Sunday, February 3, 2013

Think Like A Doctor, Act Like A Patient

An Op-ED article appeared in today's NY Times, The Boy With a Thorn in His Joints, about a mother that found relief for her child's malady by incorporating alternative therapy.

In response, I posted the following comments.

As a physician that practices integrative healthcare, but defines integrative differently, I combine the services of a MD, registered dietitian, health psychologist and physical therapist into one practice that addresses the four main constituents of healthy living.

1. Identify and address any underlying medical condition(s).
2. Optimize nutritional status.
3. Identify and develop a strategy to tackle encumbering emotional and psychological issues.
4. Ensure that a person can engage in low to moderate intensive physical activity as part of daily living.

Everything we do is based on the scientific method of trial and error. If it works great; if not, next. Each patient is treated as an individual. No one size fits all.

First, let's look at some numbers to start. The reported statistic for Celiac disease is that it affects about 1% of the population, with 4 out of 5 cases going undetected. A gGT test is very good at making the diagnosis. Somewhere between another 1 to 10% or so may suffer from gluten insensitivity. A food allergy test can help diagnose that as well.

Second, I often tell my patients to "think like a doctor and act like a patient." Thinking like a doctor means considering all possible diagnoses and all possible treatments, using those considered most effective for the diagnosis most likely. If that doesn't work, you must consider alternatives.

Acting like a patient means following the therapy prescribed by a doctor you trust. Acting independently unnecessarily raises risks and creates confusion as to what did and did not work.

If traditional medicine fails, it is more than prudent to consider alternatives. But don't be fooled into thinking that alternatives that have medicinal properties don't carry the same risks as do all medicines. Don't use an alternative until you have researched its viability and discussed it with your physician. You also need to confirm that you are taking the right dose, understand the side effects and contraindications, are aware of the effects on other medications, and have a product that is properly manufactured and labeled. Otherwise, you may end up doing more harm than good.

There's a reason why botanicals and other non-regulated supplements are called "complementary and alternative" therapies because they are usually not the best first-line treatment. It pays to keep that in mind when you are looking for a solution to a new health problem. As for eating properly, which mostly includes whole foods, that always make sense regardless of your health state.

1 comment:

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