Additions to Step Four:

Interview the Provider

Do you practice a holistic approach to health care? If so, what does that exactly mean to you?

If this physician has no interest in practicing in the spirit of holistic health care, you'll know immediately from his or her answer to this question. If the physician does practice holistically, he or she will be happy to share with you exactly what that means to them. Such information can help you decide if they are the right doctor for you.

Do you practice alternative techniques exclusively or in tandem with conventional medicine?

The answer to this question should give you an indication of how much alternative medicine the physician uses in his or her practice and if they are alternative, complementary, or integral in their approach.

Can you describe your training in the alternative techniques you use and how long you have used them?

If you feel you did not get a complete answer to this question from the staff, ask it again of the physician. It is critical that you are confident that this physician is competent in the alternative practices he or she uses before agreeing to treatment.

Additions to Step Five:

Form a Partnership
First and foremost, recognize that even though the person sitting across from you is the "doctor," he or she is also a human being like you. To get the most out of your relationship with this professional, you would be wise to respect this person and to recognize their feelings and concerns about your situation. Also, it is important to understand that this physician has been trained for years to believe that he or she is the responsible party. Even if your doctor is clearly committed to the spirit of a holistic approach to treatment, he or she has professional and licensing constraints to which he or she still must be sensitive. Dr. Christiane Northrup explains, "It's difficult in a medical situation where you are the doctor. You're expected to know everything and not make a mistake. No matter what happens, it's your fault. So it's going to be difficult to give the reins or part of the reins over to your patients."26 Still, it is important that you communicate exactly what you need and want, as well as what you do not want, so you can determine if this is the doctor for you. When working with a physician, Bernie Siegel, M.D., says, "I am inflexible about how I'm treated. I want to be treated like a human being - with respect. Also, I want to work with someone who is vulnerable enough to say, 'I'm sorry,' when things go wrong."25

What To Expect During An Appointment With An M.D. As An Alternative Medicine Provider
Most M.D.'s begin their initial appointment with a patient by taking a basic medical history and completing a routine physical exam. From this point, your appointment with an M.D. who practices alternative medicine can go in a variety of different directions, depending on what alternative treatments are provided and whether he or she is alternative, holistic, complementary, or integrative in how he or she uses alternative treatments.

If the M.D. has training in homeopathy, then a more extensive period of questioning, about everything from your sleeping habits to your favorite foods, will generally occur before a remedy is prescribed. If the M.D. uses manipulative therapies, he or she might lightly touch your back to find areas of swelling or tenderness.

Whatever modality of alternative medicine a physician uses, do some research before your first appointment so you are familiar with the treatments the physician may use. This research can be especially valuable to you if the physician gives you a choice of which therapies you'd like him or her to do. Dr. Levy says, "With my patients, I explain that there are different models of medicine and healing, and different ways of treating. Then I present them with a choice. I say, 'This is what I can do. Here are the things that you can choose from.' I will say, 'This is an allopathic [biomedical] approach and here is what it will do and not do for you. If you are interested in an alternative, here are some other treatments that I do and here is what they will do and not do for you.' "27

You may find in your experience with alternative medicine that the results do not take place as fast as the results from conventional medicine. Patients who are suffering from chronic illnesses need an extra dosage of patience regarding alternative medicine because they may not see marked change for six months or more. However, the advantage is that, in such cases, alternative medicine will probably have addressed the cause and made definite headway in permanently healing the condition.

Some doctors who take a more integrative approach to alternative medical treatment may initially address the symptoms and after address the deeper causes. "Usually I have to treat people initially for the problem, the symptoms, because in order to be credible I have to produce some relief," Dr. Levy says. "And the truth is they are entitled to this relief. Over time, this builds trust and confidence and then I can say to them, 'We treated the problem - the symptoms - now we have go deeper and treat the pattern that created the problem - the cause - or else the problem will just return.' "28

An appointment with an M.D. who practices alternative medicine can include conversations ranging from the benefits of surgery to the value to be gained from "laying on of hands" or prayer therapy. There is a very wide range of treatments you may be offered. Given this, your best tactic is to gather as much information about the physician, especially their qualifications, to give you those treatments.

Cost and Insurance

Cost
A visit to an M.D. practicing alternative medicine may or may not be similar to what you would pay a regular medical doctor. Sometimes it will actually cost you less, because the treatments do not require medical tests and are fairly simple procedures. Other times the cost can be much higher because extensive testing may be required and/or the treatments, by their nature, are costly. Given this, you would be wise to ask before treatment what procedures are usually involved for your condition and what they usually cost.

Insurance
Although all M.D.'s and most of their conventional treatments are covered by insurance plans if they are found to be medically necessary, not all plans cover M.D.'s performing alternative medical treatments. Even though more and more plans are covering some alternative treatments, such as acupuncture, biofeedback, and homeopathy, most plans still do not. For this reason, it is important to check with your insurance carrier to see if they will pay for your alternative medical treatments and, if so, under what circumstances.

However, research indicates that many people are still willing to try alternative treatments even if they aren't covered by their health insurance plans. "The biggest issue is cost," Dr. Levy says. "If their insurance doesn't cover alternative treatments, it is difficult for people sometimes to afford it. Still, even with this the majority of my patients are open to trying it."29

Education, Training and Licensing
The titles or labels of alternative M.D., holistic M.D., complementary M.D., or integral M.D. are self-proclaimed and purely voluntary. No special courses are required and no tests are administered to demonstrate competency. It is in your best interest to determine what you can expect from your doctor before your first appointment.

All M.D.'s are educated and trained in conventional biomedical philosophy and procedures in medical school. Training for competency in alternative treatments is not yet a part of that process - nor is training in the spirit of the holistic approach to health care, as discussed throughout this chapter. Dr. Norman Shealy, founding president of the American Holistic Medical Association, says, "Training [in alternative health care techniques] is the greatest weakness of the whole holistic [alternative] movement because there are no residencies. There aren't even any fellowships of any significance. So virtually all of the holistic [alternative] physicians have trained themselves through special post-graduate work."30 How much training the doctor believes he or she should have in order to be competent is a decision each one makes for him- or herself. Whether the doctor's standards for competency in a particular alternative treatment are as high as yours is a decision for you to make.

Fortunately, the American Holistic Medical Association (AHMA) is sensitive to this issue and has recently established the American Board of Holistic Medicine (ABHM) . . . "for the purpose of certifying physicians as practitioners of holistic medicine."31 The exam an applicant must take to become certified consists of seven core knowledge areas: nutrition, physical activity, environmental medicine, behavioral medicine, social health, energy medicine, and spiritual attunement. It will also cover six secondary subjects: botanical medicine, homeopathy, ethno-medicine (traditional Chinese medicine, Ayurveda, Native American medicine), manual medicine (manipulation, body work, etc.), biomolecular therapies, and health promotion. Further, "In addition to the board examination, the certification process will include an interview, a self-administered test of holistic health, and a minimum of six years in active medical practice (which can include residency training)."32 Such trends in conventional medicine are welcome, given the public interest and desire for high quality alternative medical care.

In many states, conventional medical doctors, just by the broad scope of their license to practice, can provide alternative treatments that they have not been required to demonstrate competency in. There are exceptions to this. For example, in New Mexico, licensed medical doctors must have a separate license to practice acupuncture. This means that all M.D.'s practicing Chinese medicine in New Mexico have to pass the same exam that is required of graduates of four-year Chinese medical schools, who have had over fifteen hundred hours of study to their credit. Some other states place minimum requirements of hours studied, ranging from two hundred to one thousand hours.

In Arizona, in order for M.D.'s or D.O.'s to legally practice homeopathy, they must take a separate exam from their regular license to demonstrate competency in homeopathic medicine.

Many feel that these kinds of requirements of medical doctors will be a growing trend in other states to protect people seeking competent high quality alternative medical treatment from medical doctors.

Closing Thoughts
M.D.'s who are well trained in conventional medicine, embrace a holistic approach to health care, and have competent training in alternative medical treatments, are unquestionably some of the finest health care providers in the profession.

It is these doctors that deserve special recognition because they have also been, and still are, courageous pioneers who have faced the scrutiny and criticism of their peers to speak out about the value of alternative medical systems so different from their original, conventional medical training.

It is still true today that the health care professional whose opinion is most respected and listened to is the M.D. For that reason, M.D.'s who have placed their businesses and professional reputations at risk to speak about the importance of the spirit of a holistic approach to health care and the value of alternative therapies are nothing short of heroes and heroines.

1. William Collinge. The American Holistic Health Association CompleteGuide to Alternative Medicine (Warner Books, 1996), 314.
2. George Howe Colt. "See Me, Feel Me, Touch Me, Heal Me," Life, September 1996, 36.
3. "Resolution 514 — Alternative (Complementary) Medicine," Reference Committee E, 10–11. From Washington Delegation to American Medical Association House of Delegates.
4. "Alternative Medical Courses Taught at U.S. Medical Schools," The Richard and Hinda Rosenthal Center for Alternative/ Complementary Medicine.
5. Dean Ornish, M.D. Dr. Dean Ornish's Program for Reversing Heart Disease (Ivy Books, 1996).
6. NIH. Alternative Medicine: Expanding Medical Horizons (U.S. Government Printing Office, 1993), xli.
7. American Holistic Medical Association brochure.
8. David Eisenberg, M.D. "Unconventional Medicine in the United States," New England Journal of Medicine, January 28, 1993, 246.
9. Butch Levy, M.D., L.Ac. Personal interview, June 1996.
10. Ibid.
11. Ibid.
12. Robert Duggan, M.Ac., Dipl.Ac. (NCCA), Personal interview, July 1996.
13. American Holistic Medical Association brochure.
14. Evarts Loomis, M.D., F.A.C.S.I. Personal interview, Fall 1991.
15. Evarts Loomis, M.D., F.A.C.S.I. Personal correspondence, July 1996.
16. Larry Dossey, M.D. Personal interview, Fall 1989.
17. Doug Podlosky. "A New Age of Healing Hands," U.S. News & World Report, February 5, 1996, 71–74.
18. American Holistic Medical Association brochure. 19. Butch Levy, M.D., L.Ac. Personal interview, June 1996.
20. Leonard Wisneski, M.D. Personal interview, September 1989.
21. Butch Levy, M.D., L.Ac. Personal interview, June 1996.
22. Ibid.23. Ibid.
24. Bill Gottlieb. New Choices in Natural Healing (Rodale Press, 1995), 68.
25. Mary Walker. "Choosing a Holistic M.D.," East/West Journal, April 1990, 24.
26. Ibid.
27. Butch Levy, M.D., L.Ac. Personal interview, June 1996.
28. Ibid.
29. Ibid.
30. Mary Walker. "Choosing a Holistic M.D.," East/West Journal, April 1990, 211.
31. American Holistic Medical Association brochure.
32. Ibid.