Modern Medical Care and Dietary Confusion

Medical schools and teaching hospitals control medical education. Curriculum content is determined by licensing requirements together with the preferences and knowledge of medical school deans and faculty. My working medical career was spent at several of these schools where I got to know many other faculty members. Most were intelligent, hard working and ambitious, but we were all specialists in a small corner of medicine with no or limited knowledge of other important aspects of medical science. Many faculty members are also constrained by the need to obtain funding for research projects that are the focus of their career and the determinant of salary, promotion and recognition. Increasingly, more research funding is coming from the drug and other medical industries. Professors have rarely been trained in diet and nutrition; they also have no time or motivation to learn this material. Even worse, there is often a conflict when diet information would devalue the benefits of medications- the bread and butter of medical research and medical schools. It’s no surprise that physicians and other medical workers have little or no training or interest in diet and nutrition.
This crisis in medical research and practice has been decried by some of the most respected leaders in medicine but medical institutions want money and medical businesses have the money.  Business effectively controls research, faculty priorities and medical education. Physicians come out of school and residency poorly trained except in writing prescriptions and performing complicated procedures. But health depends on lifestyle choices much more than it does on other factors. Reliance on medical professionals to give optimal guidance in health care has led to epidemics of preventable conditions: heart attacks, strokes, cancer, dementia, auto-immune diseases. The large majority of these are avoidable with proper lifestyle choices, particularly diet.
Another big problem is misinformation about best dietary choices. Everyone has dietary preferences based on family tradition and past eating habits. Human nature is to look for support for our preferences. For decades some physicians advocated cigarettes and smokers were delighted to hear that “Doctors prefer Camels,” even if they themselves smoked Luckies. The tobacco industry spent lavishly to support this misinformation just as agribusinesses, fast and processed food industries are doing now. Healthy foods are whole plant foods but billions of dollars in spending are dependent on people believing that other choices- animal products, processed and refined foods are as good or better options.
Modern medical centers are dependent on high volume to pay for expensive facilities and equipment. They often advertise these services and encourage medical providers and patients to use them. Dr. H. Gilbert Welch, a Dartmouth Medical School professor, and his colleagues have done extensive research documenting the harm from over-utilization of diagnostic and treatment options. Welch’s work has been the subject of several NY Times op-ed pieces and he has written many scientific articles published in top peer reviewed journals plus several excellent books on this topic. Medical care is big business and uses the techniques of other businesses to encourage over-utilization. The unfortunate result is often poor health for patients and huge amounts of wasted money.