I normally do not leave you hanging with negative thoughts as I may have with my last article. However, don’t fear. I will supply some hope and answers with this article.
You see, I have worked outside of “the system” for 36 years, and I have to say that, in some respects, I have developed a skill at using the system instead of fighting it. I feel I am able to walk the tightrope laid out by today’s public and private healthcare company policies without compromising the hands-on, nondrug care to which I remained dedicated. I have developed methods for accessing the necessary parts of the system when it is appropriate while rejecting the unnecessary “provider employee” mentality at all costs. I will explain that further later in this article.
It All Starts with the Right Words
I don’t want to get too far into the weeds here or to veer off too tangentially at this point, but I think that a couple of definitions might be of help in clarifying my points.
First, when Dr. Barge lectured his students to acknowledge that we WERE doctors and should therefore think like doctors, he did not use the term provider. Originally, provider or healthcare provider was derived to describe the many non-doctor categories of professionals who treat patients today.
For example, when you go to an urgent care facility, you will typically be seen by either a physician assistant or a nurse practitioner. The training of these providers is not equivalent to that of a doctor. Now I am certainly not trying to besmirch the training of these non-doctor professionals. They definitely have the training to diagnose and prescribe drugs for common ailments and maladies. However, if the condition that you complain of is too involved, is life threatening, or is difficult to diagnose, you will be sent to the emergency room of the nearest hospital or the hospital affiliated with that urgent care facility. This might be the outcome anyway, even if you sought care with your family doctor, but I would venture to say that most family doctors can handle most of the conditions and complaints that patients have when they enter their offices. Meanwhile, I will also acknowledge as I did in my last article, the things that a family doctor takes care of today have changed quite a bit over the last several decades.
Provider is a term that has expanded to one you hear quite often today. It is one you hear used in drug commercials. Here too is a term I must clarify, because “pharmaceutical” commercials would be more polite. Drug is a term that is not as palatable or acceptable as pharmaceutical due to the negative connotation associated with that word in our current society. You see a drug is defined as “any article, other than food, intended to affect the structure or any function of the body of humans or other animals.” Whereas a pharmaceutical is defined as “a pharmaceutical preparation or product.” How do you like that one, we use the word to define the word??? See if you can figure that one out?
The other critical issue, in order to “Be the Doctor,” is to remember that simple-but-often-forgotten, four letter word: CARE. Our job as doctors is to care for our patients. Today you hear about treating a patient. Here too there is a difference.
Treating has a mechanical connotation that is associated with it. It is like the cookbook or flowchart method used to determine where the issue might be located in a glitch with your computer or a mechanical problem with your car. The concept is, if A is wrong, you simply do B. If the circuit board is burned out, you replace it. However, we must remember that each one of us is an individual. Each has a different genetic, emotional, cognitive, structural, and physiologic makeup. This simply means that each patient must be cared for as a unique individual. There are nuances that must guide the course of action for one individual patient as compared to another. All of the unique properties that make us individuals must be taken into consideration. And that means care.
Having a doctor who knows you and your distinct individual nuances is important for accurate and correct care. That is where confluence of the thought and planning of care comes into the picture as well.
As I identified in my last article, the system has almost necessitated a lack of development of the doctor-patient relationship, which is a keystone to care planning. We often find today that your doctor of your choice may have moved to another facility or is in a location that is too far away for you to travel. Your insurance may have changed and the doctor who has cared for you your entire life is no longer in the right network. Further, because of the documentation that doctors are required to complete today, you may find that your encounter with him or her to be to distant, the doctor barely looking up from the computer screen to see who is speaking.
The Work Arounds
A solution to all this? Work around the system.
We are seeing this happen more and more in the medical community. I recently met with two different medical doctors who have become disillusioned with the corporate medical system and want to get out. I always say that they have “seen the light” and want to “move from the dark side.” I have been able to have conversations with these caring and skilled doctors about how they too can work outside of the system and continue to care for patients. These conversations give me hope.
For a start, those of us in the Functional Medicine world are partnering. We are joining together to collectively use our buying power to contain costs. An example of this is the blood lab analysis coop I use, which allows us to perform blood work on patients at extremely low cost to the patient. Both the blood draw and analysis are performed by a national lab. One of the blood draw facilities (Lab Corp) is right down the street from my office. I can get a full blood panel including a comprehensive metabolic panel, including a full thyroid, liver, and kidney panel, a Complete Blood Count with a differential, a vitamin D test, and a urinalysis for less then you would pay just for the vitamin D test if you walked into the lab directly to have the test done and wanted to pay cash.
I have also been able to make arrangements with MRI facilities for patients who have either no health insurance or an extremely high deductible and get a cash price which is a 10th of what you would be billed for the test through your insurance.
We can also coordinate a patient’s care with other doctors in order to have other advanced testing or procedures performed.
My point today for you to remember is that, although many things in our current healthcare delivery system have changed, there are many ways that we can still work around the changes. You can find and work with doctors who truly wish to provide consistent and quality care for their patients and their families. This type of consistent care–that we used to refer to as “cradle to grave care”–takes into account the entire tapestry of your individual traits and characteristics when planning the care that best fits your needs.
The End Goal
I know that at times many of you have felt abandoned or unheard by your doctor, but I can tell you that from my vantage point, I can see a renaissance occurring in the health and wellness world. The old disease- and sickness-care which is propagated by the use of so many pharmaceutical drugs is now developing cracks in its seemingly impenetrable shell. The doctors who want to truly be able to care for their patients without the constraints of insurance company dictates as to what a patient needs and can receive for their treatment as well as the “corporate medical” mandates which had previously shackled them and restricted their abilities in being able to truly “care” for those in need are realizing that they can be freed of those restrictive entities.
The words attributed to Thomas Edison–one of the greatest thinkers of the last century–are certainly coming to pass in what we are seeing take place in our healthcare system: “The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”
Those words, in my estimation, are the mantra of true doctors/healers/caregivers, titles that must truly sum up who we need to be in order to truly care for those who need us most.