The Changing Face Of Medicare – How It Effects You!

A couple of weeks ago The Royal Australian College of General Practitioners (RACGP) released a new directive to GP’s recommending that they say no to any requests from Naturopaths for pathology testing! This directive, has clearly resulted from a desire or need to cut government costs and from this perspective is understandable. How will this impact you, as a keen advocate of your own health, in identifying and resolving your health issues? Could the RACGP have put a little more thought, consideration and respect with the delivery of their directive?

Lets explore some issues around this – how it will effect you and what your options are.

Working Together

The style of care differs greatly between GP’s and Naturopaths and Clinical Nutritionists and should not be viewed as modalities competing with each other! Over my years of practicing I have built wonderful relationships with GP’s and our collaboration of care has resulted in the best outcomes for clients, with each practitioner stepping in to offer their specific expertise at the right time. I believe combining care is in your best interest and is the way of the future for medicine 🙂

Comparing Modalities – GP’s vs Naturopaths & Clinical Nutrition

Naturopaths spend considerable time with a client on initial presentation (1 to 2 hours) due to the nature of treatment. It is critical to obtain a proper understanding of diet, sleep, life habits, health history, family health history and peruse past pathology results to determine the best way forward. Naturopathic & Nutritional Medicine philosophy insists on not only resolving current health issues, but preventing future ones by assessing health risks. Treatment is very long reaching and considers changing one or more of the following –  diet, sleep habits, exercise habits, hydration habits, sun exposure habits, chemical exposure, EMF exposure, work/life balance, considers emotional status and supporting genetic issues.

GP’s generally (please note this does not apply for all GP’s but the majority), will see a client for 5 to 15 minutes max, they usually only obtain the information about the symptom that requires resolution, and will either prescribe a pharmaceutical drug on the spot or run some basic bloods/ swabs/ urinalysis before making that decision. Their specialty, in my opinion, is in diagnosing and dealing with life threatening issues which require immediate strong pharmaceutical or surgical intervention to save lives. It is not well suited the the many chronic health problems we now face in increasing numbers in our modern world. Standard conventional medical treatment is mostly limited to drugs or referrals are made to specialists for further diagnosis with again treatment generally limited to drug or surgical treatments – the old saying  – to a hammer everything looks like a nail!

So it is important to understand that the two modalities are treating from a different perspective and have different philosophies around health, nevertheless respecting each others differences and understanding the strengths and limitations of both works best.

Why Do Naturopaths Ask For More Detailed Investigations Than GP’s?

Traditional naturopathy used to rely on a very thorough case history taking to make an assessment of likelihood that there was some sort of condition or biochemical dysfunction or deficiency, such as insulin resistance, inflammation, gut dysfunction, zinc, magnesium, B12 etc, etc and then dietary, lifestyle and supplemental advise would be given to improve the outcomes. BUT TIMES ARE A CHANGING! We have more at our disposal now and we too are using gold standard pathology tests to check these levels. I have spent 8 years being trained by a biochemist and reviewing the research and can read pathology results within context, understand their strength and limitations and make far more targeted, educated and science based treatment strategies.  Most GP’s have not been trained in this style of nutritional and condition evaluation and assessment and evaluation. They do not need to be as their treatment strategy is to use pharmaceutical drugs or surgery to treat.

Let me give you a couple of examples to explain what I mean:

Example 1:

If you have been diagnosed with a thyroid issue – lets say you have an elevated TSH (thyroid stimulating hormone), which suggests that your thyroid is not producing enough thyroid hormones. A GP would general prescribe thyroid medication (such as thyroxine/ T4), then every three months checks of your thyroid hormones (T3,T4) and TSH would be made until the TSH looks stable, from there you may have a yearly check. From the naturopathic perspective, it is important to know why the TSH is elevated, is it because of an iodine deficiency (common cause, impossible to make thyroid hormones without the raw material – which is iodine!), is it because of a selenium deficiency (needed to converted T4 to T3), are other cofactors available, such as zinc and iron, is there liver or gut dysfunction effecting hormone conversion so on and on. How far reaching is the problem, are there thyroid autoantibodies, these can be tested. So this issue alone requires 8 or 9 pathology tests. This will then allow accuracy in treatment, all of which is scientifically backed, who wouldn’t prefer to resolve a nutritional deficiency rather than be dependant on a drug possibly forever?

Example 2:

If you are continually getting sick, from a naturopathic perspective we consider all the factors which effect your immune system, these include zinc, amino acids, beneficial bacteria and vitamin D, so we want to test these to see that they are at the levels they need to be at, this allows for very targeted treatment. From a medical perspective you will be given an antibiotic or antiviral each time you are unwell. Naturopathicaly, cause must be established, other evaluations will be considered too, such as, do you get enough sleep, are your bowels working efficiently for waste clearance etc etc.

Conclusion

Like it or not we have no choice but to accept that subsidy for pathology testing has been cut – rightly or wrongly! Functional and nutritional testing is strongly supported by the evidence and this evidence is growing at a phenomenal rate, this makes it nearly impossible to ignore for any ethical health care practitioner. I would like to reassure you that some of the pathology labs are working very closely with us, to provide excellent out of pocket rates. We will be promoting and supporting those labs who are working to support you. For my clients these discount rates will be passed on to you to help ease the burden and continue to make thorough pathology testing affordable.

IMPORTANT NOTE – Whenever you go in for blood testing it is really important to fast between 8 to 12 hours prior to the tests, even if some tests don’t require this. This allows test comparisons to be made with as few variable as possible.  

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