CLB: Almost my first day in conventional medical practice I became very aware of the limitations of conventional medicine. I had patients coming to see me that I really had no good treatments for – mostly all the chronic diseases: arthritis, fatigue and headaches. My training only trained me for acute emergencies and to give people prescriptions to try to treat symptoms. About 12 or 13 years ago I started to learn about meditation and mind/body medicine – back then it was called psycho-neuro immunology – and that led me to discover a lot of physician pioneers who were out there doing this work. I went to conferences. I read books. I learned from myself as well, because I have had lifelong insomnia – that was what really did it for me. When I finished my medical training, my insomnia came back and that led me to meditation and my own healing work. Everything I had learned I tried to teach my patients until it reached a point where I could no longer fit myself into a conventional model because of the limitations of that kind of practice.

CLB: I’m board certified in internal medicine. I trained at Medical College of Pennsylvania and did my residency at Pennsylvania Hospital in Philly. I’m also board certified in holistic medicine through the American Board of Holistic Medicine.

CLB: The center is a full service, primary care medicine/holistic health facility. We have two physicians. We have acupuncture, massage therapy, hypnotherapy, aroma therapy, skin care and some counseling. We work as a team. The physicians head the team and provide treatment plans, so that when patients come through, they have a comprehensive plan that puts all these people together. Most people who come in are looking to get off medications, or they’ve been to a bunch of doctors and haven’t had any success, or somebody in the conventional world has said, "There’s nothing more we can do."

CLB: Holistic primary care for me means that, instead of having two tools – drugs and surgery – I have 15 or 20 tools. The primary care part means that I’m taking care of my patients just like you do in conventional medicine, but because I have so many tools in my belt, I feel that I have a lot more to offer people. It’s also more relationship-based – almost like the lost art of medicine. These days, medicine is very fast-paced, it’s busy and physicians are under a lot of pressure with time, finances, insurance reimbursement, overhead, malpractice, and people are feeling that they don’t have anybody who’s really taking care of them and paying attention and knows what’s going on with their health. I did conventional medicine for six years. Nobody in those six years came back and said, "Thanks, doc, I feel great. I’m better." They would either come back with the same problem, or a new problem. Now, on a daily basis, most people that come back for follow-up are better. We’re not getting rich doing this, trust me. Most of us have made huge sacrifices to practice this kind of medicine, but we do it because it’s completely satisfying and fulfilling.

CLB: My model is basically fee-for-service. What I’ve discovered is that I can’t help people in 10 minutes, because I’ve tried for six years when I practiced conventional medicine. It takes time to sit with somebody and figure out what they need. You can’t tell somebody to stop smoking, or lose weight, or not to be so stressed, unless you teach them how. In order to teach them how, you have to spend time with them. What we do at my center is, payment is due at time of service. We submit the insurance forms for people to their insurance companies and they get reimbursement for whatever services their insurance may cover. It’s a paradigm shift because most people aren’t used to having to pay when they go to the doctor’s office. I tried to create a business model that reflects the clinical model, because clinically we work as a team. I didn’t want to be a landlord. I don’t want everybody trying to build their own business. The business model here is that each practitioner is an independent contractor. They do pay rent but everybody also has a percentage of what they bring in that supports the business: office manager, front desks, marketing, advertising, electric, needles, sheets, all the supplies. There’s also profit-sharing, so when we reach the point where the business is making money, everybody gets profit back depending on the percentage that their particular piece contributed. We are considered a group medical practice and everybody here is a non-participating provider with insurance companies.

We share a patient’s chart. It’s not everybody seeing their own patients and doing their own thing. I have to work with the person’s finances, with their time, with their philosophy, so when I’ve sat with somebody for an hour to put a treatment together for them, I might have said something like, "I’d like you to get acupuncture once a month and massage therapy once a month, and I want to see you back in two months to see how that’s working." That means that the massage therapist and acupuncturist have to do what I said and not give the patient different information. A referral goes to these practitioners to let them know what the plan is. If they feel that the plan doesn’t work clinically, from an acupuncturist standpoint, for example, they communicate back to me. We then communicate together to the patient. There’s a lot of behind-the-scenes work that goes on so that it’s a very smooth clinical process for the patient. When they walk in the door, they’re being taken care of by the whole center. The physician basically oversees the patient’s treatment, but we have team meetings to go over cases and business. I think that’s the most unique thing about our center’s model.

CLB: That’s kind of the art, because the truth is that all of these therapies work. It boils down to picking something that appeals to the patient, picking sometimes by practitioner – whose personality might work better with the patient – and sometimes it has to do with the charts. Let’s say their insurance covers acupuncture. If they need an energy-based therapy and I’m trying to decide between hands-on energy healing, homeopathy and acupuncture, then I might steer towards something that their insurance covers. You have to get a sense from the patient of how to direct them. Some people have irrational feelings about one thing versus another. That’s what’s nice about having so many options.

CLB: Yes, the pharmaceuticals, the nutrition and the supplements. I also specialize in hands-on energy healing and the other physician does homeopathy. Labs, X-rays – all the diagnostics are done by the physicians.

CLB: Absolutely. If I compare to when I did conventional medicine, I would say at least half or less because, when somebody used to come to see me in a conventional setting, the only things that I could do were give them a prescription or check some studies. Those were my only two tools. Because I have so many other tools now, if I don’t feel that something is urgent or I’m not very suspicious, sometimes I’ll just try some basic nutrition to heal their gut for three or four weeks, and 90 percent of their symptoms go away. So I haven’t had to do a whole big workup that might cost $500. Mostly, I get people off their prescriptions. I do recommend supplements. But in terms of prescribing pharmaceuticals, I probably do about 10 percent of what I used to do.

CLB: There are ways to practice holistically and have insurance coverage. It has to do with being somewhat savvy and how you code. You probably need to limit your time more than I do, so you might see people more frequently for less time at each visit. The models also vary according to the role of the physician: Are you a manager? Are you a hands-on practitioner? In my case, I’m both. They vary according to a physician’s clinical slant. There are holistic/integrative physicians who are much more allopathically inclined than I am – they still do a lot of diagnostics; they just do different diagnostics than conventional docs. There are people who use a lot of vitamins and minerals. Some people use IV vitamins and minerals and chelation therapy. I tend to lean more towards the energy-based therapies and nutrition. Holistic is a very broad definition. From the standpoint of the American Holistic Medical Association, holistic medicine is the art and science of healing that addresses the care of the whole person – body, mind and spirit. The practice of holistic medicine integrates conventional and complementary therapies to promote optimal health and to prevent and treat disease by mitigating causes. What’s different from a conventional model is that any holistic model is very relationship-based. It’s about being more of a guide and teaching patients that physical health is a reflection of spiritual, mental and emotional health and how you live your life. The logistics of the business model are secondary, for most holistic physicians that I’ve met, to the passion of understanding that conventional medicine is almost always treating a symptom and not a cause, or true healing.

CLB: For me personally, no. By definition, insurance-based practice is a volume game. You can only make money by doing volume because you have to accept what the insurance pays. What that does is automatically cycle you into having to see patients quickly. For me personally, that automatically cycles me back into quick fixes because I don’t have time to really get to the bottom of it and develop relationships with people. I tried it and I couldn’t make it work. Besides that, I do hands-on energy healing, which is not covered by insurance at all, anywhere. And thirdly, it’s a bit of an ethical and philosophical issue because part of healing is taking responsibility for yourself and your life and, as long as the consumer has no responsibility for what they’re consuming, then the insurance industry has no accountability. We’ve put the consumer back in charge of what they’re consuming.

Most insurances obviously will cover the physician visits, because it’s based on diagnoses and not on treatment. Medicare covers medical visits and counseling. Lots of private insurances will now cover acupuncture. Lots of them will cover massage therapy. Lots of them cover chiropractic. From a practitioner’s standpoint, you have to agree to accept their discounted fees. They might pay $20 for an acupuncture session. That’s ridiculous. Our acupuncturist spends an hour with their patients. While insurance companies are covering more than they did a few years ago, I wouldn’t necessarily say they’re covering it properly. Another caveat is that insurance companies have arbitrary considerations about what won’t be covered. For example, they might cover acupuncture for back pain, but not for insomnia, when it’s a perfectly good treatment for both. And sometimes they’ll cover acupuncture, but only if it’s done by a physician. That doesn’t make any sense. Some acupuncturists go to school for four years and a physician can go do a CME course and learn how to do acupuncture. So, who’s better?

CLB: That’s where you really blend the art and science. How to put them together is somewhat of an art, and that’s where organizations come in. The American Board of Holistic Medicine (ABHM), of which I’m a member, has put together a curriculum for board certification, so there is a standard of practice and a standard of excellence that people need to meet. The American Holistic Medical Association and the ABHM have said, "This is medicine, this is science and there’s a right and wrong way to do it." Just like for conventional medicine, you have to learn the information. Once you’ve learned the information, the the art of medicine is where you figure how best to put together clinically what works and what doesn’t. There are other integrative and complementary medicine groups in the process of becoming unified, but the ABHM is the only group that has put together a standard core curriculum of basic information that any holistic physician needs to know. I would say that, within a year somebody could study this material and attend a review course and probably become board certified. It really depends on how passionate they are about it.

CLB: Among physicians, number one is diet – putting healthy food into your body. This is the most basic thing and it is almost never addressed in conventional medicine. I’ve had people who have been through two years of cancer treatment and nobody has asked them what they eat. Supplement support is also important. In an ideal world you don’t need supplements. Given the stresses of modern life and the poor food supply, most people need at least some form of supplementation. That’s the physical piece. Then there’s the mind/body piece. People need to learn how to make sure their mind and body are connected, and bring in things like meditation, yoga, guided imagery, hypnotherapy, things that help people to be aware of how important their thoughts are on impacting their physiology. A huge piece that I think is often missing, even among holistic docs, is the field of energy medicine – these are our most powerful therapies, and they’re the ones that conventional medicine understands the least because they’re based on treatments that work at the vibrational level: things like energy healing, acupuncture, homeopathy, aroma therapy, sound, light, color, prayer. Anything that works at the vibrational level is working at the level of cause. A conventional approach that only looks at the physical body is always treating a symptom and it’s never treating a cause.

CLB: Everything in our universe is made of energy. Energy and matter are interchangeable. That means that we are also fundamentally just a big bundle of energy. Disease starts first by an imbalance in the functioning of the energy pathways and the energy body. Now, conventional docs are going to have a problem with this because they haven’t been taught this. If you take an ice cube and you want to make water and you try to chop it up with an ice pick, you will still have ice unless you change the energy of the system. If you heat that ice cube, you haven’t done anything except change the vibratory rate of the H2O, so the physical form changes to water because the energies have changed. If you heat it again, you change the frequency and you have vapor. From our conventional standpoint, it’s gone, but we know that it’s still there, we just can’t perceive it with our senses. So, if you have something physical and you can change the vibration underlying that physical structure – just like the ice cube – the physical has to respond because it reflects the underlying energy. There are some conventional treatments that are frequency-based energy treatments, like laser or ultraviolet light that dermatologists use, or ultrasound treatments for pain. But, in holistic medicine, we just have a lot more of them. Energy-based treatments are the most powerful treatments because they’re treating at the causal level and – just to take that a step further – most of the things that conventional medicine can’t treat, like fibramyalgia, chronic fatigue, bipolar, ADD, depression – the reason that they have trouble treating those illnesses is because they are primarily illnesses that are energy-based. You can’t find them physically, like on a CAT scan or blood test. So, if you treat those things energetically, those people do extremely well.

CLB: Research is really important. On the other hand, you can’t limit yourself to that because most of the research done in the conventional world is done by the pharmaceutical industry, because they have a lot of money. There’s not a lot of money supporting research on these therapies because nobody is going to make money off of them. I personally don’t think that we can not use therapies that may have only been studied in a limited way, or perhaps not been studied at all but have been found clinically useful, just because we don’t have the studies – because there’s not a lot of funding to do the studies. Robert Anderson, M.D., has been doing this for 30 or 40 years and has compiled a book of abstracts that lists almost all the studies that have been done on all these therapies.

CLB: From five years ago to today, it is night and day. Five years ago there was a lot of fear and suspicion, and doctors felt threatened. Physicians are starting to view holistic doctors as more of a resource for their patients and less of a threat, or something that’s suspect. A lot of these therapies are creeping into conventional medicine. Urologists are using saw palmetto and doctors are recommending fish oil. Holistic medicine is definitely here to stay. The public has been the driving force and doctors are catching up. There are about 800 board-certified holistic physicians across the country, and there are a lot of people practicing who are not board-certified.