My general practitioner has started a new practice that is termed “Direct Patient Care.” It’s a model of medicine that some doctors are using to do their part in fixing what’s broken regarding insurance-based medicine. As much as I love my doctor, I had to really consider if this was the right program for me, as I am fortunate to have excellent medical coverage. However, after much deliberation, I decided it was in my best interest to go this route. I thought it would be nice to share my thoughts regarding this…
As I mentioned, I really like my doctor. I stumbled across him by accident a couple years ago, and thought it was great that he was board certified in family medicine and sports medicine. He also had more of a holistic approach than many other doctors that I have seen. I think that will come out even more in this non-traditional format. As you probably have guessed, I am pretty involved in my medical care, so it’s always nice to have a physician who thinks like you, and appreciates the fact that you desire to be so involved.
Secondly, I am somewhat of a biohacker, although I am not really a fan of that term. I guess it’s better to say that I am in favor of personalized medicine. I am interested in studying my baseline biochemistry and genomics and learning how it works together. I also want to take it a step further and tweak my nutrition, supplements, and any pharmaceuticals that I deem appropriate, to helping my body run as efficiently as possible. I enjoy participating in appropriate medical research studies, especially the ones that provide detailed blood chemistry over time. In fact, I have used my participation in a rosacea study to provide me with baseline bloodwork that I have used to calculate personal reference ranges. I look to continue regular bloodwork as I begin to tweak some concerns that I have with my health.
Third, and probably most importantly, the medical concerns that I have are not treated by normal medical practitioners in the way I would like them treated. I took my concerns through the mainstream medicine route a year or so ago. By the time everything was explored, I was seeing several different specialists, on more medication than I was comfortable with, and later found out that I had elevated liver enzymes that no one bothered to check during my treatment. At that time, I ceased taking all pharmaceuticals, with the exception of fish oil. I have recently added one medication back, but I do not wish to stay on it any longer than absolutely necessary. In ridding myself of medication, I learned some important facts:
-My blood pressure can be controlled without medicine. If I measure it first thing in the morning, it’s relatively normal (the “old” normal definitely and pretty close to the “new” normal – as an aside, I really wonder why “normal” was changed… was it to prescribe additional blood pressure medication?). My blood pressure can become elevated when I am overly stressed, or – wait for it – at the doctor’s office and worried that it’s going to be high. Under normal conditions, it stays relatively normal. In fact, it behaves no differently than the “good” days, while on blood pressure medication.
-I have a dairy intolerance. Now, I won’t say that all of my digestive issues are dairy-related, but being dairy-free is a huge step in the right direction. Every now and then, I decide that ice cream or queso isn’t the problem I know it to be, and every time, I am reminded that it is. I definitely believe the remainder of my digestive concerns are food related.
-My headaches and body pains are directly related to the quality of my sleep. When I went drug-free, I started to hurt again. The medicine that caused my liver issues (duloxetine) helped mitigate my pain. But, I pushed through the hard time and made some changes that made a difference for a while. We got a new bed and my husband got a mouth-piece that reduced his snoring. The bed is still great, but the snoring is coming back, and for whatever reason, sleep is struggling again. Couple that with sparing class in Tae-Kwan-Do and that has brought my pain back with a vengeance. I am currently taking amitryptline and it’s helping some, but I vow to get off of it as soon as possible.
-I think that the majority of my issues are caused by hormonal problems. I read a book called “The Secret Female Hormone” and it made so much sense! I already knew I was low in progesterone, but it was surprising to see how low I am in testosterone also, for a woman. I haven’t had my estrogen tested in a while, but I wouldn’t be surprised if it was out of balance also. For some reason, hormone treatment via mainstream medicine is problematic. Reference range are very large, so it’s hard to get diagnosed with a problem, despite your symptoms, and doctors rather prescribe synthetic hormones instead of bioidentical ones. It seems like bioidentical supplementation is a completely separate branch of medicine and is not covered by insurance.
-I don’t want to see five different doctors for five different problems, where each person is prescribing the drug of choice for their specialty and no one is monitoring how this collection is affecting my body. I shouldn’t have to be the person ordering bloodwork to troubleshoot my own problems.
I want a whole body approach to improving my health that includes personal nutrition. I want one doctor, who I can communicate with regarding my personal needs and struggles, rather than have to play mediator between a bunch of specialists. I want to be able to order labs that I deem important at cost, rather than paying markup from vendors who provide “direct lab” services. I want to determine the extent of my hormone problems and fix them in the most appropriate manner possible. I don’t mind paying a reasonable monthly fee to enjoy these benefits and if I do have to see a specialist, at least for now (until my children are older or I change careers), I have amazing health insurance.
I think Direct Patient Care is a novel way to change the focus of medicine into something more patient-focused and holistic, pulling it away from the strangling grasp of insurance and pharmaceutical companies. I feel it’s my best opportunity for personalized medicine and improving my health naturally.