The patient/doctor relationship is one of the most long-standing traditions in the western world, as we turn to our GPs frequently to have all those inexplicable aches and pains broken down and explained to us. But the basis of modern medicine is unprepared for the battle that lies ahead of it, where all that ails us can no longer be cured with a prescription. So what has to change – the doctor, or the patient? According to one integrative doctor, it’s both.
What ails you
The ‘old’ method was set up to fight one very big target, according to Elizabeth Blackburn, a biologist at the University of California. “Modern medicine was formed around successes in fighting infectious disease. Infectious agents were the big sources of diseases and mortality, up until the last century.”
But now, it’s a brave new world, and infectious diseases are no longer the threat they once were. It’s now chronic diseases that are everywhere, a modern plague with no cure. Diabetes, heart disease, cancer. The World Health Organisation said 92% of deaths in New Zealand were caused by chronic diseases. With no clear cure, the focus instead is on prevention.
And so begins the rise of alternative medicine. While there are only handfuls of integrative doctors in New Zealand, it’s an area of medicine that’s fast on the rise as we become aware of just how damaging lifestyle factors can be.
Meet Dr. Frances
One doctor who’s made the move to a more inclusive brand of medicine is Dr Frances Pitsilis. And her biggest weapons against the rise of chronic disease comes down to two things: time, and knowledge.
“When I first went into general practice, I quickly realised I didn’t want to fight fires. It was all patient driven, and there was no prevention,” Pitsilis says. “But I was there to keep them well. I had a patient who came to see me who was jaundiced, with a big liver,and I thought, ‘he’s got metastatic bowel cancer. That’s the end of him.’ There were a whole lot of situations like that where I felt I should be more proactive. So I started having longer consultations.”
In a move she describes as “unheard of”, Pitsilis began to carve out half-hour consultations with her patients. And she started asking more questions. How was their family life? How was their diet? Were they stressed at work? It gave her a better idea of the patients’ life – rather than just focusing on their illness.
It’s not a new attitude, just new to western medicine. As Hippocrates – he of the famous oath all physicians must swear by – once said about patient care, “It is more important to know what sort of person has a disease than to know what sort of disease a person has.”
Traditional Chinese medicine also looks at the entire body and what might be affecting it. Yet in the current medical climate, Pitsilis points out, GPs have roughly 15 minutes to correctly diagnose and treat every health concern under the sun. It’s a set-up that benefits neither patient nor doctor, and so she set out to change it.
“I became interested in chronic illness – which they didn’t train us for. I did a course in occupational medicine but I didn’t learn anything more about how to treat people who didn’t sleep, had chronic pain, or had autoimmune diseases. I did learn more about chemicals, environment chemicals and poison. But I didn’t want to go into factories and that kind of thing – I wanted to be a stress doctor, because I’d got burnt out from stress.”
Burnt-out twice, in fact. Pitsilis jokes it was a case of “what’s the definition of stupid: doing the same thing all over again and expecting a different result”, but her second burn-out did signal a shift in how > she wanted to work.
It was then she started organising those longer appointments, and slowly, it developed into a chronic illness practice. Each patient now fills out some forms, gets blood tests, then has a two-hour consultation where they ‘hit the ground running’. The waiting list is currently under six weeks, the best it’s been in years.
When Pitsilis appeared on the 2012 TVNZ show Is Modern Medicine Killing You?, where she took on various cases of people with long-term problems, the wait to see her went up to 18 months. Then the cases – and the results – got more and more interesting.
Finding the cure
The lounge in Pitsilis’ North Shore home acts as an unofficial second office, with piles of research on every flat surface. She refers, more than once, to her work being her ‘calling’. But if Pitsilis sounds evangelical about her job, it’s because the results are almost biblical.
A girl growing blind from an allergic reaction that’s scarring her eyes, can see again after Pitsilis reduces the reaction so she can then have corneal transplants. A woman, crippled from rheumatoid arthritis, casts away her crutches three weeks after being told to take gluten out of her diet. A man with inflammatory bowel disease, who’d lost 33kg after three months of bloody diarrhoea, is prescribed probiotics by Pitsilis as a precursor to the actual appointment, and starts getting better in two days. It’s not quite water into wine, but it’s close.
“My goal is no chronic illness in New Zealand. If more doctors were working this way – and the right doctors to work like this are general practitioners because they have the broad knowledge – then we’d have better primary care, we wouldn’t use the hospitals as much, we wouldn’t use as many drugs.”
The key is getting patients to be proactive about staying healthy, rather than reactive when they start getting sick. And Pitsilis says it’s the fundamentals like diet and lifestyle that can make the difference.
“What I learned from making Is Modern Medicine Killing You, is how incredible the diet is. In real life, people have such difficulty getting their diet under control but when the nation’s watching you, they get it sorted quickly. So these people got better within one or two visits. I now tell people if you do this well, it will work.”
‘The Pitsilis method’ starts with detoxifying people’s guts, and looking at lifestyle factors such as stress and nutrition, then hormones.
“The wrong diet can lead to migraines, fibromyalgia, rheumatoid arthritis, irritable bowel, fatigue, allergies… You’re finding out what’s out of balance and correcting it. But I’ve got to know what to look for.”
Pitsilis believes this is the future of medicine, as people are already more flexible about trying alternative methods like vitamins, massage, yoga and more. But it’s not fast enough for her liking.
“My biggest frustration is most people aren’t interested. There are a small group of doctors around the country who work like I do but most don’t. When you become a doctor, you’re supposed to cure people. And ‘cure’ is a ‘be careful how you use it’ word, but at least make a difference. Improve their lives. So it’s of some frustration to me.”
Critics of alternative medicine have been vocal, crediting positive results to the placebo effect and noting that, for a lot of these practices, the rigorous tests doctors and their antibiotics have to go through don’t apply. Pitsilis is well aware of the criticism and says it’s more about adding tools to her medical tool box.
“I don’t call myself a complimentary person; I have my foot firmly rooted on solid soil with evidence-based medicine,” Pitsilis says. “The patients get well, I’ve helped them get well, and then I get questioned. That’s why I’m extremely careful, medically.”
That’s where the desire to keep learning comes from – every new study, every shred of evidence can be the difference between life and death, or quality of life, at the very least. Pitsilis is aware her goal of no chronic disease in New Zealand is a big one, but she’s not one to shy away from a fight.
“If I learn something new, it’s so exciting! That means I can help those people. For me, on my headstone – it sounds a bit chalky – but I want it to say, ‘She made a difference’. That’s all I want.”
An example of Pitsilis’ method:
“We’ve got a 35-year-old woman. Periods are getting heavy, she’s waking up at 3am, she can’t get back to sleep. She’s got irritable bowel – bloating, wind – she gets anxious and is often short of breath. She’s not as happy as she used to be. She’s being bullied at work, but it’s subtle. She’s tired, she wants to go to sleep at 3pm every day. Her leg cramps occasionally.”
“Her B12 vitamin [level] wasn’t good and her diet wasn’t wonderful. And because humans, fruit bats and guinea pigs don’t make their own vitamin C, and because she’s stressed, I knew she’d need vitamin C. A little omega 3, to help balance out the underactive thyroid, and she was burnt out. Because she’s got an indoor job, she’s also low in vitamin D.
"The bullying has made her hyperventilate, she’s only breathing in the top half off her chest which is making her anxious – and draining her magnesium, which causes the leg cramp. Low magnesium also makes you tired, makes you get an irritable bowel, and disturbs your sleep.”
“Progesterone (added to the pill)will help with the periods, and so will magnesium and zinc. A really good diet: low in starch and sugar, adequate protein, lots of vegetables, fruit, nuts and seeds. Fixing her shallow breathing will help with anxiety. Iron is important, and she’s losing her iron through her heavy periods.
"Zinc is good for mood, and the minerals in fish oils are good for her brain. Vitamin D is major – for sleep, anxiety, weight loss, energy. This is how the body works – not heart today, kidneys and bladder tomorrow, headache the next day. We don’t have silos or departments – we’ve really got a network relationship.”
Words by: Emma Clifton
Photographs by: Melanie Jenkins and Getty Images?