The "Wonders" of Modern Medicine

Doctors are excellent salespeople. I know, because I am one. When I see a patient, I have a lot of selling to do. First, I have to sell myself to the patient, in the sense that I have to get them to trust me. Without the patient's trust, they are very unlikely to do anything I say. Next, I need to sell my chosen course of therapy to the patient. It is well known that the placebo effect constitutes about 30% of any treatment. The practical meaning of this is that if the patient does not believe the medicine I am giving them will work, it is highly unlikely to do so. Finally, if I am to admit the patient to the hospital, I have to "sell" the admission to the physician who will be taking care of them on the floor. If I do a poor job of this, and the admitting doctor doesn't believe there is enough cause to justify the admission, they will not admit the patient, and the patient's life could potentially be jeopardized.

The profession of medicine has sold our usefulness to the general public. We have done so out of necessity. Most of us, while getting into medicine in order to help people, also need to make a living. I am one of the lucky few who are employed by a hospital, and am paid hourly for my work. In private practice, a doctor's earnings come solely from the number of patients they see, and what exams, studies, and procedures they can bill for.

With this comes a sort of hypocrisy. Doctors have to make themselves indispensable to patients, in order to get them to come to the office. Also, they have to have reasons for patients to keep coming in. Hence the yearly physical your doctor insists that you get, and for the older population, the monthly or weekly visits for blood pressure checks and the like.

The problem is, somewhere along the line, we as a profession oversold ourselves. We made the general public believe that if they had ANY symptom, no matter how mild, they needed to have it checked out by a doctor. As a consequence, during the months of October thru February, my ER is flooded with people who have nothing more than an upper respiratory infection (the common cold). They come to the ED with runny nose, cough, aches, chills, and fever.

The fact of the matter is, no matter what I do, they will be better somewhere between 3 and 7 days, depending on their individual immune system. Barring very high risk groups (infants under 3 months, and people over 90, as well as cancer patients on chemo), these symptoms don't require any tests, treatment, or the monitoring of a medical professional. 99% + of people with URI symptoms don't need to come to the ED. They don't even need to see their family doctor. They just need to drink a cup of tea and rest for a few days, and they will be just fine.

That brings up the natural question of why do these people come see me? People in general are not stupid. They won't do something unless they think they will get something out of it. The only possible answer is that they believe I have something to offer them. Aside from some medicines I can give for symptom relief (many of which can be purchased over the counter), I don't.

What is interesting is when you generalize this principle to all of medicine. In reality, very few things we do in medicine make much difference. There are obviously some exceptions:

• Surgery for emergent conditions such as appendicitis, bowel obstruction, and the like
• Vaccines (no, they don't cause autism, and yes, the absolutely work. When is the last time you saw someone with smallpox)
• Antibiotics for truly life threatening infections (pneumonia, skin infections, sepsis (blood infection), diverticulitis (an intestinal infection), and others)
• Heart catheterization for people having an acute heart attack
• Aspirin for heart attack (although this is a bit of a cheat, given that the ancient Egyptians used willow bark for pain relief and multiple other purposes over 300 years ago. Aspirin is made from willow bark).

This isn't a comprehensive list, but the treatments above are the best of the best.

Other than that, much of what we do, even in the very ill patient, is merely optimizing conditions and waiting for the body to either heal itself, or succumb to disease. Here is a list of medical treatments that have marginal if any benefit:

• Surgery and chemotherapy for most type of cancers (increase survival across the board by 1-2%)
• Heart catheterization for chronic chest pain (no evidence of increased lifespan)
• Coronary bypass surgery (no evidence of either long term symptom reduction or increased lifespan)
• Statins for heart disease prevention (they make your lab numbers look better, but they don't prolong life or prevent heart attacks)
• Opiate pain medicines for chronic pain (they just lead to a cycle of addiction. Your body increases its opiate receptors ironically making ALL pain worse)
• TPA "clotbuster" for acute stroke (the jury is still out on this one, although more studies than not have shown no benefit)
• Insulin and oral medicines for Type II diabetes. (Type I, or childhood diabetes, absolutely benefits from tight glucose control with insulin, but that is a totally different disease process)

So, you might be asking, what is the point of all this? Well, in the midst of all of our advances in technology and multitudes of new drugs hitting pharmacy shelves daily, we have forgotten the forest for the trees. Doctors on average have about 3 hours of nutrition education during school. During the average patient visit (about 10 minutes, just so a doctor can make a little bit of profit with a completely full schedule), virtually no time is devoted to educating patients on the benefits of the correct diet and exercise in preventing disease.

Doctors want to help people. If we had the time and knowledge, we'd talk much more about eating right and exercise than drugs and procedures. Big pharmacy doesn't really care about helping you. Unfortunately, there is no money in healthy people. They don't take very many medicines. If, on the other hand, you have several chronic diseases for which you need to take medicine daily for life, jackpot!

So, if you want to achieve better health, the answer is not in a pill. Now, don't get me wrong. Life threatening emergencies like heart attacks, strokes, and such are still dangerous, and emergent treatment is often quite helpful, so definitely don't avoid medical care if you think you have something serious. Just keep in mind the things that clearly don't work.

Now, compare the list of things that don't work to a vegan diet and exercise. Below are the benefits of a vegan diet:

• 50% lower risk of heart disease as compared to meat eaters
• 50-66% lower cholesterol
• Less than half the likelihood of high blood pressure
• 40-60% lower rate of stroke
• 40% lower rate of depression
• 66% lower rate of obesity
• Lifespan between 4 and 8 years longer than people who eat animal products
• 70% lower risk of cancer (especially the big 3- colon, breast, and prostate)

Hippocrates, the father of modern medicine said over 2500 years ago "let food be thy medicine." I find it ironic that more than two millennia later, despite all of our formidable technology and giant grab bag of drugs, his advice is still the most sound and effective.