How Come My Doctor Doesn’t Know All This?

“How Come My Doctor Doesn’t Know All This?”
My journey to becoming an integrative medicine doctor.

I remember the first time a patient asked me if she could take a multivitamin. She handed me the small white bottle with a conflicted look on her face, and I concernedly stared at the ingredients. I didn’t know the answer, and I remember my bated breath and the low feeling of shame when I told her that I didn’t know. After all, I should have known, I was a 2nd year resident in internal medicine and these were basic vitamins and minerals which are naturally found in the human body!

Now, fast-forward 10 years and I’m the sole owner of The Integrative Center for Health & Wellness, a concierge integrative medicine practice established in 2010 that specializes in menopause, wellness, and anti-aging medicine. Most of my patients are self-referred and find me online. When I think about the struggle, the years, and the accomplishment–it almost moves me to tears. But if it was so tough, why did I do it? And how did I leave the safety and security of what I learned in medical school and residency? What motivated me to start studying medicine all over again from a holistic perspective, instead of settling in a well-paying job that I was already trained to do? After being board-certified in internal medicine, why would I potentially risk being called a quack by my colleagues and society at large?

I regularly share an abbreviated version of my journey with my menopausal patients. I do it one-on-one during my educational workshop “How to Have a Luxurious Menopause & Postmenopause.” When women are suffering with menopause symptoms for years, and then hear my unique view of menopause and the alternative treatment I prescribe, unless I enlighten them on how I came to think differently, I will invariably hear or sense the heavy question, “How come my doctor doesn’t know all this?” I will now share my explanation with you too.

As a child I was always thinking deeply and asking A LOT of questions, and I still do. After high school, I attended the University of California, San Diego, and got a double major in Biochemistry and Philosophy. I have the philosopher Ayn Rand to thank for the latter decision, as she taught me that whether conscious or unconscious, a person’s ideas shape his or her life–and I was determined to be conscious of my ideas. Then while applying for medical school, I worked as an Emergency Medical Technician for both an ambulance service and the UCSD hyperbaric chamber. And, in order to further mesh my knowledge of mind and body, I also went to massage therapy school.

I attended medical school at the Technion, in Haifa, Israel. While there, my mom’s personal trainer recommended I read a book called Eat Yourself Slim, by Michel Montignac. Amazingly, I followed the low glycemic index (GI) diet described in the book and lost the 15 pounds I had gained in college! My results motivated me to do more and more research about the glycemic index, and I discovered it could also improve blood sugar levels. So, as a young intern physician, I actually prescribed a low GI diet to one of my diabetic patients and he lost 20 pounds and decreased his insulin by 50% in the first month! I was stunned. I was so happy for my patient. And I was hooked. Never again would I downplay the importance of nutrition on the health of the human body.

Another pivotal experience I had in medical school was the healing of my own chronic foot pain, from which I suffered since an Ultimate Frisbee injury in college. One of my grandmother’s friends, a retired pain clinic director with whom I shared my chronic pain story, handed me Dr. John Sarno’s book, Healing Back Pain, The Mind-Body Connection. He was an old wise man, but I remember telling him, “Oh, you think it’s all in my head.” Much to my incredulity, reading this book actually resolved my pain!

During my residency in internal medicine at Highland Hospital in Oakland, CA, I really didn’t have much time to devote to anything else except survival, but I always knew in the back of my mind that at least two things which I didn’t learn as part of my conventional medicine curriculum, had helped improve my health, and the health of my patients. I continued to recommend a low GI diet to all my diabetic patients, and I remember actually rushing to my diabetic patients’ rooms early in the morning to swipe their high-glycemic muffins from their “diabetic” meal tray. But, it wasn’t until towards the end of my training that I came to finally see that the medications I was prescribing to my patients, although life-saving when used acutely, weren’t curing any chronic diseases. This realization left me feeling empty and impotent, so I started looking online for alternative solutions to my patients’ problems. Somehow I found the American College for Advancement in Medicine (ACAM) and they paid my way to attend one of their conferences. I remember I was a little nervous about going. I actually half-heartedly feared I would find a bunch of doctors sitting cross-legged on yoga mats with chickens flying around. What actually happened was that I met a group of intelligent maverick doctors, who all had left the conventional medical community to some extent in an effort to better help their patients, and who all seemed very happy. I was relieved and excited to have found another way to be a great doctor!

I took six months off after residency, both to recover from the sleep deprivation, and in order to read more than one hundred books and articles about nutrition, vitamins, minerals, bioidentical hormones, and more. During that time, I also attended about 10 alternative medicine workshops and conferences, including the 2006 Institute for Functional Medicine’s six-day intensive, Applying Functional Medicine in Clinical Practice. When my money ran out, I got a part-time job at the VA urgent care in downtown Oakland, but on nights and weekends I started practicing integrative medicine at a small clinic I opened. I also shadowed integrative medicine doctors whenever I could, and worked part-time at San Francisco Preventive Medical Group. Then I worked at Cenegenics and the Hall Center, where I concretized my understanding of the power of hormone replacement in both men and women, and also learned how much a physician’s business model impacts patient results. Ultimately, I discovered that the concierge model of practice, where I could deliver medical care and coaching in the context of unlimited communication – unlimited emails, unlimited phone calls, and unlimited office visits, worked best for achieving and maintaining optimal health in my patients.

Now, at the age of 40, I am a wife, a mother to two miraculous children, and a concierge integrative medicine doctor. I cherish these accomplishments and feel grateful for my life every single day. As you can see, my achievement didn’t happen by accident, and it didn’t happen overnight. It took an idea, and then ongoing deliberate thought and action for years–which is what doctors have to do in order to change the way they practice medicine.


concierge-medicine-event-July-2014

Dr. Shira Miller lecturing at The Concierge Medicine Event in Costa Mesa, CA. July, 2014.

  • Danny

    After 10 years of battling with high blood sugar, no supplements made a dent in my readings. A change of diet and daily walks are the only things that help me keep an acceptable blood sugar level without any Meds.

  • Joey b

    Hey doc, my total t is only 210. Free t is 39.1. Estrogen is in range. Im 39 and done arr few steroid cycles. My last pct wasnt that strong… Will 500ius 2x week for 3 weeks followed by clomid 50 mg for 4 weeks. Help to bring back my t and keep it. What you think. Thanks