The New Age of Sickness and Scarcity: Why aren't traditional treatments working? Introducing Entry Level Clinical Nutrition™ - Part II
Introducing Entry Level Clinical Nutrition™ - Part II
| "You don't need a weather man to know which way the wind blows" |
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- Bob Dylan
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It seems we just can't count on the “old reliables” like we used to. For one thing, summer used to start near the end of June – but this year, didn't it feel like it started in May? As health care providers, we used to believe we knew how to manage chronic illness pretty well. However, as I noted in my previous blog post, the number of chronically ill patients has been dramatically increasing and many are not getting well, even though they are receiving repeated treatment.
The fact is that many chronically ill patients never “get better”. Meanwhile the cost per patient for treatment continues to escalate.
Could this be one reason that national health care satisfaction rates for practitioners and patients alike are plummeting?
Symptoms, Organs and Protocols
Gone are the days when most patients had one or two symptoms of brief duration. Also gone are the days when a great outcome could be expected with just one or two supplements. Today's chronically ill patients and their myriad symptoms, often require a regimen of 10 or 20 – or many more – different supplements to address 10 to 20 – or many more – different complaints.
And what happens in those situations? We've all been there! “Sorry, Doc, that's too expensive for me. Besides, I can't swallow all those pills, and I keep forgetting to take them….” And, even with the most compliant patients, we may find that efficacy is less than optimal, outcomes are iffy and patient satisfaction is low.
So, it's beginning to look like the old symptom-based approach just isn't doing the job anymore. Okay, if that's the case, you may ask about using an organ-based treatment approach? After all, administering supplements based on organs or organ systems is another “old reliable”. In fact, a staple of clinical nutrition has long been the “liver supplement” or the “gall bladder supplement”.
Again, this approach can be practical and effective in reasonably healthy patients whose dysfunction is of short duration. But can it work in today's chronically ill?
Unfortunately, today these patients often present with several areas of suboptimal organ function that has persisted for long periods. Unless we know with certainty which organ is causing the underlying problem, an organ-based approach can be as expensive and time-consuming as the symptomatic approach.
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How about traditional disease protocol approaches? Typically, chronically ill patients are presenting with multiple diseases. What to dose first is highly questionable when a patient presents with diseases from MS to fibromyalgia to depression. As a result, practitioners often experience low satisfaction rates when they use disease protocols with chronically ill patients.
If traditional symptom-based, organ-based and protocol-based approaches don't work very well with chronically ill patients, why not turn to functional medicine?
This is a crucial question. To give a meaningful answer, I'd like to begin by discussing the concept of Entry Level Clinical Nutrition™. As I mentioned in my previous post, Entry Level Clinical Nutrition™ is an important response to the challenge of today's chronic illness.
Introducing Entry Level Clinical Nutrition™
There are two key points to make about Entry Level Clinical Nutrition™. First, it differs in a significant way from the symptoms, organs or protocols methods mentioned above. Second, this approach is actually a form of functional medicine.
I believe it's important that Entry Level Clinical Nutrition™ be recognized as part of functional medicine because it is consistent with its principles. Functional medicine rigorously employs the scientific method. It is evidence-based, measurable and repeatable. So is Entry Level Clinical Nutrition™. Functional medicine uses credible, research-based diagnostics that identify a patient's specific metabolic imbalances. It then allows the practitioner to create an individualized nutritional program that meets the patient's specific needs. So does Entry Level Clinical Nutrition™.
Functional medicine has been a noteworthy advance in patient care. So is Entry Level Clinical Nutrition™.
As important as functional medicine is, we all know that it faces some obstacles. In practice, the cost and complexity of some of the standard functional medicine diagnostic tests (such as organic acid testing and stool analysis) can be formidable. This has created a barrier to widespread utilization of the functional medicine approach, particularly in the current economic environment.
Entry Level Clinical Nutrition™ provides a scientifically documented and highly effective “entry point” that can help the majority of chronically ill patients – at a lower cost, with less complexity.
Entry Level Clinical Nutrition™ should be used initially to identify and assist in the treatment of the foundational metabolic imbalances – such as low grade metabolic acidosis and muscle loss (sarcopenia) – that contribute to so many of the most common chief complaints seen in chronically ill patients. Many practitioners who are already using this approach have experienced excellent results and either eliminated their patients' chief complaints or made major progress in that direction.
Of course, if Entry Level Clinical Nutrition™ isn't able to completely resolve a patient's chief complaint, we still strongly recommend using functional medicine tests as the next step. We recommend this not only because of the clinical value of this approach, but because Entry Level Clinical Nutrition™ typically produces a positive initial experience for the patient. This positive experience usually reduces patient resistance to the cost and complexity of subsequent functional medicine tests and treatment.
Delivering Satisfaction and Value
As noted previously, these days patients expect satisfaction and value, just as if they were buying any consumer-based product. And, as I've said, we have to resolve each patient's chief complaint in a timely and cost efficient manner to meet these expectations.
After much research, study and discussion both inside and outside our community, I've come to the conclusion that the concept of Entry Level Clinical Nutrition™ provides a unique and uniquely effective answer to the current patient care conundrum. In my next post, I'll start discussing Entry Level Clinical Nutrition™ in some depth. Future posts will explain how you can start using this concept in your practice in the kind of time efficient, cost efficient manner that will lead to greater satisfaction levels for both you and your patients.
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