I thought I’d take a moment to give you an update on what my plans are for the next couple of years, especially in relation to my private practice, which I’ve received a number of questions about recently.
As some of you know, I closed my practice to new patients about six months ago. I did this because my patient base had grown so quickly that established patients in my practice had to wait up to five or six weeks to schedule a follow-up appointment. That obviously doesn’t work; when a patient is on a treatment plan, and something comes up that requires attention, they can’t wait six weeks for guidance.
The good news is that within a couple of months the wait list for existing patients was significantly reduced. They can now get a follow-up appointment within a week, and sometimes even within a couple of days. As a result, I’ve been gradually working through the 80 people that were on my wait list for new patients.
The bad news (at least for those of you waiting to become a patient), is that I’ve decided to scale back on my private practice, reducing the number of days I see patients from four to two. There are several reasons for this, but I describe two of the main ones below: I want to free up time to write a book and develop a clinician training program.
Now that I’m down to two days a week in the clinic, I’m going to see how things go with my current patient load over the remaining two months of 2012. When it’s clear that I can accommodate new patients again without creating a long wait for established patients, I will open my doors again – albeit on a limited basis because of my reduced clinical hours. I expect this to happen in early 2013.
The decision to go down to two days a week in the clinic was a difficult one. I enjoy working with patients and I know there are a lot of people who need help. But working directly with patients is only one of the ways I help people (there’s also the blog, radio show, educational programs, public talks, etc.), and there’s a definite limit to how many people I can help in this way. Which leads me to…
I’ve been thinking for quite some time about writing a book, but I knew that I’d have to free up some time in my schedule in order to make that happen. With the changes I’ve made in my private practice, a book finally seems possible.
The topic? The real causes (and solutions) of gut problems. Have you ever noticed that most diagnoses of digestive problems are simply fancy descriptions of symptoms? If you go to the doctor and tell her you have gas, bloating and pain, she might diagnose you with “irritable bowel syndrome”. (Of course you might be thinking, “Didn’t I just tell you that?”) If you have acid refluxing into your throat, you have gastroesophageal reflux disease (GERD). If your colon is inflamed, you have Ulcerative Colitis. I could go on but you get the idea.
None of these diagnoses tell you anything about the underlying mechanisms that are causing these symptoms, or what to do about them. For example, many (if not most) people with IBS have either small intestine bacterial overgrowth (SIBO), dysbiosis, a gut infection, a gut-brain axis problem, or some combination of all of these issues. People with GERD often have low stomach acid, an h. pylori infection and/or SIBO. People with Ulcerative Colitis have a dysregulated immune system causing their body to attack itself, as well as SIBO, a gut infection and a gut-brain axis issue. In order to truly heal IBS, GERD, Ulcerative Colitis or any other gut problem, these underlying causes must be addressed. That’s exactly what my book will be about.
The book will help me reach an even wider audience with this important message. I’ve already started planning and outlining, and am tentatively planning to publish at the end of next year or early 2014. Stay tuned for some exciting announcements related to the book in the near future.
The training program
Almost every day I get an email or Facebook message from someone asking me what I’d recommend in terms of education for someone who wants to start a functional medicine practice. Unfortunately, I don’t have a good answer for these folks.
Of course there are several options for learning the basics of treating patients: you can study to become a medical doctor, naturopath, acupuncturist, chiropractor, registered dietician, etc. However, while there are excellent programs in all of these disciplines, and many of them provide a solid foundation, they don’t teach you much in the way of the clinical skills you need to have a successful functional medicine practice.
If a medical doctor wants to specialize in a certain area, such as cardiology, he or she will first get a medical degree, and then do a residency in that particular field. We need a similar opportunity for those wishing to specialize in functional medicine. This is exactly what I plan to create.
In 2014, after the book is published, I’m going to shift my focus toward developing a training program for other clinicians and practitioners who want to specialize in functional medicine. We’ll cover interpretation of blood, saliva, urine and stool testing and how to use these tests to diagnose and treat the most common problems seen in a functional medicine practice, ranging from thyroid disorders to gut issues to hormone imbalance. It will likely include some combination of lecture, case studies, group study and individual mentorship. The majority of the training will be offered online to make it accessible to the widest possible audience, but I may have a module or two that is in-person.
I’m excited about training other clinicians, because through these programs I’ll be able to help far more patients than I’d be able to help directly on my own.
Okay, that’s it for now! Back to our regularly scheduled programming…