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October 26, 2006

Why Is Disease Prevention Treated Like a Conflict of Interest?

Meeting with Elizabeth Edwards yesterday was an honor.  She gave all of us the feeling she really cared about us and the entire community.  I have no idea how she found time to meet with us. As an influential, bright, passionate person -- and amazing listener -- we had a strong feeling she would act on behalf of the communities' needs.

I have a medical system comment that I wish I'd mentioned to her, since she is clearly a woman who can make some waves in health care, as she knows the system due to her breast cancer battle.  She mentioned trying to fix the inflexibility in making medical appointments.  She used the example of having to schedule a mammogram months in advance, only to find the appointment couldn't be kept due to campaigning or other things that inevitably come up.  Prevention, apparently needs to be scheduled.  There is no such thing as a drop-in mammogram for a busy working mom. Elizabeth also mentioned how hard it is to take care of yourself as a working mom and how health can take a back seat until it forces itself to the unwelcome forefront of your life.  A few of us who'd had our own health battles could very much relate to that.

I'm now a nutritionist who has helped reverse chronic health conditions in dozens of people, and I just have to wonder why most doctors don't think nutrition, and more broadly, prevention is worth their time. Since they only take one course in basic nutrition, and do not have time in an office visit to go into principles of healthy nutrition or illness prevention, I think MDs need to practice alongside a nutritionist or dietitian who does have the time and education to discuss these things.

I'm not just talking about primary care physicians and pediatricians. A nutritionist needs to be in every school. I'm also talking about any specialty where science supports a nutrition connection: gastroenterology, oncology, neurology, rheumatology, otolaryngology (ENT), and psychiatry/psychology.  Since if we missed the boat on prevention in the first level of health care (like I did), we can get another chance when we see a specialist.

Even the best MDs seem to only act as gatekeepers for surgery and drugs -- which is what they are licensed to do -- but since we hold doctors in such high esteem, it inflates the idea that these are the only ways to address medical problems.  Doctors* and patients alike seem to live by the old adage, "If it ain't broke, don't fix it."  But we are dying because of this and living longer lives with appallingly-reduced "quality of life."  The U.S. spends the most per capita on health care, but our life expectancy ranks a lowly 48 among the countries in the world.  Almost all European countries, Canada, Singapore, Japan, and Hong Kong rank far ahead of us.  We suck at health care. Health care spending in the U.S. is like trying to nail Jello to a wall. Incidentally, our consumption of Jello and other sugar-filled, nutrient-poor foods is one of the main causes of poor health in this country.

Why, I ask, is our vested interest in fixing people causing prevention to be treated like a conflict of interest? It should be the prime directive of medicine!  I know it's quite complicated with HMOs, no real Invisible Hand guiding the market dynamics, big pharma marketing, FDA, insurance entitlement, and lack of personal responsibility/accountability, etc., but when the entire country ends up with chronic illness and cancer, who will take care of us then?  Rates of autoimmune disease, allergies, and asthma are all up versus 100 years ago, and cancer incidence has doubled.  Can our healthcare please be outsourced to Andorra, the highest ranking country for life expectancy?

Elizabeth Edwards, thank you for inspiring this post.

Here are a few other books that might be of interest, most of which, like the other books I've posted above, are heavily referenced with published studies in major medical journals:

The 100 Year Lie, Seeds of Deception, Nutrition & Physical Degeneration, Nourishing Traditions

*Enoch and other ER and Urgent Care docs excepted, for obvious reasons.  Clearly, showing up in the ER is a fix-it time, and not a time to talk prevention...

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