Patient education page 5

[sbhikes]

I checked out some of the sites suggested here... Weston A. Price - interesting stuff, but way to alternative for me to propose at work (cherry juice concentrate for gout? fine to try, but there's no way I could send a patient with an acute gout attack home with that advice...). The Whole9 seems interesting, and I'll add it to the list of websites I recommend to patients, but can't refer to it when discussing hospital policies.

I think this is one reason why you don't find a lot of mainstream doctors discussing this kind of health advice. You know better than I do the risks involved in stepping outside the mainstream.

I guess my concern is less with patient education (in spite of the title of this thread) but more with education of staff. I went through the sites by medical providers suggested by Moochy, and realised that almost none of them have published much in peer reviewed journals. The only nutrition related article I could find was a review article by Dr. Colin Champ on low-fat vs low-carbohydrate diet in breast cancer patients. Dr. William Davis (Wheat Belly) claims that he barely performs invasive therapy for his heart disease patients anymore because of reversal of disease after changing their diets. Why can't I find anything by him on PubMed? A solid randomised trial might be too costly and not practical, but surely a case series or a concept paper would be easier to write than an entire book? did he write them and was rejected? or did he think incorporating his theories in mainstream cardiology would not be accepted? I am confused as to why MDs would write books aimed at the general public rather than propagating their ideas and theories on nutrition via academia? no funding? too hard? or just no evidence? or financial interest?

How many MDs are still in academia? I probably don't understand how the whole publishing thing works, but it seems to me that if you are in practice you're not necessarily within academia with access to the whole peer-reviewed publishing process.

I am not trying to discount their work, nor do I disagree with the theories on nutrition. But it seems to me that many MDs seem to have left "mainstream medicine" for holistic medicine or alternative medicine. Is it an either/or situation? I am a conventional doctor and have no intention of becoming an alternative medicine practitioner. I deal with fractures, acute heart attacks, appendicitis and no amount of high quality whole food is going to fix you once you're in this situation. I know doctors get a lot of criticism for pushing pills, but imagine the amount of criticism if we don't prescribe drugs. Would you prefer a doctor who overprescribes or underprescribes? Still, I think there is tremendous unrecognised value in preventative activities and feel there is no reason why this should not be a greater part of mainstream medicine.

I don't think preventive medicine is actually valued in typical modern medicine. It's not often in the "standard of care" they are required by insurance companies to follow. It takes the physician sitting down to talk to their patient for a significant amount of time. It takes getting to the bottom of the reason for a symptom rather than just treating the symptom. Many naturopaths leave regular medicine just so they can have the time and the freedom from top-down, insurance industry-prescribed treatment options to do this.

I do think, however, that it is still too early for the principles of the paleo diet to be incorporated in conventional medicine from a top down approach. I think that high quality research and hard evidence will not be available any time soon, this is not absolutely necessary. Lots of things we do is not based on any evidence at all. (probably most of what we do...). I'll continue to educate my patients the way I have been, and will probably put something down on paper to hand out to people who are interested. Not sure if it will be frowned upon by higher management, but I'd rather not ask.

Exactly. It's too early or too impossible to be done within the current system.

Finally, a question. Or a poll. Who on this board educates their doctor? I have read many stories about people getting results and surprising their doctors with it. Does anybody give their doctor information? How do you do it? How do they respond? Would you given them a handout - brief written documentation about the principles of the diet and some websites and publications to reference? I am wondering if this would be a way to encourage MDs to improve their knowledge on nutrition (since it's so terrible) and maybe even recommend it to other patients....

Sorry for the long post, but am curious to hear your thoughts...

I haven't been to my doctor since I changed my way of eating. Should I go back and he's not retired, I hope my cholesterol is improved enough that I can have that conversation. If it isn't, then I won't have the conversation with him because I wouldn't want him to think my diet is bad for everybody. I simply do not (and never have) believe that high cholesterol is necessarily a marker for poor health. And I honestly do not think my doctor would be willing to accept a long list of other health improvements I could give him, especially the more subjective ones, as reasonably strong proof against a high cholesterol number (if I have one, I don't actually know my cholesterol).

[sarasue624]

I agree with sbhikes suggestion to make your own, basic, website!

There are some very easy, free website builders - you could set something up in a spare afternoon (wix, weebly) or a spare weekend (wordpress).

You've identified a need - website that lays out the basics with links to "real" research. That shouldn't be too hard to set up. It doesn't have to be flashy. You could consider your website a portal to others.

[phitone]

I am a physical therapist and agree with your findings that the majority of people seem to just want that quick fix (surgery, pills etc.). That being said when you encounter someone who is willing to listen then I say go for it. You can cite the information that is currently coming out that supports lo-carb without being paleo specific. Write down a couple of different websites that promote the basics of good health (protein, veges, fruit, movement, relaxation and life) and state that there are many different approaches to a healthy lifestyle. I agree with Pamsc and her comment about saying, "this has worked really well for me." I constantly have people stop me and ask me how I stay in shape and as soon as I tell them that I don't eat processed food, sugar or grains and I work out regularly...they get this glassy look on their faces..Damn, I really need to invent that pill......

[RitaRose]

If you're looking for someone that has had some success with Paleo/Primal on a larger scale, then I would check out Robb Wolf's website. The financial aspect may be more convincing to those higher up, along with seeing that they wouldn't be a guinea pig.

He has been doing a risk assesment program with the city of Reno, Nevada, working with their police and fire departments. I haven't followed the whole story, but eating Paleo/low carb as he suggested seems to be saving the city a crapload of money in health related costs. More info on his website - Can Managed Care Benefit From the Paleo Diet - Paleo Diet Risk Assessment.

[kneazle7]

Thank God I'm not alone! I registered here today because of this thread. As a home health nurse I struggle with the "official diet teaching" and what I know to be true. I have settled with teaching the commonalities: eat a whole foods diet. Even if they gorge themselves with fruit and beans at least it's a start. I also throw in that all those "whole grain" products are only LESS processed. If I'm dealing with colleagues, I find Gary Taubes book and the studies in it to be very helpful... although, I've found that the overweight smoking nurses are really not that interested anyway and would be more interested in the truth or even in the massive changes they've seen in my body. I compare it to sharing my faith-- people really don't care about things that even work for you until they want it for themselves. You should have seen the questioners that were interested once the "biggest loser" contest happened

As for patients, they are individuals. I tailor my teaching to whatever I think they'll understand best and what I think they can do.

[sophie]

this is a very inspirational thread!
I think this hasn't been suggested so if I may: LCHF for beginners | DietDoctor.com

although it doesn't have a forum or everything you're looking for, I found this website quite convincing for explaining the diet in a "neutral" way...if you want to check it out.

hope this can help a little
Sophie