Palliative or symptomatic care has become standard of care in the United States. Medicines and therapies which help manage symptoms but do not address the underlying causes which create the symptoms is an easier approach to healthcare in the short-term. With this paradigm, patients can be fit into 5-10 minute office visits which are treatment oriented. But it does not take great powers of observation to grasp the downside of this approach: patients get sicker rather than more healthy, treatments become more complicated and more expensive over time, and we are left with the world’s most expensive, technologically advanced healthcare system and one of the least healthy populations in the Western World. In 2010 the U.S. Center for Disease Control released data showing that 34 percent of American Adults are clinically obese (more than double the percentage in 1980), and the percentage of obese children has tripled over that same time period to 17 percent.
When faced intellectually with a choice of receiving ongoing medical care, either in the form of physical medicine or drugs, or curing the underlying problems and restoring health, most people have no trouble choosing the latter. But engaging with issues of exercise, weight loss, diet, stress-reduction, etc.–issues which entail lifestyle changes–is hard and may be far more than a patient bargained for when she first presented to a doctor’s office with a back strain. From the doctor’s perspective, helping patients regain health require much more time, risks losing patients who are not ready to confront these difficult issues, and is often perceived to work against his own economic interests. Chiropractic doctors are poorly reimbursed by insurance companies, especially when they try to work with patients on improving health, and success in this regard means curing a patient who in turn no longer requires his services.
I made the decision before I ever saw my first patient that I would dedicate my clinical practice toward promoting health, working for cures, and empowering patients not only to get well, but to stay well. That is why dietary management, supervised weight loss, home care exercise and stretching regimens, and stress-reduction techniques are an integral part of my practice. Contrary to the belief that empowering a patient to achieve a higher level of health is bad business, I have found it to be the single best marketing tool of my practice, with most of my new patient referrals coming from other doctors who share this philosophy of truly caring for people and from healthy ex-patients. That being said, I have also learned over the course of my 25 years in practice to respect the timetable and wishes of each individual patient I have the privilege of meeting. Successful care that leads to patients getting control of their migration toward the healthy end of the Continuum means a shared desire undertake change. If a patient, for whatever reasons, is not ready for comprehensive health care management, I have learned that I must respect that decision and help in whatever way I can to meet his/her needs. Approximately half of my practice consists of restorative or palliative care, and while fixing an injury or helping a patient manage with treatments that diminish pain may not be quite as satisfying as helping a patient become truly healthy, it is still a wonderful feeling to be available to anyone in need of help on any level.