully satisfied with the contemporary approach to the practice of medicine. I felt that I was often mindlessly chasing numbers and frequently using treatments that were neither safe nor very effective. Eventually, I quit my job as medical director and began to study alternative medicine in earnest. I soon discovered doctors who were practicing a type of medicine that actually made sense to me - it was safe and effective and actually helped patients feel better, too.
Yet there are some aspects of your conventional medical training that you still strongly believe in. What are they?
I have great respect for my medical training. It has given me a great foundation for my medical career. The basic medical approach that has been taught for over 100 years is very sound. The problem is that we MDs have strayed from our core teachings. We are all taught that a diagnosis is usually made primarily by listening to and examining the patient. Unfortunately, after we leave the classroom we doctors are taught that test results are what really matter. This is a tragic distortion of a medical model that has worked for generations. Worse yet, while these tests are supposed to represent absolute science, many of them are based on unproven theories and supported by little evidence.
How would you describe your process for treating a patient?
My approach with a new patient starts with listening to my patients talk about their specific symptoms and concerns as well as their overall health. I then examine them, including both a general evaluation and a specific search for signs of the likely cause(s) of their problems. The next step is to use the best and most appropriate tests when needed. I want to focus on tests that are actually going to help me take better care of my patients, not just provide numbers. This includes some traditional tests as well as some “alternative" or non-traditional medical testing. I combine all of this information to identify the underlying cause of my patient’s specific symptoms or problems. I emphasize common and treatable problems such as thyroid or adrenal or other hormonal dysfunction, as well as vitamin and mineral deficiencies. My treatment is geared toward helping my patients restore a healthy balance of nutrients and hormones while maintaining a healthy lifestyle. This most often involves treating deficiencies with bio-identical hormones or natural nutrients. I then follow the patient’s progress, adjusting treatment as needed to restore health.
Tell us about some of the most common issues that patients are coming to you for:
I see many patients who are looking for effective, natural treatment for thyroid problems - most commonly hypothyroidism or low thyroid. What I offer is a thorough evaluation of their thyroid status including medical history, physical examination, and comprehensive thyroid testing that goes beyond the usual TSH test. If hypothyroidism is identified, it is also crucial to look for closely related problems such as adrenal insufficiency or low iron. Such problems need to be treated in order to ensure that thyroid treatment will be both safe and effective. Most cases of hypothyroidism are best treated with gradually increasing doses of natural thyroid extract. These thyroid extracts are FDA approved and available through most pharmacies. Their advantage is that they are the only thyroid treatments available that contain all four naturally occurring thyroid hormones.
Depression is a problem for many of my patients. Rather than quickly prescribing an antidepressant for mild depression, my approach starts with a comprehensive medical evaluation looking for lifestyle, hormonal and nutritional factors that may be contributing to the mood disorder. Treatment may start with lifestyle changes including recommendations for exercise and improved sleep. Any identified nutritional or hormonal deficits such as low thyroid, low estrogen, or low testosterone are treated. Safe herbal and nutritional treatments are often used, also. Counseling focused on cognitive-behavioral therapy is recommended in many cases. I use prescription antidepressants sparingly because there is limited scientific evidence for their effectiveness and they have significant side effects. Of course, I do refer patients for psychiatric evaluation and treatment in the severe or resistant cases.
A classic example of a digestive disorder that I treat is gastro-esophageal reflux disease (GERD) - a common cause of heartburn. The typical conventional approach for GERD is to give proton pump inhibitors (PPI’s) for extended periods. These powerful medications work by stopping the stomach from doing what it's meant to do - use acid to help digest food. Consequently, digestion is impaired. Serious side effects from this lack of stomach acid include decreased mineral absorption and increased fracture risk. Also, patients on PPI’s have a greater risk of pneumonia, and higher incidence of dangerous intestinal infections (such as C. Difficile infection). My approach starts with a comprehensive health evaluation to identify underlying causes and related problems. Treatment focuses on trying to relieve symptoms by reversing the underlying cause or by using safe treatments that do not interfere with normal digestion. In most cases, patients will find relief with fewer side effects.
What is the most important thing that readers should know about health care?
Patients should understand that medicine is supposed to be about improving your health, not just treating symptoms and improving numbers. The best medicine depends on doctors listening, examining, testing appropriately and maybe most importantly – thinking independently.
What resources have been most influential to you in staying current on integrative medical developments?
My approach to staying up-to-date in integrative medicine involves a wide variety of resources. These include conventional and alternative medical journals and online resources as well as attending medical conferences. However, my most important strategy for continuing to learn about the many facets of integrative medicine has been to seek out and learn from the best doctors of the past and present.
In addition to studying the writings of medical pioneers like Sir William Osler, Eugene Hertoghe and Broda Barnes, I try to find the best integrative MD’s to learn from. This spring I was able to meet with and learn from, international hormone expert Dr. Thierry Hertoghe at the Bio-identical Hormone Symposium in San Francisco. His sister, Therese, has been one of the greatest influences on my medical career. She is a fourth-generation hormone specialist who has taught me many of the finer points of natural hormone therapy. She continues to be a valued advisor, answering questions that no one else could answer with such wisdom and experience.
Another great asset is Dr. Jacob Teitelbaum, arguably the world's number one expert on the treatment of Chronic Fatigue Syndrome and Fibromyalgia. Ten years ago, Dr. T. introduced me to many of the core tenets of alternative medicine. He continues to be a great resource through his articles and through personal communications, consistently offering me exceptional advice.
Michael Doyle, MD practices integrative medicine in Stamford. To schedule an appointment, call 203.324.4747. For more information visit GoToDrDoyle.com.