Kulreet Chaudhary, M.D. is an extraordinary, heart-centered physician -- an integrative neurologist who combines the best of conventional and Ayurvedic medicine, with a primary focus on caring about and for her patients. She is the Director of Neurology at Wellspring Health in San Diego and a frequent medical specialist on The Dr. Oz Show. I had the tremendous pleasure of speaking with Dr. Chaudhary about why it's important to slow down when working with patients. Here are excerpts from our conversation.
Michael Finkelstein, M.D.: What is your perspective on Slow Medicine?
Kulreet Chaudhary, M.D.: When patients come in to see me, I'm typically the 14th or 15th neurologist that they see. They come in with this huge, thick stack of papers, and the first thing they do is hand me the papers. I look at them, and I say, "This is not you. This is a bunch of diagnostic tests. This tells me absolutely nothing about you."
So I just push the papers aside and say, "What is your story, and how can I help you?" That's how I start every single patient appointment. It's just so shocking to patients that I'm not as interested in their labs and images and so forth and that I really want to hear how they got sick. Oftentimes their stories start 10 or 20 years before their first neurological symptoms.
Conventional medicine is trying to push this highly efficient system where you have only seven minutes to see patients. Although you are able to see a lot of sick people in a day doing that, you have absolutely no impact on their health. I myself do the exact opposite. It is by no means financially rewarding, but people actually get better and get discharged from my clinic. I don't even have patients in the hospital anymore. My password in the hospital keeps expiring; and I keep getting in trouble, because I don't have any admissions!
I loved hearing the title of your book, Slow Medicine, because I think the way I am practicing medicine now is more the way that my grandfather practiced it in India, almost a century ago. I'm realizing that it is actually the key to healing people and getting them onto a path to reverse disease.
MF: What are some of the key differences you have noticed between conventional American medical practices and traditional Indian medical practices?
KC: A sense of community is present in so many of the older cultures, not only in India, but even in Europe. We just don't have as much of it here in the U.S. When there is a strong sense of community, there is a different sense of responsibility from the physician. When my grandfather was treating somebody, he was treating the entire family. Doctors like him became an intimate member of the family, and that positioned them in a very different place for healing. Here physicians are challenged because of the role of insurance companies. It's a struggle to have a relationship with patients.
In my own practice, patients see transformation happening in their own bodies and lives, going much deeper than just the physical symptoms. So they bring in their spouses, then their children, then their grandparents. I become very invested in these human beings and in the welfare of their families. The same is true in reverse: They become very invested in me, as the health provider for the entire family. It opens up this different type of relationship. I get to view the wholeness of the person, and I become part of that person's community. There is actually a love that flows between my patients and me.
MF: You were trained in a conventional medical model. How were you able to achieve this transformation in your practice, and how can you guide other doctors to follow in your steps?
KC: The way the shift began in my own practice was through some really simple steps. We just slowed down, to a point that we actually got to know our patients. We basically opened up our hearts. It wasn't hard, and it didn't require an act of Congress. My new patients are most surprised by the fact that they do most of the talking, and I wait until the very end to say anything. Surprisingly, even if you have seven minutes with a patient, if you give them five minutes to talk, you learn almost everything you need. So it's just something simple like that.
As physicians, we need to take responsibility for the little community in our own practice, doing the right thing for our patients. We need to look at our patients as our own little village, not as medical record numbers.
There are a limited number of forces that are at work in any given practice. Just the way the patient is greeted when they walk in, little things, change the environment of a practice. I know a lot of physicians don't even know what's wrong. Sometimes the problem is as basic as having someone answering the phone who is terribly rude. You can have staff who are amazing in the back office but just horrible on the phone. That might be the most stressful experience for anybody coming into your office! A two minute conversation with that staff person can make a huge difference in the patient experience.
One of the principles in Ayurvedic medicine is to make small steps -- just start somewhere. When you do a little change on a regular basis, it has a really big impact.