|
I am certain that Dr. Stephen Barrett of Quackwatch would classify me as a quack. He classifies all alternative medicine
as quackery. His opinion is not changed by new evidence-based research, and his organization itself is accused of being a
slander mill for the AMA at Quackpotwatch. Since both sides tend to sue each other and anyone else who takes a side, I officially
have no opinion on the truth of either website.
As Dr.Barrett's heir apparent, Dr. Kimball Atwood, would also consider me a quack. His attack on Naturopathic doctors is
widely circulated as an objective appraisal of my profession.
According to many at the alternative end of the spectrum, from holistic health consultants to correspondence school naturopaths,
I am an M.D. in alternative clothing. They would claim that I have sold out to the establishment for prescribing and laboratory
privileges. I have listed two below. Clayton school requires only a high school diploma and doesn't provide a referral list
for possible patients, while the ANMA is more interested in attacking licensed N.D.s than promoting healthcare.
But for the average person, a quack is several things: a snake oil salesman, or a fanatic, or an incompetent.
So, am I a snake oil salesman? I do prescribe supplements, for which I provide peer reviewed, evidence based medline
research. I have struggled with promoting specific supplements because I do not like the conflict of interest it generates,
but many of my patients were not getting what I prescribed otherwise. Alternative medicine pharmacies are not available,
and I need to be certain that what I prescribe actually has an active herb or the proper amount of amino acid that we need
to match the clinical results in the research.
My understanding of snake oil is that it doesn't have any medical research behind it, that it is unique to the salesperson
and not available anywhere else, and that it was seriously overpriced. Everything I prescribe has research that I provide
to the patient, it is available from multiple sources, and I have been known to arrange for patients to purchase at wholesale
prices when the supplement gets too expensive. So I am not a snake oil salesman.
Am I a fanatic? Many of my patients use me for confession of their health and lifestyle "crimes." They list off all
the sugary treats they love, and wait for me to take them all away. I don't, because I am primarily interested in compliance:
the ability of a patient to follow the treatment plan. Other patients come in to me convinced that I am a raw food, vegan,
yoga zen guru. They are shocked that I still have my mercury fillings or that I eat everything. But because I am far from
perfect, I can meet each patient where they are, without judgment. My only goal is each person's increased health,
whether that be on Atkins or as a vegan, on multiple drugs or drug free. It is what will work for that person in the long
run, not some fad or crash program. I am not a fanatic.
Am I incompetent? This is an issue I wrestle with, because I am a generalist in a specialist world. If all your podiatric
rheumatologist treats is your big toe, how can I expect to match his knowledge in that area? Fortunately, he and his colleagues
continually research the best treatments for the big toe, so in many cases I can benefit from the knowledge of multiple experts
and pass that information on to you.
I will not see a patient that I feel I cannot help, and I have put into place a money back guarantee to be sure that the
patients feel they are getting value from our visits. I can say that in areas I lack knowledge I immediately seek it,
and I will educate myself about any therapy, no matter how far fetched or how invasive. I have only had patients leave when
they are well or when they found another program that I did not offer. And many chronic patients return to me because after
going the rounds of the specialists they find my approach to be the most helpful. When I question patients, they tell me
that while they were doing the program that we set out, they got better, but then other things happened and they got worse.
So I would judge myself as competent, with constant improvement possible.
Within the world of medicine, the idea of incompetence has ceased to meet my standard of actually being able to help a patient.
The going standard of incompetence seems to be severely injuring a patient. I really don't respect the lowering of
standards to that level, and I wish we held our medical professionals to the same levels of other professions. Shouldn't
a specialist that is not able to provide any relief to your condition wave you out the door without charge? We expect this
of our plumbers, our carpenters, and our mechanics. Our restaurants, our supermarkets, and retail stores provide some assurance
that satisfaction will be provided. In modern medicine, we are now assured that our confidentiality will be kept, implying
that previously it was not. But when was the last time you saw a hospital advertising: "satisfaction guaranteed or your
money back?" Wouldn't it be far less expensive than waiting for highly dissatisfied consumers to sue for malpractice?
But doctors charge like lawyers, for time. And if you think about the six minutes you get with a specialist for your several
hundred dollars, then the cost of healthcare far exceeds any other commodity. I do not have all the answers for the healthcare
crisis, but I am part of the solution: an individual doctor taking responsibility for providing excellent care.
|
