Over the past 34 years seeing over 10,000 patients I have encountered a wide range of patients with an even wider range of health issues.

The human body and treatment of the ailments that can present to our office is vastly complex at times and that is probably why some people such as myself enjoy the practice of healthcare so much. It is endlessly challenging.

Some patients are very straightforward in their presentation of the history and current symptoms, while others seem to want to make me drag every little pertinent piece of information out, bit by bit. Some are eager to cooperate with my recommendations, while others sit with their arms crossed, a scowl on their face and appear to be solidly focused on not changing anything about their activities, lifestyle or taking any steps to correct an unhealthy situation.

Some patients bring a long list of other doctors they have already seen in their effort to solve a persistent problem while others brag that they “haven’t seen a doctor in 15 years.”

When the variety and complexity of the possible actual physical problems that can present are paired with the range of human personalities, it is easy to see how every patient encounter is truly unique. I don’t think I will ever be able to say, “Well, now I’ve seen it all.”

Some of the patients I have seen in the past couple of years have brought in some more complex issues that have been satisfying in that we were able to help them find welcome relief for a particularly vexing problem, yet their other health issues required that we help them find other specialists to address their needs as well.

Good healthcare often requires help from multiple providers. In our office we often receive referrals from medical physicians, surgeons and other healthcare providers for chronic pain issues. We also frequently reach out to other specialists to help the patient.

We may call on specialists ranging from orthopedists, neurologists, rheumatologists, physical therapists, urgent care providers, physiatrists (physical medicine specialists), internists, family physicians, podiatrists, dentists, oral surgeons (we treat TMJ), massage therapists and others.

This is because it often takes a multifaceted approach to best serve the overall needs of the patient. Each specialist has skills and treatment options that may be helpful for any particular patient.

One key to being the most helpful for patients is being aware of the specific roles other specialists can play in overall patient care. Knowing when to pick a specific type of provider to contact on behalf of the patient is valuable.

It is not unusual for our office to be called on to evaluate and treat neurological complaints such as peripheral neuropathy, restless legs, carpal tunnel syndrome, sciatica or other pinched nerve issues. In most cases we will do all necessary evaluation in our office to begin treatment. In some complex cases we will refer a patient to a neurologist for their opinion and possibly co-treatment.

Similarly, we will call upon orthopedists at times to see a patient and provide treatment as necessary along with the care we are providing.

Since we see TMJ patients, we may interact with a dentist or possibly an oral surgeon for the patient to receive the best care.

In some cases, although the patient was directed to see us or has called upon our office on their own, once we meet with them it becomes apparent that a different kind of specialist will best serve their needs instead of our office. If possible, we will work with the patient to try to get them into the right office for care.

As I talk with our patients as well as other people outside the office, I often hear people complain that they need to see so many different providers instead of being able to rely on one particular individual to address all their needs. Occasionally a patient will wistfully recall that it was different “back in the day.”

It was different years ago. Although there have been medical specialists for generations, the number and distinctions between types of medical specialists is greater now than ever in history.

This is primarily a result of a growing knowledge of how the body works and how to treat various conditions. It simply is impossible for any provider to be knowledgeable enough to cover all the patient’s needs. There are new kinds of specialists developing constantly as a result of a greater knowledge base.

That’s why we sometimes recommend a patient have different kind of treatment in addition to the care they receive at our office or occasionally seek different treatment instead what we offer. Although we can help a very wide range of issues (surprisingly wide for many people), there is a limit to what we can do, and it may be helpful to call on the expertise of someone else.

It may be a good idea for patients that are struggling with ongoing chronic issues to ask about other treatment options or perhaps even seek second opinions.

Dr. Mark Kestner is a licensed chiropractic physician and acupuncturist with 30-plus years of experience focused primarily on treating complex and chronic spine, joint and neurological conditions in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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