Complementary therapies are becoming an increasingly common part of the treatment process for a growing number of Australians, but while more people are turning to areas such as naturopathy and herbal remedies to help fix what ails them, few are sharing this information with their General Practitioner (GP).
With more than $1 billion being spent on the complementary therapies industry each year, the time has come to create a more collaborative approach to healthcare according to Mayfield Medical Connection owners Kath and Chris Teagle.
“The face of general practice has had to change to accommodate the way people treat their health. Compared to a generation or two ago when you went to see the GP, you were told what to do, and you went home and did it,” she said.
“But now information is readily available online - Dr. Google is out there in force, supplements are everywhere, and diets are changing. People are diversifying their interests in health and where they get their information and advice from, but that doesn’t mean they should be excluding their GP’s expertise – in fact, they should be bringing their GP in on that.”
Unfortunately, this doesn’t seem to be happening as often as it should. A survey conducted by independent national body NPS MedicineWise in 2014 revealed that while 66% of respondents had taken a multivitamin or mineral supplements in the past 12 months, only 14% had talked about it with their doctor.
Whether patients are reluctant to discuss this use with their GP out of concern it will be discouraged, or merely because they don’t realise they need to, this can be putting them at risk of doing more harm than good according to naturopath Sonia McNaughton, who also works at the Mayfield integrated medical centre.
“It’s not unusual for someone to take multiple supplements based on an internet article they’ve read that may not be specific to their health or may not mention that they’re contra-indicated with medicines,” she said.
“When patients visit their GP they may worry that it’s not ok to share that they’re on these complementary medicines firstly, or secondly they just forget to mention it. We often think that if we buy it from the supermarket, or we buy it online, that it’s harmless. But while some supplements are relatively benign, some supplements aren’t, and shouldn’t be taken without serious consideration.”
Sonia said it was particularly important for people with chronic diseases or those who are taking a range of other medications to tell their GP that they are also using complementary therapies.
“Some supplements should not be taken with certain medications as they can reduce the effectiveness of both,” Sonya said.
“An example is thyroid medication – a relatively common medication but one that can’t be taken within 4 hours of a calcium supplement – also a very common supplement. If you don’t disclose to your GP when you’re taking a supplement, they may end up giving you an instruction for thyroid medication and wondering why your thyroid isn’t correcting on this dose,” she said.
One way to combat this risk is to encourage greater collaboration between primary health carers and professionals involved in the complementary therapies industry.
Kath and Chris have been working towards this goal since they took over the Hanbury Street practice four-and-a-half years ago. Since that time Mayfield Medical Connection has operated as an integrated medical practice with both GPs and complementary therapists under the one roof. In addition to an evidence-based naturopath, the centre also offers the services of a dietician, psychologists and is about to welcome an osteopath into the fold.
“It was always our intention to create a platform where people work hand-in-hand. It’s about the balance in health and the balance in looking after yourself; the balance in advice that you get,” Kath said.
The dedication to balanced advice is such that the practice is currently researching the possibility of launching into a new era of collaboration, where patients are able to see an evidence-based naturopath and a GP in the room at the same time.
Aside from saving the patient time, money and angst by avoiding the back and forth of having to attend separate appointments at different places, on different days, the initiative will also deliver a range of other benefits.
“We expect that there’s a massive advantage to having two people who are educated in their own particular field discuss your health holistically in the same room,” Sonia said.
“The GPs here are certainly very open to this conversation, but this doesn’t mean that they will automatically accept everything I recommend. I have to back up every request with evidence. If, and when, we are able to offer collaborative appointments we hope that when there are differences of professional opinion, we are able as a team to assist the patient to decide which is most appropriate to them. It’s actually a case where the sum of the whole is greater than the parts.”
Kath said the Mayfield practice, like many others, has expanded over the years to maintain its viability, with the employment of additional doctors to increase turnover rather than cutting services or reducing care. But the Federal Government’s failure to increase the Medicare rebate beyond $37.05 for a standard appointment, combined with years of rebates failing to keep up with the market rate of appointments, has forced the practice to re-evaluate its billing procedures.
“None of the major political parties are particularly supportive of General Practice. The health budget isn’t coping with Australians’ health needs, which are only increasing. It’s short-sighted to try to save on General Practice though because it’s the preventative health measures that it delivers that will keep people well for longer and reduce the need for very expensive hospital and emergency department options,” Kath said.
“I believe Australians have an entitlement attitude towards healthcare, which has been fostered by the government for years and that the Medicare rebate needs to be seen as a safety net for those who truly can’t afford to pay for care and as a rebate on their Medicare Levy for those who can pay an out of pocket fee.
“As the Medicare rebate hasn’t kept up with rising costs GPs have been expected to pick up the slack, which by and large they have. Unfortunately, this has resulted in a perceived devaluing of the service. These guys are specialists who have chosen general practice as their specialty, they go to university for a very long time, they listen to people’s problems day in and day out and they carry a huge burden of responsibility. Plus running a good practice is really expensive. What they do is enormously valuable to all of us and we should be supporting them.
“Your one or two local General Practices are the ones that won’t be able to survive, which is why we’ve had to get bigger. As much as we want to help the people who can’t pay (and we do try to help) the fact is that Australians need to pay for their health care and we need to change the way we value the work of our GPs.”