An Important Letter About Trust

trust, physicians, alternative medicineI recently received the following letter from a reader. The name and specific profession of the writer have been withheld by request.

Dear Dr. Mercola,

Your last newsletter discussed "trust." I'm there on the front lines, providing primary care in an urgent care setting since 1977. In addition to being a licensed health care professional, I've been a serious student of alternative and complementary medicine since 1980’s.

A few years back I saw a gentleman in the clinic with diabetic neuropathy who had no feeling at all below either of his ankles. His feet were OK, free of ulcers or infection. He was on the usual blend of mainstream medications which were not helping.

I'd known him for years, so I suggested that he try two supplements:

* Alpha Lipoic Acid: Standard of care therapy for neuropathy in Europe. In fact, in Germany, it's malpractice NOT to prescribe Alpha Lipoic Acid for a patient with neuropathy.

* Adaptrin (also available as Padma-Basic): This is an ancient blend of 18 herbs which has a remarkable effect on the microcirculation. In other words, it works in the capillaries themselves to improve blood flow and oxygenation. Among its numerous benefits, many neuropathy patients have all feeling returned to their feet after two weeks on this stuff.

He asked me to write them down, so I did, having every expectation that he would be better in two weeks. When he asked his daughter to get these items, she took the list and rushed over to administration and complained. Next thing you know, I'm defending myself in a professional review action. I was condemned, in my own handwriting, by the suggestions I'd written down for the gentleman.

The issue was not the efficacy of the supplements. The committee didn't care whether they worked or not. Alpha Lipoic Acid may be the standard in Europe, but it's NOT the standard here. Their concern was that any deviation from the official mainstream published "standards of care" exposes the facility to liability. And Dr. Mercola, the sad part is, they're right.

By agreeing to stick with the "standards of care" in the future, they decided not to terminate me. I was officially counseled to NEVER discuss that "homeopathic stuff" with any patients. As a result of this experience, when I'm on the clock, I'm totally mainstream.

The take-home lesson of this experience is this: Trust works both ways. All it takes is one complaint from a patient or a family member to shut down an alternative provider. Even praise will do you in. If a patient tells another doctor, "Boy, that Sambucol really works. I never catch a cold." I'm in trouble again.

I'm not totally shut down. If a patient ASKS me about some alternative therapy, I will give them an honest and well-informed answer. But if you don't ask, I cannot tell. Another suggestion for a patient is to ask something like, "If you had my illness, what would you personally use to treat yourself." That I can answer honestly, because I'm not telling you to do anything.

Very few of the 38 percent of American adults that use complementary medicine ever show up here. The reality is that patients who go to mainstream clinics expect mainstream care. That's just the way it is. And I have to meet their expectations. The bottom-line is this: When you're a seeing person in a blind world, it's unwise to rearrange the furniture.

[Name and position withheld by request]

Dr. Mercola's Comments:

Personally I have never held back providing everything I know when caring for patients, either in my practice or in information I provide on the web. However this story reminds me that many health care professionals have similar beliefs and approaches but their employment circumstances prevent them from applying what they know to be true and effective.

This is an unfortunate consequence of the society we live in, and until we change the system from the bottom up, which is what I seek to do with this newsletter -- by educating you as a health care consumer, then this scenario will remain unchanged.

The Hippocratic Oath – the promise to Do No Harm – is, I believe, what most physicians indeed strive to live up to. Whether or not they succeed is another question. What this reader brings up is important point though: Even when physicians want to, and try their hardest to help their patients improve their health through safe, effective and oftentimes inexpensive alternative means, it is not always possible to do so.

The conventional medical system is simply not designed to give them that freedom.

Unfortunately, that does place a certain amount of responsibility onto you, the patient. Because although there may be much safer means to help with your ailment, if you go to a conventional physician, he or she is likely not going to tell you about them unless you ask, and ask in an appropriate way, as highlighted above.

Can Your Doctor Trust You?

According to a Gallup Poll from December of 2006, medical doctors rated “very high” for honesty and ethics, and were fourth from the top of the list of professions included in the poll. 69 percent of people polled believed their doctors were honest and ethical, and 85 percent of the people polled believed they could trust their doctors.

And yet, one-third of adults with health problems have reported mistakes in their care in 2007, and doctors are, according to some studies, the leading cause of death in the U.S. in combination with prescription drugs.

Clearly, there seems to be a disconnect between the amount of trust given to doctors, and the results you get in return. But, as far as I know, there are no studies showing how involved patients are in their own care and how well they understand the system, and I believe that’s part of the crux here.

You clearly need to take responsibility for your own health, and also become aware of the many limitations placed on conventional care facilities, if that’s where you go.

An estimated 38 percent of U.S. adults now use some type of complementary and alternative medicine. And many are opting for alternative medicine because their conventional physicians don’t agree with using natural alternatives like supplements instead of prescription drugs. In fact, about one in four patients thinks his physician sometimes exposes him to unnecessary risk, according to a study published this year in the journal Medicine (cited in an article in the New York Times).

But then there ARE conventional physicians, like the professional who submitted this letter, who are more than willing to provide their patients with the safest and most effective care, yet simply cannot due to the rules of the medical infrastructure.

This is not the physician’s fault,  I agree: trust must go both ways in these situations. But above all, you simply must make the decision to take responsibility for your health, and knowing HOW to ask your doctor for advice on matters relating to alternative medicine is just as important as knowing there may be alternatives to drugs in the first place.

Fortunately, Universities nationwide are increasingly focusing on complementary and alternative medicine. According to the Association of American Medical Colleges, more than 95 of America's 125 medical schools require some kind of complementary and alternative medicine coursework.

So maybe, sometime in the not-so-distant future, you will be able to ask your doctor for a non-toxic remedy, and he won’t have to withhold the information for fear of losing his license.

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