Informed Consent for Integrative Health Care

     As a physician who is Board Certified in Internal Medicine, I recommend traditional medical intervention to diagnose and treat your physical and emotional condition whenever I think it is indicated as the best approach to your individual situation. However there are circumstances in which I may suggest natural or holistically oriented methods as a complement to primary medical care. These complementary (holistic, complementary, natural and alternative are used interchangeably to describe an approach other than conventional) modalities may be suggested as an adjunctive service to support your physical, emotional and spiritual well being. Part of this approach uses natural products and lifestyle improvements such as breathing clean air, eating natural foods oriented to your needs and sensitivities, drinking plenty of fresh water, exercising appropriately and finding ways to minimize the ill effects of stress in your life by using techniques such as biofeedback, meditation, yoga, visualization or psychotherapy to name a few. Herbal products, homeopathic remedies and nutritional supplements may also be recommended. Other practitioners such as acupuncturists, chiropractors or massage therapists may also be suggested depending on your needs. However, just because a modality or product may be more natural than a conventional medicine doesn’t mean that there isn’t a possibility of uncomfortable side effects or other untoward reactions. Aggravations from homeopathic, herbal and nutritional supplements are not uncommon and are a signal that the dosage or frequency with which it is taken may need to be changed or the product may need to be discontinued altogether, just like with conventional medicines. In most cases, complementary medical advice should not be confused with medical care of a disease condition. The holistic methods suggested by me should be seen as a way to improve your overall health, not necessarily as a primary treatment of disease.
     I have found in my many years of practicing medicine that while choosing the appropriate modality of healing is very important and may even be crucial, the most powerful force that can determine your well being is within you. Your attitude, your willingness to be honest with yourself, and the strength of your desire to get well are of the utmost significance. I will not only rely on science for my suggestions, but also on both my and your intuition and common sense. It is in this light that I wish to join with you as a professional partner so that together we can help you formulate a personalized health program for yourself.

     I (the patient) understand that I have been informed as to the limits of Holistic and Complementary health advice and by applying my signature to this document I understand that you (Dr. Kafka) do not promise to cure my condition, that my participation is voluntary and may be discontinued at any time by my choice. I agree to actively participate and communicate with you in any course of action that I choose to initiate or complete. You agree to do the same.

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Patient                                                           Date

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Kenneth R Kafka, MD                                        Date