I’ll quote heavily from an article called “Heart Disease and Lifestyle: Why Are Doctors in Denial?” bemoaning the fact that “In a randomized controlled trial of primary prevention, no cardiologist would want to be compared against a good physical trainer or nutritionist. We would get trounced. Our calcium scores, biomarkers, pills, and procedures would not stand a chance. The study would be terminated early due to obvious superiority of lifestyle coaching over doctoring…”
The writer, a medical doctor, complains that: “I write a post about new oral anticoagulant drugs or statins or AF ablation, and people (doctors) pay attention. You see it in the traffic. It’s the same story at medical meetings: sessions on drugs and procedures draw the crowds. Late-breaking studies rarely involve the role of exercise or eating well. Exercise, diet, and going to bed on time have no corporate backing. The task of drawing attention to the basics is getting harder, not easier.”
The writer takes the words right out of my mouth saying: “I believe the collective denial of lifestyle disease is the reason cardiology is in an innovation rut. This denial is not active or overt. It is indolent and apathetic. Bulging waistlines, thick necks, sagging muscles, and waddling gaits have begun to look like normal.”
He argues that: “Our tricks can no longer overcome eating too much and moving too little. We approach health but never get there. If you waddle, snore at night, and cannot see your toes while standing, how much will a statin or ACE inhibitor or even LCZ696 help?” (LCZ696 is a new two-drug antihypertensive being studied.)
The writer even admits that: “In fact, a reasonable person could make an argument that our pills and procedures might be making patients sicker.”
The doctor, an electrophysiologist, further states that: “My practice is dominated by atrial arrhythmia—a disease now recognized as being due (in large part) to excesses of life, such as obesity, high blood pressure, sleep disorders, and overindulgence in alcohol. In other words: unnecessary. I make hundreds of dollars putting a hundred burns (ablation) in a left atrium for a disease that a poorly paid physical trainer might prevent or treat.” This has become cardiology writ large. But the thing I cannot get over is that I am doctor, not a proceduralist. I am tasked with helping people be well. I fail in that task if I ignore the most effective and safest treatment option. I fail if I take the easy path. The prescription pad is easy. The EP lab is easy…New anticoagulant drugs are easy. Ablation technology is easy. Statins are even easier. The truth—nutrition, exercise, balance in life—is hard.”
The very day I read the above article, while doing a CME (Continuing Medical Education) course about atrial fibrillation one of the doctors said he wanted to make it immediately clear that “First, there is almost nothing we cure in cardiovascular medicine, and AF is not a curable disease.”
Both these doctors agree they are doing nothing for cardiovascular disease but neither make the leap and say how to improve the situation. They are in denial because they didn’t learn anything about preventing disease in medical school. They didn’t learn that Big Agra foods cannot sustain us – so we eat and eat and eat and get fat but we don’t get nourishment. They may admit their drugs aren’t working but they still prescribe them. They give drugs to young people who have magnesium-induced anxiety and make their lives miserable for decades until they find the answer themselves. If they do give prescriptions for magnesium, it’s for the highly unabsorbed magnesium oxide that can actually precipitate IBS in the susceptible.
Medicine is at a crossroads leaving patients in the cross hairs of an uneducated profession that is too arrogant to admit that they have no solutions for chronic disease.
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Carolyn Dean MD ND
The Doctor of the Future™
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