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Why Ancillary Medical Services Should Reflect Physician Values


Primary-care physicians’ ancillary offerings should reflect their core values inside and outside the medical practice.

We recently wrote about a controversial “feeding tube diet” embarked upon by bride-to-be patients that sparked the question of whether physicians, in a world of declining reimbursements, should offer new medical services to generate additional revenue. 

In the article, physician Oliver Di Pietro explained the mechanics of the 10-day, enteral-nutrition weight-loss program, a variation of the ketogenic enteral nutrition (KEN) diet offered in Europe, which has in the last two months enjoyed a surge in popularity. But it isn’t just dwindling reimbursement that inspired Di Pietro: The physician also expressed his desire to help obese patients achieve greater health through ancillary offerings such as the diet.

Since interviewing Di Pietro, we’ve heard from other private-practice physicians who are offering ancillary services that reflect their core values. And in doing so, they’ve enjoyed continuing loyalty from patients, while providing care they believe will contribute to patients’ total well being.

One of these physicians, our own Practice Notes blogger Craig Koniver, spoke to us recently about his approach to organic medicine.

Koniver, who runs a busy integrative medical practice, Primary Plus Organic Medicine, LLC, in Charleston, S.C., offers organic medicine products and solutions that are complimentary to the style of medicine he practices and the lifestyle he leads. In addition to primary-care services, offerings include organic IV infusions (vitamins, minerals, Glutathione, CoQ10, and more) and comprehensive specialty lab testing (stool culture, saliva, hormones, organic acids, food sensitivities).

“I truly believe that there is a natural option for everything and that optimal health is best achieved without the use of synthetic anything,” said Koniver.”I bring my personal view about connecting with nature and the rhythms of natural life into the many options I provide my patients. I love offering them tips and ideas about how to feel better through nutrition and exercise and nutritional supplements and hydrotherapy and earthing and so much more.”

As for ethical issues involved with offering new services, especially controversial ones such as those offered by DiPietro, Koniver says it’s up to both the physician to offer what he feels is right, and the patient to decide whether to spend money on that.

“I honestly feel that each ethical question is specific to each provider … obviously everyone has a different take on what is ethical or not,” said Koniver. “I think as long as the doctor feels it is okay to offer a particular service, it is up to each patient to decide if they want to spend money on that. I offer different natural and alternative therapy options for my patients. If they don't want to partake, that is their choice and we move on to other options. For me, I enjoy providing as many options as possible and letting each patient decide.”


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