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The Other Side of the Speculum

Bits n'Pieces

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Bits n'Pieces. That is what "TL" called them. A new candy? A new board game? No, this was her way of thinking about her body parts: not identifying legs, breasts, lungs or heart. As she aged and saw a different doctor for her different maladies or concerns, she now was seeing her "Bits n Pieces" doctors.

TL just couldnít imagine having so many doctors in her life. She had spent most of her life feeling quite well. In fact, she told me, if she didn't see a doctor for years on end, this was her usual pattern. She would go to the ER for breaks and sprains, see her primary care physician (PCP) only if she needed a form filled out. She told me she thought herself healthier since she purposely avoided seeing doctors.

Then she turned 62 and TL said her life changed. She was in a car accident that caused some spinal concerns. Before she knew it, she had appointments with an orthopedist, a spine specialist, and a neurosurgeon. Then there was the physical therapist and the pain doctor. She had developed a filing system for all of her bills and her appointments that as she said, rivaled the Library of Congress.

All of a sudden, her bits n pieces all had a doctor of their own: for her heart, a cardiologist and for her pelvis, a gynecologist. She no longer saw her pcp on occasion but now quite regularly just so that he could "give her permission" (a referral) to see all the other doctors she was now being told to see.

She described this trend and I realized that her story was like so many in this country where we have become so specialized that the body truly is cared for in bit's n pieces. This departure from looking at the body and the patient as a connected whole, caused by the super specialization of allopathic medicine, has resulted in a very fragmented and very time intensive medical system. Being a patient in the United States not only demands a rolodex of doctors' names and numbers, but also the capacity to interpret insurance paperwork, the fortitude to travel distances to find the right "specialist" and the where with all to understand the many tests being recommended and medications being prescribed. Most patients are overwhelmed with the morass of medical care in the US. Being a patient, demands patience and resources to gather information so that one of your docís just might eventually pull all the data together to look at the "whole picture".

Healing used to entail knowing where someone lived, how he or she lived, who they lived with. It entailed knowing when families were challenged with affording fresh food and the conditions of their work lives'. Healing used to be lengthy visits with your family doctor so that both communication and physical exams would allow for diagnosis and recommendations. Today, the demands of filling out the electronic medical record, the need to bill codes listed in ICD-10 books hundreds of pages long and the need to see more patients in less time has all but eliminated the physicians'capacity to touch, talk, and heal in a comprehensive manner.

Over the last few decades, there have been many great advances in many medical and surgical specialties. However, until we recognize and regain the understanding of caring for people with a comprehensive view, we are simply taking care of bit's n pieces and neglecting the larger picture of human health and wellness.

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PLEASE join me and my colleague, Kelly Jennings, ND, for a weekend at the Omega Institute in Rhinebeck, NY on September 30- October 2, 2016 - Exploring Women's Health, Sexuality and Spirit! Come to relish yourself with other great women at the beautiful Omega campus where we will explore new ways of thinking about health and healing and learn more about hormones, aging and being well in mind, body and spirit!


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Amy Novatt:
My life as an obstetrician - gynecologist started in Pennsylvania in 1990 working in a community hospital delivering babies and learning the art of gynecologic surgery. As hard as residency was, I realized early on that I had chosen a career that suited me. The practice merged my interest in womenís health, reproductive policy and surgery perfectly. I spent many years assisting woman deliver their babies and then decided to focus on gynecology (only)- appreciating that in most offices, the concerns of adolescents and women not having babies, were often marginalized by doctors. I was interested in creating a professional arena for women to discuss these non-OB related issues. I have worked in a private practice for 14 years in Rhinebeck, NY. I have seen over 10,000 patients during those years. My work includes office GYN and surgical interventions, including advanced laparoscopic surgeries while lecturing both to professional peers and lay audiences.


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