Choosing a Medical Provider – Overview (Post #1)

I’ve decided that I need to find a new doctor.

The problem isn’t with my current doctor, who I like quite a bit, but with the entire system around her. All of the ancillary stuff, like getting a referral, moving my records, getting significant time from specialists, has been disastrous. Because moving medical records is so difficult, I figure that I need to switch sooner rather than later, because every visit with her is further investment into a system that I don’t want to be at long term.

My first option is finding another MD in another medical system. That’s absolutely on the table, but there are significant drawbacks: 1) It will probably take me months to get the first appointment, and then weeks to a follow up. It’s like getting my medical advice by snail mail from England. 2) It costs at least $400 per basic appointment. Sometimes I pay, sometimes my insurance pays, but it’s certainly insane. 3) It takes at least 2 hours of my time for 15 minutes of actual doctor time.

To be clear, I believe in medical science, in the sense that I don’t think there’s any other process that reliably produces better understanding and advice on human ailments. On the other hand, doctors are not doing a complete literature review before each diagnosis. They’re listening to me for about 7 minutes, glancing through my medical record, and coming up with their best guess on the spot. They don’t submit a case study document with citations for peer review, and they don’t necessarily follow up after a week for detailed feedback on their treatment’s impact. While medical school was absolutely based on science, but the actual clinical process simply doesn’t allow time for an hypothesis-experimentation-analysis cycle.

So I have the highest respect for doctors and medical researchers. The problem is in the business. With the exception of some specific chronic diseases like diabetes, the model is designed for point diagnosis, not to work with patients over time (especially not with their active participation). That is why I started considering (emphasis on considering) other options. For what it’s worth, I’m hardly alone: about 1/3 of American adults were actively using a Complementary/Alternative Medicine technique according to the NIH (though it’s worth noting that they’re grouping together things like “Deep Breathing” and “Meditation” with “Chiropractics”).

One of the attractions of CAM is that many of the interventions are extremely low risk, and low cost. I already meditate, which almost certainly isn’t hurting anything, and has cost less than $50 for books and an app. In the last year, I’ve twice gotten therapeutic massages in response to acute muscle pain. The first time, it led to an immediate and lasting improvement. The second time, it didn’t work, but felt nice. ¯\_(ツ)_/¯ The benefit of the first absolutely justified the second. (1hr/$90 each)

So I’m doing some research into nutritionists, naturopaths (UPDATE: no), and anything else that people might find valuable. Email me if you’ve got ideas or personal experiences in this space!

UPDATE: I’m getting particularly interested in finding people who are more like guides than experts. A loose example would be a fitness guide, who might give their client some suggestions, some things to read, and check back in on a weekly basis. At the outset, they can’t know what will work, but by pairing objective research with the client’s ongoing results, they help iterate towards the right solution. Most of these people are focused on weight loss, though, not sure how to find anyone who helps with anything else!

UPDATE 2: I’ve looked into dieticians, with mixed results. But I’ve scheduled an appointment with the one who seemed most scientifically grounded.

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