Building Your Collaborative Care Team
Written by: Dr. Fred Harvey, MD
The aphorism “No man is an island” pretty well describes the nature of humanity. The statement that “It takes a village to heal” is another aphorism that reflects the same concept in the world of healthcare. I was collaborating with a now famous doctor on a medical advisory board a few years back and he asked a single question for the job interview: “Fred, how wedded are you to Sarasota?” I replied that I really did not know how to answer that question, but that I was willing to explore to find the answer. I then worked part-time in Naples with that doctor for 6 months. It was through that adventure that I learned one of the greatest lessons of my life: we are here in this life for the relationships. I realized that I was truly wedded to Sarasota in many ways. Most importantly I had developed a working relationship with many other healthcare practitioners in my years in Sarasota who are vital to helping me help my clients find optimal health and vital function. It’s all about the collaborative experience.
The primary care model of health care delivery is very top down. The captain of the ship gives the orders. This didn’t necessarily provide the best outcomes. No doctor can do it alone. The collaborative model of healthcare stems from early HMO research in the ’60's that revealed as much as 60% of primary care issues appeared to be psychosocial. I have recommended behavioral, spiritual and cognitive therapies for my entire career, and I have worked with a variety of different types of counselors depending on each client’s need. There is evidence that depression and anxiety have better outcomes with therapy in addition to other interventions. Sleep disorders, diabetes adherence, smoking cessation, pain disorders all respond to therapy.
The collaborative model falls short however, because it often does not include other practitioners beyond primary care and therapists. When I think of functional medicine I think of systems based biology and relationships that we have between all the functioning systems within our bodies. When I think of collaborative care I think of the variety of healthcare practitioners needed to help achieve optimal function within the many different functioning systems. One of these vital practitioners is the registered dietitian, especially the functional nutritionist. The impact of dietitians on the overall health of medical patients is well documented. Achieving and maintaining weight loss in obesity, diabetes control, and prevention of kidney dialysis are all shown benefits of dietician intervention. I recommend that all my patients avail themselves of the services of a nutritionist for help with healthy food choices individualized to their needs.
This too may sound like a narrow range of practitioners and it is. I chose to focus on these two because they are so vital and so powerful as members of the healing team. We ARE what we THINK and we ARE what we EAT. In addition to counselors and nutritionists, I personally enjoy my relationships with chiropractors, massage therapists, physical therapists, personal trainers, life coaches and health coaches, nurses, naturopaths, acupuncturists, herbalists, homeopaths, yoga instructors, meditation instructors, shaman, energy workers, home healthcare providers and other healers unnamed but not forgotten. It takes a village to help us achieve optimal health. I am wedded to a fantastic network of healers in this area that collaborate for your benefit.
Dr. Harvey will continue discussing the topic of the “Building your Collaborative Care Team” at his Ask the Doc educational seminar at the Comfort Keepers, 3619 Webber Street, Sarasota. For more information on wellness, to RSVP for the April 19 event, or to schedule an appointment with Dr. Fred Harvey, please contact The Harvey Center at 941-929- 9355. The Harvey Center for Integrative Medicine is located at 3982 Bee Ridge Road, Sarasota.