Practitioner Question of the Month – September 2018

Can probiotics cause SIBO

Sunja asks,

I recently virtually attended a SIBO conference and the consensus was not to use probiotics in those with SIBO.  This seems to run counter to what I have heard you recommended. What is your stance on probiotics in SIBO?

This is a contentious issue.  However, I feel the statement ‘one should not use probiotics in SIBO’ is untenable.  I recently answered this question in our weekly video. Essentially, you can only come to this conclusion if you cherry-pick the data.  It’s not to say probiotics will be well-tolerated by all, but clearly, they are a top consideration. Detailed here.

Is your practice legally defensible?  

My office recently went through an audit to ensure we are not violating any regulations.  The main area where this is open to interpretation is telehealth. Here are a few key points to investigate if you have not already:

• You are only performing visits through a HIPAA compliant platform for telehealth visits, we currently use Zoom
• You are using the appropriate disclaimers and informed consents for telehealth patients/clients
• You are not billing insurance for out of state telehealth patients unless the patient has been seen once per year in person
• You have an extra set of disclaimers in your paperwork and in your recommendations for any out of state patients not being seen in person, once per year
• You make sure to distinguish that you are not practicing conventional medicine, unless you are also offering/practicing this, to patients when they seek you out for functional medicine

Some of the informed consents and disclaimers feel to be a bit of an overkill, but in today’s litigious society, it is better to be safe than sorry.

If you have found this information helpful please share with a friend using this link: https://drruscio.com/review/

I’d like to hear your thoughts or questions regarding any of the above information. Please leave comments or questions below – it might become our next practitioner question of the month.