Internal medicine with a focus on chronic fatigue-related illness, including ME/CFS (chronic fatigue syndrome) and fibromyalgia, in the Salt Lake City area
Further information
Philosophy
This practice involves the use of traditional medical treatment, however the importance of learning about and being open to treatments and approaches that have not yet reached mainstream practice is also recognized. In medicine it is wise to avoid extremes. Efforts should be made to scale back or stop medications that are causing adverse effects or are not providing a justifiable benefit to a patient. At the same time it is often necessary to use medications in cases where lifestyle changes (such as changes to diet, exercise, and sleep habits) may be insufficient to correct a problem.
A healthcare provider should never be satisfied that he or she knows everything about his or her field of expertise. I take time to look things up when it is felt that further information is needed. In this way clinical knowledge continues to expand and ability to help those with challenging problems continues to increase.
How are evaluations conducted?
Generally, the patients treated in this practice do not have routine problems that are easy to diagnose and/or treat by a primary care provider. When new patients are (or were) being taken, the approach has been to perform a thorough, detailed evaluation and come up with an initial plan. Typically a full morning or afternoon has been set aside for a patient's first visit to be able to go through the several individual issues that may be present (eg, body pain, headaches, fatigue, cognitive issues, difficulty with standing, sleep problems). Doing a thorough assessment at the first visit is a more efficient approach for addressing complicated health problems than going through multiple visits and learning of different parts of a patient's illness in a piecemeal fashion. Typically several treatments that have been considered are laid out, and then a smaller number of measures selected to start out with. At the second visit, further information may be gathered and the treatment plan further developed. This visit often extends beyond an hour but is generally shorter than the first visit. During these initial visits, significant time is spent in helping patients learn about their condition and discussing treatments.
Responses to different treatments range from no effect (or adverse effects) to dramatic improvement. It is usually better to work on treatments in a stepwise fashion. The number of things done at each visit should balance the need for making progress with the need to know whether each individual aspect of the treatment is working or not. Sometimes, brief follow-up between visits by telephone or email may be planned to discuss adjustments in management. It is important to have realistic expectations regarding the progress of one's treatment, and to follow treatment recommendations to determine which ones are helpful.
What is not routinely treated
As a specialist in internal medicine, Dr. Holladay does not treat young children, although he may treat adolescents, particularly those with chronic fatigue or widespread pain issues. He do not typically perform obstetric (pregnancy) or gynecologic (female-specific) or surgical care. Although he may address issues such as diabetes and hypertension in the overall context of treating patients, he usually does not serve as a primary care provider.
A primary object of this practice is to evaluate unexplained pain (particularly fibromyalgia and related issues). This practice is not a typical "pain clinic" (one that specializes in prescribing opioid / narcotic medication and interventions for issues such as back pain). Other clinics have specific expertise in managing these types of pain-related issues. However, if you are experiencing some form of pain and wish to have it evaluated, please feel free to call and discuss this.
Insurance coverage
At this point unfortunately Dr. Holladay is limited in the insurance that he takes. If you have a question as to whether he can work with your insurance, please call. However, rates are reasonable so that when insurance does not cover the visits, patients may hopefully still be able to afford to come in. Rates can be explained in greater detail by telephone.