HEART MONTH 2018 : DEFINING INTEGRATIVE CARDIOLOGY

February is always exciting to me, as it marks National Heart Month. The goal of this month is to bring attention and awareness to the prevalence and severity of heart disease. To me, however, this is a given. You have heard over and over that heart disease is the leading cause of death in both men and women. 

I prefer to go further. It’s usually a time to celebrate the advances in my specialty as well as a time to set new goals for my practice. This month I expand my services to the West side where I will be setting up a concierge practice in Santa Monica on Tuesdays. 

Why the move? I’ve been fortunate in having a thriving practice in Whittier, California for over 31 years. Having created a name for myself in the health and fitness arena, the time seems ripe to take my skills to the West side. 

Traditionally trained in both cardiology and internal medicine, I’m known as the doctor who looks outside the box. I’ve always been one to question why? It’s inherent in my personality. Moreover, my fellowship in anti-aging medicine reinstated the validity of how I practice. 

Integrative cardiology means going above and beyond. Certainly I prescribe medications when indicated, perform emergency coronary interventions in patients presenting with a heart attack, insert pacemakers and order all the usual diagnostic tests. 

But being integrative means performing the above plus more. An integrative cardiologist spends the requisite time discussing the need for sound nutrition, regular exercise, restful sleep and appropriate supplementation. Being integrative places me in the position of teacher, motivator and wellness coach. 

I find my work both exciting and challenging. One minute I’m discussing the need for specialized laboratory testing in a high risk cardiac patient. Such testing is not generally ordered by the traditional cardiologist. Another moment I can be found counseling diabetics, pre -diabetics and those with metabolic syndrome on the benefits of a ketogenic diet. Still another moment will find me instructing a patient with panic attacks and chest pain on proper breathing techniques. 

Practicing integrative cardiology means it doesn’t matter if it’s traditional, alternative, eastern or western! My focus is doing what’s best for a given patient. Sure I espouse evidenced based medicine whenever possible, but I can’t simply stop there if the patient needs more. 

For example let’s take a case where I’m consulting on a patient with chest pain. I’ve done the appropriate testing and fortunately all the tests come back negative. I could report back to the patient, “I’ve got good news and bad news. The good news is that the tests show that there is nothing wrong with your heart. The bad news is that you have to live with the pain.” 

Really? I can’t imagine living with pain, physical or emotional without attempting to mitigate its magnitude. So we get into lifestyle management .My role as an integrative cardiologist goes beyond what is generally expected of me. 

Being integrative means I practice functional medicine. This is where we earnestly attempt to find the cause of a particular symptom or malady. In medical school we are taught to do whatever it takes to make a patient feel better. Of course I uphold that quest, but it often takes more. 

Using heart disease as an example, realize that it is clearly a disease of excess: excess weight, excess blood pressure, excess cholesterol, excess sugar, excess smoking, and excess stress. But there is also a lack of one thing, exercise. 

So we can treat a patient with a balloon angioplasty, stent or by-pass surgery. No doubt that is the treatment of choice in a critically-ill cardiac patient. I can promise you, however that even with new plumbing, the disease process will often progress. That is unless preventative measures are taken. 

Being integrative means we go beyond. We take a functional approach. We can no longer simply place a Band-Aid over the wound. We have to look at the cause(s) and do everything within our power to treat them. 

This Heart Month I extend my practice of integrative cardiology and functional medicine to Santa Monica. Given the void of authentic integration in my specialty, I believe the need is truly present and I’m up for the challenge. 

The practice format will be different, however, as we are incorporating the concierge model .Basically this model is a relationship between a patient and physician in which the patient pays an annual fee. All services, including visits, testing and procedures will be billed to insurance as usual. 

The concierge fee will allow for extended time between patient and physician, and complete access to me via phone calls, texting and emails. Furthermore, participants will be awarded priority scheduling, unlimited office visits and little to no waiting time in the office. 

Why the change? Because of the nature of the work I perform as an integrative cardiologist practicing functional medicine, there is a finite amount of time that I can humanly deliver such individualized care. Unfortunately, I have been unable to clone myself! 

This type of practice where I treat the whole patient, regardless of whether or not it’s a cardiac issue is time honored. I believe the best way to deliver this type of care to my West side patients is to utilize the concierge model while limiting the number of patients I see at that facility. 

Regardless of the location and whether or not a patient chooses the concierge model, the principles that I uphold as an integrative cardiologist practicing functional medicine will never change. That is my promise to all of you.

A very healthy heart month to all!

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2018.

*Originally Published Monday, February 12, 2018