Family Practice medicine is an art unto itself. It literally encompasses nearly every aspect of medicine in one degree or another and the Family Practitioner learns medicine in a “womb to tomb” fashion. Thus, the FP can care for a pregnant women, treat her chronic problems, deliver her child, and care for both mother and child as they grow older, each patient having different age-related issues that need to be addressed.

Dr. Work almost does that except he decided a long time ago that he would no longer deliver babies. He delivered his last baby during his last month as a resident in June 2000. The baby was the “baby from hell” and was a difficult delivery and that is what swore him off of delivering babies forever. However, he did act as a hospice director and held the hands of dying people. Not many physicians care to be intimately involved with death and dying because many physicians think of death as a failure on the physician’s part. While intellectually they can acknowledge age and chronic disease as the primary causes of death, on a personal, “heart” level, they view it as a failure of their skills to keep someone alive. That is why most physicians avoid dying patients. Dr. Work accepts death as just another step on the road of life and believes that the journey has ended here but picks up elsewhere so there is no failure on the physician’s part unless the person has suffered unnecessary pain and suffering while dying.

Family Practice also includes the mundane of life’s problems, e.g., hypertension, high cholesterol, metabolic syndrome and diabetes. Dr. Work feels that they are all intimately related to each other and all are also affected by anti-aging medicine. Thus, while he may treat the diabetes almost the same as another FP might, he will also correct the hormones as well to provide a better milieu for the disease to be treated in. For example, while Type II diabetes is treated well with metformin (Glucophage®) and a TZD (Actos®) and perhaps even adding a DPP4 inhibitor (Januvia®) or even a GLP-1 analog (Byetta®), he has not fully treated a male diabetic until he has corrected the testosterone deficiency that comes with the diabetes. If he foregoes the testosterone replacement therapy in male diabetics, he will never truly get the diabetes under long-term control. That is where he differs with his colleagues. He uses the latest scientific studies’ findings to treat patients and not the “community standards” that may take another ten years to change and thus have patients suffer with substandard care.

Dr. Work does not see young children in his practice, though he has been trained in pediatrics. The major reason is the cost of vaccines. Vaccines are prohibitively expensive and have a relatively short shelf-life. Therefore, if the vaccine is not used up in the appropriate timeframe, then it is wasted. Most FPs (who see children) and pediatricians do not run into this problem because of the relatively high volume of age-appropriate children in the practice. If you wish to have your children included in for concierge medicine, you will need to get the vaccinations elsewhere (which really aren’t that difficult to find).

So you can see that a Family Practitioner (in general) and Dr. Work (specifically) is able to treat you in a “holistic” fashion. The problem with the word, “holistic,” is that the “foo-foo” crowd hijacked the word to make it mean something entirely different. Holistic medicine should mean that the practitioner views you as a person in all aspects of your wellbeing, whether it is your physical, emotional, mental or spiritual health. That is what Dr. Work does…he views you as a whole person and not a “sick piece of meat” waiting to be “fixed.”