Over the years I’ve helped many people to not only overcome injuries, but restore health on many levels. This could be in the form of weight loss, more energy, improved GI health, and many other things. In many instances these people are able to stop using multiple medications in the process, sometimes those they have been taking for over 20 years! (all of this of course under the supervision on their prescribing physician ;)) This is always extremely rewarding for me and I’ll never get tired of helping someone transform their life by vastly improving health and ridding themselves of the chains of medications. However, in many of these instances I hear people talk about going back to check-in with their primary care physician. Obviously as a chiropractor this has always somewhat bothered me. We (chiropractors) have always been thrown into this ‘alternative care’ bucket, as if the care I provide is some alternate to ‘real’ healthcare. This even happens with some patients in which I provide the vast majority of care when it comes to their health. Helping them with injuries and pain, assessing labs, modifying nutrition intake, running labs to assess health and not just disease, providing natural approaches to restore health, etc. All of this seems to be the real main focus in a person’s health, so why then is it considered ‘alternative’ healthcare. Since this has been boiling inside my head for quite a while I’ve decided to completely redefine the way in which we see and label physicians. While viewpoints are beginning to change many people still use their MD of choice as their primary care go-to. However, I would like to try and change that paradigm for you, in what I think makes a lot more sense when it comes to optimizing the health of an individual. So, in unfolding this new paradigm of primary care let’s explain this in what I believe should be three levels of care and how I think they should be defined. And since the term primary care is so widely used (and in my opinion so grossly misused), we will use the terms primary, secondary, and tertiary to explain this new paradigm
#1 Primary-care Physician:
Firstly, the definition of physician is:
a person skilled in the art of healing; specifically : one educated, clinically experienced, and licensed to practice medicine as usually distinguished from surgery
Now, while physician does mean someone who has a license (MD, ND, OD, DC, etc), adding the primary care to the front really changes the game. In my opinion, the primary care physician should be the one who has the most ability to change the scope of your total health and wellbeing. And if we really want to label who the primary care physician should be: IT IS YOU!!!
That’s right! If you are looking to maintain and optimize your health, then you are your own primary care physician. The #1 way that you can protect your health is by doing the things that you’ve always heard about: eat well and stay moving. Now, while it is not as simple as just that, you can tremendously improve your quality of life, vitality, and longevity by following a ‘healthy’ lifestyle. Healthy is in quotations because this doesn’t always mean the same thing for everyone. Nutrition can be slightly different for everyone, beneficial types of exercise can be different for everyone depending on their situation, and healthy protocols can differ widely depending on someone’s current health status. However, in all situations, YOU are the primary care physician. If we can start to wrap our heads around that, then I think health care may just start to shift in the right direction.
#2 Secondary-care Physician
Secondary-care physician should be by definition the layer of care necessary if the primary care physician (YOU) cannot sustain or improve health. We should have levels of intervention when it comes to health and the first level should always be the most non-invasive. So, the secondary level of care should be those health professionals who are experts in the areas that most greatly affect health status, while also at the same time doing it in the most non-invasive manner. So, then we need to know the areas that most greatly affect daily health status so we can find these professionals. These areas are nutrition, fitness/movement, sleep, and stress management. I think that most people can agree that these are definitely pillars of health and those who are typically the most healthy, are the ones who understand how to optimize these pillars. The strategies are not always the same for everyone and proper self-protocols may change situationally or depending on what stage of life you are in. So, finding professionals who are experts in these fields is important. They are crucial people that should be on your health team. Again, if we look at them as ‘secondary-care physicians’ then we can truly appreciate their importance. Some professionals that might fit this category are chiropractors (of course!), nutritionists, dietitians, personal trainers, massage therapists, movement specialists, yoga instructors, Pilates instructors, meditation leaders, tai chi instructors, etc. etc. While you might not think of all of these people as standard health care practitioners or physicians, I would argue that they many times have a much bigger impact on your health that medical doctors. Remember, MDs are FANTASTIC at acute care or disease management, but not so much at addressing the pillars of health previously described. It’s not their fault, it’s just not what they are trained to do. So, if you can’t seem to find the ways to optimize your own health, or need a little help in seeing what is going wrong, find the appropriate ‘secondary-care physician’. An even better plan is to find “YOUR TEAM”. These are the people that contribute to your overall well-being and I believe that everyone should have multiple people on this team. People who help you move well, eat right, reduce stress, and keep a clear mind.
#3 Tertiary-care physicians
This level of care should be seen like a safety in football. Once your primary and secondary defenses have not proven strong enough to restore health, sometimes you have to rely on the safety to save the day. This is when the big guns need to be called in to act. This level requires targeted strategies and interventions to help get things back on track so that health does not further decline. Again, 1st and 2nd levels should be attempted first in the majority of cases. Sometimes this third level may even require drugs and surgery. Yes, these things are not always bad!! They are extremely useful and many times can save lives. Medical doctors are amazing physicians and I still marvel at some of the things that they can do to intervene in a situation. However, we need to get away from using them as primary care tools. This strategy has really gotten us into a mess and is making people even more sick. Pharmaceutical companies spend millions of dollars annually to keep drugs as the primary tool for health care. It’s NOT WORKING! Let’s keep them as a tool because they are very powerful, but start to learn when and where to use them judiciously. But, if you need to go the tertiary level of care then you need to find the proper medical doctor or functional medicine practitioner who can handle the job. The specific professional will vary depending on what condition you may be facing. Many times a non-medical functional medicine practitioner can intervene naturally and restore health without resorting to medications. However, sometimes medical doctors are the only ones who can address the severity of the situation. Always best to have both on your team so that you can use the proper professional and they can refer to each other as needed.
I think that this re-defining of the primary care physician and levels of health care should make sense to most people. In fact, I think more and more people are trying to find ‘alternative’ health care practitioners so they can avoid drugs and surgery. Sometimes they just don’t know where to look. Hopefully this new paradigm will help you find professionals that can really make an impact on your health. It’s time to find your own personal team. A team of professionals who can play a part in keeping you healthy. You just need to stop seeing your whole team as made up by a guy (or girl) in a white coat. Your team is much more vast than that. And the major team players are probably much different than you have ever thought about before. The primary one being YOU! And don’t be afraid to ‘shop around’ for your team. Don’t think that you have to just accept what anyone on your team says. Find the people who are not only educated, but are also primarily interested in your health first. If anyone on your team in unwilling to work with other people on your team, then it is probably a good time to move on. No health practitioner knows it all. No health practitioner should be unwilling to co-manage care with others who are looking after your health. The flip side to this is also true. Don’t think that you can find a ‘secondary-care physician’ who can just take care of EVERYTHING. They must also know when it is appropriate to refer out to a medical doctor for consultation and co-treatment. Every health professional has a part to play in your health. Search for your team, find the best, and watch your health soar!