## What is a D.O.?

If you're like most people, you've been going to physicians ever since you were born and, perhaps, were not aware if some or all of them were osteopathic physicians, also known as D.O.s. You may not even be aware that there are two types of physicians in the United States… D.O.s and M.D.s.

The fact is that both D.O.s and M.D.s are fully qualified physicians licensed to prescribe medication and perform surgery.

### DOs and MDs are Alike in Many Ways

- Students entering both D.O. and M.D. medical colleges typically have already completed a four-year bachelor's degree, with an emphasis on scientific courses.

- Both D.O.s and M.D.s complete four years of basic medical education.

- After medical school, both D.O.s and M.D.s obtain graduate medical education through internships, residencies and fellowships. This training lasts three to eight years, and prepares D.O.s and M.D.s to practice a specialty.

- Both D.O.s and M.D.s can choose to practice in any specialty of medicine, such as pediatrics, family medicine, psychiatry, surgery or ophthalmology.

- D.O.s and M.D.s must pass comparable examinations to obtain state licenses.

- D.O.s and M.D.s both practice in accredited and licensed health care facilities.

- Together, D.O.s and M.D.s enhance the state of health care available in the U.S.

D.O.s, however, belong to a separate, yet equal, branch of American medical care. It is the ways that D.O.s and M.D.s are different that can bring an extra dimension to your health care.

### The Osteopathic Approach

For more than a century, osteopathic physicians have built a tradition of bringing health care to where it is needed most:

- Approximately 60% of practicing osteopathic physicians practice in the primary care specialties of family medicine, general internal medicine, pediatrics, and obstetrics/gynecology.

- Many D.O.s fill a critical need for physicians by practicing in rural and other medically underserved communities.

In addition, these modern-day pioneers practice on the cutting edge of medicine. DOs combine today's medical technology with their ears to listen caringly to their patient's concerns, with their minds to view their patients as whole persons, and with their hands to diagnose and treat patients for injury and/or illness.

D.O.s practice a “whole person” approach to medicine. Instead of just treating you for specific symptoms or illnesses, they regard your body as an integrated whole.

Osteopathic physicians focus on preventive health care.

D.O.s receive extra training in the musculoskeletal system...your body’s interconnected system of nerves, muscles, and bones that makes up two-thirds of your body mass. This training provides osteopathic physicians with an excellent understanding of how an illness or injury in one part of your body can affect another.
Osteopathic manipulative treatment (OMT) is incorporated into the training and practice of osteopathic physicians. With OMT, osteopathic physicians use their hands to diagnose illness and injury, and to encourage your body’s natural tendency toward good health. By combining all other available medical options with OMT, D.O.s offer their patients the most comprehensive care available in medicine today.

Taken from http://www.osteopathic.org/osteopathic-health/about-dos/what-is-a-do/Pages/default.aspx

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## What is Applied Kinesiology? (AK)

Applied Kinesiology (A.K.) is a system using muscle testing as a functional neurological evaluation. The methodology is concerned, primarily, with neuromuscular function as it relates to the structural, chemical and mental physiologic regulatory mechanisms. A.K., which originated within the chiropractic profession, is an approach to clinical practice, with multidisciplinary applications.
Applied Kinesiology can be divided into two distinct parts.
First, it is an aid to diagnosis. Muscle testing is used to help diagnose what is functioning abnormally. This can be a problem with the nervous system, the lymphatic drainage system, the vascular supply to a muscle or organ, a nutritional excess or deficiency, a problem with the cranial-sacral-TMJ mechanism, an imbalance in the acupuncture meridian system, or a host of other problems. Testing individual muscles is an accurate manner for determining what affects the relative strength of the muscle and, when combined with knowledge of the basic mechanical and physiological functioning of the body, this helps to more accurately diagnose the real problem.
Second, is the treatment phase. Dr. Goodheart, and others in the International College of Applied Kinesiology, have adapted different treatment methods for the problems that have been diagnosed. Nutrition, chiropractic manipulation, osteopathic cranial techniques, acupuncture-meridian therapies, myofascial techniques, nervous system coordination procedures, and some of the latest theories in medicine involving control of the vascular and neuronal systems may be employed to balance the malfunction found in the patient. Applied Kinesiology borrows from many different disciplines and, through the use of accurate, scientific muscle testing, in addition to the basic knowledge of the practitioner, helps direct the care to exactly what the patient's needs are.

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## What is Acupuncture, and what can I expect?

Acupuncture is a tradition used for health maintenance for 5,000 years in Eastern medicine. More recently, the World Health Organization has identified 41 conditions that lend themselves to acupuncture treatment. The National Institutes of Health has noted acupuncture's utility in adult post-operative and chemotherapy-related nausea and vomiting, post-operative dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma. The needles I will be using are approximately the width of a hair. Most people feel a slight sensation when the needle is inserted. However, the degree of sensation is not directly correlated to the effectiveness of treatment. Some patients fall asleep during the needling, and still have very satisfying treatments. All patients note that this discomfort is transient. However, they also note the sensations of "ease", "heaviness", "peacefulness," "calmness", and "wholeness" remain. The number of needles used varies, and can be as few as 4. Sometimes needles are left in for several minutes, sometimes they are taken out right away. It all depends on the type of treatment, and how your body responds to treatment.

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## What is Functional Medicine?

Functional medicine is a patient-centered approach to health care that addresses the underlying root cause of disease. It looks at the interactions between genetic, environmental, and lifestyle factors that can influence health. Functional medicine acknowledges that chronic disease is almost always preceded by a lengthy period of declining function in one or more of the body systems. For example, a patient may receive diagnosis of diabetes today, but the metabolic dysfunction may have been progressing since years prior. Rather than mitigating symptoms, functional medicine seeks to restore health by restoring balance and function to the body systems involved.
The functional medicine model best addresses the healthcare needs of today, because our society is experiencing a sharp increase in the number of people who suffer from complex, chronic diseases, such as: diabetes, heart disease, cancer, osteoporosis, mental illness, and autoimmune disorders. These complex conditions are not necessarily best treated by the “A pill for an ill” model. Evidence of this is the fact that the United States has, by far, the most expensive health care system in the world, based on health expenditures per capita, and yet statistics continue to rise. One hundred million Americans are currently being treated for degenerative lifestyle diseases at a cost of more than 700 billion dollars per year! Tragically, despite these alarming costs, the health of Americans is not improving.
A common misconception is ‘that disease is a part of aging’. The fact is that disease is not caused by age alone. Commonly, as we age, functional imbalances occur which eventually result in disease. This can be prevented! Functional medicine examines the following core clinical imbalances that underlie expression of disease:
Hormonal imbalances.
Neurotransmitter imbalances.
Detoxification imbalances.
Cellular function imbalances.
Digestive, absorptive and microbiological imbalances.
Immune and inflammatory imbalances.
Structural imbalances (from cellular to whole systems).
Functional medicine is not alternative medicine. It is evidence-based, clinically sound model medicine that effectively addresses the origin of disease.
The Basic Principles of Functional Medicine are:
Addressing the whole person... genetics, environment, and lifestyle.
Understanding unique biochemical individuality.
Addressing the web-like interconnections of internal physiological factors.
Viewing health as a positive vitality, not merely the absence of disease.
Functional medicine envisions longevity with an optimally functioning body. Addressing your health with this health care model can not only add years to your life, but also add life to your years!

How Is Functional Medicine Different than Conventional Medicine?
The Institute for Functional Medicine Vice-Chair, Mark Hyman, M.D., with whom Dr. Ehle has worked, explains the difference between conventional medicine and functional medicine, using the example, from his own practice, of a young girl with severe autoimmune disease. While the conventional medicine approach suppresses the inflammation in this patient, functional medicine asks and addresses the question of why the inflammation exists in the first place, and looks at the scientific drivers (causes) of the disease, which include toxins, infections, allergens, stress, and poor diet.

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## What is Prolotherapy?

Prolotherapy, which is short for “Proliferative Therapy,” is a technique designed to treat laxity (looseness) of joints, due to injury or aging of ligaments and tendons. Ligaments are the structural “rubber bands” that hold bones to bones in joints. Ligaments can become weak or injured, and may not heal back to their original strength or endurance. This is largely because the blood supply to ligaments is limited, and, therefore, healing is slow and not always complete. To further complicate this, ligaments also have many nerve endings and, therefore, the person will feel pain at the areas where the ligaments are damaged or loose. Stretched, lax ligaments cause chronic stimulation of these pain fibers. This is the underlying cause of many chronic pain syndromes that do not respond to conventional approaches. This technique triggers an acute inflammatory response in the tendons or ligaments, causing them to thicken and strengthen, pulling the joints and bones back in line.
Prolotherapy is an injection treatment method used to strengthen weakened ligaments and tendons. It is also used for connective tissues that have been overused or injured by common sprains, strains, sports injuries, musculoskeletal pain, disc degeneration, or common aging. This treatment is proven to be successful in stimulating fibroblast activity which causes new collagen.
This is a non-surgical treatment, for patients who do not want surgery or to be dependant on pain medication, that stimulates the body’s own healing mechanism, resulting in the rejuvenation and strengthening of tendons, ligaments and joints. Patients with shoulder pain, wrist pain, elbow pain, and knee pain, have found prolotherapy to be effective.
This is carried out with a high concentrate solution of dextrose (sugar), which is injected into the weakest point of any of these structures… where ligaments or tendons attach to the bone. Studies have shown these dextrose injections have no effect on blood sugar, and are not a risk for patients with diabetes. There is an important difference between acute and chronic inflammation. Chronic inflammation is an underlying cause of most diseases, including cancer, arthritis, and heart disease. Acute inflammation is our body’s natural response to infection or injury, and promotes healing. Local inflammation will cause increased stimulation, blood supply, and a flow of nutrients to the affected area. Then, it causes the tissue to repair itself. Prolotherapy produces this acute form of inflammation, which releases growth factors and induces an inflammatory reaction, which stimulates the normal repair and healing processes of the body. Chronic inflammation kills…acute inflammation cures. There is usually some increased pain for a few days after the treatment. This is treated with ice pack application and oral Tylenol. Anti-inflammatory medications should not be used after the injection. These include aspirin, Advil (ibuprofen), Aleve (naproxen), and other “NSAID” prescription medications. The body needs time to heal after each injection; therefore, the injections are administered, typically, three to four weeks apart.
How quickly the body responds depends greatly on individual lifestyle, dietary habits, and the severity of the injury. Smokers, for instance, may not have optimal results. The response to treatment varies from individual to individual, and depends upon one’s healing ability. Some people may only need a few treatments, while others may need 10 or more. The benefits can include a marked reduction in pain, and increased function that can last months or years.
The technique of prolotherapy was originally developed in the 1930s, and fully developed by Dr. George Hackett in the 1950s. This elegant, but simple, technique has grown dramatically in its popularity, due to its effectiveness.
You may drive home after treatment. Fees depend on the site or body part. Prolotherapy is considered experimental treatment, and is not covered by most insurance companies, including Medicare. It is usually reserved for problems that haven’t responded to traditional methods, including medication, physical therapy and cortisone injections.

You may visit www.GetProlo.com or http://doctorreeves.com for further information.

The Video below is of Dr. Fields, a physican, with whom Dr. Ehle worked with, while on a medical mission to Honduras.

Here is a video produced by Dr. Jose Barreto, another physician, with whom Dr Ehle worked with in Honduras regarding research in Prolotherapy.

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## What is Integrative Medicine?

The Defining Principles of Integrative Medicine

1. Patient and practitioner are partners in the healing process.
2. All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body.
3. Appropriate use of both conventional and alternative methods facilitates the body's innate healing response.
4. Effective interventions that are natural and less invasive should be used whenever possible.
5. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.
6. Good medicine is based in good science. It is inquiry-driven and open to new paradigms.
7. Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.
8. Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.

What is Integrative Medicine? - Andrew Weil, M.D. from Andrew Weil, M.D. on Vimeo.

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## What do you treat?

We are a full scope family practice, taking care of patients from birth through advanced age.

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## Do you think you can help me with my health problem?

Our providers use an innovative systems approach to assessing and treating your health care concerns. Perhaps you have experienced being examined by your doctor, having blood tests done, x-rays or other diagnostic tests taken, only for your doctor to report back that “all your tests are normal”. Yet, both you and your doctor know that you are sick. Unfortunately, this experience is all too common.
Most physicians were trained to look only in specific places for the answers, using the same familiar labs or diagnostic tests. Yet, many causes of illness cannot be found in these places. The usual tests do not look for food allergies, hidden infections, environmental toxins, mold exposures, nutritional deficiencies and metabolic imbalances. New gene testing can uncover underlying genetic predispositions that can be modified through diet, lifestyle, supplements or medications.
Dr. Ehle has pioneered the use of such testing to help his patients prevent illness and recover from many
chronic and difficult-to-treat conditions. Our providers are highly skilled in evaluating, assessing and treating chronic problems such as fibromyalgia, fatigue syndromes, autoimmune diseases, inflammatory disorders, mood and behavior disorders, memory problems, Parkinson’s disease and other chronic, complex conditions. We also focus on the prevention and treatment of heart disease, diabetes, dementia, hormonal imbalances and digestive disorders.

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## What does a visit consist of?

Initial Consultation (Approx 45 minutes to 1 hour):

Holistic Evaluation
Integrative Physical Exam (may include Tongue evaluation, Pulse Diagnostics, and/or Nail assessment)
Customized Assessment
Individualized Herbal, Nutritional, Lifestyle and Supplement Recommendations
Manual adjustments as appropriate
Health Screening as appropriate
Printed Plan for course of treatment
Prescriptions as needed
Laboratory requisitions as needed (through your insurance whenever possible)
Educational materials

Follow-Up Consultations (Approx 30 min)
Includes same as initial consultation, plus reviewing recent labs, evaluating current treatment plan, etc

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## What are your office hours?

Our office is open Monday and Tuesday 8:00 AM to 6:00 PM, Wednesday 9:00 AM to 6:00 PM, Thursday 8:00 AM-4:00 and Friday 9:00 AM to 1:00 PM. We are closed from 12 pm to 1 pm for lunch.

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## Do you accept insurance?

We accept Medicare, as well as many PPO plans. Please, call us concerning your specific insurance benefits. Patients and clients with other types of insurance plans, and those who are uninsured, are welcome to come to us and pay privately.
Several of the insurances that we accept are Blue Cross/Blue Shield, United Healthcare, IMS, First Care, Cigna, Aetna, Multiplan.
* Other insurance contracts are pending. Please inquire with the office. If you have a different primary and/or secondary insurance, we will still be happy to see you and will bill your insurance company as a courtesy to you.

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## How much is a visit?

If you are using insurance then it depends on your plan, usually it will be either a copay ranging from 10-50 dollars or a percentage of your deductable. Most insurance companies will cover a physical/preventative visit 1-2 times a year at 100% for adults. For those patients paying cash the price ranges from $105-210 for a new patient, depending on how much time is spent. For established patients it ranges from $70-140.
Acupuncture is $42, only about 20% of insurance plans cover acupuncture, so you will need to check with your insurance if they do, if this is something you are interested in. If you would like to call and ask your insurance more about benefits the CPT codes that would be used are 97810-97814.
Osteopathic manipulation is usually covered by insurance, it is usually either your copay or a percentage of your deductable. If you would like to call and ask your insurance more about benefits the CPT codes that would be used are 98925-98929.

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## What do I need to bring with me at my first appointment?

At your first appointment, please, come in 15-20 minutes early. Bring your insurance card(s), and any pertinent test results or reports from imaging studies. Please, have your history forms already completed and, please, bring in your medications and any supplements you may be taking.

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## How long will the average appointment take?

The first appointment is scheduled for 1 hour, and all following appointments will be scheduled for a time appropriate to the plan of care. Usually expect at least half an hour.

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## How can I order the supplements I need?

Our team has researched the highest quality products available that meet independently verified standards of effectiveness, quality and purity. Supplements are available for purchase in the office, or online on several different sites. We can help you set up an account with Emerson's Ecologics that carry many of the supplements we recommend.

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## Prescription Refill Request

It may take up to 72 hours to process a prescription refills. Please, plan ahead to avoid any interruption in your medications. Prescription refills can be faxed to our office by your pharmacy. Our fax # is 806-340-7975.

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## What happens if I need to go to the hospital?

Dr. Ehle has hospital privileges at BSA. He works with Texas Tech Family Medicine who may also assist with your care while in the hospital.

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## After-hours Contact

After-hours calls should be limited to urgent issues and emergencies.
If you have a medical emergency, please call 911 or go to your nearest emergency room.

We are currently available for brief questions by e-mail. E-mails, which take over 10 minutes to read and reply, will be billed at the in-person consultation rate, and charged to your credit card on file. Please, do not write any urgent e-mail messages that require same-day attention. By sending an e-mail, you acknowledge and agree that a prompt reply is NOT required, expected, or contemplated.
Telephone/e-mail consultations require a credit card guarantee, which will be charged for time spent over 10 minutes, prorated in 15 minute increments.
Most importantly, never delay emergency treatment.

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## Late arrivals/cancellations

Our time is reserved exclusively for your care during your scheduled visit. We have limited visit appointments during the day due to the fact that we believe in quality care and spend an extended amount of time per patient. Keeping this in mind, it is important to ensure the best use of both your time and ours. We have a 2-business-day cancellation policy. If you cancel an appointment less than 2 business days prior to your appointment, you may be charged a fee that represents 50% of the cost of your scheduled appointment. If you cancel less than 1 business day before your appointment, or fail to show for your appointment, you may be charged a fee that represents the full cost of your scheduled appointment.

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## Email Policy

E-mail is a convenient and efficient way to communicate non-urgent requests, questions, and messages that you may have for Dr. Ehle. However, while the security and confidentiality of email is comparable to other forms of communication, there are some special conditions that apply to e-mail.
- If your email address is through your employer, your employer may own all emails sent to that address.
- If your family shares your email address, other family members may see your messages.
- If you use an Internet service provider, there is a small risk that messages may be intercepted by others (“hackers”).
The following subjects are rarely appropriate for standard e-mail:
- Any urgent medical problem or emergency
- Mental health issues
- Alcohol and substance abuse problems
- HIV and other sexually transmitted infections
Dr. Ehle does not control the security of incoming email messages from patients. Patients who choose to email personal health information do so at their own risk. Please keep in mind that although email is a very effective tool, it is not a substitute for personal visits for examination and counseling with your doctor.

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## Test results

Dr. Ehle may order lab tests as deemed appropriate in the management of your care. Dr. Ehle will review each of the lab tests ordered, and notify you if any result requires immediate attention. Otherwise, all test results will be reviewed at your next scheduled appointment. It is your responsibility to schedule a follow-up appointment to discuss test results. Results for test kits that are sent to specialized labs generally have a 4-week turnaround time, so, please, be sure to schedule a lab review appointment for 4 weeks from the time that you submit all test kits. Copies of lab results will be provided to patients at the time of lab review with Dr. Ehle.

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## Medical Records

Upon request, a paper or electronic copy of all or a portion of your medical records can be provided to you. For paper copies, there will be a $10.00 charge plus a fee of $0.25 per page. For a CD copy there will be a $10.00 flat charge.

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## Questions

What is a D.O.?
What is Applied Kinesiology?
What is Acupuncture?
What is Functional Medicine?
What is Prolotherapy?
What is Integrative Medicine?
General Office Questions:
What do you treat?
Do you think you can help me with my health problem?
What does a visit consist of?
What are your office hours?
Do you accept insurance?
How much is a visit?
What do I need to bring with me on my first appointment?
How long will the average appointment take?
How can I order the supplements I need?
Prescription Refill Request
What happens if I need to go to the hospital?
After-hours Contact
Late arrivals/cancellations
Email Policy
Test results
Medical Records