What gave rise to the Philosopherdoc concept?
Why not just practice outpatient Internal Medicine and leave all those Behavioral Health problems to the Counselors, Psychologists, and Psychiatrists? Whatever the physical problem, there’s a pill for it, right? Whatever the emotional or psychological problem, there’s a pill (or pills!) for that as well, correct? The answer is that most of the physical problems I treat, such as Diabetes, High blood pressure, high cholesterol, are a product of poor lifestyle choices resulting in part due to poor emotional health. If you don’t feel good about yourself, you won’t care for yourself. If you feel your life is out of control and out of YOUR control, you at least know that food, or alcohol, cigarettes, excessive television will, in the short run at least, make you feel better physically and enable you to “connect” with yourself, on a consistent basis. So the problem, as well as the answer, is that the physical is related to the emotional. But to “fix” both requires that most important of commodities: time. And that’s something, in the Primary Care setting, is in short supply. How can you fix the emotional problems that are the leading cause of the physical problems? By creating other platforms, such as seminars, videos, and articles where people outside of the confines of a primary care or behavioral health visit can learn the tools to feel better about themselves, their situation, predicaments, their past, challenges, and relationships. To help them break through limiting beliefs about themselves and their future to achieve their goals and create the life they deserve! But there’s more. . .
On October 30, 2020, I had never been so close to getting up from my desk with a patient in the room and walking out of the room, never to return. I was so overwhelmed by the number of physical problems, specialists’ reports to review, abnormal diagnostic tests, combined with a laundry list of emotional and psychological problems that would be impossible to address in the allotted 15-minute slot. I was simply unable to help because of what modern Internal Medicine has become. Day after day, I sit in the room staring at a computer screen, entering data while adjusting medication for high blood pressure, diabetes, high cholesterol, low back pain, heartburn, and COPD, which more often than not are a product of poor lifestyle choices due to underlying emotional problems. Simultaneously I try to comply with insurance charting and coding guidelines. Every possible complex diagnosis and little nuance must be documented for the insurance companies and Medicare to a lot a greater budget dedicated to the patient’s care. If the budget is exceeded too often on too many of your patients, you will be penalized. This causes us to focus on what WE, the doctors, want to talk about rather than what the patient NEEDS to talk about. Unfortunately, it can decay into a situation like this: “So, you’re having problems paying your bills? You feel guilt, overwhelmed, anxiety, depressed? You’re fighting with your spouse, your kids? You become easily tired? You don’t exercise, and you overeat of the wrong food?” In the 15 minutes, we have to review your abnormal labs, enter data, review consult notes from 5 other doctors, refill ten medications that you can’t afford, review all the things missing like colonoscopies, your flu shot, and mammogram that will determine what the doctor gets paid, maybe, we actually discuss what’s on your mind! It goes something like this, “You’re sad?” I see. Have you had your flu shot? I forgot to ask you when your last colonoscopy was? Let me refer you to a counselor that might be contracted that you might like. He’ll see you in three months at the soonest and might talk to you about his problems while trying to dig through your past to fix your current problems, reminding you of past experiences that you would be better off forgetting. “Okay, I’ll see you in 3 months.”
This is a bit of an exaggeration, but I think you get the point.
The alternative, which I like to choose, is to take the necessary time, but run behind, which the patients and the staff obviously don’t like. Too many problems, and not enough time to address them the right way. I needed to take action. I decided to take on what I thought was my responsibility as a Primary Care physician many years ago. To not only help the patients’ bodies but help their minds as well.
Instead of talking about the problem and never doing anything about it, I needed to hone and develop my skills.
On October 30, 2020, I decided to pursue formal life coaching Strategic Intervention training through Tony Robbins and Chloe Madannes’s Core 100 program, followed by countless books, lectures, podcasts, and seminars to have the tools to help people deal with the underlying emotional problems leading to their physical problems not only in the Primary Care setting but outside the clinic as well.
