Saturday, April 16, 2005

Team Spirit

A recent article in The New England Journal of Medicine talked about the patient as a "great case" but not as a person. What a sad state of affairs when the thrill of a doctor's workday is to have something exciting to talk about in the form of a unique or interesting case rather than the satisfaction of helping people be happier and healthier. This got me thinking about the limited choices I have as a patient in attempting to maximize my own health. If I am not feeling well, I can call my general practitioner, who is part of a 15-doctor "factory"... wait an hour after the scheduled time of the appointment... see the doctor for 10 minutes... and then be handed the "drug du jour" that will ease my symptoms in the hopes that symptom abatement will substitute for illness diagnosis. For this, I cough up my $15 co-payment. Or, I can call my naturopathic physician (ND), who will charge me retail (insurance may not cover naturopathic care) to give me his more natural solution to my problem. Now here's the really hard part: If I mention one doctor to the other and suggest that they work together as a team, I receive big sighs about the problems with "the other guy." Would a schoolteacher and a tutor give me a hard time about working together? How about an architect and a builder? Yet, trying to get my two terrific health-care providers to work as a team leaves me with worse gastritis than when I started.
Fortunately, the times are changing -- albeit slowly. In recent years, more and more Americans have started incorporating traditional (a.k.a. naturopathic and alternative) approaches into their regular medical care, and there is an increasing amount of scientific research being done on such traditional remedies and supplements. Additionally, a new class of medical practices has been opened by some mainstream doctors who declare themselves "integrated practitioners." This is good news indeed. There's just one problem. The integrated practitioners have not necessarily received the appropriate education in certain of the traditional or naturopathic disciplines. Do I really want to receive nutritional supplements or acupuncture from a medical doctor (MD) who has attended only a weekend seminar or boned up on natural therapies via the Internet? Or would I rather receive such treatments from a licensed ND or acupuncturist who has devoted years to the study and practice of the discipline? Integrated medicine can be a great thing, capturing the best of both worlds. However, the key to success is that each practitioner does what he/she does best.
How have we allowed ourselves to come to this place in medicine today? Among other things, the system of checks and balances seems to have broken down. Drug companies seduce MDs with lavish perks and a bounty of free samples. In return, even though they might not be the most effective or economical choices, physicians prescribe these patented drugs to patients. As government grants dwindle, cash-starved academic institutions increasingly turn to pharmaceutical giants for the bulk of their research funding, replacing the objectivity of old with new pressure on scientists to produce study results favorable to a company's products. Such all-too-cozy relationships have been allowed -- even encouraged -- to flourish among MDs, research institutions, drug companies and the FDA. Last year began with an FDA scientist presenting information to Congress about the cover-up of research linking antidepressants with increased suicidal thoughts in teens. It ended with the withdrawal of one of the most popular drugs in history, the arthritis pain pill Vioxx, and another FDA scientist warning that the agency was incapable of protecting us from further drug disasters. On the flip side, traditional medicines don't generally have large controlled studies supporting their use -- they have long-term results. Yet today's patients have been conditioned to believe that scientific evidence is good and that our doctor's are all-knowing. What then does it do to our sense of security when medical scandals occur? What are health-care consumers to do?
As usual, Americans want to have it both ways. We want what we see as the security of conventional medicine with its official American Medical Association stamp of approval and immediate gratification remedies, along with the holistic and preventive naturopathic approach. We must, however, realize that getting what we want may require a whole new perspective on the roles of medical practitioners.
If integrated medicine is to work, we need to have a more coordinated system in which it can operate. The insurance industry has been very effective at training the public to use different doctors for different needs -- there's the "gatekeeper" primary care physician (a.k.a. generalist)... and then there is an array of specialists for every area of your body. It would be a natural extension for the circle of specialists to be broadened to include traditional practitioners. One of the keys, however is that training and experience in all parties is paramount, and standards in both conventional and naturopathic medicine must be equally rigorous with all physicians being licensed. Let each health-care provider do what he or she does best, and it will create the best possible outcome for the patient. Conventional medical doctors can practice conventional medicine, because that is what they are best at. In turn, when it comes to natural medicine and pharmacy, leave that to the NDs, and only they will prescribe herbal therapies and medicinal doses of dietary supplements. One day, perhaps people can use NDs as their primary care physicians and receive specialty referrals to MDs for treatment of specific illnesses and conditions, since that best leverages the MDs' disease-driven training. For me, I will be happy when all of my doctors are pleased to consult with each other, appreciating the values that different philosophies and training can bring to the treatment protocol. Then, even though insurance may require a gatekeeper, the doctors will all be working in the same garden.


At 10:16 PM, Anonymous skin moles said...

How's it going? I am a web designer, and copywriter, and if you every need help with this page I would be more than happy to troubleshoot problems or update something for you. I have a favor to ask of you though... Please post this link to my site from here. It's about Skin Cancer. It's filled with skin cancer pictures and fact about cancer. Is yours a mole or cancer? and abnormal growths. ATTENTION: SKIN CANCER MOLE PICTURES is graphic:cancerous mole pictures - great gross out stuff. On that note - check your body all the time for skin growths. If you are not sure what skin cancer looks like this is a great web site to bookmark. Anyway, I'll check back again... and if you need web help remember Reno SEO

At 2:56 PM, Anonymous arthritis pain said...

Hello John,

After reading your blog "Team Spirit", I believe you will find my site on arthritic pain to be very helpful.

To give you an idea of our wide range, some of the recent searches that found our site included ...

osteoarthritis pain
arthritis pain remedies
arthritis pain laser therapy
cure arthritis pain
arthritis home remedies
arthritis finger pain

I have many great articles on all aspects of managing arthritic conditions.

Kind Regards

At 2:09 PM, Anonymous arthritis pain medicine said...

Hi John,

As a result of reading your blog "Team Spirit", I think you will discover my site on relieving arthritis pain a great help.

To illustrate our diverse range of tests, here are some of the latest search terms that located our site ...

alternative arthritis treatments
calorad arthritis
natural arthritis pain relief
arthritis inflammation pain
arthritis pain treatments
arthritis pain medicine
arthritis joint pain

We have many interesting articles covering all aspects of arthritis pain relief.

Best Regards

At 10:27 PM, Anonymous Vitamins said...

Hey, It's me the man with the Vitamins again, just popped in to say that when you eat you vitamins you stay healthy!

At 2:03 AM, Blogger oakleyses said...

longchamp outlet, christian louboutin, nike air max, cheap oakley sunglasses, nike air max, christian louboutin uk, chanel handbags, replica watches, louis vuitton, ugg boots, nike roshe, louis vuitton outlet, longchamp outlet, nike free run, ray ban sunglasses, prada outlet, louboutin pas cher, sac longchamp pas cher, uggs on sale, louis vuitton outlet, longchamp pas cher, jordan pas cher, ugg boots, nike free, michael kors pas cher, oakley sunglasses, gucci handbags, prada handbags, polo outlet, burberry pas cher, kate spade outlet, louis vuitton outlet, oakley sunglasses, christian louboutin outlet, polo ralph lauren, oakley sunglasses, ray ban sunglasses, replica watches, oakley sunglasses wholesale, jordan shoes, nike outlet, ray ban sunglasses, tiffany and co, polo ralph lauren outlet online, tory burch outlet, longchamp outlet, tiffany jewelry, christian louboutin shoes, air max

At 2:04 AM, Blogger oakleyses said...

north face uk, coach purses, kate spade, true religion outlet, michael kors, michael kors outlet online, coach outlet store online, ralph lauren uk, burberry outlet, nike roshe run uk, hogan outlet, new balance, sac vanessa bruno, guess pas cher, true religion outlet, nike air force, oakley pas cher, ray ban pas cher, michael kors outlet, nike air max, michael kors outlet online, hollister pas cher, lululemon canada, michael kors outlet, nike air max uk, sac hermes, abercrombie and fitch uk, nike free uk, michael kors outlet, ray ban uk, uggs outlet, north face, mulberry uk, polo lacoste, uggs outlet, burberry handbags, coach outlet, michael kors outlet online, vans pas cher, hollister uk, timberland pas cher, true religion outlet, nike tn, michael kors outlet online, converse pas cher, true religion jeans, nike blazer pas cher, replica handbags, nike air max uk

At 2:04 AM, Blogger oakleyses said...

valentino shoes, celine handbags, ghd hair, herve leger, beats by dre, new balance shoes, nike huaraches, north face outlet, soccer shoes, reebok outlet, hollister, north face outlet, instyler, nike air max, baseball bats, ralph lauren, converse outlet, lululemon, insanity workout, hermes belt, nike air max, babyliss, longchamp uk, gucci, ferragamo shoes, hollister, mont blanc pens, soccer jerseys, lancel, p90x workout, chi flat iron, timberland boots, nfl jerseys, hollister clothing, abercrombie and fitch, bottega veneta, wedding dresses, nike trainers uk, oakley, ray ban, iphone cases, mcm handbags, giuseppe zanotti outlet, louboutin, jimmy choo outlet, nike roshe run, asics running shoes, vans, vans outlet, mac cosmetics

At 2:06 AM, Blogger oakleyses said...

louis vuitton, canada goose outlet, pandora jewelry, moncler, louis vuitton, karen millen uk, pandora jewelry, replica watches, marc jacobs, doudoune moncler, swarovski crystal, canada goose, canada goose, moncler uk, links of london, wedding dresses, ugg, canada goose uk, louis vuitton, canada goose, moncler, juicy couture outlet, moncler, ugg,ugg australia,ugg italia, louis vuitton, coach outlet, hollister, moncler, thomas sabo, canada goose outlet, canada goose outlet, pandora charms, louis vuitton, canada goose jackets, juicy couture outlet, toms shoes, pandora uk, moncler outlet, ugg uk, swarovski, montre pas cher, ugg pas cher, ugg,uggs,uggs canada, supra shoes, moncler outlet


Post a Comment

<< Home

Site Feed