“It is more important to know the patient who has the disease than the disease the patient has.” Hippocrates said this over 2,000 years ago and it is just as true today as it was back then. However, in our current insurance driven ‘health care’ model doctors rarely get the chance to truly know their patients.
Every year the amount of time the insurance company thinks you need to see a patient gets shorter and shorter and it is not uncommon for physicians to have patients scheduled every 15 min. In being forced to practice this way, physicians get really good at listening to a patients complaints just long enough to make a diagnosis and prescribe whatever drug(s) is associated with that diagnosis. No doctor I know planned on practicing medicine this way when they decided to go to medical school but they end up a slave of a broken system. To me it seems the current health care model is designed to keep you as a patient in their system for the rest of your life and driving you to utilizing more and more of the system every year. I was taught in medical school that diabetes is a progressive disease that gets worse over time but can be managed with medications. Initially you start the patient on oral medications to control their blood sugar but eventually that won’t be good enough and you will have to start the patient on insulin. The reality of it all is that the vast majority of diabetes is completely reversible if the right dietary and lifestyle principles are applied.
There are three main things that need to occur for this to happen. First, you have to find a physician that has the knowledge that this is even possible. When I went through medical school just 10 short years ago there was virtually no emphasis on diet and lifestyle modification. When it was mentioned it was along the lines of “you can recommend diet and lifestyle modification but it doesn’t work so let me teach you what medications to prescribe.” Everything I have learned about lifestyle based medicine I have learned on my own time through self directed study and spending good money on the right conferences. Second, you have to find a doctor that can take the time to spend with you to truly listen to your story and assess all aspects of your life and find out what unique path led you to your current level of dysfunction. If 2 patients come in with a migraine one could be from a lack of sleep, or too much stress, or a dietary intolerance or a nutrient efficiency or gut dysbiosis or an elevated toxin burden etc. and the other something completely different. If the doctor doesn’t have the time to spend with the patient to truly find out what is causing the migraine then they will fall into the practice of just prescribing a pain medication and when that medication doesn’t work they will prescribe another and when that doesn’t work they will send you to a Neurologist who will just prescribe a fancier (and more expensive) medication. Third, and most important, you have to be empowered by your doctor to take ownership of your health. The true meaning of doctor is teacher, not healer and you have to be willing to enter into a partnership with your doctor and accept responsibility for the changes necessary to truly restore you to optimal health. The Paternalistic model of medicine just does not work for chronic disease management. The best way for this to happen is through a multidisciplinary team of doctors, nurses, dietitians, health coaches etc to help patients through the difficult, yet worthwhile journey.
All of this is what led me to pursue a career in Integrative and Functional Medicine and provide my patients with all of the above. It is what led me to decide to leave the insurance world behind and practice in a patient-centered way that focuses on root cause resolution of disease. I am very excited for what the future holds and look forward to the opportunity to work with any or all of you to help you achieve your health goals!
Dr. Dyer, IntegrativeD.O.
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