Starred! Great post and Great Info!!

"The average training in nutrition for a physician in a 4 year medical school program is 2 1/2 hours."

This was my point exactly. The nutrition that is taught to doctors is rudimentary and short lived, at best, and yet the general population follow the advice of their doctors ignorantly.

-Dev

This is just me personally but I think doctors have to know enough as it is. They should just stick to the needles and diagnostic work, and leave diet and nutrition to those who specialize it. Nutrition and dieting is so complicated that I think that is one thing that doesn't also need to be dumped on a doctor. But a doctor should also have the capability to easily refer to someone to a nutrionist, and that person should also be covered by insurance.

As someone who's powerlifted and trained others for nearly 10 years I think I know as well as you that the problem isn't lack of education. It's lack of giving a crap by nearly everyone.

If I never got paid by the hour doing personal training and nutritional advising, I'd end up cutting myself. Doctors get paid by the visit and they don't have all day to listen to people pretend to be interested in dieting and then have them go home and eat an entire cake.

You know how stupid and lazy people are. Even if they shell out a couple grand over a long period of time, ultimately, unless fitness is a serious hobby, they'll quit in short order.

Maybe doctors don't spend a lot of time directly on nutrition but I'm sure during their education they end up coming across more than enough to be qualified to give advice. Even if there was such a thing as a PhD in nutritional science and all doctors had one, I would wager any money it wouldn't matter.

The majority of America isn't obese because of anything to do with doctors or lack of trying on their part.

[edit on 17-9-2008 by ANoNyMiKE]

Double Post


[edit on 25-9-2008 by DevolutionEvolvd]

Originally posted by DevolutionEvolvd
So here we have a doctor who DID know about the benefit of nutrition as a medicine but chose not to inform his patient of such treatments.

So my questions to you, fellow ATS members, are:

1) Why aren't medical doctors given more nutritional training?

2) If some doctors are well educated on the topic, why do they dismiss it and resort to drugging their patients instead?

3) Is there a conspiracy here?

It is unfortunate that most people will believe what a man(or woman) in a lab coat tells them simply because of a few letters after their name.

I think a lot of the answers to these questions have been given already, but I'd like to add my take on it. I'm in an undergraduate pre-health professions program; I'm interested in going on for a Ph.D in biochem or molecular bio, but must of my fellow students are planning on being doctors. Also, since the program is designed for post-baccs (people with B.A.s in other fields who are missing the science requirements) we tend to be older than most undergraduates.

I would say that, for one thing, my fellow students are very health-conscious personally. They are as well-educated in nutrition and exercise as any group of people I've ever met. And by and large they focus on health maintenance, not medication. In their personal lives, at least, they are very interested in organic foods, herbal supplements, vitamins, etcetera.

The second thing is that, although doctors may get very little specific nutrition training in med school, we are taught in biology and in anatomy&physiology an awful lot about how the body uses what we put into it. It's not very useful information in terms of recommending a diet to someone, because we don't learn that much about what foods have which nutrients, and even less about how to combine them into a diet that will be satisfying to eat. But it does count as nutritional training. As it happens, I just read last night the chapter in my anatomy&physiology text that discusses ketosis and ketoacidosis, so I was prepared for this thread to pop back up today

I think people who write off the medical profession as a bunch of pill-pushers are missing a change that's going on within the medical profession. More people now are aware of alternative medicines and of the dangers of pharmaceutics; particularly educated people with an interest in health. If that is true in the general population, don't you think it would be even more true among those who have decided to spend their lives studying health?

Instead, people assume that all M.D.s are tools of the giant pharmaceutics companies and are uninterested in anything but making money. The truth is that medicine (aside from a few areas, like elective cosmetic surgery) is not a very good way to make money, especially considering how much training is required. And doctors are, for the most part, genuinely interested in helping people feel better, and stay better.

One thing that has been brought up several times in this thread, and that I think remains a problem, is that doctors do not have enough time to spend with patients. They certainly don't have enough time to determine whether the person they're working with is going to be able to stick with a strict diet. We lie to our doctors all the time, so they assume that we're going to lie to them.

Also, we as consumers have been taught by the pharmaceutic companies and the media, to believe that anything less than perfect physical and mental health is a sign that something's wrong with us, and that the way to fix it is a pill. Heck, we even take our vitamins and supplements in pill form! People don't actually go to the doctor's office to hear "yeah, you're sick. Drink a lot of water, take some Vitamin C, and you'll be better in a couple days." If they hear that, they say "well, I could have figured that out myself" without stopping to realize that the doctor has done his/her job by assessing the patient and deciding there's nothing to worry about. But a patient would rather walk out with pills in hand, because then they feel like they "got something" for their time.

Sorry for the rant. But I do think that there is an image of the medical profession that was probably accurate in the sixties and seventies when alternative therapies started to spring up, that is becoming less accurate with every new class out of med school. Doctors may still have huge egos, but they're much more likely to know something about nutrition (and other health-maintenance strategies) than they were twenty years ago.

I absolutely agree about the bureaucracy and the rules also.

He very likely could not recommend echinacea because it is not FDA approved. But one of the reasons that it is not FDA approved is that the companies that sell it don't want to jump through the hoops needed to thoroughly test it, and also don't want the restrictions on marketing that would apply if it was approved as a medicine.

So, why can't he recommend it even though it's not FDA approved, the same way he could recommend something like drinking more water? Because if something went wrong (and I know it doesn't happen as often with herbs as with lab drugs, but it does happen), he would not be covered by insurance when the patient (not that you, specifically would; but many do) sues him.

Not that we should do away with malpractice laws, either: I read the thread started by nineeyedeel in this forum today Doctors that cut off parts of people's bodies without obtaining consent should be sued for all they have, banned from ever practicing in any health-related field, and probably have the same part cut off.

But it is absurd when a doctor can't tell a patient that echinacea might work for them because on the one hand the big Pharma companies are guarding their turf and on the other the natural supplements companies are guarding theirs and avoiding regulation, and meanwhile the insurance companies and lawyers are checking every move he makes to make sure there is no potential liability. Not to mention having to spend at least as much time trying to deal with insurance company/HMO paperwork as he can allot to the patient.

I know that doctors are not blameless in this, but I really believe that the attitude of "doctors are tools of the Pharma companies" is counterproductive to any real change in how our health care choices are made. There are doctors calling for FDA reform, and criticizing the AMA for cowtowing to Big Pharma. But when they look to potential allies in that struggle, and basically have their faces spat in, as many as 10 years of really intensive training completely belittled, and an average (as of a couple years ago) of $100,000 in school debt forgotten totally by people who are convinced that they're just in it for the profit, it's not surprising if they react by closing their minds.

I don't know what the solution is, and I really do believe that we're on the right path -- that mainstream medicine is moving away from the idea that a pill is always the right way to go. Twelve years ago I worked as a secretary on the oncology floor of a major teaching hospital. While I was there, one of the ongoing studies was a cooperative venture between one of the oncologists and a nurse who was also a Reiki practitioner. The other nurses would cover her patients while she treated patients.

That kind of thing makes me really hopeful.

I'm also a personal trainer. One of my former clients was a doctor and he had VERY poor nutritional habits. I had him fill out a diet log that we went over each week so that I could teach him the basics of good nutriton. He came to me one day claiming that he was getting plenty of good lean protein from eating chicken wings from BW3's and he was getting his servings of veggies by eating potatoe salad! I was simply stunned by this and had no idea what to say!

He couldn't figure out why he simply couldn't lose any weight. I eventually had to give up because he couldn't get the idea that just because you eat chicken in one form doesn't mean it's good for you.