Jan 24, 2016

Closing the doctor-patient communication gap

A growing trend of “integrative medicine” has physicians talking about everything from yoga to botanical teas

By Elaine Rogers

So, there’s that daily Facebook newsfeed and its bombardment of provocative promises about the curative powers of everything from pet ownership to meditation.

Meanwhile, five minutes spent tuned in to what Dr. Oz is talking about is sure to add another superfood, spice or yoga stretch to your ever-expanding arsenal of nutraceuticals and hoping-they’re-healthy habits.

It’s easy to see why most of us get confused about what we ought to be eating, taking or doing to optimize our health — and to know when or if to bring our family doctors in on the conversation.

Help Yourself

According to studies from the National Institutes of Health, a third of Americans seek help for their health outside of their doctor’s office, although most do so as a complement to conventional care — not as a replacement for it.

And the U.S. National Center for Health Statistics (NCHS) reports that 18 percent of Americans use herbal supplements, more than double that of the next-most-popular complementary medicines — chiropractic and osteopathic manipulation (8.5 percent) and yoga (8.4 percent).

In addition, the National Center for Complementary and Integrative Health says that 92 percent of Americans believe massage therapy is an effective treatment for reducing pain, while 74 percent agree it should be considered a form of healthcare.

“People are highly motivated now to try to stay healthy by taking vitamins, herbs and nutraceuticals or by seeking out complementary and alternative medical treatments,” says Dr. Darrin D’Agostino, chair of the department of internal medicine at the University of North Texas Health Science Center at Fort Worth.

“That’s a good thing. But, they also need to be taught to tell their doctors what vitamins they’re taking,” D’Agostino says. “It’s important, because it’s very easy to have drug interactions when those conversations aren’t taking place.”

Theresa Hocker, executive director of the Alzheimer’s Association North Central Texas chapter (www.alz.org/northcentraltexas), says this is particularly true when people are dealing with a disease like Alzheimer’s.

“It can make them desperate to try anything. … There is no cure for this disease, so we really encourage people that whatever new things they take or treatments they pursue, that they make sure their doctors know about it. You just never know what might interact with what.”

Prescribing Wellness

D’Agostino is among a growing branch of physicians practicing what is called integrative medicine, acknowleging the merits of healing traditions like acupuncture, massage therapy, yoga and nutrition — termed complementary and alternate medicine (CAM) in medical circles — and actively incorporating them into their patients’ treatment plans.

He and others say that integrative medicine and the concept of “treating the whole person rather than just the symptoms of illness” is becoming more mainstream, and even conventional physicians are increasingly more likely to discuss the nutraceuticals and wellness therapies patients have already prescribed for themselves, or to make suggestions about CAM treatments they might pursue.

“I believe there is a benefit with integrating complementary and alternative medical treatments such as nutrition, exercise, yoga, massage, etc., into traditional/conventional medical practices,” says Dr. Lea Krekow, an oncologist at Texas Breast Specialists-Bedford and Texas Oncology’s Bedford and Grapevine locations. “ Wellness is more than just the absence of disease.”

Dr. Trisha Smith, an internist with Baylor Family Medicine at Highland Village, explains that integrative medicine is about combining the best of both worlds.

“Traditional medicine, unfortunately, does focus on treating disease, and most alternative medical systems focus on tapping into the innate healing powers of the human body,” she says. “More and more we are seeing a trend in traditional medicine towards prevention and wellness.”

Personal Touch

Integrative medical practitioners may keep registered dietitians on their staffs to provide nutritional counseling, or they might recommend alternative therapeutic approaches like massage therapy or acupuncture as complementary treatments to their conventional care.

Dr. Elizabeth Carter, chair of the department of family medicine with Fort Worth’s JPS Health Network, says she was intrigued by her exposure to alternative medical treatments and eventually trained in acupuncture to provide this treatment option to her patients.

“For years, I have been interested in offering more than prescriptions for different symptoms,” she says. “… I think there is a place for treatments that may complement traditional Western medicine and some treatments that should be offered before a pharmaceutical medication is offered.”

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Dr. Carolyn Matthews, of Baylor University Medical Center at Dallas, is a physician who says she headed down the integrative path as a result of personal experience with illness.

A battle with thyroid cancer during a pregnancy— and three years of being treated with “massive doses of radioactive iodine” — inspired great personal interest in nutrition and mind-body medicine. Later, she addressed a gluten sensitivity for herself and her son with dietary changes that she describes as “profoundly beneficial.”

“Since starting the integrative medicine program at Baylor,” Matthews says, “I have seen time and again how much better people can feel by making a few tweaks to their diet.”

D’Agostino says people commonly seek nutraceuticals and complementary and alternative medicine for medicinal purposes, “not just for wellness.” He says he believes it is a course of action that ought to be implemented with physician approval.

“Those dialogues are really important,” he says. “We really need to get to a point where people go to their doctor when they’re healthy and become a partner with their physician to become healthy and stay healthy, rather than just going when we’re sick.”