Transitioning to integrative care: Two practitioners share their stories

By John McCormack

Marc Grossman, OD, LAc, practices integrative eye care. But he is just one of a small group of providers who do so. In fact, he said that he can “count on one hand the number of integrative medication eye doctors that I know in the country.” Similarly, C. David Geier, Jr., MD, a board-certified orthopedic surgeon, and sports medicine specialist, is one of very few providers who practice integrative orthopedics. He also said that he could “count on less than one hand the number of professionals that practice integrative orthopedics.”

While these two integrative care providers have taken the road less traveled, they are happy with their journeys. Not only are they satisfied with their careers, they believe that bringing innovative methods and treatments to medical disciplines that typically sit outside the integrative sphere is helping many patients as well.

Exploring off-the-beaten path options

Grossman realized early in his career that he wanted his medical practice to go beyond conventional eye care.

“When I got out of school, I started doing traditional eye care but quickly enough realized that I wanted to do vision therapy,” said Grossman, who now practices at Integral Health Associates in New Paltz, New York.

Instead of simply assessing eyesight and managing prescriptions, Grossman helps patients treat vision problems by treating them as a whole person.

“I treat the person behind the condition,” Grossman emphasized. “l help them make safe, sensible choices that prevent eye disease such as macular degeneration, cataracts, near sightedness, floaters, glaucoma and other conditions.”

Geier, who now practices in in Charleston, South Carolina, and Charlotte, North Carolina, discovered integrative care much later on his career.

“I went through a really bad bought of fatigue and burnout and I just couldn’t dig my way out of it. And so somebody suggested I see this integrative care doctor…that started me being a fan of alternative, integrative medicine,” Geier said.

At the same time, because Geier had also become frustrated with some of the limitations that he was encountering in the conventional surgery world, he decided that, in addition to receiving integrative care, he wanted to provide it as well.

“I was seeing more and more of a trend of joint replacement surgery being presented as really the only option. And if it wasn’t surgery, it would often be just a cortisone shot, which is more harm than good in the long term. And I was getting a little frustrated by this push to just operate, operate, operate,” Geier said.

So, after practicing as a traditional surgeon for about 16 years, he transitioned to integrative care.

“I do what I call integrative orthopedics, which is bone and joint health and non-surgical treatments for a variety of bone and joint injuries, but also [help many patients] with performance, recovery, endurance, speed, things like that,” Geier pointed out. “And so I do a lot of supplements in addition to regular medical treatments and injections.”

As an integrative care provider, Geier often treats patients with platelet-rich plasma (PRP) injections, exosomes, and some other treatments that the “FDA still considers experimental.”

Because Geier combines traditional treatments with these alternatives that are good for bone and joint health, he is able to take a “comprehensive approach to many patient problems, especially arthritis and not just offer surgery options or cortisone shots to patients.”

Realizing desirable patient outcomes

The integrative approach appears to be working in these staunchly conventional disciplines.

Through his integrative practice, which incorporates nutrition, diet, exercise and behavior therapy, Grossman empowers many patients to experience exemplary outcomes. One patient, for example, noted her eyesight improved from 20/40 vision to 20/25 while also experiencing decreased density of cataracts. Another patient experienced a dramatic reduction in Sjogren’s syndrome.

Similarly, Geier is experiencing favorable outcomes with his patients. After practicing integrative orthopedics for more than a year and a half, not one of his arthritis patients has had to undergo joint replacement surgery.

In addition, Geier is able to help patients “get a little bit stronger, improve their endurance, improve their energy, improve their speed, add a little muscle mass, decrease a little fat . . . which is a little different than in traditional orthopedics. You don’t really handle much of that,” Geier pointed out.

Secrets of success

To successfully transition from conventional to integrative care, both Greenberg and Geier have embraced a variety of strategies. And, they recommend that other medical providers who work in disciplines that are not commonly associated with integrative care and who wish to make the transition also adopt best practices such as:

Keep learning. “Education is really important. You have to learn outside of your specialty and become a little bit more able to talk about all aspects of health that affect whatever body system that you specialize in. I’ve had to learn about hormones. I’ve had to learn about stress and the adrenal [glands] and hypothalamic–pituitary–adrenal axis dysfunction because all of that plays a role in arthritis pain. It plays a role in over training issues,” Geier said. “You almost become a student again.”

Grossman also recognizes the importance of ongoing education. To further develop as an integrative eye care provider, Grossman has added to his repertoire of skills through the years by studying acupuncture, biochemistry, kinesiology, muscle testing, nutrition, supplements, and movement techniques.

Adjust to new payment models. “Our integrative practice does not take insurance. It is cash only, so I did lose a lot of my patients in my prior practice that want to stick with an insurance model but that comes with the territory. I have found that there are a lot of people that are looking for alternatives from that model,” Geier said. “But the insurance issue is something that everybody needs to think about as they consider making a change. You really have to recognize if you’re going to make this leap, you’ll probably lose a lot of your traditional patients that need to stick with their insurance. So it is tricky, but I don’t regret it,”

Consider all streams of revenue. Grossman, for instance, sells supplements and vitamins out of his office. “Why not sell them? I mean, patients are going to get them somewhere else anyway. If you can give it at the same price or a lower price along with some education, you are helping your patients,” he said.

Market to new patients. When making the transition to integrative care, traditional providers need to make a conscious effort to market their services to new patients. Geier has been able to attract new patients because he has a significant YouTube following, an effective website, and also serves as a medical expert for two TV stations.

“I’m on TV every night so I get a lot of visibility. I think it would be tricky or difficult to succeed if you’re just going to leave as an orthopedic surgeon or really any specialist and just start an integrative practice without getting your name out there and marketing yourself,” Geier concluded.