Why I Take a Consultative Approach to Healthcare

Depending on where you take your vehicle to have it serviced, you’ll deal with either a mechanic or a parts changer. A mechanic conducts a thorough evaluation before doing anything. Your mechanic asks you to describe what’s going on; drives the vehicle, taking note of any strange sounds, vibrations, or odors; visually inspects the vehicle; and runs diagnostics to check for any error codes.

A parts changer makes an educated guess as to what the problem is and then proceeds to change parts until the problem goes away. It can be a costly, time-consuming process that often fails to address the root cause of the problem.

Unfortunately, modern medicine is driven largely by a part-changer mentality. Many doctors spend only a few minutes talking at a patient and reviewing results from lab tests and even less time listening to the patient, coming up with a diagnosis, and generating a thoughtful plan of care. Instead, they jump right to treatments that often include prescription medications — many of which alleviate symptoms without addressing their root cause. Even worse, medications can cause adverse side effects, resulting in a symptom profile that grows longer and more complex with every visit.

In contrast, I take a consultative approach to treating and caring for my patients. This approach is more collaborative and relies far more on listening to my patients, enabling them to play a much more active role in their treatment outcomes.

What Is a Consultative Approach?

A consultative approach requires a deep understanding and appreciation of your medical history, family history, lifestyle, life events, and current health conditions and concerns.

The process begins with you completing your functional medicine analysis form, which I review in preparation for your initial consultation, and refer to over the course of your recovery. Your functional medicine analysis is an inventory of your health history and presenting symptoms. In time, we should be checking off symptoms and seeing a trend towards better health and quality of life.

The consultative approach requires good listening in an environment that is not rushed, judgmental, or dismissive. I contrast this to a visit with a more conventional healthcare provider who works in an environment that rewards speed over thoroughness and the importance of building a collaborative doctor-patient relationship.

In this non-consultative scenario, it’s a quick conversation and lab review, followed immediately by knee jerk recommendations. I see this happening today in both conventional and holistic medicine as practitioners build models of medicine based on meeting the demands of insurance providers instead of improving patient outcomes.

Key benefits of a consultative approach to medicine include the following:

• Longer visits allow for more listening, questioning, and reasoning to address your concerns and make better informed decisions about which diagnostic tests to order and which treatments are best for you. The more time I spend with patients, the fewer tests I need to order, and the less medication and other treatments become necessary. As a result, I like to spend at least one (1) hour with new patients during their initial consultation (imagine asking your primary care physician to spend an hour with you to discuss your experience with fatigue, menopause, digestive concerns, or brain fog).
• Ongoing communication with your healthcare provider opens the doors to building a greater understanding of your case and then providing long-term solutions to managing chronic conditions and optimizing health. In my practice, I prefer to offer monthly follow-up visits over an initial six (6) month period. This allows the proper time to review and adjust your plan of care and closely monitor your lab and test results.
• A wider spectrum of treatment options includes lifestyle, hormones, peptides, nutritional supplements, and prescription medications when needed.

Theron Randolph, MD (July 7, 1906 – Sept. 29, 1995), a physician, allergist, and medical researcher, once found himself struggling with a difficult case. He had a very sick patient but no clue as to the cause of her illness. He spent hours talking with his patient and typing up his observations and thoughts. Finally, the patient recalled an event from her past when she had been exposed to a petrochemical. Shortly thereafter she started to experience symptoms. Working together, patient and doctor discovered the cause of the illness.

Dr. Randolph went on to pioneer what became known as Clinical Ecology, which is now called Environmental Medicine.

What’s important about this story is that it often takes time and thought to identify the root cause of an illness. That investment of time and effort is not something that is often appreciated in the modern healthcare system. Instead, doctors are rewarded for taking the path of least resistance. They prescribe something to alleviate symptoms, order a bunch of tests, and tell the patient to come back in three months for a check-up. Or, they simply refer the patient to a specialist who ends up following that same process. Often, over time, the disease takes over the person’s life.

With a consultative approach, I work with patients to make sure that doesn’t happen. With my help, patients gain the upper hand over their illness and take control of their health and wellbeing and hence, their lives.

Making Thoughtful Decisions

Functional medicine providers, including me, are inclined to order lab tests, some that aren’t covered by insurance. I value testing and prefer it to the alternative — which frequently is just guessing. And yes, I am also aware that testing can get expensive. With a consultative approach, you and I can take our time to make well-informed decisions about which tests are most likely to provide the information and insight we need to arrive at a complete and accurate diagnosis.

This approach is quite different from ordering a generic battery of tests. What frequently happens in a more conventional setting is that the doctor usually sets aside only 15 to 20 minutes to consult with a patient. As a result, the doctor orders a broad battery of tests instead of tests that are targeted to specific suspected conditions.

Listening and Making Decisions Together

People have more influence over their health than they often realize. Many health conditions are related to nutrition; environmental contaminants in the home, school, or workplace; stress levels; exercise routines; medications (both prescription and over-the-counter); holistic treatments, including supplements; and many other factors.

A consultative approach helps to address these factors in two ways:

• Together, we can identify factors that may be causing or contributing to the health conditions you are experiencing. It is important to realize that what you do and don’t do, where you decide to live and work, how you spend free time, and many other variables influence your health to a large extent. You have a tremendous amount of control over your future health and wellbeing.
• I can help you address these factors by providing treatments and coaching. Some patients merely need guidance and support to implement their personal health program. Others can easily handle lifestyle changes on their own and have a greater interest in exploring functional medicine treatment options. Often, patients benefit most from a combination of treatment and coaching.

During your functional medicine analysis, we will look into the frequency of contact you need to implement your personal health program. Based on your input, we build a program that is appropriate for your stated objectives and preferences.

Over time, as your health improves, your goals are likely to change. A consultative approach is ideal for addressing these changes. As healthcare issues start to resolve, we can adjust your plan of care to prevent future health problems and further enhance your quality of life. Ongoing relationships like this are the ones that drive positive long-term outcomes and are exciting for both me and my clients.

Building Long-Term Relationships on Trust and Understanding

People with chronic medical conditions usually need long-term adjustments in lifestyle and treatments to manage the condition. The treatment can be as simple as making the right dietary change. It may require the addition of one or more nutritional supplements, peptides, hormones, and so on. Medication management may also be necessary.

My goal is to establish long-term relationships that allow time to build out the best solutions in a sequential fashion and at the pace that makes sense for each patient.

Saving Time and Money with a Consultative Approach

Illness is costly in terms of time, money, and quality of life. You cannot be your best self if you are not your healthy self.

There  are upfront costs of a consultative approach with a functional medicine practitioner like me. The investment will pay dividends in the following ways:

• More effective treatment will save you money over the long term. Quick visits and poor follow up are not only inconvenient, but they are also costly. Before coming to me, many of my clients spent a good deal of time and money going to other healthcare providers and not having success.
• Feeling better, you will be more productive. Living with a chronic condition and not feeling well can impair your ability to function.
• You will be less likely to receive unnecessary treatments. Conventional medicine providers and even some functional and holistic providers recommend treatments without first conducting the foundational consultation needed to determine if, in fact, those treatments are necessary.

You will be less likely to miss out on the benefits of effective treatments. I have seen patients who have not had the treatments they needed because their healthcare providers did not take the time to educate them about the appropriate plan of care. The patient felt they did not understand the recommendations and therefore did not follow through. .The cost of illness is rising dramatically and rapidly. My fees have increased over the years, but nothing close to the rising cost of being sick. The clients with whom I have established long-term relationships are taking care of themselves, reducing the severity of their conditions, and experiencing a better quality of life than they ever expected — and certainly better than they would have had otherwise. They are influencing their outcomes, and I have been there to educate, treat, and support their efforts.

Our consultations have resulted in a good investment of their time, money, and health.

Deciding Whether the Consultative Approach Is Right for You

You may benefit from a consultative approach to health and fitness if you:

• See the value in building a relationship with a healthcare provider.
• Are ready and willing to play a more active role in your health and wellbeing.
• Have had a health condition or symptoms for three months or longer without a good explanation or solution.
• Desire to be proactive when it comes to aging and quality of life.
• Desire a strategy to improve your physical and mental performance.
• Struggle with fatigue, poor sleep, or brain fog.
• Consider hormone replacement and other regenerative medicine protocols.
• Value education when it comes to your health.
• Would like advanced blood testing to check for inflammation, hormone levels, and vitamins.
• Desire a more well-rounded approach to your healthcare.
• Do not want to rely solely on prescription medications for managing illness.

Recognizing Medical Conditions That Respond Well to a Consultative Approach

Conventional medicine can be effective in treating injuries and acute conditions, such as infections, heart attack, stroke, and appendicitis. It is less successful in preventing and treating chronic medical conditions. This is where a consultative approach really shines. Here is a list of chronic conditions that respond well to a consultative approach:

• Digestive issues: Irritable bowel disease (IBD), small intestinal bacterial overgrowth (SIBO), small intestinal fungal overgrowth (SIFO), Crohn’s disease, colitis, gastrointestinal reflux disease (GERD), and gastritis.
• Rheumatological-immune based conditions (autoimmunity): Rheumatoid arthritis, osteoarthritis, Hashimoto’s thyroiditis, mixed connective tissue disease.
• Environmental illnesses: Chronic sinusitis, allergies, food sensitivities, heavy metal exposure, mold exposure (past or present), breast implant
• Endocrine-thyroid, adrenal, and stress related health concerns: Anxiety, depression, burnout,diabetes, sleep disorders, impaired sexual performance/enjoyment.
• Neurological traumatic brain injury or history: Tingling, numbness, small fiber neuropathies, pain syndromes, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), multiple sclerosis.
• Cardiovascular/circulatory dysfunction: Heart disease, high blood pressure, hypercholesterolemia, postural orthostatic tachycardia syndrome (POTS).
• Metabolic dysfunction: Metabolic syndrome, weight gain, obesity.
• Women’s health issues: Premenstrual dysphoric disorder (PMDD), menopause, polycystic ovary syndrome (PCOS), fibroids, endometriosis, adenomyosis.

If you’re seeing a healthcare provider and not experiencing significant improvement (especially after months of treatment), then you are probably not seeing the right provider. I am not questioning your healthcare provider’s competence. Even highly skilled and knowledgeable healthcare providers can exhaust their knowledge and expertise, or overlook something. None of us knows everything. I consult other experts and make referrals to other providers when I think it will benefit my patients.

In other words, you don’t need to get upset with a healthcare provider when you are dissatisfied with the results. But if you are not getting the outcome you expected or hoped for, now may be the time to get a second opinion. If you are at that point, schedule your initial consultation with me through my website. It doesn’t matter where you live — I’m happy to consult with you.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP^®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa and elsewhere.