Bad Advice from the Wrong Source

Would you accept investment advice from a physical therapist? Would you do an exercise program designed by an attorney?

Of course not. While  those people may have expertise in their own field, they lack any qualifications for advising others outside of their field.

So why on earth do people listen to nutritional recommendations from their medical doctors?

Over the past few months, I have noticed with disturbingly increasing regularity, patients coming in and telling me that their MD has recommended that they take XYZ supplement or the herb Herpatoxicus hippocratus or some such.

Unfortunately, however, the quality of the advice which my patients are receiving is only slightly worse than that which they would get from the high school kid at the cash register of the local health food store.

In one case at my office, the recommendations so helpfully supplied by one of my patient's MDs was downright dangerous, because the MD was apparently unaware of the interaction between the nutrient she was recommending and the drugs that she had  herself prescribed!

Fortunately, I was able to rectify the error before it became an emergency room visit.

But increasingly, MDs are trying to provide their patients with nutritional advice when, in fact,  they really don't have any background, education, qualifications, training or clinical experience on which to base their recommendations.

In all likelihood, they are probably only repeating something which their friendly drug rep passed on to them. Which, according to more than one recent study, is how most MDs decide which drugs to prescribe. (Don't believe me? Look here. Or here.  Or here. you really need more?)

So, in short, most prescriptions are written by doctors on the advice of a good-looking 30-40 year old with a bachelor's degree, a hot car, and who buys pizza for the staff. (By the way, before you listen to any nutritional advice from any medical doctor, go check out the food in the staff room.)

Each day more than 101,000 drug company reps—one for every five office-based physicians—call on the nation's doctors. Primary care physicians, on average, have 28 interactions a week with drug reps, according to a 2005 report by the Health Strategies Group, a consulting firm for manufacturers of health care products.

Honestly, I'm feeling kind of left out. The last time I saw a rep from one of the nutrient companies whose products I recommend was two months ago.

But I'm afraid I got away from my main point here, which is that MDs are  "prescribing" supplements and nutritional regimens to their patients and they don't have a clue what they are talking about!

Seriously. You know how many hours of education an MD has in nutrition?


Ok, if you didn't get it the first time, I'll repeat it.

0. None. Nada. Zilch.

This wouldn't be so bad if they were actually honest with their patients, and said something like, "Gee, um, I really don't have a clue about how nutrition works, but this guy who was in my office the other day and brought us all egg rolls and pork fried rice told me he heard from another one of his clients that this works, and actually I suggested it to my cousin's in-law's sister, and she said it worked great, so I think you should take it."

Truthfully, this is the level of critical decision-making that goes on in an MD's brain when making nutritional recommendations.

Which is in part because (1) the average MD doesn't have a clue how clinical nutrition actually works, and (2)  as I mentioned above, most of their prescriptive recommendations are made on heresay, anyway.

In the medical/mechanistic model of the human body, MDs are taught basic one-to-one correspondences. Pain is paired with antiinflammatories; hypothyroidism is paired with synthetic thyroid hormone;  infection is paired with antibiotic.

Within that framework, there may be subsets of, for example, painkillers or antibiotics. But the one-to-one correspondence is the essence of modern medical thinking.

In comparison, approaching a health problem from a nutritional  point of view requires that you look beneath the condition to the process which created the condition. You then alter that process, by altering the environment in the body which allows that process to exist. When the environment is no longer conducive to the behavior, the process is discontinued and the symptoms resolve.

So there can be no one-to-one correspondence, because many different processes can cause the same problem.

Take osteoarthritis, for example. The typical MD approach is to (1) prescribe a painkiller and (2) recommend (or "prescribe") glucosamine or chondroitin sulfates.

All well and good, except for the fact that glucosamine actually doesn't work that often. It does work in the percentage of the population whose chondrocytes actually have the ability to utilize the additional glucosamine, or people who are glucosamine deficient. In short, probably about 20-30% of the population.

On the other hand, what I and other alternative physicians try to do is understand where the body's processes have gone awry, and for what reason. So for four patients with "osteoarthritis," one might recieve chiropractic manipulation, one might recieve MSM, one might recieve Chui Feng Tou Gu Wan, a third will be placed on a detoxification diet, and the fourth will receive omega-3 fatty acids.

That's how nutrition is done. Unlike medicine which is pathology-oriented, clinical nutrition is process oriented, not pathology oriented.

And it is this basic, fundamental concept that MDs don't understand,  which only compounds their overall lack of knowledge about nutrition.

So my recommendation to anybody is: Take any nutritional recommendation from an MD with a grain of salt.

(By the way, did you know that salt plays a role in high blood pressure in only 10 percent of those who have this problem? I'll bet your MD didn't.)

Secondly, if you receive a nutritional "prescription" from an MD, for your own safety, consult with a chiropractic physician before taking it.

And, finally, for any medical doctors who are reading this (fess up, I know you do): For your own patient's safety, please refrain from making nutritional recommendations and refer your patients to a doctor more appropriate for this type of therapeutic intervention.