Practicing Neurology the Old-Fashioned Way
Jan 01, 2017 08:56PM
● By Kate Morgan
Dr. Charles Yanofsky
Charles S. Yanofsky, M.D., has been practicing neurology for nearly four decades, so he knows a thing or two about diagnosis. As treatment in the hospitals he’s worked in became more streamlined and increasingly dependent upon quick diagnoses, Yanofsky found he was forced to spend less time than he’d like with each patient.
That’s where Yanofsky got the idea for his private practice, Second Look Neurology, in Camp Hill, as a return to an “old-fashioned” style of medicine; no office staff, no insurance companies—just a patient and doctor, one-on-one.
“The idea is a direct link between the patient and the doctor, without any interference from insurance companies,” says Yanofsky. “I was in private practice for many years, and when I began working as an employee, I found there were barriers erected between the patient and doctor. This is an experiment in taking some of those barriers down.”
The majority of Yanofsky’s patients at Second Look have received a diagnosis from another medical professional, and come to Yanofsky seeking a second opinion. He’s able to devote a great deal of time to each individual patient, and with 35 years of diagnostic experience, he is often able to offer deeper insight into a patient’s condition and treatment options.
“At bigger offices, I can only devote a certain amount of minutes to patient contact, and with some, maybe that suffices,” says Yanofsky. “Here, I can devote as much time as I need. I can do a little bit more of a detailed assessment and maybe come up with something a little more out of the box.”
Yanofsky first entered the field of neurology through an interest in psychiatry. “I was interested in how people think and what makes them have certain behaviors,” he says. “I found that if I went into psychiatry, I’d be throwing away my stethoscope. I went into neurology because I decided I was more interested in the physical aspects of thought and interaction. I am still interested from the psychiatric standpoint, and sometimes it proves fruitful.”
That interest in psychology and psychiatry drives Yanofsky to understand each patient and their medical needs as distinctly individual. “Some things involve really understanding the patient from a psychological standpoint and seeing their medical problems in that context,” he says. “A patient with migraine headaches may not show any obvious physical cause, but maybe they’re working too hard or stressed about pleasing a spouse, not sleeping or sleeping erratically. Quite often, I see people with pain in multiple parts of their body. Sometimes there’s a physical reason for the pain, but sometimes it’s happening because the patient is somaticizing some psychiatric process.”
Yanofsky says patients experiencing symptoms with no obvious physical cause are often relieved when he is able to diagnose the problem, whether it’s psychological or physical. “Some people who come to me have gone from physician to physician and continued to complain about the pain,” he says. “So they’ll go to still another physician, see one rheumatologist, then another. They get tests on top of tests. They get tested for Lyme disease 10 times, tested for neurological diseases. Sometimes it’s time to stop doing all these medical tests and find out what’s really behind the symptoms they’re having. Some people don’t like that, because I’ll be frank with them. I’m not afraid to say, ‘We can’t identify anything organically there. It’s time to put a stop to constantly going to doctors.’ That alone is very helpful to say.”
Yanofsky considers Second Look Neurology, which he launched in 2015, an experiment in health care and a return to a time when the doctor/patient relationship was unencumbered by insurance company premiums and long waits for an appointment.
“This is an experiment to see if the old-fashioned kind of practice still plays some role,” Yanofsky says. “Eventually, it probably won’t play any role because we’ll have scans that make a full diagnosis and automatically cure your disease. For right now, it’s still an interaction between patient and doctor.”
Kate Morgan is a frequent contributor to Natural Awakenings magazine.