this post was submitted on 11 Jul 2023
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Frankly as a doc myself, I'd sort of rather my patients see a naturopath if they have to choose one. I'm not a fan of either but at least I know the local naturopaths will provide a nice listening ear, while the chiropractors just seem to do everything they can to actively hurt people.
My regular doctor refused to engage with research-based approaches to long-term health that cure underlying disease. Referred me to a naturopath instead. I'm talking about a study supporting targeted anti- and probiotics as a possible cure for a chronic condition.
Most doctors seem to busy to even consider preventative medicine.
Depending on the thing you're discussing, it sounds like your doctor referred you to a person who they felt would be appropriate for the request you had, so in general I'd say that's kind of a harsh summary. We can't be trained in all the things at all the times.
In the case of antibiotics and probiotics for chronic conditions in particular, there is - and I cannot understate this - an unbelievable amount of woo and misinformation around that topic. That isn't to say your specific concern falls in there, but I can understand why some docs feel overwhelmed with it. We get flooded with an incredible amount of pseudoscience in that specific domain, and it takes a huge amount of work to sort through what's real and what isn't.
Yeah, that's fair. My difficulty is feeling like chronic conditions are mostly ignored. In this particular case, I had a study that recommended a very specific course of action for my specific conditions, which didn't seem particularly woo to my eyes.
But yeah, every doctor should instead be 3 doctors, plus a dietician, pharmacist, and other health care providers. All working for holistic health of the patients.
The fact that this isn't happening isn't the fault of the doctors, but a lack of societal care for health.
I'll have to be vague to avoid too much specific info, but I have worked in both contexts where I have a full team at my disposal and where I'm just a lone doctor, and I agree wholeheartedly we need the team. Best if it's under the same roof. It isn't necessary for every patient but for the people who need it it makes a huge difference.
If it helps, many provinces have been trying to push something like that for a long time, but there are an entire host of problems that go along with getting it rolling. BC's interprofessional team systems are sort of that, but they're weak.
I would imagine funding and public support is among the biggest problems. Any other massive ones you see?
Well, a huge one is finding ways to make them easily accessible to doctors without uprooting the entire current infrastructure. The average doc can't just host a physiotherapist, dietician, and social worker in their clinic, and to work best there needs to be open communication between the different branches.
That's a fixable problem, probably starting by opening clinics where all the professionals work under one roof and the doctors are subcontractors to the clinic rather than owners and managers. That's a structure that wouldn't appeal to everyone but it would appeal to many. Then those clinics could take specific patient populations preferentially to do their primary care, eg. elderly people, people with multiple chronic illnesses, etc - helping to take the load from docs in independent practice who would rather not be part of a larger team. There are already clinics like that out there, and they've been pretty successful.
Ultimately though the biggest barrier is just money and trained professionals. The interprofessional teams in BC should fill this role fairly well, but don't have enough employees to reliably meet the gaps