
I started teaching health care providers about the use of functional medicine and comprehensive lab testing to help patients make the most of their resources to help advocate for optimal patient health and well-being. Another motivator is to help teach providers that they work for their patients and not the insurance companies.
I don’t know about you (if you’re a health care provider), but I write over 100 letters of medical necessity to other health care providers per year. Why? I’m an integrative health practitioner-it’s vital for patients’ other providers to possess a clear idea of how their patient is thriving, how we can work together or in some cases, how they can bridge “the gap”.
A huge gap exists between what takes place in research and how it is disseminated among health care practitioners in practice. As providers get busier, they make less time for independent research, often at the expense of their patients. As artist Ed Ruscha concisely put it, “Science Is Truth Found Out.” Science is ever-evolving new diagnostic features, specialty lab tests and innovate multi-systemic technologies to extend to our patients in private practice. These innovations aren’t meant to live in research labs though. Innovation, by virtue of its meaning is all about creating new, useful tools. So, why deny patients tools that will heal them, empower them… offer them reliable health options?
It’s About Doing The Right Thing & It Doesn’t Really Involve Your Beliefs
After going back and forth with one of my patient’s providers for about two weeks in an attempt to have her order comprehensive thyroid labs for a clearly ill patient, she refused claiming that she didn’t believe it was necessary. Not only did she believe it was unnecessary, she claimed that if the patient did in fact elicit what I hypothesized, that it wouldn’t matter anyway because the patient was at an advanced age and the thyroid could simply burn out on its own. SAY WHAT? I suppose I wasn’t terribly surprised considering that she had informed the patient the day before that the tests weren’t available in the state of New York, but if they were, insurance companies would never cover such a thing. A bold faced lie or a complete lack of un-knowing? Either way, bad, very bad. Ever heard of the more conservative comment, “I’ll look into this and get back to you”???
Turns out I see three of this provider’s patients. To save patients on expenses I always order labs via their primary providers to have their insurance cover it. Since it was a no-go with this doc, I referred the three frustrated patients to another reliable colleague to have the comprehensive labs completed.
Here’s what I found out:
1. Patient One: Hashimoto’s Thyroiditis with gluten intolerance.
2. Patient Two: Hashimoto’s Thyroiditis
3. Patient Three: Hypothyroidism with exceptionally disproportionate ratios of free, un-bound thyroid hormones.
What does this mean? First off, the patient that was referred to as being in advanced age-she’s 50! I’m not one for medical labels, but leaving ill patients under- or mis-diagnosed is completely unacceptable. There are so many health factors pivoting on thyroid health such as reproductive concerns, cognitive and emotional well-being, overall immune health, cardiovascular health and related endocrine issues such as diabetes and adrenal insufficiency.
What This Means For My Patients
If patients can get tests performed great. It can spell new opportunities for healing and disease prevention. It can answer so many mysteries for patients who have suffered for years without real answers. For these patients I mentioned above, here’s what it meant:
Patients one, two and three because they were able to undergo comprehensive thyroid testing are all now on bio-identical, non-synthetic therapies that regulate and balance all aspects of thyroid health (not T4 only meds which rarely address the full scope of thyroid health). May make for increased monitoring to place patients on bio-identical prescriptions, yet patients subjective health is a valuable tool in these cases.
Patients one and two, before the testing were complaining of fatigue, weight gain and un-explained stress and anxiety. Although neither opted for their use, the same provider who refused the tests offered the patients anti-depressants to address their concerns. With their new-found results however, an auto-immune thyroid concern called Hashimoto’s was discovered. Before this, both patients ingested nutriceuticals with iodine. Fine and helpful for a non-auto-immune case, but quite harmful over time to those with the presence of auto-immune antibodies. Both patients were switched to non-iodine containing nutriceutical programs.
All three patients report a re-newed sense of health and overall improved well-being.
Patients-here’s a message for you-if your providers can’t or won’t help with your concerns, it’s okay to fire them. Imagine if you took your vehicle in for repairs and the mechanic refused to fix certain parts, but still charged you the same amount of money each time. Would you settle for that? Absolutely not! So why settle for this with your health care providers?
Team Care
Find a team of providers who are willing to work together to hear your concerns, guide you and bring you toward your best health yet. As your health care providers and guides, we’re here to challenge you and move you beyond your comfort zone, but only when that will create a better state of health.
What This Means For Providers
Bottom line, if you aren’t willing to work for your patients, they will leave you for another provider who is. A more serious concern is whether you could be held in a negligible state for not addressing a patient’s imminent concerns. Would you settle for a health care provider treating your spouse, parent or child that way? You wouldn’t.
The system we practice in is flawed, but what we offer to our patients doesn’t have to be. You work for your patients, not for the insurance companies. So what if you need to spend a few extra hours filling out special insurance claims or writing letters for your patients. At least you’ll know you tried as hard as you possibly could to serve your patient. And, rather than say to a patient’s face that they don’t need a test or that the other provider who suggested it doesn’t know what they’re talking about-refer out if you aren’t aware of the topic or let them know you simply need to look into it further. Create change for patients, not roadblocks to their health.
And remember, there’s a time and place for beliefs. Think churches, personal conversations, but about re-futing fact-based research and science?.. get ready to travel on a two way street if that’s your modus operandi. Theories and hypotheses are meant to be blown apart, but if you haven’t done the research and you’re swapping belief based information for inference, that could spell trouble.
Don’t Know What’s Going On In Your Own Back Yard?
As many of you know, my private practice resides in Rochester, New York. Home to many great institutions of higher education-one you’ve likely heard of is The University of Rochester (my very own practice specialty, psychoneuroendocrinology traces some of its roots here). The U of R offers new and recent research in Chinese medicine and the science of acupuncture, studies of the neuro-hormonal affects on immunity and endocrinology and stem cell therapies.
Despite the fact that the U of R’s research touches far stretches of the globe, little of it seems to make its way into local health provider’s offices. Providers, unless it’s about one of the drugs you provide, the information isn’t going to land in your lap, you must seek it out.
Practitioners need to take research in their private practices to a new level.
No more eye rolling or telling your patients something isn’t valid just because you haven’t heard of it. You’re the medical professional, so do your research. Your patients shouldn’t have to beg you to do your job.
Demographics Matter, Look Around
Although the situations I’ve described above could occur anywhere, I’m specifically describing the Rochester, New York area. I have a very unique perspective on this topic because of my own demographics. When I’m not in Rochester seeing patients, I’m consulting to all types of health care providers, assisting to establish integrative medical modalities in their practices as well as comprehensive and functional lab testing. Rochester providers are surprised to hear that I almost never run into issues with other providers or insurance companies in California (where my residence is). A majority of primary physicians tell me they know they need to step the game up if they want to offer the modern patient what they’re looking for. Sure, some still want quick fixes, but modern patients are cultured, smart and looking for preventive wellness that will keep them sharp, active and happy for many many years to come.
Whether you’re new to the profession or a seasoned provider, never ever stop learning. And learn about a wide variety of research, done by a wide variety of folks, because some of it is outstanding and some not so great. The more you review, the more you can compare and make use of in practice. Look beyond your own specialty and beyond the regular reviews. You might be surprised to find that a new treatment is just waiting for one of your patients. So embrace change and evidence-based innovation because some day you might need it to help heal a family member, or even yourself!
Some of you will still say, “but the problems are so complex with the insurance companies and we don’t always have the time or…”
My answer to that is a question-I’m making it work, so why can’t you? You can, I know it. Work smart and think in possibilities for your patients. Don’t be afraid to advocate for what you know can pave the way for others to reach health.
Providers-we are all part of the same thing and that thing is health CARE. Doesn’t matter what school we attended or what initials now come after our names. Our obligations to our patients are the same-keep them safe, keep them well and give them all we’ve got to make it happen.