YOUR HEALTH TEAM: Talking About IM with Pros
Fueled by both consumer demand and government-sanctioned research, integrative medicine is rapidly becoming commonplace. As a result, physicians and healthcare practitioners are becoming more accustomed to and skilled at discussing integrated approaches to healthcare with their patients. Whether discussing acupuncture with your physician or doctor-prescribed medications with your acupuncturist, here are some easy tips for opening a healthy dialogue.
Practice full disclosure.
Whatever therapy you’re using or planning to try, honesty is always the best policy. Always let everyone involved with your healthcare know about everyone and everything you are accessing to address your needs. If your physician prescribes a medication, inform him/her about any herbs or supplements you are taking. Or if physical therapy is suggested for an injury, discuss whatever chiropractic care or acupuncture you are already receiving. Physicians and other healthcare practitioners can often offer important insight about how therapies might complement or clash with each other. For example, we now know that some herbal products, like St. John’s Wort, contain ingredients that interact adversely with some commonly taken medications, like Prozac. Other herbal therapies have been shown to cause immune-system suppression. Practitioners can only share these potential dangers if all of your information is available to them. Not to mention, such information may also help you and your practitioners identify the most cost-effective treatment for your condition.
Think addition, not substitution.
Scientists have irrefutable proof that certain treatments, like stress reduction techniques and particular herbal therapies, can contribute to healing. The body of research showing the efficacy of such therapies is quickly growing. However, it’s always wise to retain what already works for you. IM isn’t about “alternative” therapies; it’s about using all the safe and effective tools available to you. When adding a new therapy, keep practicing already effective health habits like good daily nutrition, as well as more “serious,” tailored regimes involving chemotherapy, insulin, or other drugs and modalities. Discuss with your physician how additional treatments may be integrated into these routines to address everything from secondary symptoms, side effects, or mental health. In other words, think “addition,” not “substitution.”
Arrive prepared. Be assertive.
After healthcare appointments, people often express some all-too-common regrets. “I was nervous, so I forgot to ask about x,” or “I felt rushed, so I just didn’t have time to discuss y.” Sound familiar? Then take some quiet time before your appointment and list the five (or two or eight) most important topics you’d like to address with your practitioner. If you have researched these topics yourself, arrive with notes or copies of the relevant information. Some practitioners will applaud you for taking this initiative and use your interests in their decision-making process. Realistically, other practitioners may react negatively, claiming sole expertise and/or dismissing patient research as folly. Your practitioner’s reaction may offer insight on his or her ultimate willingness to approach your healthcare in an integrated fashion. If you don’t feel respected, consider finding another practitioner.
Be a patient patient.
Government funding has recently doubled for integrative medicine-related research, so many once “alternative” therapies are being integrated into “conventional” medicine. However, as with anything new, a learning curve exists for both practitioners and patients. Researchers are developing and disseminating information on best IM practices at a very rapid pace, so don't be put off if your provider cannot immediately answer your IM-related question. The practitioner may be taking the extra step to research your concern or tap into his/her colleagues’ knowledge on the subject.
Understand possible hesitation.
Aside from the relative unfamiliarity some practitioners may have with certain treatments, a professional may advise against certain therapies for very good reasons. For example, few herbal preparations are subjected to controlled clinical trials, so few standards govern their quality, safety, or efficacy. In addition, no proof is required to advertise the “benefits” of nutritional supplements or herbal medicines. In other cases, concerns may exist if you are representing a minor or dependent patient. If your practitioner believes a therapy could harm this person, she or he is legally obligated to advise you to discontinue therapy.
Outline a plan.
Regardless of what kind of medicine he or she practices, your healthcare practitioner should be able to answer three basic questions about treatment. (1)What kind of benefits can I expect from this treatment, and how soon will I see the benefits? For example, should you expect alleviated pain in two or three sessions of chiropractic care, or are you more likely to need nine or ten? (2) How much will this cost? (3)What is the evidence for or against this therapy? If a practitioner cannot address these questions in a satisfactory manner or seems to be offering an unsubstantiated “miracle cure,” consider this a red flag.
Even if your practitioner has reservations or openly disagrees with you about therapies, you should always feel valued, respected, and heard by your healthcare team. Ask yourself: are your practitioners interested in your life outside their office? Do they inquire about family, work, diet, and lifestyle? Are you at ease talking about both personal and financial issues with them? Can you discuss all treatment options? Do you feel safe and comfortable with procedures? Can you comfortably ask questions about possible side effects or treatment risks? Whatever your question or concern, keep in mind that you are, of course, worthy of respect. In addition, you are a consumer who is paying hard-earned money for services rendered. You get to ask questions, disagree, learn, and talk.
Be prepared to look elsewhere.
If, after presenting your questions and concerns, you feel like your practitioner isn’t listening or being respectful, by all means, don’t be shy about looking elsewhere. You have the right to request second-opinions and/or change providers. And if the suggestion of a second opinion upsets your current practitioner, he or she is probably not representing your best interest in the first place.
Take the reins.
Above all, integrative medicine is patient-centered and you are the navigator of your own healthcare. So it is up to you to tell your healthcare practitioner what is important to you, research the therapies that interest you and share that knowledge with your healthcare providers. Establishing open communication and joint decision-making practices with your practitioners will only make you a more savvy (and healthy!) consumer.