Tuesday, July 31, 2012

My frustration with mainstream medicine and its practitioners

This is going to be anther whiny, rant.
I'm sorry, but I have to get it out of my head.

It feels a little hopeless doing things differently from the rest of my colleagues in medicine.
I keep worrying about when someone from the profession is going to point fingers at me and say I'm doing the wrong thing by advising a low-carb, high-fat diet. Maybe I'll get sued. Maybe I'll lose my license.
Its tiring to keep pushing this message when media, government and the the medical profession are all pushing this misguided agenda of "fat is evil".

I'll spend an hour with a patient clearing their doubts and teaching them how to eat low carb, and on the follow up visit I'll see them exhausted, because they have dutifully cut carbs like I asked them to, but stubbornly refuse to up the fat or protein. My message got across when I sent them home from the clinic. I'm sure. I make them repeat back to me what I tell them, I cross question them to make sure they understand the concept, and once they reply satisfactorily, I set them loose,back into their lives.
That's when things go wrong for a majority of these people. They see stuff on TV that tells them animal fat and coconut oil are bad for them. They meet a friend who is shocked that a doctor advises them to eat eggs, butter and meat. They clash with relatives who can't believe that grains are off limits. And I lose them.
Its enough to make me want scream and beat them over their heads with the chairs in the waiting room.

Why cant doctors see that the current paradigm works for only a minority? Does it?
Why cant they change their view when they see that the treatment isnt working?
Its type 2 diabetes, the problem is insulin resistance. How can adding even more insulin into the mix help?
If blood sugars go up when patents eat oats, wheat and rice, why would you ask them to eat that trash 5 to 6 times a day?
If someone walks in asking for solutions for weight loss, why do they stick to the same old eat less move more mantra? Have they tried it themselves? Its a scam.
I work in a hospital that has around 30 other doctors. Only one other doctor is not overweight, and she is skinny fat. Quite a few of them are pre diabetic. All of them are in denial. None of them would do a HbA1c. All of them have had their total cholesterol levels checked. Go figure!
The nursing staff are obese, and pre diabetic.
The paramedical staff as young as 25 are pre diabetic.
Are they all blind? Can't they see they're dying?

I'm probably now known as the crazy doctor who lost 20kilos of bodyweight and doesn't let his patients eat grains. I'm sure a good majority of them laugh behind my back for talking crazy stuff like LCHF.
Its a little lonely out here. I thought people would try this method before laughing it off. They're not even trying.
Is it because I'm giving free advice? Should I start charging for this stuff? Will it make my patients and unwell colleagues more receptive? I get much better results advising my friends. And they dont need tis much hand holding. We talk for an hour about the diet, and a month or two later, they call back and tell me they've lost 10 kilos.

I find people attending every conference in town, mainly for the free booze and oppurtunity for socialising that it offers. These events are sponsored by our favourite pharma companies. They talk about stronger, faster acting insulin analogues, about DPP4 inhibitors and GLP1 analogues, but none of them want to even hear about the dietary modifications that are necessary.
A patient walks in with backache, they get hit with NSAIDs, not even one of them gets advised on how to strengthen the lumbar and abdominal muscles. You can forget about advice on hip flexibility and posture.

If you look at the recommendations from any diabetes related organisation, the first mode of treatment which everyone needs to be put on, is diet and exercise. Then comes metformin(which I quite like) and then comes all the other crap that I detest.

When a diabetic walks in, most doctors, will tell them to watch their diet and do some exercise. Thats it! Then they reach for the prescription pads, because we all know medicines are the only thing that will really, truly, control diabetes. *facepalm*
If the patient is lucky, a rare doctor might tell them to eat less rice, and go for regular walks every morning.
No one tells them how truly awful using wheat as a substitute for rice is.
No one tells them that oats will spike their blood sugars and leave them hungry and eating more an hour later.
No one tells them that walking for an hour is useless, compared to a HIIT session lasting 8 to 10 minutes
Most doctors don't even remember that resistance training improves insulin sensitivity, bone density and balance.
If some one has osteoarthritis of the knees, they still get advised to go for a vigorous walk every morning. Knee pain be damned! Do you want to lose weight or not?

I'm a little tired of this bulls***!
I might just retire at the ripe old age of 40, if I can afford to keep a roof over my head, and start a farm or something. healing people is dirty, thankless and tiresome business.

PS- I realise that this is almost a replica of an earlier post, but I just had to vent. The internet has a lot of soapboxes and crazy people. This is mine.


  1. Hi, someone just posted a link to your blog over on Google+, and although I'm not a doctor I'm starting to agree with what you said.

    I've had low HDL, high LDL, and high triglycerides for years, as well as being overweight (not enormous, but 6'1" 246 pounds. About three and a half weeks ago I started a low carb diet. In three weeks I dropped down to 226. I gained five pounds back since then as I had a day of circumstances out of my control (Bring Your Child to Work Day with Pizza lunch and my wife's birthday which was her choice of dinner + cake/ice cream). I'm back on low carb since that day though, and I'm sure the pounds will start coming off again.

    I spent years refusing statins from my doctor for the cholesterol/triglycerides issues, and him telling me more oats, wheats, etc and exercise. Last year I was running 15k+ a week and eating all his recommended foods and made no difference.

    I read a few articles a month or so saying that triglycerides and cholesterol are raised by eating carbs (http://www.foodandtechconnect.com/site/wp-content/uploads/2012/01/Carbs_Are_Killing_You.png was one of them, but not the main one I'm thinking of which I can't find).

    Once I'm down in the 180 - 200 pound range I plan to go back in for a physical, and hopefully the TG/HDL/LDL levels are where they are supposed to be. And when he asks how I did it, I'll be sure to let him know it was by doing to polar opposite of his recommendations.

  2. Low carb works very well for high triglycerides. Combine that with a Paleo approach to eating and exercise, the weight will melt off.

    There are a bunch of low carb and paleo people on Google+, me included.

    I'm hoping to make a follow up post to this detailing the thought process and situation from the other side. Its difficult to blame just the doctors/medical professionals for this mess we're in.