The benefits of collaboration outside of the network of M.D. specialists in today's medicine are becoming apparent. The successful M.D. does not have the time to incorporate much of the time intensive aspects of Complementary Medicine into the treatment protocol. It is not only in the patient's best interest to involve other Complementary specialties in the treatment plan in many cases, but it is also a practical consideration for the M.D., osteopath, chiropractor, physical therapist, psychiatrist, psychologist, clinical nursing specialist and naturopath. This L.Ac. brings a long history of collaboration, especially in the field of Occupational Medicine and Workers" Compensation, to the table. He is also knowledgeable and experienced with integrating Complementary Medicine into treatment with cancer, autoimmune dysfunction, endocrine dysfunction, and fertility therapies.

Health Reform is topic that is a concern to everyone, patients and physicians alike. The cost of health care has topped $2.5 trillion per year, or about $1860 per person, and is rising rapidly. Physicians are finding that new paradigms are necessary to repair this system, and patients are demanding change. Some physicians, such as Dr. David Newman, an ER physician at St. Luke's in New York, and the author of “Hippocrates‘ Shadow” writes that medical doctors must expand their thinking beyond prescriptions and procedures to get the patient well in an era of health care reform. Integrative medicine offers the physician a partner to help educate the patient to healthier diet and lifestyle options, as well as effective Complementary treatments. The Medical Doctor often does not have the time to devote to patient instruction and guidance as does the Licensed Acupuncturist. In addition, the scope of practice of the California Licensed Acupuncturist may bring a host of therapies and knowledge to the treatment team to augment the knowldedge and skill of the M.D. or other physician.

A good working relationship involves a secondary physician who receives a treatment recommendation and short report or diagnosis from the primary treating physician and adheres to the case management guidelines. A short progress report following the course of therapy helps the primary physician keep track of the patient progress. Conversely, this secondary physician becomes acquainted with other specialists that show interest in complementary integrative medicine and is able to recommend physicians to their regular patients who have the the open attitude toward Complementary and Integrative Medicine that many patients are seeking today. With the practice website, a large number of patients can easily find the recommended physician that they need when a new health problem arises. As more and more patients become interested in Complementary Medicine and preventive measures with a holistic perspective, this type of collaboration becomes an important aspect of the medical doctor in the twenty-first century.

This type of collaboration helps build patient confidence and allows the physician to have another specialist answer questions that may be outside of their scope of clinical experience. An M.D. often has a tight schedule and needs another physician to take the time to explain such subjects as guidance with nutritional supplements, herbal formulas, ergonomics, or to explain just how acupuncture works. It also allows the primary physician to offer a greater variety of therapies to their patient, and thus expands their practice, in this case offering myofascial release, neuromuscular reeducation, soft tissue manipulation, patient training in targeted stretch and exercise, as well as correction of body mechanics, in addition to acupuncture. This type of thorough and holistic treatment protocol performed before surgery insures a better outcome, and performed following surgery results in patients achieving quicker functional restoration and avoiding the scar tissue adhesions that inhibit range of motion and create chronic pain.

This Licensed Acupuncturist brings a number of practical manual therapies and a good working knowledge of modern medicine to help bridge the gap between standard allopathic medicine and the growing and complex field of nutriceuticals, herbal medicine, the science of trigger point stimulation and the holistic and mind body approaches to treatment. I also bring a modern understanding of musculoskeletal medicine, physical exam, myofascial pathologies and other soft tissue injuries to the practice so that treatment protocol is not confusing to the patient in relation to their primary diagnosis, and reports to the primary phsician are clear and concise. My care is time intensive and serves to develop a better proactive participation in patient recovery, which is recognized by physician groups such as ACOEM as very important to the success in chronic cases.

There is also the practical consideration of office management and paperwork. I have learned much about the medlegal aspects of proper case management from years of work in the Workers' Compensation system and insure that my paperwork keeps up with the changing demands of the insurance industry concerning medical necessity to facilitate problems of approval of therapeutic recommendations. I also belong to a number of provider networks so that referral is easier within the scope of the patient's policy. Out of network care is also a legal right of the Workers' Compensation patient with a chronic case, and I am able to help the patient and primary physician's case mangagers with this problem. If the patient care must be paid out of pocket, my care is relatively inexpensive, and professional superbills are offered to help the patient seek compensation where possible. Care in personal injury cases is often performed in lieu of a physician's lien when necessary. Such experience and practical knowledge aids the collaborative relationship greatly.

I believe that the term 'alternative' medicine has long promoted an unhealthy and mistaken attitude about the science of TCM, which historically has always been a complementary partner with allopathic medicine. The benefits of TCM were outlined in the early historical text, Huang Di Nei Jing, as early as 2800 BC, and cite the benefits of the holistic approach in alleviation of contributing factors, with preventative medicine, and with reduction in risk and side effects. Thus, this medicine has been part of standard medicine worldwide, and brings a level of competency to conservative care options. My practice of TCM allows physicians to try a complete package of acupuncture, physiotherapies and herbal/nutrient medicine when patient injuries and diseases may not require a surgical or pharmaceutical approach, when subclinical syndromes are seen, or when chronic cases are not responding as well as we would like to standard therapy.

My life experience has involved a personal history with the multidisciplinary approach to treatment. I returned to graduate school to study this medicine after a team of physicians consisting of a medical doctor, chiropractor, physical therapist and licensed acupuncturist helped me to regain full function after a serious injury. Unfortunately, I have now had three of these devastating experiences, but have recovered remarkably well and in half the time expected in each case because of the combination of care. This has cut the cost of care considerably, and kept me from being permanently disabled. I only hope that I can be a part of such collaborative care for other patients.