By Dr. David Boguslavsky

As long as there have been human communities, there have been those whose duty it was to care for others: the shamans, doctors and healers. As science advanced, it offered more and better solutions for alleviating human suffering and for addressing the diseases that plague mankind. One of the  best ways to help someone, however, is to help a person prevent illness in the first place. Some would argue that the current model of cookie-cutter medicine and the complete standardization of treatment leads further away from this goal. While this approach may lead to a better “bottom line”, it risks treating each patient as a widget instead of as a person with history, worries and context.

For example, if a person goes to their regular doctor or urgent care clinic with complaints of back pain, they may immediately be prescribed NSAIDs, muscle relaxants or, possibly, opiates. X-rays or MRIs may be ordered and the patient will be asked to come back in a number of weeks. A more holistic practitioner, conversely, may obtain a more detailed history, examine the patient for spasm and muscular hypertonicity, confirm absence of neurologic signs and seek to determine if there are underlying conditions contributing to the patient’s pain. Then, instead of reflexively reaching for a prescription pad, a consideration will be given to other complementary approaches, like chiropractic care, medical acupuncture and massage therapy. A dietary overhaul may be suggested to further reduce symptoms of inflammation. Rather than seeing the patient back weeks later, a more holistic practitioner would more likely closely supervise the recovery process and alter treatment depending on the individual response.

Similar divergences may occur in the treatment of patients presenting with a sinus infection. Many patients have been conditioned to think that the only solution is immediate antibiotics. Oftentimes, if the infection persists, patients are given multiple rounds of stronger and stronger medicines. Evidence suggests that this therapeutic approach leads to over-prescription of antibiotics and may cause more harm than good. The same patient, when seen by a more holistically-minded practitioner, may instead be recommended sinus rinses, Chinese herbs and medical acupuncture. These therapies oftentimes limit the discomfort experienced by the patient without the additional risks associated with antibiotic exposure.

Of course, most medical practitioners care for their patients and offer medical care that they think represents the optimal path towards recovery. However, multiple pressures exist to reduce patient care to a conveyer belt method, where each patient gets a minimal amount of time with their doctor needed to establish a diagnosis, prescribe care and to move on to the next exam room.

Although it is unclear if the patients are best served by such a system, it is evident that most patients prefer it when their doctor knows them and takes all the time necessary to consider every complaint and to examine it from the standpoint of both traditional and complementary medicine. Finally, time is essential to craft a treatment plan that is suited to that particular individual and their complex, bio-psycho-social context. All patients deserve such care and should demand nothing less.

David Boguslavsky, MD, graduated from Tufts University prior to obtaining his medical training at the RWJ Medical School. He completed his residency at the Somerset Family Medicine Residency program and received additional training at UCLA Helms Institute for Medical Acupuncture. Dr. Boguslavsky is dual board-certified in family medicine and medical acupuncture.

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