Private General Practice
Integrative medicine applied to general practice.
Primary care outside the public system: diagnosis, treatment, prescriptions,
referrals, and prevention. Government funding follows the number of patients a
practice has enrolled, rather than the time spent with any one of them.
Consultations are shaped accordingly, which serves a common problem well and a
complicated one poorly. At Health Function, the length of a consultation and what
happens in it follow the patient’s clinical need.
Private General Practice suits people whose health does not call for an extended
investigation, but who want a doctor with time. One who explains what a result means for them in
particular, and what should be done about it. A doctor who welcomes clinical
questions and feedback between appointments. In general practice, an integrative
approach assesses sleep, food, environment and anything else that may sit behind an
everyday problem.
Integrative Medicine
Medicine applied to the whole person, and to everything they live with.
Light, environment, nutrition, movement, sleep, stress, and what a person believes
about their health are assessed alongside conventional care. Where complementary
approaches are considered, they are discussed openly and weighed against the
evidence and the patient’s circumstances. Conventional treatment is always set out,
with what it offers and what it asks. The decision is the patient’s.
It runs as a programme in stages, beginning with a full assessment in the first year
and settling into regular review after that. A protocol sets the order of things:
which supplements start when, which foods come out and when they go back in. Most
protocols are written for a condition. A protocol at Health Function is built around
the patient, with the diagnosis informing it without determining it.
Integrative Medicine suits people whose problems have not been settled by the usual
investigations or treatments: symptoms that persist alongside normal results, several
things happening at once, a diagnosis that accounts for only part of the picture. The
work is to find the pattern, and keep testing it as things change.
A Year of Working Together
Health rarely changes in a single appointment.
Registration begins with an assessment of the history and what has already been
tried. What follows is a change made, time to see whether it worked, and the next
change after that. The cycle cannot be hurried. A change takes weeks to show
anything, and a result only means something read against the one before it. A year
is the shortest period in which that can happen more than once.
That is also what the year asks in return. Changes to sleep, food, environment,
medication and supplements take effort to sustain, and the ones that work are rarely
the easiest in the first fortnight. Registration is accepted on that understanding.
What this practice does is work out what is actually going on, and stay with it. A
single appointment with someone whose full history and response to interventions are
unknown cannot do that, which is why one-off consultations are not offered. That is
what a year is for.
At least the first consultation is in person, wherever a patient lives. Patients in
Nelson are asked to attend in person for follow-ups when possible, and those living
further away can be seen by telephone or video. Everyone is asked to be seen in person
at least once a year. Where mobility or illness makes travel impractical, a different
arrangement is agreed.
The clinic is in a garden setting, complete with a view and birdsong. As there is no
waiting room, patients are asked to arrive at the clinic door no more than 5 minutes
before their appointment start. Ring the red bell on arrival.
