It’s time to take another look at what sort of “medicine” is being used to treat patients, a New Jersey doctor says.

Earlier this month, PremierMD opened its fourth Garden State location at 88 Park Avenue in Nutley, adding to its offices in Bridgewater, Morristown and Hoboken.

According to David Boguslavsky – a family physician and medical acupuncturist who has been practicing for more than a decade – the office in Nutley follows the same model as the other locations, blending traditional family medicine with Chinese herbal therapy and other complementary techniques, such as homeopathic injections.

Boguslavsky, who is originally from Russia, moved to New Jersey at a young age, later earning a medical degree from Robert Wood Johnson Medical School and completing his residency training at Somerset Family Practice, where he was presented with multiple “Resident Teacher of The Year” awards. He underwent additional training in medical acupuncture at UCLA Helms Medical Acupuncture Institute in Berkley, California.

Boguslavsky and his nurse practitioner, Kayla Yanga, now put this blend of Western and Eastern medicine to work for their patients with acute illnesses such as headaches and sinus infections, as well as chronic conditions like thyroid issues, hypertension, diabetes and high cholesterol. Some patients leave their visit with a script for medication; others are treated with Chinese herbal medicines.

Boguslavsky said he’s also been embracing another outside-of-the-box treatment for patients with Treatment Resistant Depression … a ketamine-based drug called Spravato.

Not quite ketamine – a Schedule III drug regulated under the Controlled Substances Act – esketamine is better known as Spravato. This derivative of ketamine – which has some key differences from its close cousin – is produced as a nasal spray, which is used together with an antidepressant taken by mouth. It’s used to treat patients with depression who have previously received at least two antidepressant treatments that did not work well.

Because of the risk of adverse outcomes resulting from sedation and dissociation caused by Spravato administration, and the potential for abuse and misuse of the drug, it is only available through a restricted distribution system under a Risk Evaluation and Mitigation Strategy, the U.S. Food and Drug Administration notes.

“As you know, ‘using psychedelics in medicine’ is definitely having its moment in 2024, but of all the options being considered only one, Spravato, is already studied enough to win FDA approval – and to be covered by most insurances, including Medicare and Medicaid, which we accept,” Boguslavsky told Patch.

“Traditional antidepressant medications have been a life-saver for many patients over the decades they’ve been around, but somewhere between 30 percent and 40 percent fail to see a meaningful reduction in the severity of their symptoms,” Boguslavsky said.

“Stronger medications like antipsychotics or electro-shock therapy, have also been tried for these patients, but often the side effects of treatment prove to be intolerable,” Boguslavsky added. “This high number of patients who don’t respond well enough to traditional approaches are the ones for whom Spravato makes the most sense.”

“Our patients come for treatment once or twice a week and, often, see a rapid reduction in their symptoms of depression,” Boguslavsky said, adding that patients often describe the experience as a “dark veil being lifted.”

“This poetic description points to the chemical changes inside the brain that allow our patients to look at their life in a brand-new way, one that doesn’t zoom in on all the negatives, but instead recognizes the beauty and dignity of life one can always find if they look for it,” he said.

The philosophy of working “outside the box” is also embraced by other staff members at PremierMD.

“I am proud to be a nurse practitioner in a primary care practice that does things differently,” said Yanga, who added that patients often appear on their doorstep “deeply dissatisfied” with their previous health care encounters.

According to Yanga, it’s all to common for patients to encounter a clinically cold “web of phone calls and internet

interactions” before getting into a doctor’s office, where they are often prescribed a medication – sometimes without being examined – and are quickly escorted out the door after they pay their bills.

“To add insult to injury, this deeply unsatisfying experience is so expensive that even with health insurance, a medical visit can often be so expensive it pushes a family into debt,” Yanga said.

“No nurse practitioner or doctor begins their career dreaming of delivering care this way,” Yanga continued. “Instead, we all aspire to become a trusted confidante to our patients, to be someone our patients can count on to ease their burden of suffering. But instead of living out these dreams, clinicians are harnessed to the revenue-generating machine that is modern medicine.”