When I was a nurse in the clinical setting, I was fortunate enough to work within a traditional model of medicine, where the nurse was the gatekeeper for the doctor. All urgent matters would go through the nurse, who would then triage them out determining how a patient needed help and from whom they needed the help. In this model, the nurse would see the patients first and record their medical history, medications/supplements they were actually taking, and any updates on how they had been feeling since their last appointment. Then, the nurse would condense all this information down in order to brief the doctor before he or she went into the room. A little while later the doctor would come out with orders and the nurse would go back in to coordinate care, provide education, help discuss options, and advocate for the patient and their ongoing needs.
Today, most clinics are run by doctors and medical assistants (who are wonderfully skill-based by the way). This is a brilliant economic prototype. In today’s healthcare model our patients’ biggest complaints are that they see too many providers and that no one, including themselves, knows what’s going on. We have these giant medical institutions that have every specialist one may ever need. From cardiology to immunology, from pediatrics to geriatrics. These institutions are huge, inviting, and remind many us of a hotel or resort. But, what if the walls could talk? What are the walls noticing? They are probably noticing patients wandering the halls all day-long from appointment to appointment and from lab draws to x-rays. They are in search of answers and have been told by countless doctors they need to go see a “specialist” for what ails them. Only to be shuffled to another specialist. This western model of medicine is test happy, specialist happy, drug happy, and quick-fix happy. I ask this, who is holding the space for the patient? Who is advocating for the patient? Who is helping the patient maneuver the seemingly endless amount of appointments and tests? Who is assuring the patient complies with all of the orders and recommendations they receive from their providers?
Many individuals throw up their hands and seek alternative methods. An integrative medicine doctor, a functional medicine doctor, a naturopath, an acupuncturist, a massage therapist, and an herbalist – just to name a few. We have functional medicine doctors that specialize in thyroid disease, in pelvic pain, and in Lyme disease. We have integrative pediatricians and other integrative doctors who specialize in mindfulness, dentistry, and rheumatoid arthritis. Can you see a pattern here? Is alternative medicine following in the same footsteps western medicine has paved? Individuals are being bounced around from one practitioner to another, all of whom don’t even work in the same zip code, and they definitely don’t have access to the same medical records. All this disarray leaves the individual very unsure of what to do. Take this example: A patient is suffering from anxiety, fatigue, joint pain and insomnia; an acupuncturist told them to take chinese herbs, the naturopath 15 miles away told them to take ashwagandha and skull cap, and their primary care physician wrote a few prescriptions to be filled at the local pharmacy. One may ask, is it safe to take all that? Do any of these herbs and pharmaceuticals interact? I ask again, who is holding the space for the patient? Who is advocating for the patient? Who is helping them maneuver their appointments and tests? Who is helping them live out all the orders and recommendations from their providers?
Traditionally, it’s been a nurse’s job to advocate for patients and help coordinate care, but I’m not aware of too many alternative medicine offices that employ RNs. Will it be a Health Coach that can help these patients? That (Health Coach) seems to be the new buzz word especially in functional and integrative medicine. Do they know anything about medicine, labs, and medications? Plus, where has that Health Coach been trained? Did you know that you can pop online and purchase a complete e-course and become a health coach within days?
Who is going to come to the rescue for the patients? Many families and patients try to do this all on their own. But shouldn’t our western or alternative models provide this continuum of care for patients? Shouldn’t patients demand that the right and left hand come together and start talking about each and every life changing decision a patient has to face? My answer is Yes. Whether it be a Health Coach with a true medical background (like a nurse), or a nurse who simply has an integrative approach; we have to coordinate patient care, we have to advocate for patients, we have to build centers where the providers, support staff, and other integrative practitioners sit down in the morning and look at plans of care for all their patients coming in for the day. We have to put the patient first and work for them. After all, these patients are sick, in pain, in crisis and we ask so much of them. It’s time we allow a space for healing, education, and care. And most of all, it’s time to allow these patients to Thrive!