Alternative medicine ideas?

November 28, 2012 11:02 AM

I am looking for alternatives for the standard "doctor sees you for five minutes and prescribes drugs for whatever ails you."

I am a little fed up with the current medical care that we have been receiving so far. My wife for example has eczema. She has been to 3 different doctors. The standard seems to be they look at it for 5 minutes, ask minimal questions, and prescribe drugs for it. Now I am a layman and even I know that there are connections between eczema and other factors such as allergy to something, dry air, irritants in everyday products, etc. But none of the doctors even talked about those. None.

What I am looking for:

1. people who actually sit down with you to try to figure out if there is any bigger underlying picture to whatever ailment you have. "Let's see if your eczema improves if we eliminate these laundry products" as opposed to "Here's a cream for that and that's that" as the first line of defense.
2. whole body health. Instead of "here's surgery to fix your knee problem", I want people who would say "Let's look at your everyday posture and walking style first"
3. Communication between specialists. Here's what I see: a primary care will send me to a specialist and the specialist will do what they do...oftentimes without consultation with the primary care. Now if I have a knee problem and I'm sent to a knee specialist whose specialty is knee surgery - chances are I would get a knee surgery even if there is a better way of dealing with it. I heard that in Mayo Clinic, different doctors would get together and discuss best treatment options as opposed to doctors handing off responsibilities to the next one in line.

So - what am I looking for? Is there a name for the branch of medicine that practices the points above? Yes - I understand that good conventional doctors do those already but honestly I do not think that is the standard. Holistic and naturopath seem to offer those but they have been tainted with quackery, as today's answers to the naturopath question in the green have indicated.

posted by 7life to health & fitness (29 answers total)

I think you might be looking for a doctor of osteopathy, similar to an MD in training - accredited and non woo.
posted by iamabot at 11:03 AM on November 28, 2012 [3 favorites]

How about an executive physical? You'd get a thorough, comprehensive and unrushed checkup but you'd have to throw some serious money at it - say around $3K. No quackery, though.
posted by hazyjane at 11:08 AM on November 28, 2012 [3 favorites]

If you can find a teaching practice, probably associated with a university/med school, they rock all those points. They're not concerned with squeezing in another botox shot after your eczema appointment.
posted by fontophilic at 11:11 AM on November 28, 2012

I don't think you're likely to get different treatment from a DO - most of the DOs I know say that they don't utilize their osteopathic training at all in their practice. The problem is that MDs and DOs, as physicians, are under the same broken system of compensation. Because of the reimbursement rates and what you can bill for, the incentive for primary care physicians of all stripes is to see as many patients in as short a time as possible. If they spend 30 minutes talking about eczema with you, they will only get to bill the same as if they spent 5 minutes talking about eczema, because it's a single minor medical problem and you can only upcode the visit if the person has more complex and multiple medical problems.

The Mayo Clinic does tend to get around this somewhat. In fact, most academic centers get around it to some degree because the physicians are paid on salary rather than by the visit/procedure. Remember though that if you booked a standard appointment with an internal medicine office at Mayo, you'd be seeing a resident. If you can afford it what you'd be looking for is the Executive Health program at Mayo. But there are also concierge medical practices around the country that might be more accessible.
posted by treehorn+bunny at 11:11 AM on November 28, 2012 [5 favorites]

I read an interesting blog recently by a primary care doctor who decided to switch to a concierge model (though he didn't call it that... I can't remember what he called it) because he felt it gave him more opportunity to connect with patients individually and really spend time with them.
posted by mskyle at 11:15 AM on November 28, 2012

Maybe you'd be better off asking, "I live in city X, can you recommend a doctor like this?" Because, yeah, I think it's an issue of getting personal recommendations and finding a doctor who will do this. (I know one in DC, who was recommended to me online, and I'd be happy to pass it on.)
posted by instamatic at 11:16 AM on November 28, 2012 [3 favorites]

Ask around, you may find a great doctor.

I like my MD a lot. He's also got a degree in pharmacy, and he LOVES him some meds.

I go for my annual visit and I get about 45 minutes of 1:1 time with him. I can ask him questions and he gives me thoughtful answers. We explore lots of stuff together and he commiserates with me.

I read my chart once, when he was out of the room, and he described me as "pleasantly plump". I mean, HOW could you not love that? I've asked about issues with weight and he pretty much said, "unless you want to starve, I don't see it happening. It's genetics. Just eat well and excercise and we'll do the best we can."

I think he has Aspergers, but he really makes an effort and is always pleasant. His office staff is fun, and it's like old home week whenever I'm in there.

They let Husbunny and I go back together, so we can advocate for one another and ask questions (Husbunny used to be an RN).

You build relationships with your docs, and the system is flawed, but if you're patient and ask for referrals, you'll find someone you mesh with.
posted by Ruthless Bunny at 11:18 AM on November 28, 2012

Do you live in a major U.S. city? If so, try One Medical Group. I like them -- they generally seem to care more about you, and don't rush through appointment.
posted by aaanastasia at 11:20 AM on November 28, 2012

You just need a better doctor. My annual physical is 10 minutes of the doctor checking reflexes, listening to your lungs, etc, and 20 minutes of him sitting and chatting about what is going on in my life with my job, kids, etc. and how all of that may be impacting my health.

My doctor is an Internist. He is a solo practitioner in a practice that doesn't even take credit cards. I don't know that there is any correlation there, but I do sense that he runs his business that way to avoid some of the stresses of a high volume multi-doctor practice. So you don't have good recommendations to work from, trying somebody in small /solo practice might tilt the odds in your favor.

On preview - I thought of something else. Our dermatologist is the same way, and he is in practice only with his wife, who is also a dermatologist. So that is two data points on smaller is maybe better.
posted by COD at 11:25 AM on November 28, 2012 [1 favorite]

You may want to look into integrative medicine. Some of it sounds a little woo, as they may blend conventional and alternative therapies (like suggesting meditation for stress, which is not all that woo but may seem woo to some), but I've found that doctors who embrace this approach do exactly what you are describing. They look to work with you on figuring out what is causing your issues, how to address them, and what they can do to improve your overall health. I see a doctor who practices integrative care and really like his approach.
posted by bedhead at 11:34 AM on November 28, 2012 [4 favorites]

You need to visit a doctor to the stars.

Or, one that treats the wealthy. You will experience a remarkable difference, and will never go back to your old doctor again.
posted by Kruger5 at 11:39 AM on November 28, 2012

Despite your reasonable reservations, you still want a naturopath. A naturopath is a 'real' doctor in the sense that they can prescribe all conventional medicines (except chemo drugs). But they are much more given to trying to find root causes of illnesses. Here is a page that might be helpful What is a Naturopathic Doctor?

I am in the PNW, and naturopaths are quite accepted here, they are now working in hospitals and more conventional Western medicine enclaves.
posted by nanook at 11:44 AM on November 28, 2012 [2 favorites]

I used to work for a doctor in St. Louis whose specialty was Environmental Medicine, although he also practiced traditional allergy treatments and was a member of the American Academy of Pediatricians as well. He was absolutely wonderful and worked very hard to find and treat the cause, not just the symptoms. You might look into that sort of specialty; I'm sure it does attract some weirdo types but there are some genuinely wonderful doctors who are interested in actually fixing their patients' problems, not just throwing prescriptions at you.
posted by something something at 11:44 AM on November 28, 2012

I second the recommendation for an integrative medicine practice. I've seen a few, and the doctors have all been great about thoughtfully explaining all options and allowing me to be part of the decision. Generally there is just a lot more respect, and they frequently bring up lifestyle changes when appropriate rather than simply jumping to prescriptions/surgery.

The "woo" factor can be an issue but it is easy to filter for, just ask beforehand about the doctor's opinion on antibiotics and vaccines before booking an appointment.
posted by susanvance at 11:45 AM on November 28, 2012 [2 favorites]

Seconding the recommendation for One Medical Group. I think the yearly fee is now $150, but my annual appointment was 45 minutes, not rushed at all, and involved referrals to specialists with a similar treatment philosophy. If there's a similar practice in your area, it's money well spent.
posted by psycheslamp at 11:49 AM on November 28, 2012

There can be some woo factor to some naturopathic doctors, for sure, but I will say that I have been healthiest in my life when in the care of naturopathic doctors. I wouldn't take a breast lump or shattered knee cap to one, but I find for those chronic, nagging things like eczema, sinusitis, gastro complaints, etc. they are the best at fixing things up. Because, as you suggest, a lot of that stuff is lifestyle or diet related and that really just isn't an MDs bailiwick any more, apparently. There are better ones and less good ones, and it seems like every single one of you will have you eliminate wheat, dairy and sugar from your diet (which, sadly, seems to actually help) but I think it's worth a shot, especially if you have coverage.
posted by looli at 11:58 AM on November 28, 2012 [1 favorite]

Seconding fontofilic's advice about using a teaching practice. I switched from a too-busy one-doctor practice to a university teaching/research clinic. I really like my new doctor and ready access to multiple specialists in the same location.

Also, be a knowledgeable, pro-active patient. Research your condition at reputable sites like the Mayo Clinic or WebMD. Ask questions, ask about decisions, and ask about alternatives.

I think most patients see doctors as unquestionable experts and don't ask enough questions. Or they want the easy answers that treat the symptoms like medication or surgery. Doctors get used to this. If you think there's an alternative, or you're interested in underlying causes, ask about them.

But be prepared to change doctors (possibly more than once) if you can't get the attention you want.
posted by Boxenmacher at 12:05 PM on November 28, 2012

I get that kind of care from my family doctor.
posted by The corpse in the library at 12:45 PM on November 28, 2012

Go to a doc that doesn't accept insurance. They'll probably do things their way.
posted by discopolo at 12:53 PM on November 28, 2012 [1 favorite]

I've had really good luck working with Nurse Practitioners - the nursing training they have tends to give them a totally different perspective on patient care and interaction.
posted by polymath at 12:54 PM on November 28, 2012 [4 favorites]

I suspect that if you add a location to your profile or have the mods add one to your question, you could get specific recommendations, if you wanted them. On the offshot that you're in the Akron, OH area, I have someone who fits this description and who I'd happily rec.
posted by MeghanC at 12:58 PM on November 28, 2012

Regarding the suggestions for naturopaths, have you seen this question from earlier today?

Also: at least at my clinic, I can request 45-minute appointments, as mentioned above. They're good for talking through things, especially if you have any chronic or recurring health concerns. Is this something you can request at your doctor's office? Ask!
posted by vivid postcard at 1:04 PM on November 28, 2012

Thirding recommendations for a clinic that advertises itself as offering "integrative medicine". At the place I go, appointments are booked for 30 or 45 minutes.
posted by Sidhedevil at 2:11 PM on November 28, 2012

Find a doctor in his or her 80s. I'm lucky if my annual physical only takes an hour. The first visit we spent more than an hour going over my health history (and I'm pretty healthy).
posted by MarkAnd at 2:47 PM on November 28, 2012

A DO turned out to be the answer to this question for my partner - she does exactly what you've described and he loves her enough I've considered switching to a DO myself. But like any other specialty it's probably hit or miss, so try asking around,
posted by Stacey at 3:14 PM on November 28, 2012

My husband and I go to the same clinic for primary care. I happen to see a PA (physician's assistant) as my primary care provider, but my husband sees an MD. We've both found that our PCPs take the time to talk to us about our general lifestyle, particular things going on in our professional and personal lives, alternatives to pharmaceutical/surgical interventions, etc. Our appointments tend to include at least 30 minutes of talking to our providers, and they really listen and try to offer solutions/options that will work for us.

What matters in our case is the culture of the practice. It's small, unaffiliated with a big hospital or hospital system, and was founded specifically to deliver this type of care (when planning the practice, the founding members considered starting it as a commune). This type of practice is getting harder to find, but it's worth asking for recommendations in your community. I don't know if this matters, but our clinic serves patients from babies to the elderly, which seems to give it an extra community-oriented feel.

In my experience, there are caring physicians in large hospital organizations, but they often simply do not have the time to spend more than a few minutes with each patient, even for primary care visits. See if there are any small practices in your area, where an MD, NP, or PA is more likely to be able to give you really thoughtful primary care.

(A word on your provider's credentials: if you have complex health issues, you'll probably want to seek out an experienced MD, but if you're in relatively good health, an NP or PA can provide fine primary care, and may have more time for you--without any extra woo. I've seen my PA for three years and have felt I received excellent care.)
posted by Meg_Murry at 3:20 PM on November 28, 2012

Another search term that may help you is "functional medicine."
posted by charmedimsure at 4:29 PM on November 28, 2012

Go to a doc that doesn't accept insurance. They'll probably do things their way.

How would you go about finding a doctor like that? I'm in a major city but I'm not sure what I'd google.
posted by bradbane at 12:18 AM on November 29, 2012

I should have been more clear about this in my previous answer, but if you want someone to spend a longer time with you on a specific subject, then you may not want a doctor at all. The nice thing about having a good doctor is that they can refer you to the right people to get things looked at more in depth, whether it be a medical specialist like an allergy/immunology physician or a dermatologist, or a non physician allied health professional such as a physical therapist for musculoskeletal pain issues or a dietician for nutrition and diet issues.

It seems to me, and this is just an observation, that once people have tried all that conventional medicine has to offer and it has not worked for them, they can go to an alternative medicine provider who can suggest that they try various lifestyle changes/diet changes or alternative therapies. Although such things may not be scientifically proven to work for the condition, and thus are not things that medical doctors would recommend, they may work for that specific person for whatever reason. Personally, I feel that eating a better diet or trying an elimination diet, or exercising more or trying a supplement or whatever is all stuff I can do myself without paying someone else to recommend it, but I know that others may feel differently.
posted by treehorn+bunny at 10:51 AM on November 29, 2012