Everyone needs access to the healthcare system. Even with insurance, however, using the healthcare system is costly. So ideally, you want to save it for when you really need it.
Getting the most out of the healthcare system is a matter of having the right expectations. The healthcare system’s greatest strength is acute intervention for a sudden or unexpected event. If you were in an automobile accident or had a heart attack, the services offered by the healthcare system can stabilize the injury and possibly can even save your life. Note, however, that healing comes from inside your body. The healthier your body is, the faster you will recover from the injury or bodily insult.
Having access to the healthcare system is also important for screening. Labs and other types of diagnostic tests can sometimes pick up hidden signs of chronic illnesses before you would notice symptoms. While there are hundreds of different types of tests that can be performed, only certain tests are done routinely and covered by insurance.
Following are some of the routine diagnostic tests commonly ordered by health care providers:
- Complete blood count (CBC): screens for anemia and abnormal white blood cell count, which can indicate infection or blood cancers, such as leukemia
- Blood chemistries: generally normal unless you’re really sick
- Liver function tests: screens for the rate of loss of liver cells, but not liver functional capacity. It does not test for the presence of fatty liver disease or define the ability of your liver to process toxic substances.
- Blood glucose: screens for prediabetes and diabetes
- Kidney function tests: screens for certain kidney diseases
- Screening colonoscopy at age 50: screens for precancerous polyps and early cancer. Less invasive DNA stool testing is also available, but is less accurate.
- Mammogram in women: for detection of early breast cancer
- PAP smear: screens for cancerous and precancerous lesions on the cervix
- Prostate-specific antigen (PSA) in men: screens for prostate cancer
These types of tests, however, are designed to pick up early disease, not disease before it happens. There are few other tests worth knowing about that can indicate other health parameters. Although these tests can be ordered through a doctor’s office, they typically aren’t covered by insurance. Fortunately, they are available as at-home tests that can be ordered through the internet or purchased at a pharmacy.
- Hemoglobin A1c (HbA1c): tests for the rate of glycation in the body. Glycation is a significant risk factor for chronic illness. The lower your rate, the better off you are. See Chapter 17 for more information about HbA1c.
- Vitamin D level: measures the body’s level of vitamin D. Vitamin D is important for many functions in the body. Though you get some vitamin D from a healthy diet containing fish, your body makes most of it from exposure to sunlight. If you live in northern latitudes and have reduced exposure to sunlight in the winter, having your vitamin D level checked once or twice a year is a good practice.
- Omega-3 fatty acid level: indicates balance of omega-3 vs. omega-6 fatty acids in the body. An ideal ratio for a normal inflammatory response is a ratio of 1:6 omega-3 to omega-6. See Chapter 11 for more information about omega-3 fatty acids.
Although testing can be an important part of preventing chronic illness, staying healthy is your responsibility. The healthcare system has little capacity to prevent chronic illness from happening or restore you back to wellness if you become chronically ill.
Symptoms are your best indication of changing health status. Pay attention to what your body is telling you. At the first sign of any symptoms, you should become proactive. Go down the list of the stress factors, and look for deficiencies.
- Could your diet use an upgrade, or have you been taking too many dietary liberties?
- Are you being exposed to hidden toxic substances, such as mold growing in a basement?
- Are you pushing the stress button too much or not sleeping enough?
- Have you picked up an infection of some type?
- Have you been taking herbs every day?
Acting early might save you a trip to the doctor’s office. Even with the best intentions, however, sometimes life’s events can’t be controlled. Stress adds up while you’re not paying attention, and suddenly symptoms come out of nowhere. And then, you start to worry about what type of chronic illness might be brewing inside. Worst of all, is it cancer?
This is another place where the healthcare system is valuable. Diagnostic tests can rule out possibilities such as cancer. If cancer is present, conventional cancer therapies are important for eradicating the cancer cells. For other chronic illnesses, drug therapy and surgical procedures can reduce symptoms and stabilize the processes of illness, which can help set the stage for recovery.
What these conventional therapies can’t do, however, is promote healing. That part is up to you. It’s all about creating an environment inside your body to allow your cells to recover. If you are chronically ill or you become chronically ill, the guidelines in this book are your pathway back to wellness. Always remember, 90% of recovery from any chronic illness is a result of self-care.
Access to the Healthcare System
In the United States, physicians undergo four years of training in medical school and then three or more years of training in a specialty. The primary care specialties include family medicine, pediatrics, internal medicine, obstetrics/gynecology, or emergency medicine. Some physicians choose to specialize in more advanced surgical or medical specialties, such as cardiovascular surgery or neurology, which are typically accessed only by referral from a primary care provider (PCP).
Your connection to the system is a PCP. That can be a physician from one of the primary care specialties, but it also can be a nurse practitioner or physician’s assistant who works under a PCP.
There are three different types of encounters with a PCP. The first is a routine screening exam, often called a well visit. In other words, you’re not sick. It’s an opportunity to connect with your PCP, have a basic screening physical that may include a breast exam, prostate exam, or PAP smear (depending on your sex), and they may order screening labs or other diagnostic screening tests. This type of exam occurs every one to two years.
The second is a sick visit. It’s scheduled if you develop concerning symptoms or become ill in some way. Your PCP will take a history, do a physical exam, and order appropriate tests to evaluate your symptoms and determine a diagnosis. If your situation is straightforward, your PCP may be able to administer treatment or prescribe drug therapy, depending on the nature of the problem. Otherwise, you may be referred to a specialist for further evaluation.
As you’ve learned, chronic illnesses are typically associated with stressed cells throughout the body, and therefore all chronic illnesses can be associated with a diverse range of possible symptoms. Medical specialties, however, are compartmentalized. In other words, you may end up being referred to multiple specialists — one for each type of symptom — who each may have different opinions about your condition and what therapies to offer.
The third type of visit is a follow-up exam. Once you’ve been diagnosed and receive treatment, you return to define whether the treatment is working properly and receive prescriptions for ongoing therapy. Initially, this may include follow-up visits with multiple specialists and your PCP. Because medical therapies for chronic illness typically only suppress symptoms and inhibit the processes of illness, follow-up visits are typically scheduled on an ongoing basis. In fact, medication refills make up the majority of office visits for many PCPs.
It’s important to keep in mind that all medical providers are trained exclusively in treatment of illness with pharmaceutical and surgical therapies. They receive little training in nutrition or prevention of illness. Information about herbal therapy, nutritional therapy, or other alternative therapies is not part of the medical curriculum. If a provider happens to know about those things, it’s because they have sought out education beyond what the medical system offers.
It’s also important to note that conventional medicine is highly procedure driven. Even an office visit is defined as a procedure. The bigger and more complex the procedure, the greater the reimbursement to the provider and health care facility. Of all procedures, office visits garner the lowest reimbursement. This provides a huge incentive for health care providers to turn over office visits rapidly and order diagnostic and therapeutic procedures whenever possible.
The key to making the best use of the healthcare system is to respect its limitations and learn how to work with practitioners within those limitations. The following guidelines will help you cultivate a more positive relationship with any health care provider you might encounter.
Establishing a Good Relationship with a Health Care Provider
Here are a few guidelines to help you establish a positive, productive relationship with your general health care provider:
- Be specific about the goals of the visit. If it’s a routine screening exam, there isn’t time allotted to discuss symptoms or issues that may be bothering you. Touch on the highlights of your concerns, and schedule another visit to go into the details.
- Be respectful of your provider’s time. The system is designed around strict time limitations. Your provider only has about 15-30 minutes (depending on the type of visit) to spend with you. If you press for more, then you will throw the provider’s schedule off, and nobody is going to be happy.
- Be organized. Have information readily available, such as previous lab results and/or personal observations, which may be helpful in achieving the goal of the visit.
- Accept that your provider will likely offer only drugs and possibly surgical procedures. Your provider’s knowledge and training generally does not extend beyond conventional medical therapies. If you expect more, you will be disappointed.
- Don’t be afraid to ask questions. If something isn’t clear, make sure it is clear before moving forward. Many doctors know less about the long-term side effects of the drugs they prescribe than they should. Also, many doctors take a “shotgun” approach to ordering labs or other diagnostic tests with little regard to cost or whether the results will actually influence your outcome. All surgical procedures are associated with potential risks and adverse outcomes. It’s up to you to make decisions about risk vs. benefit.
- Remember, you always have the last word. Do your own research. The internet provides a wealth of information (but sometimes misinformation) about medical therapies, but also alternatives to medical therapies. Before making decisions about your health, you should be as informed as possible.
Types of Medical Providers
Doctor of Osteopathy (DO)
DOs are the equivalent of MDs. They go through similar medical training as MDs, but some DOs have more training in natural approaches to healing. DOs can go through the same specialty training as MDs. Specialty-trained DOs function the same as specialty-trained MDs. Both are considered physicians.
Nurse Practitioner/Physician’s Assistant (NP/PA)
NPs and PAs work under the license of a medical doctor. Generally, they work in the same office as the doctor who sponsors them, but they can also work in free-standing offices. They can, within certain restrictions, write prescriptions and order labs or diagnostic procedures. In general, NPs and PAs are able to take more time with you than a doctor and can tap into the knowledge of the doctor when necessary.
Integrative Medical Doctor
Integrative physicians are defined by the use of alternative therapies or alternative applications of drug therapies. They typically do more extensive laboratory evaluations than conventional doctors, with the hope of picking up subtle abnormalities that can be corrected. They commonly offer alternative medicine procedures, such as IV nutrient therapy, IV chelation, IV ozone therapy, and hyperbaric oxygen. While these procedures can improve patient well-being, they come with a hefty price tag and typically aren’t covered by insurance. If you decide to work with an integrative physician, know upfront the purpose of each lab and procedure, the overall cost to you, and how the information will guide your treatment plan.
Functional Medical Doctor
Providers trained in functional medicine take a holistic approach to therapy. They look for underlying causes that can be reversed with diet, lifestyle changes, and supplements. They typically spend a generous amount of time with patients and use less in the way of invasive procedures. Seeing a functional medical doctor can be a best-of-all-worlds situation, short of one big drawback: the out-of-pocket cost. Because the healthcare system does not pay them to practice this way, most functional medicine providers are only found in larger cities, typically do not take insurance, and can be quite expensive.
Naturopathic doctors operate much like functional or integrative medical doctors, except they generally have more extensive training in herbal therapy. Naturopaths can also write prescriptions for drugs in states where they are licensed, but this is limited to select states.
Most chiropractors rely on realignment of the musculoskeletal system to reduce symptoms of pain and discomfort. A chiropractor can be valuable for relieving musculoskeletal symptoms without the use of drug therapy. Some chiropractors also offer care much like functional medical doctors, but they cannot write prescriptions. Many chiropractors are far more knowledgeable about natural therapy options than conventional physicians.
An acupuncturist uses specialized needles or pressure at specific points on the body (called meridians) to restore balance in the body’s energy fields. Studies have documented benefits for many types of conditions. Achieving benefit generally requires multiple sessions and may fade when sessions are discontinued. Many acupuncturists are also trained in traditional Chinese medicine (TCM) with Chinese herbs.
To become certified as a practicing herbalist, the American Herbalist’s Guild recommends 1,600 hours of didactic training and 400 hours of clinical training at a certified school of herbal medicine. That being said, there are some highly skilled practicing herbalists who have little formal training, but have accumulated years of practical experience. If you are fortunate to have a knowledgeable herbalist in your life, this person can add great value in tweaking and varying your herbal regimen. Many herbalists offer or partner with complementary wellness services such as energy healing, acupuncture, or massage therapy.
Rather than offering medical advice, a health coach is trained to help individuals be accountable, proactive, and remain motivated to improve their health habits. They are there to support the goals you’ve set with your health care practitioner. A health coach can keep you moving in a positive direction – wherever you are on your health journey. While health coaches are generally more accessible and affordable than other providers, know that most coaching services are not covered by insurance.
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