NDs vs MDs vs DOs - How to choose?

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My wife is looking for a PCP in western Washington. Looking through past recommendations on this site it seems like the vast majority of recommendations are for NDs, with the rare superstar MD like Kaufman thrown in the mix. I was wondering what is it that results in the lists of doctors being so heavily skewed towards NDs?

Is it that NDs receive specialized training as part of their education that helps them better treat ME? That they are more open minded and therefore more willing to work with their patients in running tests a MD might think unnecessary? Is it just a matter of "traditional" medicine having a lot of harmful biases about ME so it's hard to find a MD who isn't just going to suggest CBT and GET? I would also think that a DO would offer a good balance between a ND and a MD but I don't see them recommended either, but maybe that's just cause there aren't a lot of them.

So: what type of doctor do you prefer, and why?

I've been calling doctors offices for a few days now and it seems like almost no one is seeing new patients. We've given up hopes of getting a doc who's an expert on ME, and just want to find someone who is compassionate and understanding and will stick with us trying to get some of my wife's symptoms under control. My wife was preferring not to see a ND - she had one when she first got sick and it wasn't a good experience and also they're not covered by our insurance, but ultimately we just want the best possible care for her regardless of the alphabet soup that comes after the doctors name.
 

lenora

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Hello. I've spent a lot of years with ME and have found good and bad in all capacities.

The Dr. I rely on the most is the one who diagnosed one of my early illnesses. He's a neurologist and had a patient load of the worst of the worst patients. He's very knowledgable and, as you pointed out, kind and compassionate. He goes the extra mile for his patients.

We seemed to have a shortage of ND's at the time in Dallas, TX., so I never go to one of them. I was referred to a DO by my PT who recognized that I had FM. He was a lifesaver, but sadly died a few years later. So I've found that having a DO who does nothing but myofascial or cranial-sacral work to be very helpful. No one is going to cure me, and I understand that. However, they do make my life easier. My internist is also a great help and I rely on her for many things.

I avoid my cardiologist as much as possible...the practice of medicine has changed so much since I began this trek. The younger ones are good for their computer knowledge and ability to spend more time with you at the beginning of their practices. They're still in a learning mode. I avoid doctors who don't spend time with me or I feel put my symptoms aside. There really haven't been many of them, as a matter of fact most go the opposite way. Try to help me as much as possible.

I've also seen acupuncturists for at least 3 full trials but received no assistance in that area. They tried, I'm not saying that, had plenty of empathy....but it simply never worked. Since a lot of the other doctors rely directly on my internist, then I do the same.

I've now had at least 4 DO's over the years, and the best are the ones who have what they call "the hands" and specialize only in that type of work. It's very time consuming and 30 minutes is often enough for the body to recover from over the next few days. No twisting of the neck....the same results can be obtained another way. Wishing you well. Yours, Lenora.
 

Wishful

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So: what type of doctor do you prefer, and why?
I prefer a GP who is willing to write prescriptions for drugs that I might want to try. After trying lots of doctors and specialists, I've given up on them for actual help with ME. I don't think any of them know enough about ME to have more than a slightly better chance of helping than what I can do on my own. None of the tests they did changed anything, aside from checking for problems other than ME. While medical services are free in Canada, these doctor visits still had a cost in travel, exertion, emotions, etc.

I did try some alternative medicine practitioners, which aren't free here, and found them all useless. Some were outright quacks. Quantum Xzyrcl (can't remember exact spelling) testing???

I read about some doctors who claim to have success treating ME. I haven't read about any confirmation of these claims of success. Surely if some doctor could cure 80% or whatever of his patients using autoantibodies or whatever, someone else would be trying it too, and making no secret about it. Until there's reliable confirmation, I don't accept their claims.

My opinion is that you are very unlikely to get an improvement in your ME from a doctor. It's not impossible, but I think it's around the same probability as getting an improvement by your own experimenting with diet, supplements, herbs&spices, etc. That's where I've gotten all of my improvements: trying things and paying attention to what makes me feel better.

Another point is that treatments for ME are very individualistic. What works great for one person does nothing for someone else, and makes yet another person feel much worse. So why should we expect a doctor to know what treatment to prescribe?

If your wife has a definite comorbid condition, she should see the appropriate non-ME practitioner. Diagnosis and treatment might be affected by also having ME, but that's just something to take into account.

My experience is that potential treatments are out there; it's just a matter of getting lucky in finding the right ones. There might be something on the local grocery spice rack that will help, or maybe it's in the produce section of an ethnic food store. I wouldn't have expected cumin to be an effective PEM blocker, but it was a most excellent treatment for me. I certainly didn't expect beef (or sheep) fat to be an effective treatment, but it was for me (temporarily only, grumble grumble). Of fancy pharmaceuticals, prednisone worked well the first two trials, but then stopped working, and LDN was an effective muscle ache blocker for a couple of years. I think those were the only two prescription drugs that made any difference with my ME, and LDN was my suggestion, not my doctor's.

My opinions is: don't put too much effort and hope in finding 'the right doctor'. That's no guarantee of a happy outcome. At present, doctors are for treating medical problems other than ME.
 

lenora

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HI @Wishful.....Certain things have to be ruled out as we begin this journey. ME bears many symptoms common to a lot of neurological diseases, for instance. Thus, a neurologist is necessary to rule out the many other illnesses that may cause the same symptoms. Fortunately testing is easier and probably better today.

Above all, you want a kind and caring doctor who will give you good basic care. As one ages, other things slip in and also cause symptoms. I'm in my 75th winter (an apt description given by another member) and can tell you that things like heart problems, cholesterol, bp, joints and surprises such as epilepsy, autoimmune encephalitis to say nothing of something like COVID are all out there.

When I was younger, I never gave much though to any of these problems. I have an internist who specializes in older patients, and she's a real blessing in my life. A good, thorough doctor that you can talk to is a plus. Her personality...not so great, but I can live with that....we're getting friendlier as time passes. The big plus is that she knows my forever neurologist (I have 2) and they communicate, no small thing today.

So while I've found some supplements, vitamins, etc., helpful, I've also really needed help from an MD. Do I like having to take the required meds....no, but for me there is no choice.

I've seen surgery come in and out of vogue for some of my problems....well, I had it years ago and it helped me live this long. Is it right for everyone...no. That's the thing with this illness, we do have to make hard decisions but we can find plenty of help along the way....or at least kindness. I wish you well. Yours, Lenora.