Over the past few decades, conventional health care providers have responded to growing demand for alternative forms of healing.
While this development has opened the doors to integrative care, a functional medicine doctor from California, Dr. Terry Franklin, noticed something missing.
While alternative modalities (like acupuncture) certainly differ from conventional medicine, the way they are practiced often reproduces the same hierarchical doctor-patient relationships and problem-based thinking that limits conventional medicine.
To remedy this, Dr. Franklin spent the next 20 years developing a model of solution-based, patient-centered care in his own practice. After witnessing higher levels of compliance, miraculous healing, and a renewed sense of purpose within his practice, Dr. Franklin began sharing his method of care with other practitioners and patients who were also looking for better solutions.
We sat down with Dr. Franklin to ask a few questions about his approach as a functional medicine doctor, and learn about his new startup, TelMD— an app and software platform launched in 2019 which aims to become the ZocDoc of integrative medicine.
What made you want to practice medicine?
As a medical student, I cherished the opportunity to study the art of medicine. Like countless others, I was motivated by a desire to help people and to assist in alleviating pain and suffering. I deeply wished to make a difference—and to make my own life meaningful.
I was astounded at how little healing was actually being accomplished.
In medical school, role models were few, and the uncaring attitude of some specialists toward patients was shocking. I did my residency in Family Medicine, perhaps the most humane area of modern medicine, but I still found treatment options and modalities limited—and limiting.
What, in your mind, are some of the main limitations of conventional medicine?
As we enter a new millennium, we see the incredible advances brought about by medical technology. But, despite great breakthroughs, many people feel abandoned by conventional medicine. When someone is diagnosed with a disease pattern—such as chronic fatigue syndrome or low back pain— this person inevitably faces a sea of x-rays, lab tests, referrals, and consultations.
As I listened to my patients over the years, I discovered a whole new realm of treatment options not considered viable in my world of university medical centers. These “alternative” modalities consisted mostly of hands-on, non-invasive techniques and benign remedies seldom in conflict with conventional medicine. Nevertheless, they were at odds with its practitioners.
A new avenue was desperately needed. Everywhere, I encountered patient dissatisfaction, problem patching, fragmentation of therapies, skyrocketing costs, and compromised services within the managed care system. Meanwhile, what we call alternative or complementary medicine had exploded into a 27-billion-dollar industry — a figure comparable to the combined out-of-pocket expenditures of all U.S. physician services. Still, patients were left without a true alternative. That is, these treatment options merely perpetuated the same limited problem-oriented approach.
Nonetheless, people were flocking to unconventional types of health care, with or without a physician’s blessing. Why? I knew I needed to educate myself beyond what I had learned in medical school. So I began reading books, attending seminars, and conversing with naturopaths, chiropractors, and acupuncturists about more holistic possibilities.
What, in your mind, are the limitations of alternative medicine?
Alternative medicine, in combination with conventional allopathic care, has no doubt brought comfort, healing, and good health to millions around the globe. Nevertheless, alternative integrative health systems are not always a true alternative.
Many health care approaches may utilize holistic treatment options, but they often encompass the same philosophical approach to patient care: the problem-oriented approach.
For medicine to be a true alternative, physicians need to consider a new paradigm in patient care; to redefine health challenges as wellness solutions, and to provide partnership models within the patient-doctor relationship.
In your experience, which approach to medicine offers the greatest chance of healing?
I know of no better way to promote healthier living than by lifestyle modification. Yet too often, doctors are recruited to patch problems rather than to act as partners in helping our patients make significant, healthy lifestyle changes.
So, the most important component of any approach is to encourage patients to become proactive, to take responsibility and to assist in developing their own optimal health plans.
That’s the main thing we want to accomplish with TelMD. On a regular schedule, patients can review their progress with their primary care physician and discuss goals as they plan the next step.
This system applies medical technological advances appropriately and to the fullest while building upon doctor-patient relationships of trust to provide the most appropriate choices.
The TelMD approach opens the door to a full range of healing strategies that include complementary medicine options, some of which have become almost routine, such as acupuncture for back pain or yoga to help lower blood pressure. But more importantly, it creates a new opportunity for patients to reframe their individual health challenges and focus on developing an optimal wellness plan.
What motivated you to create TelMD?
With TelMD, we want to accomplish 3 main things:
- Create a system that promotes patient-centered care.
- Move from a problem-oriented to a solution-based paradigm specific to each individual’s health.
- Streamline communication across networks of patients and practitioners.
To reinforce patient-centered care, we designed our platform to feel like a health journal — people can set goals, monitor progress, and keep track of how each treatment or medication made them feel. This increases compliance and also offers excellent data for health care teams to reference, which is far better than the fragmented information we typically get.
To move towards solution-based care, we created a simple formula called SOA2R. While most health care providers currently assess patients with a formula called “SOAP” (Subjective, Objective, Assessment, and Plan). This familiar, problem-treatment approach may work well enough for certain acute conditions, but falls short for chronic conditions and can lead to a vicious cycle of dwelling on complaint after complaint.
In contrast, SOA2R outlines the (Solution, Objective, Assessment, Action, Reinforcement of possible solutions). First, patients derive the solution (e.g., an affirming statement) through in-depth reflection. In other words, it is not necessarily the foremost medical opinion of the attending physician. Second, the objective supports what patients themselves see as being true, not necessarily what practitioners may observe as problems to correct. Third, health care providers and patients achieve the assessment phase together, in which they agree on what action is to be taken. Finally, reinforcement supports patient-doctor collaboration and does not automatically, or of itself, dismiss or supersede conventional methods of treatment.
Finally, we saw an opportunity to connect the worlds of trusted alternative and conventional medicine practitioners who are open to patient-centered, solution-based care.
It can be quite difficult to find trustworthy practitioners who are open to a complementary approach on both sides of conventional and alternative medicine. With TelMD, we want to make that search a lot easier for wellness-seekers.
What, in your mind, is the future of healing?
There are plenty of exciting developments unfolding in medical technology –– notably around longevity and healing from our most common diseases.
My work supports the worldwide paradigm shift currently taking place as we become more aware of the relationship of our emotional state, the essence of our being, and how any physiological changes might affect our overall health.
I’ve seen miracles happen when patients self-design their own guides through medicine’s maze of physicians, therapists, and allied health professionals.
The best part is that, at the same time, practitioners begin to revitalize their interactions with patients, transforming themselves as well.
Indeed, a new paradigm like what we offer through TelMD can assist all of us to find the correct balance. If complementary medicine is to flourish and continue to grow, we need to view diverse modalities from an alternate paradigm — an integrative approach that spans the full continuum of health care.
Visit the TelMD Upstream Blog for more ways to achieve optimal wellness!
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