Laura is about 25, a sweet kid with a doting husband, Mike. She was in the office yesterday to follow up on a weekend emergency room visit for vomiting and diarrhea. She wasn’t getting any better. Her liver tests were off the scale, but her pancreas numbers were pretty good. Her hepatitis profile was still pending. I got an urgent ultrasound on her to make sure she didn’t have her family curse – unusual and dramatic presentation of gallstones. This test was normal.
Today she was back for a follow-up visit. She wasn’t getting better. Her hepatitis profile from this weekend came back negative. Her liver tests from yesterday were unimproved from the ER visit. Overnight she had run a fever. She was vomiting more, her diarrhea was worse, and the pain was getting worse. She needed to go back to the hospital for some IV fluids and a CT scan.
Laura was alone in the room today. I asked if Mike was in the waiting room, which would have been unusual. No, her father had brought her, but he was waiting in the car. I must have looked puzzled. She said: “He’s a chiropractor, remember, and he has problems with doctors’ offices…”
I made the arrangements and Laura went back to the hospital with her father at the wheel.
I have had reason to think about physician-chiropractor relationships before; my brother-in-law is a chiropractor. We have never talked shop. I have always been a staunch allopath but have sometimes seen patients who were helped, dramatically, by chiropractic. Recently, Caleb, our horse with an unexplained limp, seemed to be very much improved after acupuncture and chiropractic treatments.
The practice of medicine in America is flavored by the malpractice climate. I have a form letter on my computer, stating that I as a patient’s primary care physician agree to authorize insurance payments to their chiropractor, but I don’t assume any responsibility for the chiropractor’s diagnosis or treatment.
When patients ask me if they should see a chiropractor, I usually answer their question this way:
“You wouldn’t ask your rabbi how often you should go to confession, would you? Chiropractic and allopathic medicine are like two religions. We don’t speak the same language and we use different tools. But even though our practices are different, we ultimately work for the same higher purpose, and it may be that our differences are smaller than we were taught. We don’t know enough about each other’s practices to make specific recommendations, but support you, our patients, in your pursuit of better health and wellbeing.”
I wished Laura’s father had been more present as she sought allopathic care for a potentially serious, maybe even life threatening condition, and I wish my brother-in-law and I could sit down and talk about what it means to be in two different, yet similar healing professions…