With some many different doctors out there, who do I go see?
In my years practicing allopathic medicine, I must admit I could see the confusion an inflammatory bowel disease patient would have between choosing to see a Family Practice Physician vs Internal Medicine Physician vs a Gastroenterologist vs a General Surgeon. Initially, it would seem logical for the IBD patient to choose a Gastroenterologist. Not all abdominal pain symptoms in the IBD patient come from a flare of IBD however. So back to the question: who to go see for intermittent abdominal pain? The Family Practice MD, Internal Medicine MD, Gastroenterologist MD or Surgeon MD?
That used to be the question 10 years ago.
Now the question has become: who do I go see? The Medical Doctor? The Naturopathic Doctor? The Functional Medicine Doctor? The Integrative Medicine Doctor? The Chinese Medicine Doctor? The Acupuncturist? The Herbalist? The Pastoral Medicine Doctor? The Dietician?
It’s more confusing than ever. As an MD, I must admit, I’m a bit confused myself.
Here’s how I would approach it knowing what I know about disease management and wellness prevention:
- Is this a life threatening situation or a bothersome symptom that needs immediate medical attention? Life threatening means the symptoms are unbearable, and you can’t go about your daily activities. You can’t go to work, can’t sleep, can’t eat, can’t get anything done; too unbearable. This means it needs immediate attention to evaluate for life-threatening disease or impending permanent disability. That means go to the hospital, which will involve seeing MD/DO’s.
- If it’s not a “the world is gonna end now” type symptom, that still needs medical attention despite home remedies I have tried, then there’s great leeway with which medical provider to work with.
- I think to myself: What results can I can realistically and efficiently achieve with whichever practitioner I call for help?
What’s appropriate at the time of the evaluation?
- Do I have a significant emotional component of anxiety, depression, anger, or fear that seems connected to the GI symptoms every time? (I.e every time I get stressed, it develops into a bowel obstruction)
- Is there a habit that I know needs to stop, that reliably feeds into my GI symptoms? (I.e. I know I eat too much processed sugars. My symptoms flare when I indulge every so frequently).
- Is there a history of exposures that have led to my symptoms? (I.e. So many past antibiotics and now my digestion and bowel habits feel way off)
- Are there nutritional deficiencies as a result of my poor gut health? (Ie. Vitamin and mineral deficiencies that are causing easy bruising, fatigue, brain fog)
- Are there longstanding symptoms that would benefit from an invasive medical procedure? (I.e. Colonoscopy or upper endoscopy for biopsies)
- Are there severe symptoms that need immediate rapid attention for possible pharmaceuticals (I.e. Bloody stools, severe dehydrating diarrhea, abdominal pain with fever that could be colitis)
Based on the root cause of the symptoms, it may be more appropriate to see:
- A Health Coach
- A Naturopathic Doctor
- An Allopathic Medical Doctor
- A Hypnotist
- A Functional Medical Doctor
- A Chinese Medicine Doctor
- An Acupuncturist
- An Integrative Medicine Doctor
- A Dietician
- Some medical problems can easily be addressed by all of the health care provider types, some problems can be addressed by some of them with varying degrees of efficiency, some can be addressed by only one provider type.
- What ratio of the health concern comes from: spiritual, mental, emotional, or physical component? That helps guide which health care provider to see.
- There are a myriad of health care provider types now more than ever before. It’s important to research which provider type addresses the health problem in the most expeditious manner. When the most costly and sometimes inappropriate provider type is initially chosen, I would then just recalibrate my care to a different provider that works better for me. These critical decisions highlight the power of the social support groups that network which treatments, modalities, and providers to see.
Aka: One Great Gut.
With great power (the ability to choose your health care provider), comes great responsibility (the fortitude to accept the success or failure of the resulting treatment, and keep recalibrating to what’s best for you).