We have made numerous referrals over the years to doctors around the country who have indicated to us that “they do what we do“. Based on comments of those we have referred to these doctors, they didn’t. In most cases there was very little similarity between our services and most others in the chronic pain field. Now that statement certainly opens one up to the obvious criticism of being conceited, overly confident, or delusional about our services and their results. We have thought about this at great length but in the end we realize that we have developed a unique algorithm to address chronic conditions. So here’s what makes our services different from other practitioner approaches to the complex problem of chronic conditions.
- Chronic conditions are complex, multifunctional conditions that may require a team approach to address certain patients’ disparate contributing factors to their individual condition. Many clinics refer to their services as “integrated”. This model generally employs multiple doctors from various disciplines who each individually “evaluate” the patient from their own unique perspective. The problem that we have observed with the integrated model is that usually there is not truly “integrated” communication or coordination of treatment among the doctors. Generally the patient begins care with one discipline and when that discipline’s approach doesn’t produce results the patient is referred to another within the office. Sometimes they will attend more than one doctor at a time but the approaches are never particularly coordinated. This is the ultimate representation of “too many cooks (and opinions) spoil the broth”. Power Health uses a team approach.
At Power Health, the initial consultation is conducted with attentiveness to understanding all of the factors that may be involved in that persons’ case before the decision to follow through with an evaluation is made. Dr. Martin Rutherford D.C., CFMP conducts the interview to determine whether this patient’s case is one that has the potential to respond to the treatment protocols employed by our doctors. Assessment of the various symptoms involved in the clinical history is performed at the initial consultation and the patient is informed as to whether we can accept their case or need to refer the patient to the appropriate discipline for further care. If the patient is accepted for care, a 24 page history that thoroughly evaluates and helps to determine the most likely systems contributing to their condition is completed. An examination that we have developed specifically to evaluate chronic conditions and chronic pain is performed by 2-3 doctors to fully evaluate the brain and nervous system, and get a full evaluation and examination according to the findings of the 24 page history form referred to above. The examination thus evaluates all of the systems of the body with specific attention being paid to targeting the most commonly involved dysfunctional systems that create chronic pain and chronic conditions – digestive bowel, brain and nervous system function (or lack thereof), immune system dysfunction, thyroid, and/or potential musculoskeletal system dysfunction.
These exam findings are then coordinated by Dr. Rutherford and one targeted plan is developed to include the participation of only those clinicians that need to be involved in the case. Our mantra at Power Health is less is more and simple is better. Less drugs, less supplements, less herbs, and less doctors! Only those clinicians critical to that persons’ case will become involved. If outside referrals are indicated by our history and exam findings, they are made (i.e., MRI’s, CATScans, EEG’s, etc.) But Dr. Rutherford coordinates all treatment even if additional treatment from other team members is indicated. Because of our approach (the exam is about 3 hours in length) and our precise record keeping we have developed a good working relationship with the medical community and regularly work with PCP’s, internists, neurologists, cardiologists, APN’s, CNP’s, and more. This is a “team” approach. Utilizing the best of alternative and allopathic disciplines when necessary and only when necessary.
If there are other offices that address chronic pain with this particular model of organizing and cooperating four professions, Functional Neurology, Functional Medicine, Chiropractic, and the objectively indicated medical allopathic professional – to address the chronic patient – we are not aware of who they are and apologize to these doctors in advance for that professional slight.
- This diagnostic approach allows us to create an initial game plan to attack the patient’s individual case before care even begins. There are many moving parts to chronic pain and as you have probably already found out. It’s difficult to get any two doctors to agree to what they are – or if your tests are normal “to even believe you have a problem”. This leads to no treatment or “trying a little bit of this or a little bit of that” along the way and a lot of guessing or throwing diagnostic darts at the wall without a plan then ultimately recommending standardized one size fits all treatment programs that cannot work for conditions which result from multiple dysfunctioning vicious cycles, multiple dysfunction biochemical pathways and or overlying dysfunctional neurological conditions.
A successful game plan can only be created after making a correct diagnosis. That sounds obvious but evidently it is not in many alternative and medical facilities. Doctors must be willing to put in the time to master the functional neurological, functional medicine, and at least have knowledge of the general musculoskeletal examination procedures that lead to targeted and useful testing procedures. To learn this evaluation is no small feat and I can name barely a handful of doctors that I am aware of who have done so. Without becoming conversant with and understanding how to conduct a relevant neuro-musculoskeletal, neuro-metabolic examination doctors are led to utilizing questionable, unsubstantiated means of diagnosis (i.e., muscle testing, Vol machines, unreliable specialty testing as in Lyme disease, computer generated blood test results, etc.) and treatment (magic machines, standardized diets, the “you name it” cure, shopping bags full of supplements), symptom chasing, and the failed model of “legitimate” prescription drug treatments that can only address one aspect of the patients many faceted conditions. All of these trial and error procedures lead to an overall high fail case rate.
- The examinations and testing procedures at our facilities are thorough (1 ½ to 3 hours for initial evaluative work) are recognized in both medical and alternative arenas, are based on mountains of legitimate, peer reviewed research, and are specifically tailored to the chronic conditions that compose our patient population. As previously indicated MRI’s, CAT Scans, EEG’s, NCV’s, and all blood panels that are ordered are ordered only after individualized history taking and examination procedures are completed and as a result are concise, targeted, and specific to that patients particular case. Then and only then in our opinion can a practitioner devise a consistently successful game plan based on having created a comprehensive understanding of that patients’ case and their unique specific neurologic, metabolic, and musculoskeletal contributing components to their condition. Including records reviews from previous doctors this entire process takes about 5 hours to complete. I personally don’t believe it can properly be done in less time than that.
The evaluative procedure conducted on every patient at Power Health enables the development of a definitive diagnosis in each chronic condition or chronic pain case. As a result the approach is not treating solely “by the test” and if that doesn’t work then “we’ll keep trying until we find it and so let’s do another test.” From a definitive diagnosis, we can, before we begin care answer what kind of recovery to expect, how long will it take, what’s the treatment going to look like, how much will it cost, etc. OR, should we find that we cannot successfully treat you, we’ll know that we should refer you to another discipline and, if so, to whom. We, at Power Health, have been at this a long time and have a clear understanding of which cases do and do not respond well to our individualized treatment algorithm for chronic pain. We do not advise all patients to begin care, a policy which we have found to be somewhat unusual in the alternative field of care. In fact most of our patients cannot be “cured” as many have autoimmune diseases and chronic neurological components relative to their case. Most can, and have had the “disease” process brought under remission, have had tissue and neurological damage reversed to an often substantial degree, and have been able to be trained as to how to maintain their new found “health” with a minimum of ongoing in office care. We have not found many doctors to refer to who embrace this philosophy or believe these long term results can be obtained at all – no less consistently. Many doctors we’ve referred to have looked at the chronic pain sufferers as a life-long patient that will need continuous management while they slowly continue to get worse. That is not our model.
As briefly alluded to in section number 3, we screen all patients as to their overall mental and logistical fitness to be offered the opportunity to participate in our program. We do this for two reasons. The first is that patients who are not one hundred percent embracive of our program philosophy do not do well. Patients who wish to do only part of the program, want to “only do the blood testing”, don’t have the supportive spouse or have a significant other that may interfere with their motivation to complete the program, those who are already self-styled healers and only “need a little help because I have it mostly figured out” and others with many additional “red flags” of behavior or circumstances that will hinder their success in the program are discouraged from participating. Second, insurance doesn’t have an ICD10 code for our program so it won’t pay for it. We take that very seriously. We do not want people starting care that already exhibit numerous of the above mentioned red flags that generally increase their potential to fail. For the vast majority of our patients after we’ve completed our evaluation and give our recommendations the patient does well if they follow and do not alter our instructions. We have many signs around the office that state “We didn’t say it would be easy – we said it would be worth it.” If we perceive any of the above negatives that might cause that patient to not persist and see the program through to its completion the way it would be designed for them, we strongly urge them to take time to think about committing to care until they are certain they can embrace our philosophy and be certain they indeed will follow our instructions. If you have to pay us your hard earned dollars we want a successful outcome. I’m not sure but it seems this type of commitment may also be unique to our practice.
Treatment is highly individualized to each patient. “Treat the patient and not the diagnosis”. There are a zillion functional medicine doctors who claim to do what we do. For the first five years of our existence in the chronic pain field we referred to them. We have never found that they do what we do to be the case. Firstly we have combined unique and diverse fields: functional medicine and functional neurology – allowing us to coordinate treatment of all systems of the body’s physiology in the most comprehensive fashion possible. We have engaged a team of alternative and allopathic doctors and therapists who work with us when and only when the case dictates they are needed for success of the case.
The “team” then follows an algorithmic approach that is organized, orderly, and specific to the patients’ case. For example there’s no “one diet fits all” dietary approach. We use several different diets based on the patients’ exam findings and lab work results. Each step of treatment along the way in our algorithmic approach to chronic conditions not only is clinically therapeutic but is diagnostic and allows us to not only help the patient recover to the maximum degree possible in their case but to create a specific individualized home maintenance program which the patient can follow once they have completed care. Our goal at Power Health is for the patient to be empowered to be able to take care of themselves with a time efficient, cost effective, self-directed home maintenance program once their initial program is completed. We have largely accomplished this goal as near as we can tell. Our biggest clinical and therapeutic breakthroughs in accomplishing this goal has been our understanding of the immune system, proper management of thyroid disease, comprehensive, successful management of gut conditions, and recognizing the fact that most of our patients are not just “stressed out” but are actually in some degree of post-traumatic stress syndrome and developing mostly non-drug procedures to address this serious neurological condition and perpetuating factor to chronic pain. All chronic conditions possess some or all of these broken down systems. These understandings have come from years of clinical trial and error based on reviews of thousands of peer reviewed studies published in prestigious journals of various medical and alternative disciplines and then applying the findings of these studies to thousands of patients and eventually developing our chronic pain algorithm of care.
We may be myopic or seem self-absorbed to suggest there isn’t another practice that does what we do. But to our knowledge, there isn’t. Is there another practice that treats what we treat and experiences the consistent success that we do? We’ve never seen one. That doesn’t mean they don’t exist. We just don’t know who they are. So it makes it difficult for us to refer to doctors who “do what we do” around the country.
Should you decide to investigate doctors in your region relative to these matters, I would suggest that utilizing the parameters set out above for successfully addressing the specific causes of chronic pain would be a good template to follow in developing potential questions to pose to a prospective allopathic or alternative practitioner when interviewing them relative to your particular case. If their answers reflect that their procedures are similar to those we’ve outlined above, you stand a good chance of success in that office. Remember – there’s no silver bullet for chronic pain. If someone tells you that there is or that they can “cure” you – keep looking.