How To Lower U.S. Health Care Costs by Needing Less Health Care. Part 2: Opting Out
When the white coat isn’t your first call: how to find the right healing support, avoid bankruptcy, and stay in charge of your own recovery.
Editor’s note: This is Part 2 of a three-part series. Part 1 was about the mindset shift - recognizing that the way to lower health care costs is to need less health care, and that your mind is the most powerful healing tool you own. Part 2 is what to do when something’s actually wrong and a white coat isn’t your first call. Part 3 is about when you genuinely need conventional care, and how to get it without a hospital system bankrupting you or making things worse.
When last I last left you, I was making the case that the best way to lower health care costs in the U.S. is living like a human, and the health that follows. Real food, real sleep, real sunlight, real movement, real people in your life. When we can pull this off, a shocking number of problems simply never show up asking to be “fixed.” But given that you’re operating inside a human body living in a toxic world, sooner or later, something is going to break anyway.
This article is about what to consider when you know something’s wrong. It’s real, it hurts, and every instinct you’ve had installed since childhood is coaching you to just go to the doctor.
If you’re reading this, you already know that the system conditions us to outsource our healing to authorities and experts in white coats, to rely on the conventional doctors and hospitals covered by our insurance plans.
You also already know this system, and the “authority” and “expertise” we pay it to provide us, has presided over the last century of medicine, coincidentally the same period during which we have become the sickest, fattest, saddest, most anxious, most infertile population in human history. We are facing extinction-level chronic illness rates.
The solution to these problems won’t be found in the health care system that’s failed to prevent or reverse them at best, and that profits from and contributes to them at worst.
Of course, if you have a bullet in your belly, or a bone sticking out, a heart that’s stopped beating, or some other serious mechanical problem, there is no place you’d rather be than an American emergency department. But if it’s not an emergency, there may be alternative approaches outside the system worth consideration.
As I described in Part 1 with my own aches and pains, and my encroaching vision issues, that means breaking the habit of getting on the orthopedic surgery superhighway, avoiding diagnostic imaging (aka hex-casting), and not assuming that certain symptoms (like vision loss) are just inevitable with aging.
There are alternative pathways.
There are practitioners like homeopaths, classical osteopaths, traditional naturopaths, acupuncturists and holistic-minded chiropractors. There are also conventionally trained practitioners who have chosen treatment strategies that are outside the mainstream, like the neuro-optometry clinic I described in Part I, the formerly-licensed MDs who now practice at the New Biology Clinic, or integrative oncology centers who use many more tools than traditional poison/cut/burn cancer protocols.
But I’m here to confirm just one more thing you likely already know - when you step beyond the white coat, it’s the wild, wild west. I mean that as both a warning and an encouragement. There are healers doing things that will genuinely blow your mind. There are also people who will happily separate you from thousands of dollars while accomplishing nothing. And there is no directory, no referral system, no friendly gatekeeper to sort them for you.
The gatekeeper is YOU. (Which, if Part 1 landed at all, is obviously exactly how it should be.)
Six Questions Before You Hand Anyone Your Body (or Your Wallet)
Every practitioner on earth - licensed or not, ancient tradition or invented last year - is situated somewhere on a continuum, or several. Knowing where you want to be on each continuum is half the battle.
Let’s go through the process I go through when evaluating a practitioner I might want to engage with.
1. Who’s in charge here?
The white coat system operates on submission. You’re the child. They’re the adults. They have all the power and all the expertise, they make all the decisions, and if you disobey, you get shamed (and sometimes punished) for it. That’s one end of the authority continuum. We won’t go that far.
The other end is full agency: the practitioner contributes structure and guidance, but you run your own healing. This may be too much agency for many beginners.
But neither end is inherently wrong. If you’re fresh out of the conventional system, the expert-authority model may be what makes you feel safe - and feeling safe is itself therapeutic (I wrote about your brain’s bootleg pharmacy here). You’ll migrate along the continuum over time. Everyone does, but figure out where you are on the spectrum and what type of help you are looking for - today - before you go searching.
2. What is their license actually worth?
Something you might not have thought about is that a licensed practitioner’s actual client is the state.
The state has total power over that practitioner’s livelihood, so he’s going to be careful, and you will get a bit more governmental groupthink out of the licensed ones - not because they are evil, but because they’re humans with kids and mortgages of their own. In exchange, you get some degree of accountability (as in, a licensure board to complain to) and a much better shot at insurance coverage. That’s the trade off. There’s no right answer, just know what you’re buying.
Beyond licensure, there are certifications (which are of course a mixed bag - though I confess a soft spot for practitioners who never stop taking courses) and then there’s experience. Some of the best healers out there have no letters after their name at all. They got good the old-fashioned way: by doing it, over and over, on real humans who left a trail of glowing testimonials.
3. What do they think a symptom IS - and what are they measuring?
This divides the entire healing world. Camp one: symptoms are pathology, something has gone wrong, and the job is to make it stop. Camp two: symptoms are adaptations - your body doing something right in response to a toxin or a threat - and the symptom is the visible part of that response.
Notice: are they chasing your lab values, your waistline, or the radical metric of whether you actually feel good and function well? Some practitioners won’t rest until your bloodwork is beautiful even if you feel fine. Others take the view that if you’re thriving, we’re not going hunting for reasons you shouldn’t be. There are merits to both. Just know which one you’re hiring, and which one you need. (I’ve had my own “I don’t care what the root cause is, I need to function tomorrow” moments. I’m not judging you.)
4. How do they know what they know?
Holistic practitioners aren’t anti-science.
Many of them just value ways of knowing beyond randomized controlled trials. Things like observation of nature, thousands of years of accumulated clinical pattern-matching, and intuition. Meanwhile, the trial-and-evidence crowd will tell you exactly what the latest study did and didn’t show (although often they fail to notice the garbage study design). This can be genuinely valuable, right up until you remember who funds most of the trials and how negative trials don’t get published in the journals.
As a practitioner, I try to consider it all. But everyone has a bias here, including your humble correspondent. Ask about theirs. You need to know.
5. How rigid is their framework?
An acupuncturist operates inside Traditional Chinese Medicine, a gorgeous, ancient, meticulously mapped system. She is not going to give you stretching exercises or prescription meds, because that’s not her framework. An energy healer may not notice that your elbow hurts because the bone is fractured, because fractures aren’t in her framework. Just like the functional medical doctor is going to lab you into oblivion and might miss the childhood trauma at the root of your autoimmunity.
The single most practical thing I can tell you is to understand what each practitioner sells, and don’t go trying to buy eggs at the hardware store. The hardware store sells hardware. It will not notify you that it’s out scope. It will simply keep speaking with authority. Knowing the boundaries of someone’s framework is your job, not theirs.
6. Is the healing done TO you, or BY you?
Some modalities are receptive. You lie there and you receive - bodywork, sound, frequency, prayer, laying on of hands. Others are active (eg, nobody can do your breathwork for you).
They both matter.
In fact, receiving matters more than our do-it-yourself culture wants to admit because a lot of what turns your symptoms on in the first place is running on subconscious processes, things like fight-or-flight programs responding to threats you’re barely aware of. Your conscious mind can’t switch off what it can’t see. Receptive modalities can rattle loose what your conscious mind can’t yet reach.
My strong recommendation is to pair one active modality with one receptive one. Because it’s very possible that the combination outperforms either alone.
And now, finally, the who’s-who, from most familiar (feels like a doctor’s office, only better) to the most woo (you’re running the show).
The descriptions of practitioner types in the Field Guide below are stereotypes, lovingly deployed. Individual practitioners vary wildly, which is why you’ll be doing homework on every single one.
Next: The Field Guide.
Everything above this line was deconstructing how to think. Everything below is about knowing who to call.
In The Field Guide I outline the entire landscape from functional MDs and classical osteopaths (sorcerers, I’m not kidding) to homeopaths, naturopaths, Traditional Chinese Medicine and Ayurvedic practitioners, herbalists, craniosacral therapists, energy workers, formerly licensed physicians, and the full-woo frontier.
Plus, how this works with insurance (and how it doesn’t) as well as a few cheap back doors and my field-tested rules for not getting fleeced. Paid subscribers get the full download.
(If you’re not joining us for this next part, no hard feelings - I’ll see you next week for Part 3: what to do when you genuinely need conventional care, maybe even a hospital, without letting the Soviet-style hellscape known as your local hospital bankrupt you.)
