Dr. Alexander Kulick, MD, is turning his vision of "the perfect general practice" into reality. He is building an integrative one-stop shop with traditional and alternative treatments -- from x-rays to acupuncture -- and thereby broadening treatment options for his patients.

After 17 years practicing New York City ER medicine -- and simultaneously training extensively in alternative and Asian healing techniques, Dr. Kulick already has built a base of enlightened patients who are serious about living well -- and are doing something about it.

Following is an in-depth Q & A with New York City Integrative Health practitioner Dr. Alexander Kulick, MD, meant for journalists and others with an interest in learning more from one of the pioneers of integrative medicine and best practice health care.

  Tell me about your patients, and why they decided to come to you.

  They are well-educated, aware of, and curious about alternative treatments that are combined with or replace traditional conventional treatment. They appreciate that alternative treatment can go hand-in-hand with internal medicine.

My patients ideally are not concerned simply with acute conditions, but look further. They desire maximum health and well-being. Everything at our practice is individualized to the patient, based on overall lifestyle and the big picture.

We develop a very close relationship with the patient. Our ability to offer an array of alternative treatments, as part of a well grounded internal medicine practice adds a great value.

  What makes your integrative practice unique?

  With 17 years in primary emergency care at several top New York City hospitals, my expertise and medical knowledge is extremely deep.  In fact, it's very unusual to last so many years in the ER, given its tough, unremitting pace.

Those few who do stay, develop extensive clinical medical knowledge through exposure to an extremely wide array of illness. Consulting 6,000 to 7,000 patients per year for medical, surgical, psychological, and gynecological illnesses, and trauma, requires the practitioner to develop an extremely good eye, skilled hands, and the ability to make rapid and accurate diagnosis.

I bring this exposure and strength of diagnosis to the practice -- then combine it with alternative treatments such as medical nutrition and herbal medicine, mesotherapy and acupuncture. Most importantly, we know when to stop and retreat back to conventional medicine. A patient can trust me to be told when a nontraditional application won't work. I also maintain an extensive network of highly qualified practitioners, both conventional and alternative, whom I can refer to for particular techniques and approaches.

  What makes you different from a regular internist?

  Internists offer regular, conventional treatment, period.

I first develop a working relationship with the patient, in part by gathering a detailed history. That naturally leads to a superior understanding of the patient and, hence, a more effective diagnosis and overall more cooperative working relationship with the patient.

To make the best diagnosis, a doctor must fully understand the patient's lifestyle: how diet, time management, stress, family and business relationships relate to his or her health. In short, you need to know the patient, and you need a broad range of experience and diagnostic skills. Given my ER experience, when I hear a patient describe, for example, lower stomach pain, I am trained to consider all the possibilities – medical, surgical and gynecological.

Once the problem is identified, or significant conditions we can review our conventional and alternative treatment options. The course of treatment is chosen according to the comfort level of the patient.

 
  What is your approach to learning about the latest in medical and health innovation?

  Nonstop reading and education is paramount. It is crucial to keep abreast of developments and treatments in the conventional medical and alternative worlds. It makes for a better doctor. And for me innovation is what keeps practicing medicine interesting, as well as fun.

A doctor should always be learning both for himself and his patients, then incorporating that into his practice so that treatment is constantly evolving and improving. There is a plethora of information on health, alternative and traditional, out there in the form of the Internet, magazines, books, new diets and fads. How does the patient wade through all that? How do they know what is real and what is not real? What works?

My role is to help the patient make sense of the information, and to guide them through the maze and in the best direction of what is safe and effective.

  Allopathic (conventional) and CAM (complementary and alternative) medicines appear to be at odds with each other, as it is practiced in the US Do you agree?

How do you see the practice of medicine changing?

Also, describe the experience of studying new and alternative medical practices while simultaneously performing as a conventional ER doctor. Was that frustrating? And do you perceive a role for CAM within hospitals and ERs?

  Presently, these two approaches are perceived as diametrically opposed camps. Complementary and alternative medical practitioners and those in conventional medicine, each assert that only theirs is the correct worldview.

Think of the Sufi tale of the four blind men asked to describe an elephant. Each feels a different part of the animal, each insists that the elephant can be described as tree trunk or sinuous like a snake, one is describing the tail, the other the legs, each missing the entirety of the animal, each grasps only one element of the truth. Integrative medicine can, by definition, draw these two camps together -- through education and understanding.

Already there are several schools offering courses, including the University of Arizona Program in Integrative Medicine, founded by Dr. Andrew Weil, the University of Maryland, School of Medicine, Program in Complementary Medicine. A GME Fellowship in Integrative Medicine has been developed by Dr. Woodson C. Merrell at the Continuum Center of Health and Healing in New York City, in conjunction with Albert Einstein College of Medicine and Beth Israel Medical Center.

In addition, U.S. medical schools have begun offering courses on alternative and complementary therapies, recognizing that more and more Americans have tried at least one application.

With so many vitamins, supplements and herbs out there these days, it also makes sense to teach medical students to become more aware of this realm regardless of how conservative they might be, if only to become aware of conflicts and reactions that occur when popular supplements are improperly combined.

However, there may never be a place for certain alternative practices, in high-pressure departments of hospitals such as the ER. Regardless of a doctor's knowledge of alternative treatments, for example, an ER patient suffering back pain will receive treatment that is very specific and confined. That is because it is simply too difficult for a hospital administration to oversee the use of alternative treatments in the ER.

CAM is obviously best suited to treating and managing chronic long-term illnesses and pain-related injuries, and certain techniques will eventually be embraced, with a slow, gradual acceptance into the private practices of conventional medicine.

  Recognizing that when a patient consults with you, he or she will receive a completely individualized program. That said, could you offer any general recommendations for those seeking optimal health?

  If a person is adequately motivated through diet, exercise and supplements, they can control the majority of chronic health conditions and ease symptoms substantially.

Assume that, these days, most people are going to live a long life, here is my question -- how do you want to live?

The health templates we have developed are centered on a healthy lifestyle. From our perspective, this translates to such elements as diet, exercise, medical nutrition and selected supplement templates. By following our templates, patients are enabled to minimize their exposure to illness or sub-par health and maximize their health and quality of life.