DOCTORS DIVERSIFY herbs to support my treatment. I emphasize exercise, stress reduction, sleep hygiene and other lifestyle modifications to improve long-term health and mitigate disease flares. I offer counseling and coaching to help manage stress and pain, promoting overall well-being. I make referrals for acupuncture, massage and physical therapy to help with balance and mobility, reduce pain and support healing. Integrative rheumatology seeks to offer a more comprehensive approach to managing chronic conditions, acknowledging that factors such as trauma, stress, diet and emotional well-being significantly influence disease progression and symptom management. I am now able to offer my patients the care I envisioned while training at the Mayo Clinic.
In my new practice, I’ m also seeing a growing number of individuals experiencing other, not strictly rheumatologic or autoimmune, but still complex conditions, including fibromyalgia, central sensitization syndrome, hypermobility disorders, mast cell activation syndrome, chronic fatigue syndrome, complex regional pain syndrome, celiac disease and irritable bowel syndrome— conditions that frequently result in substantial functional impairment, loss of independence and reduced quality of life. Most of these patients are not referred to me; instead, they find me on Google. Many of them complain of joint pain, stiffness and fatigue, yet often are declined a rheumatologic evaluation or not offered a diagnosis. Many tell me they feel like a“ nuisance,” labeled as“ hypochondriacs” who go from specialist to specialist, often without a unified, comprehensive treatment plan. Their symptoms are real, and their suffering is real. Many travel out of state for treatment or find themselves seeking cures from alternative providers, who frequently use expensive, often unnecessary testing and dubious therapies but also offer them their time and validation. These patients have been marginalized and traumatized by our health care system, often dismissed, underdiagnosed or inadequately managed due to training gaps, inconsistent clinical guidelines and system barriers that prevent thorough evaluation. These patients are burned out, just like their doctors. While research continues to evolve in many of these areas, established clinical frameworks— particularly for conditions like fibromyalgia and chronic fatigue syndrome— offer decades of research backed guidance for identifying and treating these patients. Without insurance constraints and with longer visits, I can utilize these evidence-based approaches and target various disease components through structured, research-informed care that enhances patient outcomes. and respect for patient experiences. And, time with their doctor. But making this transition requires support.
Medical schools need to integrate entrepreneurship, business fundamentals and exposure to alternative career paths into their curricula. Students should learn that medical training opens doors to a diverse range of opportunities, not just traditional employment. Medical societies and professional organizations should provide mentorship programs connecting established physicians with those exploring nontraditional paths. For physicians considering these paths, my advice is simple: start where your passion aligns with the patient’ s needs. What aspects of health care frustrate you most? Your solutions to these problems may become the focus of your innovation. Build business skills through courses or mentorship to complement your medical expertise. Network with other physician innovators and maintain clinical connections to stay grounded through patient needs. The future of health care depends on physician-led innovation and a return to the private practice model of health care. We possess the clinical expertise, systems thinking and patient advocacy skills necessary to address health care’ s most pressing challenges. Every physician who launches an innovative practice model, develops a health care technology or influences policy, creates a pathway for others to follow. We’ re not abandoning medicine— we’ re expanding its definition and reclaiming our role as leaders in health care. The health care system that trained us is broken, but we have the tools to fix it. The question isn’ t whether physicians should pursue non-traditional roles— it’ s how quickly can we create the support systems necessary to enable this transformation? The time for physician-led innovation is now, and the only question remaining is: will you be part of the solution?
References
1
Changes in Burnout and Satisfaction With Work – Life Integration in Physicians and the General US Working Population Between 2011 and 2023
2
Shanafelt, Tait D. et al. Mayo Clinic Proceedings, Volume 100, Issue 7, 1142- 1158 https:// www. mayoclinicproceedings. org / article / S0025-6196( 24) 00668-2 / fulltext
3 https:// www. va. gov / wholehealth /
Dr. Pinkston is a rheumatologist and practice owner of Whole Health Rheumatology.
My practice is still in its infancy, but I have a vision and mission. My mission is to provide patients with trauma-informed, compassionate and evidence-based care, along with actionable resources that support their health care journeys. These resources include condition-specific treatment strategies and support, all designed to enhance both daily functioning and long-term health outcomes. For them to live longer with a better quality of life requires coordinated care built on a clinician-patient partnership characterized by mutual trust, shared decision-making
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