Why might doctors not routinely check heart rate variability?
Written by
David Nelson
Reviewed by
Prof. Graham Pierce, Ph.D.During my wellness consultations, many clients inquire about why their doctors do not routinely measure their heart rate variability during medical checkups. This reflects a fundamental difference that I have observed in clinical medicine and the preventive health approaches I have advocated throughout my medical career.
Medical practice tends to design check-ups around diagnostic tools for existing conditions. Standard cardiac exams are mostly focused on immediate concerns, such as arrhythmias or blockages. Tracking HRV lends itself to preventive optimization rather than disease identification, which, again, would not typically be part of clinical protocols.
Time Constraints
- Appointment limitations: Standard visits allow 15-20 minutes
- Priority triage: Acute symptoms take precedence
- Wellness focus: Requires extended consultation time
Reimbursement Systems
- Billing codes: Insurance covers diagnostic not wellness metrics
- Treatment focus: Pays for interventions not prevention
- Documentation burden: Extra measurements increase administrative load
Specialization Divide
- Cardiology scope: Focuses on structural not functional issues
- Autonomic expertise: Requires neurology collaboration
- Referral patterns: Functional practitioners handle optimization
Interpretation Challenges
- Context dependence: Requires lifestyle history understanding
- Variability factors: Numerous influences complicate analysis
- Standardization lack: No universal clinical reference ranges
Wellness practitioners fill this gap effectively. Functional medicine practitioners and health coaches commonly use HRV. I integrated it in client evaluations to identify autonomic nervous system control strain even before symptomology developed. This proactive process complements clinical care.
Bring HRV data to meetings deliberately. When I see a situation that alarms me, I would want a client to share months of sequences with their doctors. The evidence of these patterns warrants a more comprehensive investigation of autonomic function, which is probably not possible during an ordinary visit.
Read the full article: Heart Rate Variability Explained Fully
