T Nation

What's Wrong with Doctors

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Sadly, how true! I have had this said to me (althogh not 70 pounds, more like 30-40). I had abs at the time. When I tried to explain to the doctor about muscle actually weighing something and how some people have bigger frames/wider shoulders/heavier bones etc than others, she looked very confused and flustered.

The thing that bugs me the most about doctors is that if your attitude is “Sorry, I don’t think you understand. I want to be healthy WITHOUT medications or surgery” they are completely clueless and useless.

I ran into this a few months ago when I was diagnosed with gallstones (the symptoms being episodes of upper abdominal pain every several weeks). Once the problem was identified, all they could offer me was gallbladder removal sugery. Which apparently is not a Huge Deal, but it’s one of my organs for God’s sake… unless I’m in constant excruciating pain or my life is in danger, I want them! They were just way too casual about cutting things out.

So I did my own research, and made an attempt at improving the conditions that lead to stone formation… and with some diet and supplement modification (general improvement and cleanup of diet, and throwing in some milk thistle, extra vitamin E, choline and lecethin), I haven’t been having pain, and when I went in for follow-up blood tests last week my liver function tests, which had been highly elevated at the time of my diagnosis, were almost down to normal. To top it off, when the doc gave me some dietary recommendations they were mostly the opposite of what I’ve been doing!

Bottom line is, if you really want to be healthy, it’s in your hands… I appreciate the docs being there for their diagnostic work and diagnosis, which was truly valuable. But as far as treatment goes, you should always second-guess them and do your own research to determine what’s best for you.

Nick

The Medical industry is geared towards making money from medical problems. Don`t be surprised if prevention is not on national medical priorities.

Medical schools made a mistake when they left nutrition/natural preventative off the cirruclum long time ago when they switched to chemical treatments. D.O. (Doctor of oestopathic) is probably a better choice at least for primary care as they take more of hollistic approach (think Dr Mercola). My mom is very lucky to have such a caring doctor from what she told me. Her doctor doesn’t believe in precribing medications to just fix the symptoms but try to look for underlying cause to the problem. Drug companies are such a HUGE business and i wouldn’t be surprised if there are incentives for MD doctors to precribe as much medications as possible for extra money. One classic example is drug cholestrol lowering statin which is ABSOLUTELY unnecessary. High cholesterol has no direct correlation to heart disease at all but it doesn’t stop the drug companies from making statin. They prey on clueless people and make billions of dollar. That’s right. BILLIONS of dollars just on statin drugs. I truly believe that majority of health problems are fixable by just changing the diet. It all started when we started eating processed food 100 years ago and it’s getting worse every year. The book called Nutrition and Physical Degeneration by Weston A Price is a valuable book wriiten 50 years ago. If we had relied on this book, our overall health would be much better than it is now in this country. 50 freaking years ago!!! They didn’t believe it at that time and it turns out that Dr Price was right after all when he predicted that we would have all kinds of problems due to processed food at that time. This country is run by greedy people/businesses that have no regard for our health. Look at the food at grocery stores… 90% are processed junk!

Bottom line, folks: doctors are not all-knowing. In fact, some of the ones I work with are complete idiots. They couldn’t diagnose their way out of a wet paper sack. Good for you Nick, that you didn’t have to have surgery. But understand, most (99%) people don’t want to or are intimidated by the thought of being responsible for their own health. Doctors are just people, like you and me. There are brilliant ones, funny ones, assholes, and morons. They just drive better cars. :slight_smile:

Now there gents, lets not write off the entire medical community! I also had a good laugh last year when I was determined to be morbidly obese and at severe risk of dying from diabetes according to the BMI (Body Mass Index). At this point I was in the best shape of my life and even gave myself the nickname of Fatboy to make a joke of the results. But the truth is, people who take care of themselves and who train hard are usually not part of the “norm”. And as such, the normal tests for measuring obesity and health risks don’t apply to us.

Back to my point about Doctors though, they’re not all quacks. I found one who works out at my gym and who understands the problems that are common among athletes. In terms of medical advice I couldn’t be happier. My suggestion would be that if you’re tired of your current physician then dump him/her and find a sports med doctor or a doctor who works out in your gym. You might have to shop around a little, but I guarantee there’s one out there somewhere.

Dinomite

As frustrating as it seems no matter what physician I take my children to, and almost no matter what for it’s

1)Listen to chest
2)Look in ears, nose, throat
3)Prescribe antibiotic
4)Come back in a week if not better

Agreed, there are some who truly care for their patients still, but there’s nothing worse than a physician who makes you feel like you’re holding him up for his tee time.

I thought I might provide a little perspective from the inside. I will be the first to admit that there are good/bad doctors (remember, the guy that graduates last in his class is still called doctor), but this is true with every profession. For the record, I’m a chiropractor and I have an undergraduate degree in exercise phys. and have add’l post-graduate cert. in clinical nutrition. Therefore, in my practice, I treat musculoskeletal problems, educate the patient on the condition, prescribe rehab and exercise, and can give nutritional advice regarding any other condition they may have in additon (if they are interested)to the muscskel problem.
Here are some of the problems I see with the current healthcare system.

  1. The medical system is great at treating emergencies but is not designed to promote optimal health. The so-called preventative health services are mostly aimed at early detection or earlier intervention.

  2. Everyone wants top quality healthcare, but no one thinks they should have to pay for it.

  3. Most people do not take responsiblity for their health (what do you mean I have to eat healthy and exercise, stop smoking and cut back on alcohol, can’t you just give me a pill?
    I also like the diabetics that don’t watch their diet and eat like shit and take an extra insulin shot to make up for it.)

  4. Most doctors do not take enough time with their patients, and therefore do not get to know them well enough to develop a good relationship.

  5. Most doctors have no formal education in nutrition or exercise, any unfortunately do not take it upon themselves to learn. If you don’t have any knowlege of anything to help a condition other than prescription meds, what do you think you will recommend? Public demand for nutrition advice and alt. treatment is growing.

  6. Many doctors instead of saying they don’t know or that’s a good question and they’ll research it a little to try to find an answer, will just dismiss your idea.

  7. The pharmaceutical companies market directly to patients, so they show up and ask the doctor to prescribe them that medicine they saw on tv with all the old people smiling and dancing.

  8. The pharm companies are supposedly having to scale back on their pimping to doctors offices. I know that there are some MD’s on this site so they could better tell you. But from what I’ve seen/heard, drug compaines can track every script that a doc writes. Doc X writes 100 scripts for celebrex, the vioxx rep show up at his office with lunch, tickets to events, etc, and says let me tell you about the studies we’ve done on vioxx. Often the drug companies sponser weekend seminars in nice vacation areas, within walking distance of the closest high end golf course etc. and pay the docs to go to them. Now I’m not saying that would cause the doc to write more scripts for the company’s products, but if TC invited you out to Colorado Springs, treated you like a king, and gave you some T-jack, are you more likely to buy GROW or Myoplex.

I could go on and on, but this has been to long already. My advice is to shop around. If your doc herds you through like cattle and doesn’t listen to what you have to say or isn’t open-minded, find on who is. Also, have both an MD and a DC as they will complement each other well. As far as DC’s go, find one that specializes in sport’s med and does myofascial release as well as stretching, rehab and the adjusting. If on the first visit the doc tells you that you need full body xrays (and there hasn’t been significant trauma) and that he will need to see you 3 times wk for 6 mo because you have a subluxation, find a different chiropractor, you can tell him I said he is full of shit.

As always, if you guys have any questions, please feel free to ask. I will be glad to provide any info I can. I can’t really diagnose over the internet, but I can help limit the poss. and make recommendations I think might help.
Now if I would stop spending so much damn time on this forum and treat some more patient’s maybe I could drive one of those nice cars, one of the previous posts mentioned.

uh…chiropractor = doctor?

[quote]drryan wrote:

  1. Everyone wants top quality healthcare, but no one thinks they should have to pay for it.

  2. Most people do not take responsiblity for their health (what do you mean I have to eat healthy and exercise, stop smoking and cut back on alcohol, can’t you just give me a pill?
    I also like the diabetics that don’t watch their diet and eat like shit and take an extra insulin shot to make up for it.)

[/quote]

The biggest problem I see with health care in the US is that 2 and 3 are the same thing, but there’s no way people are going to act like it.

IMO “paying” for health care doesn’t just mean laying out cash, but also paying the price in time and energy to live a healthy lifestyle.

I will be looking for health care in the near future, as the coverage I had from my university runs out in September. It scares me to think that when I am paying for health care I’ll be subsidizing a bunch of lazy jerk offs. I wish there were health care plans that catered to people who do their best maintain reasonable standards of health and go out of their way not to use the health care… but there’s no way to keep lazy irresponsible people honest when they go home, and I just can’t see universal health care in the US if people don’t shape up and stop insisting on every stupid drug they see on TV.

Nick

I agree with both Lothario and Dr(Jack?)Ryan. MD’s generally have attitudes because the general public diefies them so much. Don’t even get me started on surgeons.
I think everyone gets a little snotty when their secure world gets blown up. To use an example that applies to board members: I get bitched at every time I write an article that contradicts current dogma. We just have to keep an open mind and take everything for what it is, nothing more.
(What the hell am I talking about anyway?)

jdbtensai
A doctor (derived from the middle English word doctour, meaning teacher), by definition is one who is skilled or specializes in healing arts and is licensed to practice, especially physicians (by which chiropractors are classified by the government for medicare and insurance reimbursment),dentists, and vets.
DC=doctor of chiropractic
MD=doctor of medicine

If you would like more information regarding the education of chiropractors compared to medical doctors, please feel free to look at the Agency for Health Care Policy and Reasearch web-site or txchiro.edu for the curriculum of the DC program. Suffice it to say, the “doctors=MD’s” that either are my patient’s or refer patient’s to me are confident that I am a doctor.

Other posts:

If my previous post left any impression that I was speaking only of MD’s, I apologize. I was trying to make the point that much of society does not take responsibility for their health and instead rely on doctors to fix everything with a pill, etc. I also agree with the post about “paying” being more than money, but also effort. Unfortunately we live in an instant gratification society where people have no patience and expect everything to happen quickly or with little effort. Many people do not want to change their diet and exercise as this requires discipline, hard work and personal responsibility (which is rare in this country, it is so much easier to blame everything on someone else). However, they will make the excuse that they have no time to work out etc, but if their TV was powered by riding a bike, obesity in this country would drop in half in a month.
As a doc, it is frustrating when you spend 30 min talking about diet, exercise or you give patients rehab exercises to work on at home, and then they come back later with the same problem and you ask them about the exercise, etc, and they say they haven’t had time or blah blah. I usually will jokingly give them the line from Jerry Macguire “Help me, Help you”

The biggest key for patients/doctors is communication. The doctor is there to help you, and if you have questions or comments, speak up. Educate yourself as much as possible and get the doc’s advice. Don’t expect the doctor to know everything about nutritional supps, etc. However, if possible,if you have questions about it, provide a copy of the article/research etc and ask their opinion. If the doctor is unwilling to look at it, then get a new doctor. There is so much new info that comes out daily, so one can not be expected to know everything, however, if they are presented with the information that could help their patients and do not care to learn, that is a problem.

Another factor to consider why docs don’t recommend more nutritional supps, is the rash of malpractice lawsuits. If a doc rec. something outside the typical standard of care, even if it is more effective and less dangerous, and god forbid the patient should have some problem, even if unrelated to the rec., the doc would be at risk for lawsuits, since they did not follow the standard of care.

Take care

From experiences I found EMS personnel (MICT, MECS, EMT B-I-&P) to be better at diagnosis, prevention, and treatment in areas that doctors take more credit for. That’s pretty bad.

I used to joke around at work that if you found a good doctor, you found a doctor who used to be an EMT.

your proof for this being?

peer reviewed epidemiological data is ok for this.

tia

[quote]cycomiko wrote:
Tungsten wrote: High cholesterol has no direct correlation to heart disease at all

your proof for this being?

peer reviewed epidemiological data is ok for this.

tia

[/quote]

I think the most convincing evidence of this is the fact that all the commercials for cholesterol lowering drugs specifically state that the drugs have not been shown to prevent heart disease or heart attacks. No joke, and to double-check this I went to http://www.lipitor.com and right at the bottom of the front page it says this.

So, dogma says that high cholesterol leads to heart disease… So lowering cholesterol should reduce heart disease, right? But the manufacturers of drugs that lower cholesterol say this has no effect on heart disease.

W. T. F??? Something doesn’t add up. And I don’t think I’m being a smartass or unreasonable for coming to that conclusion.

I always like to remember that the same medical community that tells us cholesterol is so evil told us to eat margarine (trans-fat) instead of butter because it’s low in cholesterol. HAHAHAHAHAHAHAHAHAHAHAHAHAH!!!
HAHAHAHAHAHAHAHAH!!!

Nick

[quote]The_Incubator wrote:
I think the most convincing evidence of this is the fact that all the commercials for cholesterol lowering drugs specifically state that the drugs have not been shown to prevent heart disease or heart attacks. No joke, and to double-check this I went to http://www.lipitor.com and right at the bottom of the front page it says this. [/quote]
So your saying that a disclaimer on a statin website is proof that lowering cholesterol doesnt reduce risk (you understand what risk implies dont you?)

have you actually read any of the meta-analyses published about statins etc? usually around 30% reduction in coronary events and 12-15% reduction in strokes.

Strange innit

[quote]I always like to remember that the same medical community that tells us cholesterol is so evil told us to eat margarine (trans-fat) instead of butter because it’s low in cholesterol. HAHAHAHAHAHAHAHAHAHAHAHAHAH!!!
HAHAHAHAHAHAHAHAH!!!

Nick[/quote]

so now your comparing dietary cholesterol to blood cholesterol levels. Butter has trans, as well as saturates, margering can either have lots of trans (usual;ly the hard margerines or shortnings) or it can have nil trans (usually soft margerines/spreads)

[quote]cycomiko wrote:
The_Incubator wrote:
have you actually read any of the meta-analyses published about statins etc? usually around 30% reduction in coronary events and 12-15% reduction in strokes.

Strange innit
[/quote]

Depends on what a “coronary event” is. I’m weary of euphamisms. What’s the improvement in mortality rates?

Well, doctors and general dogma constantly make the connection between dietary cholesterol and blood cholesterol. I don’t buy that. At least, I don’t believe that dietary CHOLESTEROL is very relevent. I do believe DIET is relevant.

What I am really getting at is, I find it ironic that the same medical community that is so wild about reducing blood cholesterol would advise people to consume fats that have detrimental effects on health (Eat margarine! It has no cholesterol!) when in fact hydrogenated fats have the exact opposite effect on cholesterol than what is considered desirable (increase LDL, decrease HDL).

The rise of heat disease rates has corresponded with the rise in the use of hydrogenated oils in foods. The evidence of the detrimental effects of trans-fats, and particularly hydrogenated oils, has been there for years, but well placed lobbying and intimidation by the companies that produce hydrogenated oils has naturally caused the medical community and the government to roll over with their ass in the air. It’s just that now the evidence has mounted too high and the tide has turned.

If you think there is one Key or Magic Bullet for heart disease, I would put my money on hydrogenated oils. That stuff is literally poison. It is not food, and it has the nasty effects on heart health that blood cholesterol levels get all the blame for.

Nick

sorry dude, don’t buy it.
i’ve seen the hours studied, etc. before. but i just don’t buy it.
well…as far as doctor=healer goes i don’t buy it.
i think someone with a phd deserves to be called doctor, but that’s a different issue.

separate question…
why do chiropractors always call themselves Dr. Name? is that because without saying “Doctor” no one else would think to call them that?

[quote]The_Incubator wrote:
cycomiko wrote:

The goal of cholesterol reduction is not reduction of mortality from any cause, its to reduce the mobidity associated with Cardiovascular or cerebro-vascular disease (peripheral vascular disease isnt as affected by cholesterol as the other two)

however, some of the meta-analysis do show a decrease in overall mortality from any cause of ~15% (ie relative risk of all-cause death (RR, 0.85, 95% CI, 0.81, 0.89, *p < 0.0001) or a nonsignificant decrease in non-cardiovascular deaths, but thats ok.)

[quote]Well, doctors and general dogma constantly make the connection between dietary cholesterol and blood cholesterol. [/quote]THere is a connection, but its also tied into saturated fat intake as well, makes things a little less cut and dried than most doctors (who are not exactly nutrition experts) would generally comment on.

[quote]I don’t buy that. At least, I don’t believe that dietary CHOLESTEROL is very relevent. I do believe DIET is relevant.[/quote]Dietary cholesterol is relevant in some people at a certain level, which is the main reason for the population recommendations, but its not important for normal healthy people. Saturates (or more specifically the hyper-cholesterolaemic ones) are more of an issue, as well as fruits, vegetables, other fatty acid consumpion (like n-3 reduce risk via many mechanisms but usually reduction in risk of thrombogenesis) and potentally certain vitamins, like b6, b12 and folic acid. Coronary/cerebro vascular diseases are not the cause of one single thing, they are multi-factorial. Reducing blood cholesterol is one easy method to reduce risk, but its not hte only way as resarch is pointing to a ton of other potential areas, which one day may make an awsome test (at the moment it looks like certain lipoprotiens + inflammatory markers + potentailly homocysteine, create a awsome test (and moderately cheap - cholesterol being the cheapest, homocystine relatively cheap and hs-CRO requiring specialised equipment usually), with huge power to measure risk.)

[quote]What I am really getting at is, I find it ironic that the same medical community that is so wild about reducing blood cholesterol would advise people to consume fats that have detrimental effects on health (Eat margarine! It has no cholesterol!) when in fact hydrogenated fats have the exact opposite effect on cholesterol than what is considered desirable (increase LDL, decrease HDL).[/quote]Try not to confuse hydrogenated fat with trans fat. And try not confuse margerine with trans fat. Like all things it depends. Other research has shown changing butter for margerine (even the higher trans fat) actually results in an improvement in lipoprotein status. Sure it can be more with a low trans margerine, but thats not hte point.

[quote]The rise of heat disease rates has corresponded with the rise in the use of hydrogenated oils in foods.[/quote]Is that a claim from one of the odd websites or results from an epidemiological study?
Strange thing about the introduction of hydrogenated oils is that the western population started eating more of everything and started doing a lot less of everything else.

They got fat and lazy

[quote]If you think there is one Key or Magic Bullet for heart disease, I would put my money on hydrogenated oils. [/quote]its multifactoral, trans fat is only one part of teh overall picture

[quote]That stuff is literally poison. It is not food, and it has the nasty effects on heart health that blood cholesterol levels get all the blame for.

Nick[/quote]

Hydrogenated fats are not poison, well at least wouldnt be classed as a poison in moderate dosages. The typical american intake of large quantities is a completely different picture. Its one part of an overall picture, and its not obscuring the blood cholesterol effect at all. It had an awful blood cholesterol effect, but its also pro-inflammatory (as is saturates) and potentially pro-carcinogenic amongst others.

Im not defending margerine or trans fats at all, its just taking them within the big picture is also important.