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You claim to be a ‘Specialist in Integrative Medicine’. What exactly is this?

Integrative Medicine or Integrated Medicine is a term used to describe a blend between Conventional Medicine, Complementary Therapies and Self-Help.  In practice it means Conventional Medicine supplemented by therapies within the CAM (Complementary & Alternative Medicine) sector.

What is the UK situation ?
Integative Medicine does not exist in the UK as such. For a variety of reasons, there is no contact at all between conventional doctors (GPs and Hospital Doctors) and other therapists even including Osteopaths and Chiropractors, let alone Chinese Medicine Practitioners, Ayurvedic Medicine practitioners, and others.
Mental Health Services are in a similar position, as NHS  Psychiatrists, Psychologists and Counsellors do not legally recognise a psychological therapist outside their fold.

This has profound implications as there is zero public/NHS funding for this sector and NHS related doctors are not insured to have any dealings with the CAM sector.

GPs however do provide referral letters, at patient’s requests, to see Osteopaths and Chiropractors as this allows patients to recover their costs via several Private Health Insurance companies eg BUPA that recognise certain therapists.
However the BMA ( British Medical Association) advises GPs to keep any referral non-committal  eg:
‘Dear Osteopath/Chiropractor,
Thank you for seeing this patient who wishes to see you about their bad back’
This type of wording does not commit the doctor to specifying that the referring doctor thinks that it is an appropriate referral or specifies a name. But it covers the Insurance Company requirements, and everybody is served.

What makes you a ‘Specialist’ in this area?
Having worked as a fulltime General Practitioner for some 15 years, I can claim to be a master of conventional medical practice.
In the 1990’s while I was still in GP training, my exposure to what was then called Alternative Medicine, made me consider becoming a ‘GP specialising in knowledge of Alternative Medicine’ a viable side line as a Private GP alongside my NHS Practice. The 1990s was a time where public interest in what is now called CAM was so high, that GPs and Hospital doctors were expected to know something about it, and there were numerous articles in the standard medical press such as the BMJ, Pulse, GP and Update published. These were published to help conventional doctors to make sense of what their patients were doing.
I kept and archived all these articles, and have probably accumulated one of the largest private collections of physical books and articles on the subject of CAM by any doctor in this country. Some of this can be seen on the ‘Lorenzo’s Medical Library’ page on my main website ie (www)
Although during the time of my tenure as a fulltime GP, this was not of use, it was an interest about which I compulsively collected information.  In this sense, I regard myself as a specialist. There are no accredited specialist courses or qualifications in this subject.

You have relinquished your registration with the UK General Medical Council.
In doing what you are doing are you not ‘practising medicine without a licence’?

The Background
To practise medicine in UK Law the practitioner concerned has to be registered with the GMC ( General Medical Council), has to have valid Malpractice Insurance ( for UK GPs this is provided by organisations like the MPS or MDU and currently costs in the region of £6000 pa. for a GP working fulltime).
This entitles the practitioner to see the person wishing to see them as a ‘patient’ .
The practitioner takes a case history, physically examines the patient as appropriate, and requests blood tests and other tests, such as scans as appropriate,
(This guides the medical practitioner to his next steps. The practice of Medicine is sometimes thought of by the lay population as a process of ‘diagnosis and treatment’.
In practice, from a doctor’s point of view it is about ‘the management of a situation at a point in time’. Neither ‘the diagnosis or treatment’ may take any kind of clear outline when the doctor first sees the patient, and how things proceed, depend on a number of factors largely influenced by the individual doctor and his professional competence and the larger system he works in. For example in the UK funding and standards for healthcare are centralised and funded by general taxation. In the US , depending on individual funding and insurance ( or lack of it), standards may vary from the very best to something more akin to the third world).
A UK registered practitioner has the right to prescribe Prescription only Medicines-  (PoM).  All transactions with the patient ie the history, the examination , the tests, the treatment plan, and all patient doctor contacts are by law required to be recorded in a set way as agreed by professional bodies and the NHS.  This has important implications in the event of litigation.

In my case
I am not legally bound by any of the above constraints.
I operate as a retired GP and a private citizen. Clients who seek my opinion do so in the clear knowledge that in consulting with me, they are seeking my private assessment and my private advice. I do not do physical examinations, ask for tests, or interfere with the relationship they have with their GPs, GP Practices or the Specialists they may be seeing. I cannot and do not make referrals to other doctors or organisations.

What is the difference between a ‘client’ seeing you and them seeing a doctor as a ‘patient’?
The difference is that a person sees a GP, a Specialist or a therapist in the role of a ‘patient’ seeking to be treated.
My focus is different. I spend my time taking a detailed medical, social and psychological history including their journey through the health sector whether this be NHS or private.
This helps me build up a picture of the person and the issues involved. Based on this I am able to discuss with them what, in my experience, I believe their options to be, going forward. Each person is unique and I encourage my clients to record our conversation for their benefit. I have no objection to them sharing this with their normal medical attendant if they so choose.
I provide an analytical and advisory service. It is the client’s responsibility what they wish to do with this.
As a matter of principle, I do not involve myself with matters where litigation is involved or likely to be involved.

How do you work?
I prefer to know little or nothing of a client before I see them.
I discourage a client from sending me any lengthy details of their past medical history, results of tests, doctors’ letters or their medication list.
I like to start with a blank slate and my skill is in asking them the right questions to get the information I need. This, by the way, is the skill of all proficient General Practitioners who are seeing a patient for the first time or dealing with a new situation.
I work on Skype and on the telephone and a client needs to have details of their medication etc, close to hand, so they can inform me when I ask.

How many consultations are needed?
Maximum of two or three.
I do not take on the role of a therapist and so I do not need to see them again and again or to follow up on the situation.
Once a client has got my analysis and advice it is up to them to decide how to proceed.

What do you charge?
I work around the figure of £120 per hour.
This is based on what seeing a private GP costs at the very minimum.
Clients who are unemployed or on a low wage, or in financial difficulty can be seen at a discount, or in some cases for free.

What kind of situations would you like to be dealing with?
Ideally these would be clients with complex situations, who are unsure of how to proceed in the milieu of health care providers, that they are currently dealing with.

Given that most UK patients receive almost 100% of their healthcare via their GP Practices and local Hospitals, client’s issues with their GPs are likely to loom large.

Having been a GP for 15 years, I am in a position to be of some help, whilst taking care not to interfere with the client’s relations with their GP Practice.

Or they may be seeking greater clarity around issues to do with seeing a Complementary Therapist.
Please refer to my section on ‘Client Services’.

How does a potential client process an enquiry or make an appointment?
Please see the relevant section on the website.

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