Doctor Knows Best

If you've ever read the fine print on any book or website that offers nutritional advice, you've probably seen the standard disclaimer, "Be sure to check with your doctor first."

I always find that advice amusing.

Now let me be the first to say that what I'm about to tell you is not a hard and fast rule. So let's get the exceptions out of the way first: There are doctors who know a lot about nutrition. I see them at the seminars and workshops that I participate in around the country. They are my friends and colleagues. They are really bright, integrative, edgy practitioners who aren't afraid to take a stand, and who combine conventional western medicine with a cornucopia of techniques and information from all sorts of conventions — acupuncture, chiropractic, TOM (Traditional Oriental Medicine), Ayruvedic, herbal medicine, and nutritional medicine.

That said...

Most doctors are nutritional illiterates.

Let me repeat: there are exceptions. And to a man (and woman) they will be the first to tell you that everything they learned about nutrition they learned on their own, through the very seminars and workshops and certifications where I run into them. Ask them how much of what they know about nutrition they learned in med school and every single one of them will tell you the exact same thing: Absolutely nothing. And if you think I'm hard on doctors when it comes to what they know (and don't know) about nutrition, you should hear these guys: They're positively vicious.

Checking with your doctor about nutritional recommendations is like checking with your accountant about your golf game. Now, obviously, there are accountants out there who play great golf. They take lessons, they play in club tournaments, they're really masterful. But none of them learned their golf games in accounting school.

You can find a doc who will speak up for nutritional interventions, but it's about as common as a Republican congressman who is going to actively campaign to remove Tom DeLay. They exist — but they're rare, and they're completely bucking the party line.

Up till the mid-nineties, no med school even had nutrition in their curriculum. Most med schools still have zero nutrition in their curriculum, but a few have a single course, usually equivalent to high school home economics. The relationship of the pharmaceutical companies to doctors begins right when the docs are struggling students, and continues through internship and practice, from free lunches to Zoloft note pads to honorariums to paid vacations at "research seminars." This is not just my opinion — it's been lovingly documented all over the place (nofreelunch.)

Most docs barely have time to keep up with the New England Journal of Medicine and JAMA. The majority has never seen an issue of The American Journal of Clinical Nutrition, let alone the dozens of other journals in specialties other than their own. Please remember this the next time a conventional doc tells you there's "no research" on vitamins. Better yet, go to the National Library of Medicine, and put in the name of your favorite vitamin in the search engine.

Get back to me after you've checked out the first couple thousand entries.

But God forbid, let me go on a TV show and recommend a change in diet and perhaps some chromium and omega 3 fats to some poor diabetic whose doc has him on a diet of 70% carbs and before you know it, you've got a potential lawsuit on your hands. No wonder the lawyers get nervous.

My mother recently spent some time in a hospital and was diagnosed with congestive heart failure. The cardiologist had "heard" of Coenzyme Q10 but wasn't sure what it did and wouldn't recommend it because the hospital pharmacy didn't carry it. I asked a nurse in passing if she had ever heard of COQ10 and she said — I'm not making this up — "Yeah, that's some enzyme that the heart makes when it's failing, right?"

Well, anyway, I'd love to stay and chat, but I have to go file my tax return.

Before I do, I'm going to check it for accuracy with my tennis pro.