March 2003
Competing for recognition,
referrals and revenue
by Dr. Howard F. Loomis
In
last month's column, I wrote about the practice of immune suppression by
the pharmaceutical industry. I stated that contrary to television
commercials and prevailing medical practice, inflammation is not a
disease. Rather, it is the simplest and most fundamental reaction of the
body to tissue irritation and it is characterized by the appearance of any
of the following symptoms: fever, redness, swelling or even pain. I
suspect that most readers believe as I do that while these symptoms are
inconvenient and annoying, they should not be suppressed. A more logical
approach is to determine the stress, remove it and nourish the affected
tissues.
With
this in mind, I would like to bring to your attention another area you and
your patients should be aware of.
The
January 9, 2003
issue of The New England Journal of Medicine reported that more and
more people are getting health care from non-medical clinicians. Benjamin
G. Druss, M.D., MPH, of
Emory
University
's
Rollins School of Public Health stated that "people are increasingly
seeking health care from non- medical providers with different training
and different philosophical orientations."
There's
been a huge change in the way people get health care. A trend for people
to seek care from non-medical physicians accelerated in the 1990s, says
the study leader. By 1997, more than 36% of patients got clinical care
from a professional who was not a medical doctor. That's up from 31% in
1987.
You
may recall my reporting in previous columns that the pharmaceutical
industry became alarmed by this trend in the late 1980s and began
petitioning Congress in 1994 to change the FDA rulings that prevented
advertising prescription drugs on television. The changes became effective
in 1997 and the marketing blitz began. With the release of this study, we
see a changing attitude on the part of medical practitioners, if not the
drug companies themselves.
The
study cited above stated that patients are not necessarily moving away
from traditional medicine, but rather including other professions in their
health care.
For
example, we see more and more multidiscipline teams of clinicians being
formed. Dr. Druss says that "these teams may include not only nurse
practitioners and physician assistants but also chiropractors, midwives,
optometrists, podiatrists, physical or occupational therapists,
psychologists, social workers, and others." He continues, "For
people with chronic illness, multidisciplinary teams are the state of the
art. Our study shows that non-physician practitioners are providing
routine care to sicker patients. So this would be a good thing for
patients."
I
would suggest to you that now is a good time to broaden your scope of
practice. Find an area of health care that would fit neatly into your
present patient load that is also needed by a great number of those
patients. It will come as no surprise to you that I recommend specializing
in digestive problems. Correlating viscero-somatic reflexes with segmental
spinal muscle contractions and symptomology is actually quite easy.
Digestive
problems are always accompanied by muscle contraction (not spasm) in the
muscles that share spinal innervation with the involved organ. This
includes the para-spinal muscles associated with the innervation. Anyone
skilled in palpation can quickly correlate symptoms with painful trigger
points in the abdomen and spine.
The
following is a partial list of commonly seen clinical syndromes that
invariably have a dietary or digestive component:
***
Heartburn and indigestion
***
Gas pains and bloating
***
Constipation and diarrhea
***
Anxiety and depression
***
Insomnia
***
Stiff, sore joints
Accompanying
the Druss study is an editorial by nursing professor Linda H. Aiken,
Ph.D., RN, who is Director of the Center for Health Outcomes and Policy
Research at the
University
of
Pennsylvania
.
She says the study is "very important. This is the wave of the
future. It is a positive outcome." This suggests that many consumers
have benefitted from visiting a large array of non-physician clinicians.
"Doctors
are now recognizing that consumer requests go beyond what they can fulfill
themselves," she states. "They are referring patients to this
interdisciplinary workforce. It is now legitimate to think of health
providers as a combination of different disciplines."
I
would remind readers that there is no one in the health care marketplace
who presently specializes in normalizing digestion. Many chiropractors and
other clinicians are using their expertise in this area to broaden the
service offered in their offices, thereby increasing recognition,
referrals, and revenue.
Dr.
Druss believes that professional associations and specialty organizations
still fight turf wars, but that "relationships are generally quite
good between individual non-medical and medical doctors. Specialty
organizations, both medical and non-medical associations, tend to be much
more adversarial." He points out that they "would probably be
better serving their patients, as well as their membership, to be thinking
about ways of working together, bridging across their specialties to
ensure that clinical care is delivered in a coordinated fashion."
(Dr.
Loomis welcomes input on the subjects covered in this column. To make a
comment or ask a question, write to him at
6421
Enterprise Lane
,
Madison
,
WI
53719
.
Visit www.loomisenzymes.com online or call 800/662-2630 for information on
upcoming Loomis Institute seminars.)
