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A Modest Medical Proposal

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Here’s an idea that will probably cause some of my physician colleagues to get their knickers in a twist: it may not be a bad idea to find a good chiropractor to act as your primary care physician.

This isn’t as radical as it may sound. Blue Cross of Illinois, by far the largest insurer in the state, offers its HMO members a list of chiropractors who are willing to act as primary care providers. If Blue Cross is willing to pay for this kind of health care, they’ve surely done their research.

And here, from a conventional internist (admittedly with an alternative medicine bias) are some points to consider:
• Chiropractors are indeed physicians. With the exceptions of pharmacology and surgery, they have the same training in science as medical doctors. They can recognize signs and symptoms of organic illness, know the limitations of their expertise, and are taught when to refer patients to medical doctors. This is broadly the same process as an internist referring patients to a cardiologist or other specialist.

• Chiropractors learn how to perform the basic physical exam, plus very sophisticated musculoskeletal and neurological testing that I was simply never taught in medical school. In addition, most chiropractic offices now draw blood for tests, and chiropractors themselves can interpret these tests (referring to MDs when necessary).

• Remember that most symptoms aren’t caused by disease, but rather by unhealthful choices and lifestyles. Most headaches are caused by stress; most digestive problems by poor diet. Instead of spending time teaching patients how to make better choices, medical doctors too often treat symptoms with prescription drugs (often ineffective and dangerous). Chiropractors are geared more toward nutritional therapies, diet changes, body therapies, and other health-oriented techniques.

• Between the ages of 18 and 60, a huge percentage of any person’s symptoms have their origin in the musculoskeletal system. In this regard, chiropractors are in their element, balancing your body, teaching you exercises, and offering a wide variety of treatments that are not drug-based.

• Primary care medical doctors refer patients too quickly and frequently to specialists. Although specialists are necessary, their perspective is a narrow one, confined to their area of expertise. The result is that many patients receive far too many complex and potentially dangerous diagnostic tests for symptoms that might have been treatable with simple lifestyle changes.

I’ve worked with my associate, chiropractor Paul Rubin, for years. In fact, our partnership in WholeHealth Chicago was the first of its kind in Illinois. Many of our patients use Dr R as their primary care doctor, and he’ll call me in when the situation appears to need medical intervention.

If it’s crossed your mind to have a chiropractor as your primary care provider, you’re not being unrealistic. Just be sure to ask if he or she has a medical doctor available for referral. And if you decide to make a chiropractor your primary doc, the result will likely be health care that’s just as effective and just as thorough, but geared toward wellness rather than prescriptions, specialists, and surgery.

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