GPs must know and deepen in all specialties

We talk to Dr. Xercavins, one of the best doctors of the head.

Dr. Xercavins, do you think that the definition of a family doctor corresponds to his vocation and to his daily work?

Absolutely. This is my vocation. Knowing each of my patients and all the circumstances that may in some way influence the control and improvement of their health. And notice that I have spoken of "health", not of illness. Every doctor has the obligation to cure what is curable and to prevent what is preventable. But the general practitioner, knowing the globality of his patient, also, has the sacred duty to increase his health.

But we know that you use a lot of the latest technologies and advances. We thought this was more typical of the specialists.

The doctors of the head are unique, since we must know and deepen in all the specialties and to know each one of the branches of the medicine. And, of course, new technologies help us in this mission. Of course, we use them constantly.

But, I insist, where do you take the time to meet and care for your patients as the almost paternal family doctor before, be up to date with the latest advances and also use new technologies?

That's easy: time is out of hours. And an engine called "vocation", that to go at full speed needs its gasoline, which is the trust and affection of our patients. But, in addition, you must have effective strategies. And one of the ones I use is sharing efforts. Look, general or internal medicine is almost unacceptable. In an expression used a few years ago: "it is total". But in our medical center we are two doctors. Myself and Dr. José Mª Diéguez, who has been with me for more than 20 years. So, it is not a colleague who changes every x years or months, but is someone stable and also committed to permanence. This fact, which is fundamental, together with his great professional, makes my trust in him and that of our patients is total.. All this makes it possible to divide efforts and have more time. And so, for example, Dr. Dieguez is currently with the latest advances in biological and orthomolecular medicine and I with the latest genetic polymorphisms.And although we both know and use both sciences, Dr. Dieguez uses more biomolecular subjects for his nutritional and obesity studies, and I use genetics as a breakthrough in ultrapersonalized preventive medicine.

Are there more collaborators in your center?

Yes, there is Inmaculada Rodríguez, who is an excellent psychologist. I would say that, as we like to call ourselves general practitioners rather than internists, our psychologist can also be called "head psychologist". For his vast knowledge and for his dedication to each patient. And, as we should visit our GP at least once a year, we should also do it with our "head psychologist" to clear up doubts, minor anxieties or ask for advice.

We also have a physical therapist, Modest Rodríguez, who with his vast knowledge in anatomy and physiology and his manual techniques, chiropractic, reflexology, anatomy trains, etc., takes care of the physical part of his patients, who deeply knows his needs. We could also call it "bedside therapist". And, moreover, for some time now it has and uses the most advanced equipment Indiba Activ, Sistema Proinic, the most efficient technique in recovery and regeneration of the cell. The two have also been in the consultation for more than 15 years.

We know that within its priorities is the fight against obesity.

Certainly, for years the whole team is dedicated to this subject. It is personally directed by Dr. Dieguez, nutrition expert, with a global approach to obtain the most permanent results possible. Our therapist Modest and our psychologist Immaculate collaborate in this, when necessary. We know that every gram of more abdominal fat (the most harmful) is like a gram of more at risk. Not only cardiovascular risk, but today we also know how this fat influences other pathologies, such as diabetes and even some cancers.

He has told me that in obesity they are involved for several years, even for one gram. But in preventive medicine is always, right?

Good (smiles), where I said a gram could have said a kilogram. And think that a kilo of more in the abdomen between the fat that is seen and the hidden or visceral, is even more dangerous, is very common.

And yes, certainly, preventive medicine is something innate in our vocation. I started practicing all my patients since the beginning of my private activity more than 30 years ago. I still remember how I was a pioneer importing reagents from Germany to assess the presence of microscopic blood in feces and thus prevent or diagnose early colon cancer. This system is not only practiced the same, but has recently been approved by international medical bodies and is even offered free of charge to some patients in anti-cancer campaigns. We, in these 30 years, have saved many lives only with this way of preventing colon cancer.

I also remember when, about 25 years ago, leaving my skin economically, I imported from France one of the first Doppler devices for the study of carotids, already seeing that what I found of pathology in these arteries could also be in other proximal ones like coronary or cerebral.Also, today, top-level scientists like Dr. Valentí Fuster advise to perform a Doppler ultrasound of those arteries as screening in a cardiovascular checkup.

And, at the moment, has already launched to some other newness in preventive medicine?

Naturally. They do not usually spend two years without introducing new or renewing existing equipment. To give an example, in recent months we have introduced a new Swiss team that determines the antioxidant capacity of the patient, fundamental to preserve good health.Also a cardiovascular monitor Health Wirelles and a device that measures the arterial elasticity, both very effective to prevent or to control atherosclerosis. And we are already valuing other new equipment.

Give me a small example of how you can improve your health with these technologies.

Well, an easy one. Everyone talks about cholesterol. Even on TV it is said that it does not exceed 200. Well, some experts say that the most harmful thing is not the total amount of cholesterol but its fraction LDL, the so-called "bad cholesterol", is high but especially oxidized. With our oxidation test and by determining oxidized anti-LDL antibodies, we can see if that cholesterol fraction is oxidized or not. And if it were so, deoxidizing it, we can improve health and prevent cardiovascular processes more effectively than reducing only total cholesterol. We could almost say that it is better to have a slightly high cholesterol but with its LDL fraction not oxidized than the other way around.

And among so much science, does naturist medicine fit?

Precisely today the naturist medicine can already be totally scientific. That is, today, with those advances biomolecular, genetic, etc., we can give base and scientific criterion to the naturist medicine. We already use it in this way in an approximate 50% of the cases. In fact, we like and we identify with the so-called "integrative medicine", which includes conventional medicine and natural medicine, the latter with its scientific basis. We are finishing a book with the development of these topics in order to share our knowledge.

Finally, give us some advice to improve our health.

It's easier to give you 100 tips than one. But I give it a multiple that, of course, can have its exceptions: breakfast well, and always with protein. Dine little and never with sweets. And go up all the stairs with which you are.

Always resolve your health concerns with your primary care physician. Trust him and reward him as if he were someone in your family.