If you’ve glanced at the cover of a magazine or watched TV news anytime in the past 12 months, you know that healthcare reform is causing a major buzz these days. Most of that talk revolves around who pays for healthcare and how. But bubbling just under the surface, there’s another debate about the way American doctors approach patient care.

Birmingham doctor Jim McMinn ascribes to an integrated approach to medicine. "Ultimately there’s one thing that trumps science, and that’s the patient," he says.

“I feel sometimes that in traditional Western medical practice, your toolbox is too limited,” says James. E. McMinn, M.D. McMinn operates Total Wellness clinic in Homewood. “You mainly use drugs and surgery. Someone comes in with a problem, and here’s some Motrin, here’s some Lortab, or go see the surgeon.

“I think some folks are just tired of taking pills,” he says.

McMinn advocates a different approach. McMinn practices what he calls “functional medicine” – a combination of evidence-based Western medicine along with alternative therapies such as massage, acupuncture and homeopathy.

“I think the big difference is I try to gather the best of both worlds in my practice,” McMinn says.

This being our annual Women’s Issue, an astute reader might note that McMinn is not a woman. In fact, he is a middle-aged man who has practiced medicine for 20 years and served on the faculty of Harvard Medical School and Brown University School of Medicine. But McMinn is included in this issue because 90 percent of his patients, he estimates, are women.

Many of those women come to McMinn’s clinic because he offers something many American doctors do not: bioidentical hormone therapy. Hormone therapy is used to treat night sweats, hot flashes, fatigue, “brain fog” and the many other symptoms of menopause. Pharmaceutical companies have been offering synthetic (but not bioidentical) hormone replacement drugs like Premarin and Provera for this purpose for many years, and they’ve been extremely popular. In fact, in 2001, Premarin was the best-selling drug in the U.S.

“When I was a young doctor, everyone who came through got Premarin or Provera,” McMinn says. “The mantra was ‘They’re going to live longer and feel better.’”

But there was a problem – a 2002 study found that the drugs were causing blood clots, heart attack, strokes and breast cancer. In response to that study, doctors lowered doses but kept prescribing the drugs. And they ignored the bioidentical hormones that doctors had been using successfully in Europe for nearly half a century. Why?

“You can’t put a patent on a human hormone,” McMinn says.

He explains: “Here’s the important difference: If I was to take a woman’s blood and look at a molecule of her progesterone and compare it to, say, Provera , they would look like different molecules. Provera isn’t found anywhere in nature, much less in the human body, but we’re putting it into the body because it has progesterone-like effects. Whereas the bio-identical progesterone is exactly 100 percent identical to the patient’s, so the body knows what to do with it.”

“All I use is the bio-identicals,” McMinn says. “And I’ve had just a fantastic response to them, from women who have suffered for years and years.”

No doubt Oprah Winfrey has been the most prominent advocate of bio-identical hormone treatments. An episode of her program that aired in January, titled “The Great Debate: Should You Replace Your Hormones?” initiated a conversation that has continued in the pages of O, The Oprah Magazine and on Winfrey’s popular website, with thousands of women asking new questions not only about bioidentical hormone treatments but all kinds of hormone replacement therapy.

But McMinn isn’t merely following a trend in providing bioidentical hormone treatments. It’s just one part of his integrative practice. In addition to bioidentical hormone therapy, the Total Wellness clinic provides a wide range of procedures, from standard physical exams, minor operations and health screenings to acupuncture, intravenous vitamin and nutrient therapy, smoking cessation and detoxification. He also provides many services for men, including testosterone therapy and treatment for erectile dysfunction. In May, McMinn is opening a new facility that will expand his capabilities to include yoga and other services.

“We’re going to have a world-class wellness center right here in Birmingham,” he says.

McMinn moved to Birmingham with his wife and children 12 years ago. His parents grew up in Alabama. “When I was growing up this was always home, but we moved around a lot,” he says. His parents eventually retired to a farm in Anniston, prompting McMinn to move from Boston to Birmingham.

“We decided to move on down to Alabama to be closer to the family, so our kids could enjoy their grandparents, but also because we love this Alabama weather,” McMinn says. “Birmingham’s a wonderful city, we love it here.”

No matter where he practices, he will offer women and men alike medical options based on what is effective and just what is easily available, he says.

“We get up on our high horse in science, and look down on other people and say they’re not scientific,” he says. “But ultimately there’s one thing that trumps science, and that’s the patient.”

“If it works for the patient, that’s what really matters.”

To learn more about bioidentical hormone therapy and other women’s health services, visit www.totalwellnessmd.com.