There is a wave of wellness sweeping across America today, as people lay claim to their own health and well-being. Gone are the days when patients humbly went to a doctor and trusted that the physician had all of the answers for questions they dare not ask.
People are sick and tired of being ill. Studies have shown that the average 65-year-old is prescribed more than 32 prescriptions every year. But patients aren't getting better. Despite the massive amounts of drugs being ingested, overall health just doesn't seem to be improving with traditional medicine alone.
Acupuncture, chiropractic, medical, naturopathic and osteopathic schools are now jumping on board with integrative medicine, as are 46 of the top teaching medical schools. We are seeing a movement of traditionally trained providers embracing integrative (functional) medical. It is acknowledged by many that integrative medicine will become mainstream within the next five years. Professional medical groups and the public will be looking for practitioners who are knowledgeable about integrative medicine.
Are you prepared? You'd better be, because there has never been a better time to incorporate integrative medicine into your professional practice.
Consumer-Driven Market
Health care is a consumer-driven market. However, you must know how to drive patients to your practice, educate them to become partners in their own care and have them take financial responsibility for their care in order to be successful. Those who have made the move to incorporate integrative medicine into their practices have seen tremendous positive impact, both on patients and on themselves.
There has never been a better time to be an integrative practitioner. Our society is wallowing in a sea of disease and our current health care system is desperately in need of fixing. As pharmaceuticals continue to be prescribed in never-seen-before amounts, disease and physical dysfunction continue to run rampant. People understand that traditional medicine is not answering all of their health care needs. The public is moving toward things that are more natural and are demanding more options from their health care providers.
The wellness revolution is here now. Those who wish to be on the cutting edge of the future of health care must learn to incorporate evidenced-based integrative medicine into their practices. Doing so requires one simple element: the right tools.
The difference between a general practitioner and a specialist comes down to two things: education and tools. Specialists receive more specific education in a particular branch of healing than do general practitioners. And they use tools that make a difference.
A tool must have five attributes to be appropriate to your practice. It must:
- Be inexpensive
- Be safe
- Be effective
- Have easily reproducible results (achieve similar results every time)
- Achieve results that are easy to explain to the patient
Many doctors already use a significant number of tools in their practice. Specialized blood tests, saliva tests, urine tests and an in-depth patient history can determine what ails a patient beyond the "normative" of the traditional blood analysis. With traditional tests, "normal" is based on a bell-shaped curve of answers from patients who thought they were feeling well. But "normal" is not always optimal.
In integrative medicine, treatment protocols are designed based upon a patient's disparity from "optimal" health, not just falling within what is considered the so-called "normal." Through the use of specialized testing, you can develop individualized treatment protocols based on each patient's deviation from optimal health.
Communication Is Vital
Communication is vital, from the in-take forms to test outcome analysis to patient follow-up. With highly developed communication skills, you can become a successful medical detective, discovering each patient's unique situation that is preventing them from realizing optimal health.
With input from multiple angles, patient questionnaires, blood, saliva and urine tests, you can investigate the underlying problem that in many cases has gone undetected by traditional practitioners and methods. With that information, you can learn to successfully implement a treatment plan that addresses the underlying condition on a patient-specific basis and from a functional standpoint.
To better educate yourself about your patients, you must develop a comprehensive in-take questionnaire that helps pinpoint specific information that can be of benefit to you in your diagnosis. For example:
- Have they lived on a farm? This would determine exposure to insecticides, fungicides, pesticides, fertilizers and other sources of poisons that live in fatty tissue and the liver.
- Do they dry clean their clothes and, if so, who picks up the clothes?
- What is their history of use of antibiotics or exposure to radiation?
- How many amalgam fillings do they have (mercury exposure)?
- Compared to five years ago, what is their energy level, their libido level, their endurance level? (Change in five years indicates something is wrong; something is amok.)
- What is their stress level?
- Do they exercise? How often?
- What are their eating habits?
All of these questions will help you form a history of use in functional medicine. Lifestyles make all the difference in the world.
Of equal importance is finding out their beliefs. Never argue with their beliefs. Understand their beliefs (whether religious or medical) and work within those viewpoints. Three words are key to forming a true and lasting partnership with your patients: "You indicated that--." When you use these words, you let them know you have listened to them and are taking into consideration what they said. This then lays the foundation to find a protocol to help them.
Use their history and their lab tests to determine where the abnormalities are, where the problems lie and what is less than optimal functional. In integrative medicine, we don't simply name a disease or dysfunction and then prescribe a standard treatment. We look at the underlying cause of those diseases and dysfunctions. Integrative medicine addresses causes, not symptoms.
For example, 20 years ago, "normal" cholesterol for an adult was 300. Today, we are told that "normal" is less than 200 and drug companies keep pushing drugs to bring the level even lower. If drug companies had their way, every man, woman and child in America would be on medication.
Traditional medical practitioners are trained primarily to prescribe pharmaceuticals for dysfunction. Integrative medicine professionals understand that the body naturally uses neutraceuticals to maintain optimum health in the body. The body has built-in sensors to gauge optimal physiological levels. Understanding these sensors allows you to prescribe according to a body's needs not according to symptoms.
In integrative medicine, we don't simply treat for heart disease, but we look for those elements that lend themselves to heart disease and high blood pressure: whatever inflames the lining of the artery allowing plaque to be produced. There are numerous tests that can indicate the cause of arterial clogging.
It's all about knowledge and education. The more knowledge you have, the more effectively you can educate your patients.
When you treat your patients, they must believe in your commitment, your conviction and your belief in the treatment you offer them. It is vital that you understand you needn't change a patient's mind about traditional medicine, but rather offer a complementary treatment and approach that will benefit them more than traditional medicine can.
Never tell a patient that what they are doing is incorrect or that the general practitioner is doing something inappropriate. Rather, explain that with 100 trillion cells in their bodies, it is vital to understand the relationship between those cells and the 868 trillion chemical reactions per second that are going on within their bodies. To obtain optimal function, these cells must be healthy on the inside and out, and you try to achieve this optimal health through integrative medicine and by as natural means as possible.
The more you educate your patients, the higher their rate of compliance will be. Any protocol is worthless without patient compliance. Your reputation is a function of compliance. The more you believe in the efficacy of what you are offering, the more likely your patients will respond, both mentally and physically.
Secrets of Successful Practitioners
As with any endeavor, there are some secrets to success. In integrative medicine, success depends on patient compliance, which, in turn, depends on your conviction, commitment and belief in the health care you offer to your patients. With each client, you must commit to thorough follow-up relative to five specific areas:
- Diet
- Exercise
- Hormonal equilibrium
- Nutritional repletion
- Detoxification
You must focus on all five areas. If you focus on one area, but not the others, then you can possibly diagnose a significant number of the patient problems you see on a daily basis. Optimization requires you to focus on all five areas at one time.
Follow-up labs and reassessment of your patient's condition pave the road back to health. This requires consistent and in-depth notation for each one of your patients.
Keep accurate notes: How often are you meeting with the patient? What changes have occurred in terms of patient symptoms or lab results at each visit? What are your plans in terms of ongoing care? After several follow-up visits, have you changed your plans? If so, why? If not, why not? Note every conversation, test result and decision. These notes will be a key to your success with each patient.
Maintain partnerships with your patients, allowing them to be part of the decision-making process. When they understand the tools you are using (lab tests) and understand the results of these tests, they can better understand and accept your recommendations for treatment.
Appreciating PGA: Performance Gap Analysis
Success comes from understanding your strengths and weaknesses, and then building on those strengths and overcoming those weaknesses. The Performance Gap Analysis (PGA) helps you to manage the inner game of practice management, gaining continuous improvement through analysis of core job functions: who you are, where you are and what you are doing in light of who, where and what you would like to be in practice and life. The inner game is vital as you rate yourself and illuminate the negatives in order to close the gaps en route to increased success.
Drs. James Padilla and Steven Ross, DC, DAAPM,
FASBE have a combined practice experience of more than 45 years. They have worked with thousands of patients around the world to help them find the root cause of their health challenges and restore them to health utilizing Integrative Medicine. They founded the Institute for Integrative Medicine in 2009, when it became apparent to them that many of their patients were suffering from illness and disease that could have been prevented with early detection. The institute will hold its second Comprehensive Integrative Medicine Conference, Advances in Integrative Medicine - 2011, Jan. 26-28, 2011, at the Waldolf Astoria, Bonnet Creek Hilton, on Disney property in Orlando, Fla. Additional information about the conference can be found at www.theifim.com.