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Sensible Medicine: A Rational and Collaborative Approach

Food as MedicineWhat I publish on DrDeborahMD embodies what I think of as Sensible Medicine. We offer you a partnership in health, similar to what I offer patients at my medical practice. Similar to most doctors, I perform a wide variety of jobs around the office, medical tasks such as physical examinations, clinical diagnosis, and ordering lab tests. Interestingly, in the world of medical reimbursement, these tasks hold little value. Paul Levy's recent entry in his informative blog Not Running a Hospital, describes the annual process of how a small team of physicians decides the reimbursement value of every action a physician might take, also known as the Relative Value Scale (RVS). Surgery and other procedures rank highly, whereas exams and diagnoses receive less reimbursement.

What I love doing the most as a doctor receives the least reimbursement value of all. I enjoy the collaboration with patients on the results of their tests or the effects of their new eating plan, and how those results then coincide with their own plans and desires for future health. Such a conversation is considered educational and not strictly speaking medical, and thus falls lowest on the RVS. An optimistic view of the future includes increased insurance reimbursement for preventative care, including health discussions such as these.

Physician-patient collaboration starts with findings of lab tests, x-rays, and other physician's diagnoses to produce answers to patients' four most common questions:

  1. What does it mean that I have (insert incomprehensible medical term or personal complaint)?
  2. What would be the healthy way for my body to function instead?
  3. Can I somehow return my body to its normal healthy state?
  4. Is it possible to do that without taking expensive and harmful drugs?

The path forward is not always clear, so we often work things out together. I can bring my knowledge of normal and abnormal physiology, as well as a review of medical literature. My patient may bring family history, personal experience, and questions or advice of friends and relatives. We then make a plan forward based on the prescriptive principles of Sensible Medicine:

  1. We start with food, food as medicine, both in treatment and prevention. A balanced selection of foods can provide support the body requires to regain good health. We talk about the healthiest way for the patient to eat, taking into consideration nutritional wisdom, personal preferences, and pocketbooks.
  2. Beyond food, my next recommendation is food-based supplements. Just as our bodies did not evolve to eat fast food, they did not evolve to eat the synthetic chemicals found in discount vitamin and supplement brands. My standard supplement advice is to buy the best, and take it as often as you can afford to. Better a whole food multi-vitamin four times a week, than an overloaded synthetic concoction on a daily basis. In fact, it is often the case that taking nothing (and eating well) is better for your health than taking that chain store bargain option.
  3. High quality single-ingredient supplements comprise the next category of intervention. I am wary of combination supplements unless an individual has experience with some or all of the individual components, in which case the components' fixed ratio is the only uncertainty. High quality means coming from a reputable manufacturer and passing quality assays where available. Most of the products recommended on the Your HealthWorks website have been well used by many patients before suggested for purchase.
  4. Apart from the above mentioned principles, Sensible Medicine factors hormone balance into the patient's overall health. Hormones are chemicals our bodies make that serve as messengers for regulating all sorts of body functions. Hormone deficiencies and imbalance are relatively common and can wreak havoc with good health. Some of the suggestions listed above can help replace and balance hormone levels. Additionally physicians can prescribe specialized treatment such as thyroid or post-menopausal hormone replacement therapy.

I consider the practice of Sensible Medicine to be reasonable and balanced. It speaks of common sense medicine, but also of using good sense. With this method, a physician considers basic physiology as well as modern clinical trials, and finds health-supporting solutions for the problem at hand. Medical findings and research always change, and given the transient nature of our certainties, the solutions of sensible medicine evolve with our understanding of health. as a website is a luxury for me: a place to compile the information about health that I find fascinating, where it is not fixed in stone but constantly changing to reflect the most recent medical findings. Our Health Topics constant update as we access new information. At Your HealthWorks we will be quick to announce a new finding - and add to or correct our previous advice. I enjoy the collaborative process the website offers, and want to hear from you. Does Sensible Medicine make sense to you? Do our Health Actions help you solve questions you have about your own health?

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