Implied here is the need for a practitioner to develop or have access to a wider range of therapeutic options (sometimes I call this a "toolbox"). Further implied here is the ability of a practitioner to envision a person's symptoms or illnesses in various ways (much like a teacher is able to explain the same concept in different ways to different students according to their ability to understand).

In medicine and healing, "one size" simply does not "fit all"!

During the early years of my practice, I often observed that even in accurately diagnosed illnesses correctly chosen treatments did not always work. Patients would return unrelieved or possibly worse on what appeared to be the indicated, carefully chosen medical therapy or would experience unpleasant or debilitating side effects making continued therapy impossible. This occurred so often in my practice that it caused me to rethink medical treatment in general and to explore new ways to treat people. Indeed, I found a world of different methods and practitioners using them.

This was the main driving force for me to begin to integrate my medical practice back in 1990 to include alternative and complementary methods like classical homeopathy and acupuncture - people just did not always get better even on the "right" treatment.

I also often observed that conditions would sometimes resolve on their own without treatment being used or needed. This awakened me to the obvious (but often ignored or forgotten) fact that, regardless of the type of medicines or healing practices employed, our bodies were designed to be self-corrective and, therefore, self-healing. In any illness, that self-correcting mechanism is always operating to return an imbalanced state back to a balanced, normal state. This is how nature operates! Any medical treatment, whatever its nature, must be planned and executed with this critical fact in mind. Ignoring it can lead to treatment failures or adverse effects from even well chosen treatments.

It became clearer to me that many patients who would seek my help already had some ideas on their own as to what might work for them. They had a great curiosity and natural interest in exploring new avenues of diagnosis and treatment they may have heard or read about. This "curiosity" and "interest" really often represents the operation of the intuition in a person, a most valuable tool we all possess. I also shared that curiosity and interest, and this allowed us to work as more of a team with an interchange of ideas and methods.

I further experienced that the more time spent in carefully listening to patients' complaints, the more frequently I would have success in treating them whether I used conventional or alternative therapies. This included acknowledging and addressing such areas of the patients' lives as level of stress, spiritual/emotional states, marital/family problems, job satisfaction, etc. This allowed medical evaluation to be centered around the "doctor-patient relationship" which is the critical factor in medical care. I consider it as important to health care as a marital relationship is to family.

I explored other methods of diagnosis often used by other practitioners such as electrodermal screening (Vega, Avatar), kinesiology (muscle testing) and the homeopathic interview and analytic methods. I was led to other scientific testing methods that were employed by more holistically oriented laboratories including saliva testing of hormones, comprehensive stool testing, blood food allergy testing and urine heavy metal testing. Many of these methods extended my ability to diagnose and therefore treat more conditions.

For a more detailed discussion of the states known as "health" and "disease" and the potential value of "holistic", "alternative" or "complementary" medicines (Why we consider their use), read on!

It is important to keep in mind that, regardless of the type of medicines or healing practices you employ, our bodies were designed to be self-corrective and, therefore, self-healing. In any illness, that self-correcting mechanism is always operating to return an imbalanced state back to a balanced, normal state. This is how nature operates! Everyone has had the experience of this process at some point in their lives.

This is why many common problems fortunately resolve themselves without the help of a doctor (a "cold", sprain, cuts, some headaches, etc.) and even more serious illnesses often experience some improvement without specific interventions. You and your body's many regulatory and response systems are doing that constantly, automatically-- 24/7/365! (And you don't have to remember to throw a switch to activate them each morning when you awake!).

When these self-corrective mechanisms fail to completely resolve the problem, we then seek the assistance of "the doctor". Even under a specific treatment, such treatment is still operating in the context of those regulatory and response systems and in conjunction with them to assist in the resolution of the problem.

For any treatment to be really successful, these concepts of self-regulation and self-correction must be taken into account. This also highlights the fact that "treatment" may be seen as having two general forms:

• Those that attempt to be specific for a disease (i.e. an antibiotic to "kill a bug", surgery to remove a growth or join two bones back together again, "stitches" to aid a wound to heal, etc.)
• Those that are designed to support systems that are already acting to resolve the problem (i.e. using antioxidants, herbs, vitamins or other nutrients that support the defense/immune detoxification systems of the body).

The most effective treatments often incorporate both methods where indicated. It was once said that "The physician is nature's assistant". This clearly shows that, without the physician, our bodies have the ability to reverse illness and maintain health and that any practitioner should approach a problem and design treatment with this in mind. The "doctor" isn't doing it - you are! This is one of the foundational principals of alternative and complementary medicine. In my opinion, all attempts to treat people should be built around this principal.

An additional foundational principal of holistic medicine is understanding the concepts of "health" and "disease". "Health" is defined as the natural state or condition of the body. We call it by the name "normal". Health represents a state of freedom - freedom from symptoms, illnesses, inhibitions, etc. at all levels, body, mind and spirit. This allows us to live a full, joyous and loving life and share that with others. Through this state, we are able to experience and express all that we were meant to and to develop our full potential as humans in God's plan.

By contrast, "disease" may be defined as an alteration, distortion or deviation to varying degrees in that original state of "normal" or "health". "Disease" is not simply the absence of "health" -- even if we are experiencing symptoms or are ill, the state of "health" still exists and is always present to some degree - the more serious the problem, the less "health" exists and the more "disease" exists. This alteration in health may express itself as individual or small groups of symptoms (pain, fatigue, anxiety, stomach pain, etc.) or in the form of a more organized, committed, namable problem (diseases or syndromes such as pneumonia, irritable bowel disease, lupus, fibromyalgia, cancer, etc.). Disease then is a loss of some degree of health and, therefore, a loss of freedom at any level which prevents us from a full experience and expression of our lives.

The key philosophy behind "holistic" or "alternative/complementary" medicine is to aid the body to readjust itself and restore the state of health, our freedom, thereby allowing us to optimally function and meet our full potential (or to just "feel good"!).

As noted above, our bodies were miraculously designed for just that purpose - the power to be self-restorative, self-regulating, self-healing.

Maintaining the highest level of this state of health is our main goal throughout life (sometimes referred to as "quality of life"). It begins with the simple recognition or self-awareness that such a state exists and that it is in continuous process throughout our entire lives; indeed, this state (process) is the definition of life itself at one level of understanding. Such awareness allows us to "intervene" in it when it is called for, such as when we fall ill (i.e. lose health) and to be able to prevent illness.

The more traditional (ancient) methods of healing, found in all cultures worldwide for millennia, that we today refer to as "alternative-complementary", were founded on just this critical self-healing principle.

Based on this divine bodily ability to self-restore and self-heal, it should follow that any and all diagnostic or treatment efforts should be focused on assisting those processes already in place to proceed more rapidly or efficiently and to not be blocked in any way.

The use of foods as medicines, nutritional supplements, herbs, acupuncture, homeopathy, etc. and even conventional drugs are to be aimed at supporting, enhancing and maintaining this already-in-place, already-in-progress (although now altered or distorted) state of health in its self-corrective efforts.

At the same time, any such medical methods should neither add problems, additional symptoms (in some forms called "side effects") or diseases ("complications") to the process nor be an additional burden to the body in its efforts to heal itself. .

An ideal treatment is therefore one which performs in just this way. It is a goal to which our healthcare system should aspire constantly.

The key to good health, our natural, God-given state, is first and foremost our simple awareness or recognition of its existence. The maintenance of this state of health (including through specific therapies) and prevention of its excessive alteration (including good self-care) follow logically from that.

At some time before we develop symptoms and "get sick" (and in the prolonged, chronic state, actually develop a committed, namable disease), there is a step-wise deterioration in those normal bodily processes, a malfunctioning of the self-corrective systems and a decline in the presence of health. It is during this time (of variable length, usually days to weeks, even years in the case of a chronic illness not recognized or addressed early enough) that our various symptoms develop - the reason we typically seek self-treatment or treatment by a practitioner. Such symptoms or the loss of health (disease), so uniquely experienced and judged by each of us, vary in intensity, duration and ability to interfere with our quality of life - our freedom to live unburdened.

Thus, health and a disease of any type and its effects on us may be seen as occurring along a time-line of development - along a continuum or spectrum-- of events from "perfect health" to "committed disease":

Ideally, our first goal would be to have diagnostic efforts focused if possible at the earliest recognition of an alteration in function (health); this would allow therapies to be designed and employed earlier to assist the state of health in the progressive reversal and complete restoration it has the potential to accomplish. Such early diagnostic efforts must also take into account and explore potential causes of the problem.

With an understanding of these concepts, we can now proceed to a critical analysis of our forms of healthcare, both conventional and alternative/complementary. What are their roles in our health maintenance and disease treatment? On what basis and form of reasoning do they build their methods and theories?

Our current, predominant form of healthcare in the United States (variously referred to as "western medicine", "the pathologic model", "scientific medicine", "evidence-based medicine", etc.), while able theoretically to address an illness at any phase of its development or symptom appearance, was really designed to work and intervene at the level of the more committed, more fully developed, "pathologic" stage of the health-disease continuum or spectrum (toward the right side of the diagram above).

The powerful medicines and technologies upon which its main methods are built (x-rays, CAT and MRI scans, blood tests, endoscopy, laser, surgeries, antibiotics, steroids, etc.) are best suited to discovering and treating more catastrophic conditions where the alteration in the degree of health is more profound (traumas, fractures, infections, cancers, etc.). These conditions are the most familiar to us in the form diseases or "syndromes" - ways of categorizing symptoms in order to analyze, understand and intervene in them.

Has anyone not known a family member or friend who needed or themselves experienced the need for such medicine for a fractured bone, infection, heart problems, etc.? We are all usually glad such methods exist when they are needed.

I believe that the suiting or design of western medicine for such states occurred because its development depended on the recognition of alterations in the state of health that were more recognizable or "objective" materially - more dramatically realized and observed in the more obviously ill person; for example, the appearance of a lump that could be cancer or bleeding reflecting more serious organ function, altered mental or consciousness states from a stroke or serious toxic exposure, etc.

Some obvious, dramatic, often alarming change in the body structure or function was addressed first as they developed and could be observed. Their actual underlying causes and developmental process would, in many cases, still await our understanding secondarily. For example, breast cancer diagnosis and treatment is very advanced and effective in our country, but the actual causes of the disease are still quite obscure in most cases.

This concept forms the basis of western medicine's "pathologic" model of disease based on objective structural or functional tissue changes. It forms the basis of modern diagnosis (disease discovery) leading to methods such as x-rays or other imaging methods and surgical explorations of the interior of the body (to visualize it and repair it if possible), the examination of blood and other bodily fluids to analyze the chemistry of the body and tissue sampling to examine under the microscope or naked eye (lab tests).

All such "observations" of the body in more committed states of illness (markedly distorted states of health), obviously rely on more visual, tangible, objective methods. Understanding this foundational philosophy of western medicine with its focus on the more developed end of the health-disease spectrum is the key to understanding both its strengths and weaknesses in diagnosing and treating diseases in general.

This also leads us to an understanding of why there was a real perceived need for other ("alternative/complementary") medical methods and ways of viewing and understanding our bodies in "health" and its distortion - its alteration into "disease".

It is not that western medicine is wrong per se; rather, it is that western medicine is incomplete in its scope. Western medicine was historically developed and designed, and is therefore best suited, for the identification and management of alterations in states of health when those states have already progressed farther along the health-disease spectrum.

As such, western medicine is often most useful when we fall very ill or sustain more serious injury. In contrast, western medicine may be seen to be not as helpful or effective in the earlier phases of disease development, phases of illness and symptoms that are not as well defined and therefore less categorizable via more pathologic-based disease classes as many of our illnesses so commonly are. In fact, western medicine has been applying more effort to study and determine potentially earlier states of developing disease. Much more effort is needed in this area to complete medicine's scope.

This earlier phase along the health-disease continuum (toward the left side) may be termed the "pre-pathologic" or "functional" stage - dysfunction of the body in the absence of clear-cut tissue or other objective changes.

The concept on which this concept of a pre-pathologic state is founded is that our bodies are composed of a continuum from the energetic (not easily detectable) state of the cells and tissues to an actual material, physical (mass) (more readily detectable) state of the cells and tissues.

Energy and matter (mass) are equivalent, and they exist along and a continuum or spectrum as well from pure energy to solid mass. This is not fantasy or mysticism; it is science and is based on the theory of physics of the equivalence of mass (matter), m, and energy, E, known by the famous equation E=mc2. Thus, our bodies also are made of matter and energy and exist in that state. What is "seeable" or "observable" is the matter (tissues, cells, growths, etc.); what is "unseen" or (not so easily) "observable" is the energy (i.e. the energy measured during an EKG of the heart or temperature (heat) measurement). In fact, this is the objective evidence of the electromagnetic fields of the body.

The theories and reasoning methods of existing alternative and complementary medicines such as classical homeopathy, Oriental medicine, herbalism, Ayuveda and others have traditionally included the concepts of an energetic state and a material (mass) state. They are not readily recognized in Western medicine. This represents one of the key differences between these forms of healing and their methods.

The existence of such states is very helpful in our understanding of many phenomena including why, when we go to the doctor with various symptoms, even extensive medical evaluation and testing are reported as "negative" or "within normal limits". The cells and tissues of the body are changing at the energetic (unseen) level, but not yet at the material (observable) level.

The doctor is then at a loss to diagnose such conditions and treat them. The patient is left feeling frustrated, confused and without relief. In an effort to help, besides reassuring the patient that he does not think anything serious is wrong at that point, the doctor will often prescribe a variety of medicines to control or relieve the symptoms including antidepressants, sedatives, mood-altering drugs, steroids, pain pills, anti-inflammatory and other medicines. Sometimes these may help; sometimes they do not, or they may cause other problems or "side effects".

This also raises the equally important issue of the need to properly and effectively treat such conditions by curing not simply suppressing them. In many cases, such use of symptomatic medicines often merely suppresses the condition instead of operating to remove the disease state itself, thereby restoring the normal state of health.

In these situations, I have wondered if such undiagnosed symptoms could develop over time into more serious, chronic diseases. These are for all physicians and patients some of the most challenging situations in healthcare.

Patients in this dilemma often search further for help using alternative and complementary medicines.

Please understand that most of your regular, conventional physicians are not familiar with such tests, do not use them at all and likely will be confused, put-off or negative about their use. In fact, I and my patients have experienced the responses of such physicians to be frankly hostility and negative about such testing and often make unfounded accusations of "fraud", their being "non-scientific", "unconventional", etc.

At best, these physicians tell the patients "if it helps you and you want to this testing, go ahead." To date, I have not had a single physician call me to inquire about such testing, ask for available literature about them or show any curiosity about their value, use, etc. Patients have reported a few physicians to say "that's very interesting", but never have they pursued learning about them or how they may help in the diagnosis and treatment of conditions.

Both female hormonal panel and especially the adrenal panel done by saliva sampling have numerous technical and research papers attesting to their potential clinical value over the past 10+ years. In a recent review in a major American peer-reviewed journal, the Endocrine Reviews, researchers recommended that salivary testing of the adrenal gland should be adopted as a standard in the diagnosis of Cushing' Disease, a major adrenal disease. They stated that saliva levels of hormones were far superior to the use of blood and urine sampling, methods used by conventional physicians for decades, which were demonstrated to be less reliable for accurate diagnosis. In fact, it had been known for years that use of blood and urine hormone sampling were believed to be missing the diagnosis of people with Cushing's Disease, a fact that prompted a search for more accurate methods.

In a similar fashion, potential inaccuracies in conventional blood testing for suspected thyroid disease led to a search for a better method. As some of you may be aware of, several US organizations are questioning the use of routinely-ordered thyroid testing such as the "TSH" or "total T4". Please refer to the website, http://www.nacb.org/ , for a fascinating and pertinent analysis of the current rethinking of conventional thyroid testing by an official committee of the prestigious National Academy of Clinical Biochemistry ("Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease", L.M. Demers, PhD, FACB and C.A. Spencer, PhD, FACB). Additionally, this same article of the NACB discusses the results of a major, large, ongoing research project in the US, "NHANES", reporting that the normal range of blood TSH (Thyroid Stimulating Hormone": 0.4-4.5) is missing the diagnosis of hypothyroidism in a significant number of patients and recommended reducing the upper cut-off level to < 3.5. Clearly, a more accurate thyroid testing method is being actively sought.

The salivary thyroid test was recently researched by the Diagnos-Techs. Inc. Laboratory, Kent, WA. This lab has done the first-ever comprehensive study of the use of saliva for thyroid hormone analysis, comparing it to blood samples. This study was endorsed and approved by the state laboratory authorities in the State of Washington. In this case, the evidence of its value is preliminary but very promising. Based on this as yet unpublished research, I have been using this method for over three years with very satisfying results in patients. Here, a conventional physician's hesitancy over the value of such testing is more justified (than in the cases of adrenal or sex steroid salivary testing) because the results are preliminary and have not been repeated as yet.

I want to emphasize the point that one of the roles of medicine is to examine for and research new and more accurate laboratory methods for the diagnosis of diseases, especially as early as possible. Research methods currently employed over the past 15 years in our country (the "large, randomized, double-blinded, placebo controlled" studies or "Evidence-Based Medicine") are believed to be the highest levels of science possible and have very stringent guidelines for deeming a method of diagnosis accurate and useful. This is good.

However, individual, practicing physicians like myself are still confronted daily with the responsibility to evaluate your complaints and diagnose and treat your ills. These high-level research methods are generating very significant data in a number of disease states but the progress is slow; often even common areas of interest are not fully researched as yet or have not been addressed at all. As might be expected, of particular urgent priority is the researching of the most common, life-threatening disease such as cancers, stroke and heart attacks. Equally common, but not as immediately life-threatening conditions, the ones we encounter the most (fortunately) are not always the intense focus of research that they could be. With time, they will likely be addressed more so.

We (you, the patient and me, your physician), are still left with the immediate task of evaluating your symptoms and designing good treatment plans. This process is known as "clinical medicine", a time-honored term that refers to the day-in, day-out process of evaluating and treating patients. This process includes the use of up-to-date research reports where they are available. Often they are not yet available.

Before such high-level research started to become available (in the mid to late 1980's), clinical medicine relied (and this day, still relies on) general practice experience, "anecdote" (the reporting of individual cases of diagnosis and successful treatments) and the results of other research methods (epidemiologic studies, basic human and animal science research, "observational studies", etc.). Many physicians would also agree that, within the boundaries of patient safety and common sense, the use of "good old Yankee know-how" (experience and intuition based on it) is a mainstay in daily practice. We must then use these and all available techniques to try to help you, our patients, techniques that have been studied in various ways and used over the past eighty or so years of modern day medicine. Such methods are commonly used daily, but have not been subjected to the more intense research methods as noted above.

It is in this spirit of exploration in wanting to our best and provide the highest and most effective level of medical care that physicians like myself all over our country are exploring other methods of diagnosis and treatment, including the use of such creative testing as I have described above. In this area is also included the growing number of medical physicians and other vital healthcare practitioners addressing the need for incorporation of alternative/complimentary" methods (herbal, homeopathy, acupuncture, etc.) into our system. Not surprisingly, it is you (or us as either patients or doctors!) the patients that are pushing this boundary of exploration by seeking out and utilizing such methods. Even insurance companies are looking at the feasibility of reimbursement for such methods as acupuncture which many more companies are doing.

Today, medicine is being subjected to great changes in all aspects of its functioning including in the areas of insurance reimbursement, scientific-based medicine, practice standards, safety issues, the use of "alternative/complimentary medical methods to note just a few. These changes have created at once, in both patient and physician, confusion, anxiety, frustration as well as avenues for new and exciting changes that promise to make our medicine the best it can be.

Doubtless, you have experienced some of these feelings in the seeking of your health care in our era. Our grandparents and their parents experienced the healthcare system much differently than we do this day!

What does this all mean to you the patients and we the physicians?

I firmly believe in my heart that, in the face of all these changes, we need to maintain, and in some cases redevelop, close relationships between patients and doctors. Communication, careful listening (especially by physicians!), acceptance of uncertainty and mystery, tolerance, empathy, patience and maintaining a position of openness to new ideas and other human qualities are needed even more today with all the changes we all are undergoing.

Understandably, both physician and patient alike are frustrated at times in this shifting setting. Equally understandable is the frustrating experience of patients and "holistically-minded" physicians like myself when other conventional physicians vitally involved in your care dismiss such methods or even put them down. This has been reported by some of my patients and has been my experience at times as well. Such opposing views of your care are to be expected in this setting of change.

All change is difficult but essential to our growth both in our healthcare system and in ourselves and our relationships. I also firmly believe, whatever the reasons for our frustrations, resistances, concerns, etc., we all, physicians and patients alike, will benefit ultimately from this grand endeavor.

I believe we all must be a little more open, tolerant and curious about new methods and especially so of the desire in us to explore and use them where safe and possibly effective. After all, all physicians and patients can attest to the fact that this is how it has been throughout the history of society and medicine throughout all times: individuals use their God-given intuitions (grace, common sense) to explore ourselves and our world, including healthcare. Indeed, such spirit led to the development of better research and clinical medical methods in the first place!