“I am in family practice, and may be subject to loss of salary. I am not sure how to create a viable practice for myself.”

That’s what one primary care doctor had to say about the current situation in the trenches of medicine these days. The doctor in question was one of nearly 100 physicians and ancillary health professionals who gathered in Tucson, AZ, in June month for Holistic Primary Care’s first “Heal Thy Practice: Transforming Primary Care” conference.

Billed as, “A conference exploring effective practice models and business strategies for patient centered healthcare,” the meeting was a first step in addressing the many roadblocks and difficulties that prevent doctors from providing the type of prevention-focused, health-centered care that even the most medically conservative institutions are now calling for.

Simply put, the time pressures and paperwork burdens of insurance-based practice combined with decreasing reimbursement and the increasingly complex health problems of our rapidly aging “fast food nation,” have made it difficult for many primary care doctors to stay in business at all, let alone provide good, quality holistic care. Many doctors are looking for ways off the merciless treadmill that medicine has become.

“Heal Thy Practice” touched on a wide range of models and strategies, including direct fee-for-service as advocated by Dr. Brian Forrest, an Apex, NC, family physician who has side-stepped the bureaucratic stranglehold of insurance-based practice and charges patients a straight $45 per 50 minute (!) office visit.

Dr. Elson Haas, a holistic physician in San Rafael, CA, described his group visit model in which he facilitates weekly gatherings for patients facing similar health challenges, thus eliminating redundancy while at the same time fostering peer support and camaraderie.

We looked at various “concierge” or “direct care” models, like Dr. Jami Doucette’s “ModernMed” program, in which patients pay doctors a fixed annual fee to be members of the practice in exchange for more or less unlimited access to the doctor for basic primary care and preventive health services. Medical spa consultant Janice Gronvold offered insights on trends in that field, which continues to grow, despite the economic downturn, especially overseas.

Dr. Sherri Tenpenny, one of the country’s most outspoken advocates for functional medicine, energy medicine and nutrition-based healthcare shared many lessons learned while establishing holistic health clinics in the medically conservative Midwest. She noted that stepping outside the framework of mainstream medicine is, for many doctors, “kind of like leaving a street gang!”

Dr. Aaron Katz, director of Columbia University’s Center for Holistic Urology, and one of the world’s leading clinical researchers on herbal medicines in cancer care, urged physicians to become familiar with well-researched botanicals so as to better guide patients as they try to find their way through the nutraceuticals “jungle.”

The conference chair, Dr. Grace Keenan, founder and director of the 4-site NOVA Medical Group, offered several in-depth sessions focused on the nuts and bolts of running a multidisciplinary integrative medical clinic.

These were just a few of the highlights of the three-day conference. While it was primarily a forum for physicians to learn from each other, “Heal Thy Practice” also offered us-and our exhibitors-a great opportunity to learn more about what’s happening on American medicine’s front lines.

As part of the conference evaluation questionnaire, we asked attendees about their practices, their most pressing challenges, and their visions for the future.

The data offer several promising signals for the nutraceuticals industry.

The audience consisted mostly of medical doctors in family practice or general internal medicine, though we also had chiropractors, naturopaths, nurses and physical therapists. The meeting had something of a “holistic” focus, but 47% of the attendees described their practices as “primarily conventional primary care”; 37% said they had “mixed/integrative” practices, and 6% described themselves as full-on holistic practitioners.

Fifty-three percent of respondents indicated that more than half of their patients routinely ask about nutritional supplements and natural products, and an additional 23% of the doctors put the estimate at about half of all patients.

The really good news for the industry is that nearly 70% of these doctors said they routinely recommend supplements and natural products to patients, while almost 40% actually dispense them in their offices. In some cases, they noted that supplement sales represent a significant portion of total practice revenue.

Many said they plan to dispense in the near future. Practitioner channel distributors that offer a wide array of well-vetted products “under one roof” are appealing to this time-strapped crowd.

We also gained some insight into what these doctors want as far as information about nutraceuticals, herbs and other natural products. In short, they want education and honest science, not sales pitches or infomercials. The doctors understand that supplements are not drugs and that few of these products will have the extensive research portfolios that are standard issue with pharmaceuticals. But they do expect transparency about what evidence there is, and they don’t react well to gloss or hyperbole.

Keep in mind that as much as medical thinking is still very much shaped by the pharmaceutical industry, there’s now a strong backlash against drug company marketing even in mainstream medical circles. Drug reps are lately finding that the doors to hospitals and clinics are closing, and pharmaceutical marketers are dealing with a much more aggressive regulatory environment. Many primary care doctors have become hypervigilant about anything that smells of a sell-job.

The bottom line is that if you can educate doctors about issues that really matter to them and their patients, if you can help them face the myriad challenges they must confront every day, then you can and will win their confidence. But if your product message comes off like a late-night TV spot and is focused more on moving bottles than helping them help their patients, you’ll have a hard time connecting with the clinical crowd.

“Heal Thy Practice” attendees provided a lot of insight into their personal and professional frustrations, and the obstacles they face in trying to provide the kind of care they really want to give.

By far, the most common complaint is lack of time with patients. Several said they came to the conference to learn about practice models that would afford them more time to delve into each patient’s underlying problems. The reality is many doctors are themselves deeply uncomfortable with the pace at which they must move patients through their offices.

So don’t be surprised if doctors are slow to respond to your marketing efforts. It doesn’t mean they’re not interested. But many of them barely have time during working hours to go to the bathroom!

They also struggle with trying to balance their family/relationship lives and personal interests with their exhausting professional lives. Chronic stress and health challenges that run along with it go without saying (Someone out there would be smart to design a product line specifically for high-stress clinicians!!!)

As much as they want out of the managed care rat race, doctors find that the transition can be scary. One attendee said that the biggest challenge is “not having the financial cushion to get me through the transition. I have no savings, three kids in school, and a mortgage to pay.” Others said they felt they lacked the organizational and administrative skills needed to bring in the broader array of integrative/holistic services they would like to offer.

The first “Heal Thy Practice” meeting garnered high marks and great enthusiasm from attendees. One physician said, “I wish there had been a conference like this 20 years ago, when I was first starting out!”

We are certainly exploring the possibilities of putting on another “Heal Thy Practice” conference. The current state of primary care in this country is bad-to-ruinous, and the need for health-focused preventive practice has never been greater.

Audio recordings, powerpoint presentations and support materials from the 2009 “Heal Thy Practice: Transforming Primary Care” conference are available for purchase on www.holisticprimarycare.net. Click on the “Heal Thy Practice” conference banner at the top of the homepage.