The Transformation of Healthcare

• Understanding our Current System
• The Hippocratic Oath
• The Advent of Complimentary Health
• Patients Caught Between the Two Worlds of Health Care
• The Value of Nutrition
• Environmental Toxins
• The Concept of Collaborative Medicine

I am a Board Certified Psychiatrist and have been in practice for the last twenty years. For at least fifteen of those years, I’ve been acutely aware that there are flaws with our health delivery system. While I see that the quality of conventional health care technology improving, I see the delivery of this care getting worse and worse. Frankly, our delivery system is in a shambles.

This book is dedicated to the creation of communication between and the implementation of an integrative or collaborative model of health care. In principle, when people or systems communicate, problems get resolved. There is an inherent maturity of the parties or systems involved. Collaboration implies that each party is open to examine and evaluate the total picture from the other’s perspective. Integration allows the two separate systems to work together to become one.

In health care today, there are two different worlds: the Conventional Heath care system, consisting primarily of medications and surgery, and the Complementary and Alternative Medicine care system (known as CAM - and referred to as Complementary Health in this book). Each, in and of itself, is quite a large system. The Conventional Health care industry annually exceeds a trillion dollars in the U.S. alone. Complementary Health is rapidly rising in popularity and accounts for billions of dollars in annual expenditures and it is expected to exceed a trillion dollars by year 2010.

What’s most disturbing is the near total lack of communication between these two huge systems of health care. Most conventional practices need to integrate nutrition and preventative care. Complementary Health settings, likewise, tend to be very “anti-drug” and defensive towards conventional practices. There exists very little communication and collaboration around patient care among practitioners in these two systems. This consequential lack of communication poses considerable risks to patients engaged in care in both of these health delivery systems.



Take Mr. Smith, for example, a 55 year old gentleman with diabetes, high blood pressure and obesity. He is currently prescribed three medications to lower his blood pressure and two medications to help control his blood sugar. His daughter is a Certified Nutritionist and has worked hard with him to establish a healthier diet to include the taking of nutritional supplements. In addition, she personally accompanies him on a walk three times per week. Mr. Smith has a wonderful relationship with his daughter as well as he has a good working relationship with his medical doctor. It was uncomfortable for him to share with his doctor that he was taking extra nutritional supplements for fear of what his doctor would think. So instead of sharing the entire regimen including the diet and exercise, he didn’t discuss any of it with his doctor. In addition, he didn’t want to hurt his daughter’s feelings by getting into any conflict with his doctor and run the risk of stopping the supplements.

Mr. Smith, after three months on the diet, new exercise routine and supplements, experienced a sudden blood pressure drop and fell down a flight of stairs at home. He sustained a leg fracture and fortunately no other problems. Eventually, he told his doctor what had happened. His blood pressure and blood sugar were so improved, his doctor reduced his blood pressure medications from three to one. His doctor agreed to closely monitor him, knowing that these healthy lifestyle changes offered the promise that he could lower his dosages even further and possibly discontinue some medication entirely. Fortunately, Mr. Smith and his doctor had a genuine respect for each other. The doctor assured Mr. Smith that he wanted to hear about any and all lifestyle changes in the future and Mr. Smith was very relieved.

Mr. Smith had a good outcome, but this scenario could have resulted in some serious problems for Mr. Smith. Indeed, there are other patients in this very same scenario who do not fare as well due to the lack of communication and collaboration between the conventional and complementary system of care.

Conventional doctors, often rightfully, speak to the lack of scientific evidence necessary to validate natural Complementary Health modalities and the number of unregulated practitioners and highly variable scopes of training. Complementary Health practitioners, also rightfully, point to the potential risks of conventional modalities and medications, surgeries, chemotherapy, radiation and the like.

It is the consumer that is caught in these two worlds. It is largely through the internet and word of mouth that the consumer attempts to stay abreast of new natural health advances. There is a rise in public awareness that the ‘feel ill take a pill’ philosophy is not enough. Many in the U.S. utilize employer health plans and visit primary care doctors. Often patients DO NOT tell their primary care doctor about the natural health supplements they are taking or the other Complementary Health treatment modalities they utilize. This is not to put the blame on them. A 5-10 minute “medication check” appointment scarcely leaves time to discuss how they are feeling physically.

True collaboration involves a great deal of effort and energy. It involves stepping out of one’s comfort zone and viewing a situation through the eyes of another. It involves asking a lot of questions and being open to actively learning. Collaboration implies that each party acknowledges and validates each others’ existence. It means one party is not threatened nor intimidated by the other. It implies wanting to work together for the best interest of higher goals and understanding each other’s strengths and weaknesses.

Lack of communication or collaboration is of great risk in any relationship. Personal relationships disintegrate due to lack of communication. The same is true of our health care delivery system. It is the system that communicates and collaborates that will survive. The systems that do not will perish.