What your doctor is missing

For those of us who have managed our diabetes over the decades, we often experience mixed feelings about our doctors. Some of us love our physicians while others are dissatisfied. Many of us are ambivalent about our doctors; can’t live with them and can’t live without them.

In another thread one of our members commented about a mention I made regarding functional medicine. She said she had never heard that term before. I have only been aware of it for a few years, primarily when my daughter started to encourage me to see a naturopath or functional medicine practitioner. I think she was tired of listening to the stream of complaints I voiced about my diabetes doctors.

The video below is a great introduction about what functional medicine is and how it can help us. From the descriptive comment posted with this video:

Conventional medicine approaches illness as a name it, blame it, and tame it game. But these labels or diagnoses are just names we associate with a collection of symptoms. They have nothing to do with why you have those symptoms—with the root causes of the “disease.” Conversely, just because your standard lab panel comes back normal does not always mean you are experiencing optimum health.⁣

In this episode, Dr. Hyman speaks with Dr. Todd LePine about how Functional Medicine seeks to get to the root cause of health issues. They dive into the world of unconventional and advanced lab testing that they use to identify dysfunction in the body and optimize health.⁣

I know many people look at any medical practice that moves beyond the realm of traditional Western medicine as being “woo-woo.” I understand that because I had the same feelings as I struggled to understand my coronary artery disease diagnosis and what to do with it. I decided to give it a try and am glad I did.

While the jury is still out about my reliance on lifestyle measures to treat my heart issues, I have made significant progress using functional medicine to restore normal non-pharma mediated sleep as well as treating digestion disfunction.

I realize that this video doesn’t speak directly to diabetes but instead is more general in nature. I also realize that almost all of us have other health issues both related and unrelated directly to diabetes.

I wish that TuD included a topic category, “managing your doctor,” because I think that’s what a lot of us spend time and energy on in the pursuit of better health. Enjoy the video! I am interested to read your comments.

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@Terry4, Managing Your Doctor would be a splendid topic for TuD. But we already have lots of threads on that topic. I would say that just about everyone here is managing the doctor. I have always felt that medicine in this country divvies up the body into tiny sections and doctors specialize in those small pieces, never really taking the entire body into consideration. As a consequence, my policy is to stay away from them as much as I possibly can because I know that my body is not composed of independent parts that can be fixed or treated with this or that pill. As an integrated being, every part of me interacts with every other part… a disruption of the digestive system may cause eruptions on the skin, have mental effects, or, ultimately even cause death. If there is something wrong with me, the symptoms have to be followed to their core cause. MDs rarely do that and end up treating the symptoms and frequently causing other problems with their pills and interventions.

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I couldn’t agree more. When I tried to counter my cardiologists insistence for me to take statin drugs with instead using lifestyle tactics, I did not persuade him, at all.

They all seem to give a nod toward making lifestyle changes but rarely get beyond, “move more, eat less and use the Mediterranean diet.” My doctor used that as a brief segue into long discussions of the evil LDL and we need to slay it with statins.

When I raised rational objections to statins citing many different studies and the conflict of interest embedded in Pharma and doctors, he asked, “Why are you such a cynic?” I responded that he should not misinterpret my skepticism as cynicism. Awkward!

I think the best doctors are curious and command awesome interview skills. And they respect the patient perspective as legitimate and germane. But they are few and far between.

I’m enjoying more doctor success by favoring functional medicine practitioners.

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Are you finding issues with insurance/MC coverage ?
Or in general are all functional doctors not covered?

Insurance coverage is spotty with functional medicine. When I was seeing Naturopaths, I did not get coverage for visits and many of the blood tests they ordered. I now see an MD functional medicine doctor and my appointments are covered by Medicare as well as many, but not all, of the lab tests.

I think that traditional medicine’s low regard for functional medicine practices has influenced the payers and scuttled coverage for us over the years. One good example of this is the coronary artery calcium scan. Traditional medicine looked down its nose at this test and insurance and Medicare chose not to pay. Even now, as most traditional doctors see a legitimate, yet more limited, role of the CAC scan, payers still don’t cover it. Luckily, it can often be found for $100.

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I believe that insurance coverage is limited to MDs. And finding an MD who is also into functional medicine is very difficult. More so for me as I live in far western rural Wisconsin and finding a good doctor of any sort is quite an adventure. Luckily, I have reached a ripe old age without the need for anything but basic medical care. I aim to keep it that way.

I use regular physicians, specialists, naturopaths, and right now a chiropractic neurologist. I am covered by Medicare and a good State plan. I rarely find that my appointments aren’t covered. When I am out of state, at least a good percentage of the appointment is covered. I have never had to pay for a lab test.

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Don’t forget about Doctors of Osteopathic Medicine! DO instead of MD. They’re fully accredited just like MDs, can practice in any specialty just like MDs, and are indeed covered by insurance just like MDs! They just take a more holistic, natural, and preventative care approach than the traditional “drug all the symptoms” approach.

That was my surprise when Terry mentioned function medicine, because his definition of functional medicine is quite literally the difference between an MD and a DO. I honestly thought he was seeing a DO and didn’t know it, because so few people even know that DOs exist. I figured the doctors just used the term “functional medicine” to illustrate the difference. It’s refreshing to see that some people within the MD community recognize this problem with modern practices are are filling in the giant void! I’d love to see all medicine lean that way in the future.

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Thank you for reminding me of DOs. One of my sons has always used DOs to care for his family. However, he lives in the suburbs of a large city. I intend to call my insurance company to ask about a DO. I haven’t had a primary doctor in many years and rely on a CDE who is willing to work with me on my terms. But, obviously, she is limited in her scope. Thanks again, @Robyn_H.

I selected my previous endo, partially due to him being DO, within same Endocrine Group. But he disappointed me on several issues, and had minimal experience with pumps. Switched to another, younger endo (same group), that has excelled in optimizing my Tandem pump settings.

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Definitely. Even though I prefer the Osteopathic school of medicine, there are still good and bad amongst the lot.

Conversely, I’ve found two MDs in recent years I just adore, which is a first ever.

I can see that a DO is similar in medical philosophy to a functional medicine doctor. I was aware of DO’s for many years. When I sought chiropractic treatment for back aches I remember being told about using a DO for these adjustments. Good to point out about the DO credential. I agree that the general population is unaware of this distinction unless they have experience themselves.

As I was watching this video I was taken back thirty plus years to a younger version of myself sitting in a doctors office being told for the first time that I had hypertension. My first question was why, the answer, we may never know why that’s not what’s important the answer may be too difficult to find. Just accept that you have it and we will deal with it.

Wouldn’t it be delightful if our older selves could, from time to time, give advice to our younger selves? I would give advice about what my younger self should eat and that I should take better care of my teeth. If that fantasy ever occurred, I think my younger self would reject the advice!

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I have seen dozens of traditional and functional medical advisors in the past 30 yrs. Some excellent and a few losers. I find that it is always best to first read about the condition and then consult doctors. I like to know as much as I possibly can about the illness before seeking advice. My research has saved us from bad advice given to us from the professionals we have consulted.

There are many treatments for different health issues that work well that traditional physicians have not had the time or interest to look into. I have been fortunate to find a few physicians who have also been interested in what the functional doctors have to say.

I have done brain training to cure my chronic fatigue after seeing 11 traditional and functional physicians. I had every test in the book from normal labs to some very strange tests.

I am waiting now for advice about my recent labs from both my GP and my chiropractic neurologist.

My son was 6 when he first started ticcing. At 33 he still tics and has coprolalia. I am surprised that it took the doctors in the video about 14 minutes before mentioning genetics. I have a very slight case of TS and my son was blessed with every tic in the book.

My family has had to deal with many very serious illnesses in the last 30 yrs. I just keep asking questions.

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My T1D started in 1945. My doctors were GP’s for the rest of that century. They knew very little about diabetes. I have had three endos in this century, and they do know T1D, but not as well as I would like. All of them showed great concern for any low blood sugar I had. They did not seem to be concerned about high blood sugar. My current endo wants my low alarm on my CGM to be set at 80, or higher. There was no recommendation for a high setting.
There are other disagreements I have with my endo, but she is very good at contacting my Aetna/Medicare personnel and getting everything I want approved. When she talks to me about my diabetes management and recommends changes that I know will not serve me well, I smile and say thank you. Then I do my own thing. I know what works and what doesn’t for me. My A1C has been 6.0 for 6 months and I have been Type 1 for 75 years without any serious complications. I want to keep it that way.

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Bravo, Richard! I aspire to consistently use this proven “smile and nod” tactic but sometimes it’s hard to resist my desire to share what I know with my doctor. But no one learns anything until they are ready! That’s a truth I need to keep in mind.

This is enough! Especially when you don’t need any glucose management help.

I have only lived with diabetes for half as long as you. Keep up the good work, Richard!

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Hi Richard. Always good to hear from you. I think I can understand why your endo would want 80 to be your low. I think as I age, the lows might be harder to treat.

I think it is fantastic that you don’t have any serious health problems caused by diabetes. Were you always in good control, even during the years of urine testing? I had plenty of times during urine testing when I just ignored my diabetes although I never forgot my insulin. I was not trained well in the 50’ and 60’s. I shudder when I remember what I used to eat before I cleaned up my act.

I am so glad that you and your wife still have each other. You are very fortunate.

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I have ‘no statin drugs’ in my Living Will

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It seems to me that many doctors write the script, be it for statins or blood pressure meds and that’s where their interest stops. While they may give a nod to lifestyle factors, most doctors just don’t seem interested in pursuing root causes for issues like high blood pressure and coronary artery disease.

They prescribe the med and move on. They know precious little about nutrition, sleep, and mindfulness practices as these things relate to poor heart health.

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