I've got some chronic unresolved health issues. What should I look for when selecting a primary care doctor? I'm thinking about choosing a medical doctor who also utilizes various eastern and 'alternative' treatments. I've had the drug pusher docs in the past, but I'm sick of them.
Choosing the right doctor(17 posts)
Have you done research on your own? At least half a dozen times I've gone to traditional docs and had a variety of ineffective antibiotics prescribed only to solve the problems later on my own with household items, foods, so on.
http://www.earthclinic.com might be a good place to start, I've found some excellent solutions there.
Trying to get "eastern" or "alternative" medicine out of a "western/traditional" doctor may not be a very fair proposition. Giving a personal example, I think that my role in my community is to provide traditional "western" surgery. This is what I'm trained in, and that's what the sign on the door says (figuratively, of course). I don't really have a lot of interest in talking to people about things like drinking cactus juice to boost their energy level-- it's not the role I'm trying to fill in my community.
Be wary of the traditional MD who also dabbles in eastern and alternative medicine. In my experience, very few do this well, and an undesirably large percentage of those who try to do both fall into these categories: (1) traditional MD with a poorly performing traditional business trying to increase revenue (2) traditional MD who has limited qualifications or education to maintain a full traditional practice (e.g. did not do enough training to obtain hospital privileges)(3) traditional MD who has been rejected by the traditional medical community (hospital privileges revoked or similar sanctioning, I've never seen anyone rejected for offering alternative treatments).
Most importantly try to find someone who you can relate to and trust, and someone who can relate to you. If you can't relate to the person, move on. It may be worth the frustration to find someone you feel like you trust.
In dealing with traditional MDs, be upfront with your desires-- if you don't want to take a "western" medication for a problem say something like: "I'm having trouble with X. I'd like to know if you know of any way for me to improve this situation that doesn't involve me taking a prescription medication?" The answer may simply be "No." but at least you've gotten the information you were looking for.
Lastly, a major failing of our current system is that the traditional MD often operates in a setting that requires the MD to spend no more than 15 minutes on each patient encounter. If what you really want to do is spend a lot of time talking to a doctor about your health, seeking out an MD who does not take insurance may allow you to get more face time.
So there are two prospective doctors I'm considering. Both are MDs. One is an internist who also does Chinese medicine including acupuncture. He practices within a hospital. What are your thoughts on the effectiveness of acupuncture to treat diseases?
The other is a family doctor, integrative medicinist and rolfer (though no longer accepting rolfing patients) who's a member of the American Board of Holistic Medicine. He has a private practice in an office building. Is it a red flag that he got his medical degree when he was in his 50s? Quote from his website,"At any given moment any intervention may be appropriate. Sometimes an MRI or course of antibiotics is the perfect intervention. Other times life style changes, acupuncture, or flower essences may be the key."
I would repeat what Mo said here. The theories behind *most* "alternatives" treatments are just bullshit that doesn't hold itself up if you take any critical view to them. They are just opposed to science and a lot of it is used just to steal money from people. A doctor practicing both western medicine and some alternatives that doesn't hold themselves in front of science should really make you wary. This kind of person either don't understand science, don't understand the alternative medicine at hand, don't understand both or, more likely, is just trying to fool you for money.
The better approach would be understanding better your condition, studying what science has to say about it, and then maybe you could take a look at the "alternatives" to see if any of them make sense enough that you would like to try. You really need to act on the source of the problem to overcome it. Both western and most alternative approaches seems to focus mainly the symptoms, not on the underlying situation and lifestyle that generated the condition. What could you improve about your lifestyle? That's a good way to start.
@jzt83, I think I would go with the first one. The second one sounds a little flaky. But you might want to actually talk to them before you made a decision.
Acupuncture is probably not so much a long term disease treatment as it is for immediate effects like reducing pain. My wife's chiropractor (another pain specialist) was able to induce her labor with our third child using acupuncture, specifically a couple needles behind the knee. Which turned out to be more important than we knew at the time since he was due on 9/11/2001 (in Washington DC), but was born four days earlier.
The AMA recognizes accupuncture as effective. Look for studies on accupuncture and your condition.
I'm on the more alternative end of things but I'm with everyone else on doing your own research. I've had many experiences dealing with doctors and hospitals who were treating loved ones in the last couple years, and the doctors are rarely even up to date on current research. My loved ones have had more harm done than help by doctors. For example a few months ago a friend with severe skeletal issues went to the ER with back pain. They admitted her and she soon contracted staph and went septic, then started going into organ failure and they told me she had DIC and was very likely to die. After a couple days I kidnapped her from that hospital and took her to another one where they said she didn't have DIC but the other hospital had been giving her a drug that was killing her. After weeks inpatient dealing with the infection they discharged her still in pain and with a new opiate dependency. Come to find out she had 4 displaced ribs. OTOH my mom's in remission from cancer...
I wouldn't expect my general doctor to know non western medicine. Just like I wouldn't expect an acupuncturist to know western medicine.
Personally i think your relationship with your doctor is really important. If they see you regularly you can have a check up and track any changes Different people understand different personalities, so don't stay with a doctor if communication stinks.
But I still try to find out as much as I can for myself.
Have you ever sat in the emergency room and heard the conversation between doctors and patients, I wonder sometimes how doctors manage to work out what is wrong with people.
Thanks for your replies. It just difficult finding doctors who are highly knowledgeable and amicable. I once went to the ER for a skin infection caused by an insect bites. They did absolutely no testing and ended up administering 5 different antibiotics in all. The various doctors I've seen made various tentative diagnosis which included, herpes, cellulitis, foot and mouth disease and a couple other diseases; they just threw these possibilities out there without taking a culture of my skin. The bill came out to $4 grand. I'm most concerned about my anxiety and depression, which I've had for over 10 years. I just want to find a doctor who is open-minded, up-to-date with current medical research and amicable. I guess I'll check out the western doctor who also practices Chinese medicine and see what he's like overall.
I am truly sorry to hear about your long term predicament with depression. I sincerely wish for you to get well soon.
Have you read this book by Julian Simon (yes the same guy with the bet about natural resources) on depression? He was also suffering from depression (he used to feel suicidal) and sort of cured himself. He documented his findings and experiences as a book:
It helped me a lot. I hope it helps you in some way.
+1 to what george said. Good Communication between you and the doctor solves 3/4th of the problems. Also, having a long term relationship with the doctor helps in better diagnoses.
I'm big on alternative medicine but I am close to the source, so I have an advantage over you. (Siddha medicine/Ayurveda + living in India is a good combination, no
I read somwhere this observation "Western medicine treats symptoms and alternative/holistic medicine treats the cause. Therefore Western medicine is often more impressive when compared with the alternatives. But in the longer run, alternatives offer a more fighting chance over Western medicine."
Also, because we are exposed to Human physiology in our education, and Western medicine's use of terms and definitions follow this closely, this makes Western medicine both effective and easy to comprehend. Alternative medicines by contrast suffer from negative press to begin with, and are somewhat counter-intuitive because our awareness of them is very low.
So, I won't necessarily agree with some of the views raised by Mo and bigato on alternative medicine. I would say, it takes a different mindset to understand other branches of medicine. And my advice to you would be the same as @Dragline's view from another thread. Please keep an open mind, and do not hesitate to switch to one or the other, when the benefits seem obvious.
Your experiences with the doctor regarding the skin rash was both farcical and tragicomic. Reminded me of an earlier thread that I had started on a certain article:
How Doctors Die
BTW, that essay has won the "Best American Essays of 2012" award, and translated to multiple languages, so the essay's popularity says something about perception of "Western" medicine. Your choice of alternative medicine is not out of ordinary for me (no offence meant, @Mo)
Anyway, all the best with whichever doctor you decide to go to.
Everyone going through the health system would benefit from having someone with them.
No matter how good the health system is, they're human.
So is there someone you can discuss this with and take to the practitioner with you. or is there an organisation that that supports people with your illness who can mentor you.
When you see health people it's all so quick and two remember better than one and another person might bridge a communication gap.
And if anyone who is reading this goes into hospital, the helper would just check simple things like having your health number and that they're using the right persons details, the right medication, even just keeping an eye on your belongings or making sure you get fed. And sometimes you can even help the nurses. And when the specialist visits to remember what they said etc etc.
If you're looking for a primary care physician, hospital affiliation is very important, especially the best one closest to you where you're most likely to be admitted. Also, prepare in advance a brief outline of your condition with previous treatment history to bring the doctor up to speed quickly and see how each responds.
A strong endorsement of @george's advice on having someone with you or at least available. This precaution is also advisable due to another horrible practice; debt collectors disguised as hospital staff:
I had this done to me, not for debts but to secure payments in advance even though I had insurance acceptable to the hospital. It can be a war, and it's always good to have backup :)
Well, if doctors haven't been helpful before logic would point away from them, eh?
"A strong endorsement of @george's advice on having someone with you or at least available."
When my son was in the hospital in March an "admissions facilitator" came to see us and said they wouldn't be able to complete his admission until they had a credit card on file (even though we have insurance). Nice try. I told her we were regulars and I probably knew the rules better than she did. She said they might put me down as indigent. I told her she could put me down as belligerent.
Agreed; logic and everything else points away; I could swap horror stories. But unfortuantly it's not always possible to avoid. I look at it as two separate worlds; health and medicine. The latter can kill you quick, so best to be very careful. I have never heard of someone maimed or killed by acupunture (or flower remedies for that matter).
Maybe the antibiotic shot caused your anxiety/depression, and/or maybe you also have genetic predisposition to it.
Whatever the cause, it's good to see you sorting it out. 10 years is a long time to struggle with it.
Because there can be all different causes, different things work for different people. I knew someone once, they tried everything and then they were recommended really high doses of salmon oil, It was suggested by a Mental Health doctor (can't remember title)
Anyway worked, and they had suffered really badly with it.
I think you need to see two different doctors,one for the physical and one for the depression. They need to help you find a solution.
I don't know whats available in your area
Some workplaces have an anonymous phone number you can call, paid for by work, but completely separate.
Heres a self test
Anyway, keep searching for the solution and I really recommend that you find someone to support you. Once you start talking about it with people you care about its amazing how many people have been affected, and can offer helpful advice or relate experience.
I'd like to summarize my post above, as it seems to have lead to the perception that I disagree with "alternative or eastern" medicine:
Be wary of those who have trained in western medicine, but market themselves as practicing alternative/eastern medicine.
I have undergone acupuncture myself, so clearly I see some value in this type of treatment. I do encounter patients who ask me about acupuncture to treat things that I think will not benefit from it. My response is this: "No. I don't think acupuncture will help this condition. But, understand that's my opinion based on my training-- I'm not trained in acupuncture. If you want an opinion on acupuncture for this condition, you should talk to an acupuncturist."
@jzt83, Obviously you can't put all doctors who went to medical school in their 50s in the same pot as bad or good. It's unusual that someone would go to medical school so late in life. If you're looking for a traditional PCP, I would say that it is a red flag if the doctor graduated medical school in the past 30 years and is not board certified by an ABMS board-- it's pretty standard.
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