The A.C.E. System[1] ASSESS*CUSTOMIZE*EMPOWER[1] We need to have a systematic approach to deal with health issues. That’s why I developed the A.C.E. system for my patients. The A.C.E. system is a three-phase approach that starts with “Assess “the patient. My detailed assessment begins with listening attentively to the patient and finding out as much about their history, their symptoms, their whole story, what they want to accomplish, and so much more. Then, based on everything I’ve learned, I am able to properly decide the number and types of tests needed to make a proper evaluation and target the root causes of their health issues.
Sometimes, to move the process forward, I will order a baseline but comprehensive lab test that covers most of the common baseline labs before the patient is seen. Additional tests are then ordered as needed after the initial visit. After a detailed assessment of the testing has been done for the patient, I'll then merge this information with the history or the story I have from the patient. And with that in mind, I can “customize” a program for them because no two individuals are the same. Even if you have two patients with low thyroid function, they're still not the same. One person may have low thyroid function because they’re not getting enough of the raw material to make their thyroid hormone, while the other person has the raw material but the factory’s not working.
So, the approach for these two patients will be completely different. One may have other issues compounding their problem. They may have issues with their gut, they may have issues with sleep, and others might have issues with toxins. So, I take all those into consideration and customize a program to fit the patient and discuss with them what is needed. And then there comes the E.
The E part of the A.C.E. is “empower” the patient. Most of our patients will do what they need to do to get healthy as long as they understand why something needs to be done and how they can do it. The empowerment part of my program is to make sure that my patient understands why we need to do what we need to do. A lot of the time, doctors will say their patients are not compliant. Yes, they're not compliant because they don't understand what's going on. However, there are still a few truly non-compliant patients. Empowerment involves educating your patients, continuing to assess them, and finding out how they are doing. It’s paramount that I find out if there are any obstacles keeping them from doing their part, and that I help them see how to overcome those obstacles.
As a good example, with diabetic patients, I tell them, "Don't eat a lot of bread, don't eat a lot of simple carbohydrates, and don't eat sugar.” But do most doctors tell them why? Unfortunately, most doctors don’t. I tell them your blood sugar will rise if you do. Here is what I most often hear in response. “Well, doctor, I’ll just take more pills to get my blood sugar down.” But if I get them to understand that it is not just the blood sugar but the damage the blood sugar causes from the inflammation and the damage to their organs, that’s when they begin to understand. Most patients will expect you, their healthcare practitioner, their doctor, to tell them what to eat if they can't eat donuts. If you are unable to provide that to the patient, then you really haven't done much for them. You've just caused unnecessary panic and anxiety.
So, part of my empowerment program is to make sure the patient knows the right alternative to what they have been told to avoid. Think about the patient who drinks sodas. Why do people like sodas such as Coke, Pepsi, or Mountain Dew so much? We know they have energy issues and still crave sodas. Ideally, you need to find a way to improve their energy before you can expect them to kick their caffeinated soda habit. So, you first have to explain to them why they need the sodas. And next you need to make them understand that if they can generate more energy by doing something else, then their need for the sugar and caffeine in the soda will diminish.
Healthcare practitioners should understand that some habits are difficult to break, and empowerment involves handholding to help patients get through this difficult period. What I usually will tell my patients is, "I know you can't stop your soda completely immediately, so drink soda but just drink less.” So many of my patients have come back for their next follow-up and said, "Thank you, doctor. I've gotten off sodas.“ Empowerment is a crucial part of the program, but there is one part of it I haven’t discussed. You can assess all the patients you like. You can customize a program for them, and you should empower them in other ways… but you also have to coach them. Expect some patients to fall off by the wayside if you don’t. Part of the empowerment program is to find they haven’t been back… and what’s going on? And if you ask, a lot of patients will tell you what's going on. Some are due to financial reasons. In that case, you have them develop things they can do for themselves, and if you can continue to do that, many of these patients… at least in my practice, when their financial situation improves and they can afford more care, do come back to the practice to continue.
When you empower your patients, they are then able to be successful on their own… which is the most important thing because they are not going to see you forever. But if they can carryon that healthy lifestyle change and disseminate it to their family members and friends, then you'll be keeping the society healthier. And that's what I think every doctor, every physician, and every healthcare provider should aim to do.
If you would prefer this approach over the conventional medicine approach of prescribing pills and more pills that maybe improve symptoms, but don’t solve the problem, then you are in the right place. Just call my office or leave me a message, and we can move forward on making a difference in your health with my A.C.E. Wellness Program.
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