Our guide to selecting a primary-care physician who will work with you to get the alternative treatments you want and need.
There are many reasons why you might want to find a new family doctor: Your longtime physician may be retiring, or you may be moving, changing jobs or health-insurance carrier. Perhaps the level or type of care you've received has not been satisfactory. Whatever your motivation, the decision of which doctor to choose to oversee your care may be one of the most important you ever make, and in these days of managed care, the choice is more crucial than ever before.
As alternative treatments become increasingly available and more insurance plans cover them, it is your choice of primary-care physician that will impact most dramatically on your ability to integrate conventional with alternative care and shape your own medical future.
WHAT IS A PRIMARY-CARE PHYSICIAN ?
The primary-care physician is the critical gatekeeper of your managed care and insurance plan. As an informed generalist, he determines whether or not to refer you to medical specialists and what tests and' treatments should be administered. The case of Lois Lai, a 39-year-old singer and songwriter from Oxford, Conn., afflicted with a severe kidney disorder, bears testimony to the importance of seeking out a physician who can help you navigate through today's complex health-care maze. This person is responsible for deciphering any symptoms you might have, determining the most beneficial diagnostic tests, preventive services and healing treatments--both conventional and alternative--that your insurance will cover, and coordinating the multiple decisions your care requires.
LAUNCHING THE SEARCH
Lai went looking for a new doctor when her team of kidney specialists (at a local Ivy League teaching hospital) told her that total kidney failure and a transplant would be imminent. She viewed the prognosis and prescribed course of treatment as a judgment call based on her medical team's extensive experience, but one that ignored the role that hope, spirituality and less popular medical therapies can play in healing the body and mind.
"The medical profession is a business now," says Lai. "They go by the book. My doctors at the medical center didn't talk to me; they monitored me. The head of the kidney department told me pointblank that sometimes people get better with a condition like mine (glomerulonephritis), but they don't know why." Lai believed that her doctors did not regard her as a partner in the management of her own health and that they dismissed the validity of combining tried-and-tested alternative treatments with the conventional ones for her particular condition.
Lai wanted a doctor who could oversee her program of prescribed medications but also consider authorizing or administering alternative treatments rooted in a more holistic concept of the body; a doctor who would view the body as an integrated system rather than as a set of discreet parts and consider illness as a disruption in the system rather than as individual symptoms.
After an arduous search process that included Internet and library research, interviews of friends and family and finally, of the doctor candidates themselves, Lai found her ideal primary-care physician. He is Polish-born Tadeusz Adam Skowron, M.D., a board-certified internist who, having experienced great frustration with the symptom-management emphasis of conventional medicine, became proficient in two alternative therapeutic approaches--nutrition and bioresonance, a healing technology developed in Germany that works on rebalancing energy. "I had been trained to treat symptoms and not heal people," Skowron recalls. "I got to the point where I was either going to have to give up medicine or find more effective ways to practice it. Fortunately, I found several alternative treatment approaches that make people well."
Offered in conjunction with Lai's conventional treatments, these therapies ended up improving her kidney function (as confirmed by classic medical tests) enough to reduce the frequency of her dialysis sessions from three times to twice per week and imbued her with the conviction that she may continue to improve and, one day, no longer need dialysis.
Although Lai was critically ill and therefore, had more at stake in finding an alternative medicine-friendly doctor than someone who is well, her determination to broaden her options and the methods she employed to find a new primary-care physician are instructive to anyone who would like more holistic, patient-centered care.
The search for a doctor who combines conventional medical expertise with hard-core knowledge of alternative practices or, at the very least, who is open-minded and willing to refer a patient to alternative practitioners, can be a difficult, time-consuming process. In fact, there are more people interested in holistic health care than there are doctors to provide it. Why? Joel Evans, M.D., an obstetrician-gynecologist practicing in Stamford, Conn., suggests that the problem is a matter of economics. Effective alternative therapies, such as acupuncture and nutrition, take more time than most conventional treatments. Because their insurance reimbursements have decreased under the managed care system, physicians are pushed to see more patients a day. "It's faster to prescribe a pill than to talk to patients about other options or administer them," says Evans.
The enhanced well-being Lai experienced shows just how worthwhile the search can be. It is, of course, best to take on the task before illness gives you a compelling reason to do so. You are in the best position to choose wisely when you are feeling well and clear-minded.
Jane Heimlich, a Cincinnati-based writer, started hunting for a primary-care physician receptive to alternative healing when she began to doubt the wisdom of managing her health via a scattershot approach comprised of visits to many specialists. "An old saying popped into my head," she says. "`He who treats himself has a fool for a doctor.' When you don't have a primary-care doctor to coordinate your care or have one who is operating along strictly traditional lines, no one has a complete vision of your health but you; and there is no one to mastermind a multi-layered approach in a coherent way."
The approach Heimlich took to find such an M.D. involved five major steps. Use these steps to guide your own search for a primary-care doctor and any alternative practitioners you consult.
1 LEARN YOUR OPTIONS.
Knowledge is power, so gather all the information you can about any medical condition you have, and familiarize yourself with the range of alternative therapies that exist. Visit web sites, conduct library research and read books and articles. Seek information about treatments from experts, such as alternative therapists, nurses, dentists, representatives of holistic organizations and information services including the American Holistic Medical Association and the American Preventive Medical Association (see Medical and Health. Information Sources). Remember, the more you know, the better you can direct the quality and type of care you get.
Personal research--a serious look within--should occur in tandem with your external information-gathering. "Learn what support you need to heal your emotions," says Jeremy Geffen, M.D., director of the Geffen Cancer Center and Research Institute in Vero Beach, Fla. "Explore your beliefs about the conscious and unconscious meaning of your illness or state of health, your life's purpose and your values and priorities. Until you are clear about these issues, you can't really make intelligent choices."
2 GET GOOD REFERRALS
We spend more time shopping for a car than for a health-care provider who may mean the difference between life and death. Get high-quality referrals for primary-care physicians from people you know or whose opinions you trust--family and friends, professional associations (see Medical and Health Information Services) and experts in the field. Sandra McLanahan, M.D., medical director of the Integral Health Center, Retreat and Spa in Buckingham, Va., says: "Sixty-four medical schools have departments or courses in alternative medicine now. Ask those who are teaching the courses for names of M.D.s who embrace alternate routes of care."
