Trust Me, I’m Your Doctor

We all hear about health care. Usually it’s through the microcosm of someone’s illness, or the macro-view of dueling pundits and politicians. Frequently it’s adversarial, or negative.

Thanks to long-time Trust Matters’ own trusted advisor Shaula Evans, I met Dr. Craig Koniver. He brings a fascinating perspective to the topic, as you’ll see.

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Charlie Green: Craig, you’re a doctor in South Carolina. Are you a native?

Craig Koniver: No. I grew up in Delaware, went to one year of undergrad at Johns Hopkins, hated it, and transferred to Brown. I then went on to medical school at Jefferson Medical College in Philadelphia. So I did end up being a doctor, mostly in Arizona, and recently moved here.

Charlie: You say you practice “organic medicine.” How did you come to that?

Craig: First of all, I am a “regular” doctor, board-certified and all that, but I also came to believe in a certain approach to medicine. The transformative event in my life was when our daughter was colicky.

The pediatrician said what I’d been trained to say, but since it was our daughter this time, we were wholly unsatisfied. We went out and found unconventional approaches to the issue. And once you’ve seen behind the curtain, it’s hard to stop.

Charlie: What is behind the curtain?

Craig: The standard routine is label, diagnose, prescribe medicine or surgery. Repeat, repeat, repeat. The paradigm of modern medicine is medicine-based, which is to say, pharmaceutical – pills and chemicals.

100 years ago this was not the case; the doctor had a relationship with the patient. But today, the doctor is trained to see the patient as a series of chemical pathologies.

Charlie: So, on a practical level, what do you do differently than other doctors?

Craig: I am interested in helping the patient reach optimal health through natural means. I am not against prescription medicine, but I think they are highly over-utilized by doctors not interested in pursuing alternative/ natural modalities.

So with my patients we look for the root cause of disease by running specialty lab tests and then use herbs and vitamins and nutrients to get their health back on track. I am a firm believer that there is a natural option for everything–we just have to look in the right place and be willing to try any different options.

Charlie: What’s the effect on patient health?

Craig: One telling study suggested that as many as 1/3 of prescriptions get tossed away on the patient’s way out of the doctor’s building. They want more than a prescription, they want a relationship and they want options.

Charlie: What did you do as this became apparent to you?

Craig: I finally decided to move to a holistic practice. That entailed moving away from insurance, and cutting my patient load from about 4,000 to about 400.

Charlie: Wow. Now, hang on a minute; that raises all kinds of interesting issues. What does that say for coverage?

Craig: It affects many people differently. First, there are a large number of people who are quite willing to pay for personalized, holistic healthcare. It is quite valuable to them!

In addition, remember that existing health insurance policies don’t generally cover doctors suggesting things like exercise and nutritional changes; as well, procedures like bypass surgery are reimbursed while time-tested acupuncture is not.

And I now get to spend real, quality time with my patients. I take as much time as I want and they want, and they leave satisfied feeling that I’m concerned about their whole life.  Which I am! A lot of people find this hugely valuable.

Charlie: What about those who can’t afford it?

Craig: Before we get there, there are number of people who may or may not be able to afford it, but don’t see the value in it. They’re used to thinking that a doctor visit should cost the amount of a co-pay. They can’t get past a more cost-based model.

Are there those who are left out by this? Absolutely there are and it’s a real tragedy because they continue to get the acute-based, chemical-and-surgery, impersonal kind of medicine that doesn’t help them.

Charlie: Ah, interesting. You’re not a selfish doc going off to serve well-heeled patients, there really is no choice.

Craig: That’s true. I’m not abandoning poor people, I’m abandoning bad medicine. And the existing insurance system simply cannot support the kind of medicine I like to practice. Is it tragic? Yes, and a real shame.

You pretty much cannot have a holistic medicine practice that operates within the existing high-volume insurance-based delivery method we have today. The choice is not which clientele to go after – it’s which kind of medicine I want to practice.

Charlie: Does the patient-physician relationship of trust affect health?

Craig: Yes. Again, if the relationship is pill-based, then it’s not personal; that is not a good basis for trust. Before too long, patients will stop trusting a physician because there is only that basis for the relationship.

In a holistic practice, where by definition the doctor is concerned about the whole patient, you have the basis for a personal relationship. That means you have the basis for trust. And with trust, patients share more with you, they take your advice, and there is probably even the positive placebo effect.

Charlie: One implication of what you’re saying is that our existing approach, based on insurance reimbursement of pills and surgery, is basically built to minimize trust.

Craig: Yes, I think that’s an accurate statement of the current situation. The health care delivery system is tied to the doctor-patient trust level. And not in a good way just now.

Charlie: Well, this has been enlightening indeed; thanks so much for spending time with us.

Craig: Thank you, Charlie.