Changing Primary Care Physicians

I found a new primary care physician this week after an extended period of procrastination. I scheduled a visit for my first wellness exam in four years.  As far as I know now (pending completion of lab work), I am healthy. Nevertheless, at age 63, I thought it was important to find someone new to be a resource for my overall healthcare as I move deeper into my last third of life. There were several reasons why I made this change now.

For 25 years I have used the same primary care physician. He was a friend although we did not see each other socially. He was an internist and ER physician who owned an urgent care clinic but he agreed to see me as a primary care doc. However, in recent years, he sold his clinic to a chain and became more of a medical director than a treating physician. He was not in the office seeing patients very much.

Another concern I had was that he was close to my age. Who knows how much longer he would want to actively practice medicine? I wanted someone with experience but perhaps 10-20 years younger. This increases the chances that I could maintain care continuity for an extended period into the future.

But the biggest reason why I made this change is that, through reading, watching, and listening, I have become increasingly skeptical of the way that big pharma has been calling the shots in this country on healthcare. We have a healthcare system that is mostly focused on managing disease using drugs.

As a nation, a majority of our healthcare dollars are spent on controlling diseases that are caused by our poor lifestyle choices. Not enough money is spent on preventing disease. Medicare doesn’t reimburse doctors for that. If we weren’t so sick, drug company profits would drop.

Yes, we have great medical technology. However, while we spend way more (per capita) than any other country on healthcare, our outcomes are poor relative to dozens of these same countries. Why should we accept that?

If you want to learn more about this, I encourage you to watch the documentary Escape Fire. It should open your eyes a bit to what we are doing to ourselves as individuals and as a nation focused on the wrong components of healthcare.

I am more interested in managing and improving my health using all available science-based tools. I wanted a primary care physician who would look at me holistically, with equally strong emphasis on lifestyle and nutrition as on conventional western medicine. I wanted a physician who was not determined to maximize his revenue by maximizing patient throughput. I want more than a prescription writer.

I think I found him.

He is an MD who is board certified in Internal Medicine with 10 years experience as an ER doc. He is also a former president of the American Holistic Medical Association and is board-certified in Holistic Medicine.  He is 15 years younger than I am. He and other holistic practitioners in his field believe in what they call the “Five Pillars” of wellness:

Nutrition, Movement/Exercise, Sleep, Stress Reduction and Management, and Meaning and Connectedness. When these are optimized in a safe, loving environment our innate healing mechanisms can flourish.

Don’t you agree that our bodies have evolved to be self-healing? We just have to support and nurture those self-healing mechanisms. Many of us do not.

His practice group includes a mental health counselor, a chiropractor, and an acupuncturist. (The Escape Fire movie includes some fascinating content on use of acupuncture for pain management in the military.)

Appointments are 30-45 minutes – not the typical 5-10 minute hit and run visits you find in a volume-based medical practice. He sees 8 – 10 patients each day. Most primary care docs see 20-30.

My wellness visit went great. He asked about my nutrition and diet habits. When I told him that I was a Paleo eater, he said that was the very best eating plan I could be on, particularly for maintenance of good cognitive functioning as I age. He explained that the medical community is starting to re-learn some of the bad nutrition science that has dominated conventional medical practice, including the relationships among dietary fat, grains, cholesterol, cardiovascular health, and cognitive health. He was not upset that I had taken myself off statins several years go (although that could change when my lab tests come back!)

He asked about stress. We discussed recent events in my life that were stressors. He asked how I managed them. I told him I had received some counseling, meditated regularly and practiced yoga. He liked that – he is a meditation teacher himself.

The only prescription medicine I take is a nasal spray for seasonal allergies. He recommended that I try two specific nutritional supplements that have been shown to work as natural anti-histamines in the body. Awesome – I hope they allow me to drop the nasal spray.

I also like that his practice uses an online “patient portal” where all health records are maintained online and accessible by patients, including his notes and findings. You can also interact with him directly there.

So this change in primary care physician appears to have been a good step for me. What about you? Who will be on your healthcare team as you move forward into your golden years? Are you ready?

 


Comments

    • MJP says

      Sure – Quercetin 500 mg capsules – take 1500mg 2-3 times per day and Butterbur (specifallu the Petadolex brand_ – take as directed on bottle

      Good luck!

  1. LJR says

    I am looking for exactly this kind of doctor–very, very hard to find. Does your doctor accept insurance? Probably not. A doctor like this is likely in a “concierge” or simply a “no insurance” practice, which may be too costly for many people. I’m in NYC and the “out of network” docs are so expensive here. It’s a real problem. (Know any docs like this in NYC? I have been to practices that are supposedly “integrative” medicine–but in fact they were business as usual.)

    • MJP says

      LJR – My new doc recently changed and now takes insurance. To participate in his patient portal and get related benefits, you need to become a “member” which cost $250. I think that is reasonable so I joined. To find a similar doc in your area, try the American Holistic Medical Association website and run a search there. Also, some teaching hospitals have launched integrative medical practices. Vanderbilt here in Nashville has one. Good luck with your search.

  2. Peggy says

    Wow, thanks for sharing this. It is very timely for me as I’m almost 64 and DH is 65. I retire next year and will move ‘home’ (work keeps us overseas)and will also be looking for a primary doctor, and I’d love to find both a female and male doctor who have a similar approach to medicine as yours. Could you please let me know how you found your doctor. Is there a ‘yellow pages’ of doctors that lists their area/s of expertise?

    Our family has also taken a similar approach to health and wellness as you. None of us are on prescription meds and prefer natural remedies to prescriptions. Knock on wood, we’ve never had the flu nor taken a flu shot. We use Oregamax and Oreganol oil (North American Herb and Spice) which has really helped us.

    Regarding your Paleo diet, do you eat any starches. I’m not familiar with it and skimmed through the wiki article, but it seems there are several versions. Our diet usually consists of salad, small amounts of chicken or pork and lots of veggies. Starches are rice, bulgur, sometimes potatoes and plantain. We stir fry (have mostly lived in Asia) veggies, use lots of spices and minimal salt.

    Thanks for a very informative article.

    • MJP says

      Hi Peggy -To find a similar doc in your area, try the American Holistic Medical Association website and run a search there. Also, some teaching hospitals have launched integrative medical practices. Vanderbilt here in Nashville has one. Good luck with your search.

      The Paleo eating plan is straightforward- don’t eat anything our Paleolithic ancestors didn’t eat: No grains (including rice and pasta), no dairy, no added sugar, no potatoes (sweet potatoes are OK), no corn, no legumes. What you can eat are grass-fed meats, wild caught fish, veggies (except corn, potatoes, and legumes), eggs from pastured chickens, fruit (in moderation because of the sugar), nuts (but not peanuts which are legumes), and seeds. If you need bread, buy or bake some almond or coconut flour bread. (Whole Foods sells it.0 You can cook in olive oil or even better, coconut oil which is extremely healthy. I have no problem finding plenty of food to eat, even at most restaurants. If you want to learn more about this, I recommend the book “The Paleo Solution” by Rob Wolf. All of the science is in there. Healthy eating to you!

Leave a Reply

Your email address will not be published. Required fields are marked *