Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
10 May

Primal Minded Practitioners?

I know what many of you are already thinking: where do I sign up? Let’s face it: we organize much of our lifestyles contrary to CW specifically to live healthier and feel better. When it’s check up time, however, we find ourselves back in foreign territory. If it’s just an annual ritual, we can grit our teeth through the usual advice and make the best of it. On the other hand, if we’re receiving care for on ongoing condition and using the Primal Blueprint to get on top of our health – or if we’re just looking for more from our health care – it’s harder to skirt the Primal issue. Some practitioners will listen and offer gentle, cautionary advice. Others will agree to give your approach “a chance” before going back to their prescribed route. A few will unfortunately fly off the handle and tell you they will need to sever the treatment relationship if you continue on this ill-advised course. It can be a tricky, awkward situation to handle: living out your Primal principles while trying to garner benefit and help from your conventional (a.k.a. insurance covered) health care providers. A less explored question is this: what is it like to be on the other side of the fence? What is it like to be a Primal-minded medical practitioner swimming against a wholly un-Primal mainstream?

It’s one thing to swim against the current in your own personal life and quite another to openly navigate a professional career devoted to Primal health. What is it like to live one way but feel held back from sharing the truth with one’s patients and clients – the very people whose care is entrusted to you? Is there a place for Primal yet in the medical field?

The establishment, as we know, sticks with the same old, same old in rampant fear of litigation. (I’m sure Primal-minded practitioners are forever conscious of this anvil over their heads.) Ironically, for the establishment it doesn’t matter if conventional results themselves are lacking or even fatal – as long as the treatment regimen coheres with accepted CW. If the majority agree to uphold the same message, it’s the prisoner’s dilemma, I guess.

For many practitioners and health care students, however, the incongruence between common practice and they’ve come to know as common (Primal) sense becomes a source of continual stress and even fundamental questioning about their career trajectories. Here’s just a sampling of the mail I get:

My question is, what kind of careers are available to a B.S. in Nutrition with a primal/paleo methodology? I imagine I will have to forge my own path; despite the fact that the paleo/primal community is growing, it still isn’t generally accepted.

I’m dreading the idea of doing a year long ADA dietetic internship (despite being called in internship, I pay tuition and do not receive pay), followed by a state licensure exam in order to become an RD, when I disagree with the majority of the ADA’s positions! Unfortunately, opportunities seem quite limited without that RD after my name.

I’m an MD just finishing up my first year of family practice residency…, and I am going crazy!! I have had it up to here (my eyeballs) with modern medicine and how it exists basically to manage disease and not promote health. …My dilemma: I’m an MD who wants to do paleo, paleo, paleo! I’ve even toyed with the idea of getting out of residency after my intern year. I would if I could find gainful employment that would help me pay off loans and get on track to starting my paleo-centered practice.

Currently, I’m in my last year of school … studying nutrition and can honestly say the best thing I have gotten out of it has been the biochemistry classes I’ve taken. I’m going to get my RD credentials within the next year, but definitely don’t want to be stuck in a hospital treating sick patients and (for the most part) making them sicker or not helping them to my fullest potential. To me, that’s against my morals. I’m considering starting up a private practice that focuses more on the paleo lifestyle, but I was just wondering if you had any thoughts on other options for those of us with nutrition backgrounds.

The conundrum becomes this: how does a Primal practitioner maintain gainful employment and fulfillment in his/her chosen health care field? Sure, there are a few big names: Drs. Michael and Mary Dan Eades, Loren Cordain, cardiologist and blogger Dr. William Davis, and geneticist and researcher Cynthia Kenyon. Other than Dr. Davis, they’ve all gone the route of teaching, research, and publishing. They’re high profile, effective messengers for a better health approach and those who would follow and practice it. Nonetheless, barriers still remain in the day to day practice of health care.

The right path will ultimately be different for each practitioner. Some will choose to head out on alternative tracks in research, publishing, or less conventional health domains. Others will add their unique and needed expertise to change the system from within the heart of the beast – however slow and small (yet significant) their steps toward progress. Obviously, it’s not a black and white issue, and my point here isn’t to stand in judgment of anyone as they navigate the murky waters. It’s not about who can both live and “work” the most genuinely Primal. Rather, I think it’s a chance to further explore – and support – the opportunities of Primal minded professionals.

For those who choose to go out on their own, don’t underestimate the power of networking – virtual and old school. Get your name on the full array of low carb, paleo, and Primal directories. Get connected with local professionals and centers that cater to people who already view wellness (and health care) outside the restrictive bounds of CW: chiropractors, osteopaths, naturopaths, midwives, and even doulas (trust me – these women can network!).

Then there are the semantics. While paleo or Primal raises eyebrows, something like “functional medicine” (which approaches health in terms of nurturing the whole or “holistic” system rather than treating isolated conditions) can perhaps fly more effectively under the radar if you’re working in a more traditional health care setting. As a more widely recognized philosophy, FM can also garner you attention from more alternative/open-minded clients. The Institute for Functional Medicine is a pretty established and expansive organization with some serious networking clout. Granted, it’s more than just tomato-”tomahhto.” Functional medicine is a pretty big umbrella (one that might present its own conflicts), but it might be an area to look into.

For those of you looking for a Primal minded practitioner (or want to see how – and where) others are navigating the medical field with their alternative principles, you can check out Robb Wolf’s new directory (under construction as we speak) as well as Jimmy Moore’s catalog. You’ll find a lot of chiropractors, acupuncturists, osteopaths, and naturopaths. However, you’ll also find a few pioneering family physicians, cardiologists, bariatric specialists, and even a neurosurgeon! Folks, they’re out there. I think we’re just on the cusp of making these pivotal networking connections.

With that, let me open up the issue for lively discussion as a good old Primal community – a resourceful, thoughtful, informed lot if there ever was one, I’d say. Share your thoughts on connecting with Primal minded practitioners or seeking out professional networks that support Primal physicians. Thanks for reading today.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. While only tangentially related, I find hope in today’s comments. I am a PhD Sociologist sometimes working on public health issues. It can be trying in meetings to bite my tongue while epidemiologists and hospital practitioners talk about diabetes, obesity, and so forth.

    I first came to low carb with the Eades around 2000 and was astounded at the implications that the food and health system was actually at the root of many of the problems they purport to help. I thought for certain that science would win out. Especially, as one person after another added their anecdotal successes.

    But alas, it turns out the forces of darkness are stronger than I thought. Now I enjoy my better health, better weight, and bite my tongue as my vegetarian colleagues struggle with health issues. This includes, perhaps not ironically, at least one vegetarian epidemiologist who is over a hundred pounds overweight. Without picking on her – I never wanted to be overweight when I have been – I just can’t imagine how she is processing the evidences of her successes and failures regarding diet and body management. How can her n=1 empirical experiences resonate with her scientist’s mind? Cognitive dissonance? Or in more colloquial terms – How’s that working for you?

    I do also think that it’s important we remain openminded too, so as to avoid the rigid and unempirical closed-mindedness with which we charge the vegans. We must remain willing to challenge our own assumptions in the paleo movement.

    Michael wrote on May 11th, 2011
    • You are right that your credibility as a proponent of public health depends on your own example. Good on you for practicing what you preach. You are regrettably in the minority.

      It is mind-blowing how many physicians are overweight or otherwise obviously unhealthy. Even the surgeon general is obese. The cognitive dissonance is unbelievable. One would have to be blind to take health advice from these people.

      Would you trust your finances to someone who couldn’t get out of bankruptcy? Would you take music lessons from someone who couldn’t play a note?

      Physician, heal thyself.

      Timothy wrote on May 11th, 2011
  2. Well – I am a Psychiatric Nurse Practitioner with a private practice and I have been prescribing primal nutrition and lifestyle measures of sex/sun/laughter/move your body etc for the past 8 years. Clients refer via word of mouth and the bulk of my new clients are consistently middle aged pre or post menopausal women who have put on weight, developed anxiety, poor sleep maintainence and low energy. To them – the primal lifestyle is miraculous. Their PCPs do voice dissent sometimes (well, often) but generally quiet down when triglyceride levels plummet, HgB A1C levels plummet and mood and energy issues resolve. It does seem like nearly every day I have to dissuade a woman with a total chl read of 170-200 not to accept the statin her PCP prescribed…But this population is highly motivated and most of them even finish the homework I assign them of reading Taubes GCBC – and I know that is asking a lot. I tell them not to simply take my word, but to read and become owners of this health information so that they can firmly advocate for themselves (such as when that statin is pushed their way).
    And I have the greatest practice, filled with people willing to work hard for their health who want to know why they were never told any of this before…

    Lisa wrote on May 11th, 2011
  3. AM wrote on May 11th, 2011
  4. Since I have a panel of experts at my disposal, I’ll repost a question I had asked a few months ago but received no reply to.

    Right now, I’m not interested in losing weight. I’d estimate my body fat at 17-18%, though it may be lower. BMI is around 18.7-19.0. I’m very active and work out daily, including strength training every second day.

    It sounds like the people who went primal did so because they had a lot of weight to lose. I think it would be dangerous for me to lose fat, right? I’m really just looking to stay as healthy as possible, since I’ve never had blood pressure, blood sugar, or cholesterol problems. (I actually have low blood pressure!)

    My diet is close to primal; never been a big meat eater, but I love chicken and fish, so I have those regularly. I’ve never had a problem with carbs, but as I said… just looking to try something new, but not sure if it’s really for me. Any comments would be appreciated. :)

    Lisa wrote on May 11th, 2011
    • Well…consider yourself your own bio-lab test steak..Go with the Primal Diet and some of the more Primal type exercises that you cant get in a gym. Go find a rock to move or roll along. A log to carry..things that fire neuro-muscular connections of the “no handle” type. Do you climb?..trees/rocks/boulders are fun and increase strength and agility. See if this process improves your functions or you in any way..And dabble in a few different kinds of fat, remember that man eats many things and I think an occasional adventure into a different food cant hurt might clear the pipes at worst..but that’s not so bad after all. Try it for a Month solid..after even one month you may see changes…or not..but then you have a baseline to use that your brain is ok with.
      GROK ON>>>

      DAVE PARSONS wrote on May 12th, 2011
      • I DO climb trees! It’s fun… not so fun when you miss a branch and break your ass falling out of it, but hey. I mainly use the gym for free weights and occasionally treadmill during the winter when I can’t walk outside. I do primal inspired exercises with them.

        Thanks for the reply. I’m normally adventurous with my health, but when it comes to fat loss I’m a bit hesitant for the reasons above (Where would I lose it from? lol.) I’ll give this a go and see what comes of it.

        Lisa wrote on May 12th, 2011
  5. I have degrees in Exercise Science, Nutrition, and Nursing. It was a mental struggle the entire way. I’m so tired of rx of aerobics for hours and hours and eating high carb even for diabetic patients. Most of my acquaintances think I’m crazy. I do love to see there eyes light up, when I say I can eat an entire pack of bacon and never gain an ounce, sleep like a baby, and have so much energy I feel like I’m going to explode! In the end, they always think its some fad. Their eyes dim in disbelief. I wanted to further my career and get my NP, but I don’t know… I can’t stand the thought of learning more useless information. Branching out on my own to educate the public would be so much fun, but I fear no one would listen.

    Matt wrote on May 11th, 2011
    • they listen….not all, but then again you cant ever expect 100% from humans..they are all too different…
      And remember that using your brain is a wonderful way to burn energy and information is only a platform..the delivery and modification of this information is for you to develop and deliver in your views….Use the medical base as a base…and then show & tell what a modification can do..
      GROK ON>>>

      DAVE PARSONS wrote on May 12th, 2011
    • If you get your NP you can go private (in most states anyway) and have this health teaching as your specialty. That’s what I did. People love it because I understand their medical histories and have nonmedical interventions to offer them. I have hundreds of patients. They listen. They work their butts off. And the majority get relief and feel stronger and healthier. Even if their diet and lifestyle changes won’t cure a chronic condition (some things are set in utero or before) they will get some relief.

      Lisa wrote on May 12th, 2011
  6. I will repeat: if you are a professional, you do what is best according to your reading of the facts. If you don’t, you are not a professional, you are just a money-grubbing hack. So, stop using “someone might sue me” as an excuse for making and keeping people sick.

    And I will add that that is apparently exactly what some people do. The CW people have an excuse: they believe that what they are doing is for the best. The others do not. They are cowards and hacks.

    As to whether I put my principles on the line, you bet I do. If someone wants to sue, bring it on. I will sue them back and off we go. If you are such a coward that you are willing to help kill your patient in order to avoid legal trouble, then GET OUT OF MEDICINE. You are a disgusting fraud.

    Bookstorecowboy wrote on May 11th, 2011
  7. I am a level one CrossFit trainer as well as an alternative minded pastor. I think the definition of CrossFit might be helpful: Constantly varied FUNCTIONAL MOVEMENTS executed at high intensity (or relative intentsity as needed). Primal/Paleo is functional in everyday life-it allows us to function at a higher level of intensity and the food choices are constantly varied, seemingly without limit. If I were a full time health care professional I think I’d look seriously at the functional part.

    Jack Swank wrote on May 12th, 2011
  8. Wondering what you think of Dr. Mercola (

    Oathay wrote on May 12th, 2011
    • Dr. Mercola’s insights are very much in harmony with those of the primal/paleo community. I find him an invaluable resource for health.

      Timothy wrote on May 12th, 2011
      • Agreed. Doc Mercola is my other main source of information. He sells products also, but so far, everything has been the best quality I can find on the market. This guy is passionate about educating “why” also. BTW, if you’re going to do a protein powder, his is the best. I mix in some coconut oil with it and it is quality stuff. I HAVE to do this since I contract in Afghanistan and Iraq, where they feed us mostly filth. His vitamins are top notch, so I consume them like their going out of style. With that combination, and doing my best to be as primal as I can over there, has saved my health while being overseas.

        sixMidgets wrote on March 23rd, 2012
  9. Sherry-Thanks for the referral to the article on grains and the Bible. I’m sending it on to my doctor. It was a great article.

    Brenda wrote on May 12th, 2011
  10. ..whatever happened 2000 years ago does not affect me today.

    DAVE PARSONS wrote on May 12th, 2011
  11. I like Mercola to. I have read his articles for years.

    Matt wrote on May 12th, 2011
  12. To Larry Clapp

    I agree with you in many ways. I didn’t want to turn this into a religion debate and I surely wasn’t going to tell my doctor that I have my doubts about the Bible being totally on the up and up since I know he does believe in it. I may very well annoy him eventually as time goes on with just me challenging him. I didn’t think I needed to do it over religion too. Ha!

    And Matt- I did like your extra tip bits of Bible info……those were good ones to use in a debate.

    Brenda wrote on May 12th, 2011
    • > I didn’t want to turn this into a religion debate

      That was probably wise. :)

      Larry Clapp wrote on May 12th, 2011
  13. My doctor has been taking care of my family for 40 years. He’s always been a proponent of alternative medicine and low-carb, though he’s never called it that. Just always told us that the best way to lose or maintain weight was to watch starches and to keep the fat moderate, not too low. He agrees that fat has been unfairly villified and encourged us to include things like olive oil (duh, we’re Italian, not much prodding needed there) and grassfed meat. We’ve been lucky.

    Lisa wrote on May 12th, 2011
  14. It’s unfair for some medical professionals to belittle complimentary and alternative professionals as being quacks and not interested in scientific evidence. Just as with conventional medicine, there are good and bad within the complimentary and alternative therapies. As a massage therapist working within the confines of medical practices not only did I provide evidenced based care but I also had to have at hand scientific research supporting everything I did or said to provide to both patients and physicians. Many of the practitioners I know in other fields did the same as well. Just as there are some MDs who don’t research studies beyond what the drug reps tell them as they drop off samples and lunch, there are good MDs who are on top of the research out there. The same holds true for any health care profession. In the end we have the same goal, giving our patients the best care they are willing to receive while maintaining our license.

    Sarah wrote on May 12th, 2011
  15. *sigh*
    I wish it was easier to be a paleo-doctor. I am a doctor aspiring to become a general practitioner. Can’t wait to get my own practise so I can start relating real health to my patients.

    At the moment I’m employed and have been told (repeatedly, since I’m a bad listener) that I should stick to the guidelines. The warning “or they will take your license away” have been hung over my head more than once. I hate it.

    I keep telling my patients, in roundabout ways, about paleo and it’s benefits. Tell them to dig up some research and try it for themselves.

    I have tried to sway my colleagues by talking about “good calories, bad calories”, Robert Lustig, all the great blogs (you’re all great guys :) ) and by showing them the awesome results I’ve had. But to no avail. So now I have to do it the old-fashioned way.

    I’m planning to write a PhD about paleo and diabetes type 2. Researching for it now so I just hope I can make it come together. Maybe that will sway some opinions. And maybe people will keep being pig-headed and afraid of change :S

    We’ll see.

    Majken wrote on May 13th, 2011

    DAVE PARSONS wrote on May 13th, 2011
    • A heartfelt thank you from an NP here Dave!

      Lisa wrote on May 13th, 2011
  17. My uncle lives by the paleo/primal lifestyle and introduced it to my dad, who introduced it to me. He is an OBGYN and counsels many of his patients with good paleo/primal nutrition. He’s even had some “success stories” of women who have lost weight using his nutrition advice. I think the more we spread the word- the more widely accepted it will be. I work in Labor and Delivery at the hospital and many of the other nurses have seen my success and want to give primal living a shot for themselves!

    Sonia wrote on May 13th, 2011
  18. I think finding a doctor that agrees with the primal lifestyle would be wonderful. My dads doctor actually told my dad this was a diet he needed to be on because his Health was so bad, he ignored her at first but once my husband and I changed our lifestyle he decided to try it out and has been doing great since. I thought it was cool that his doctor was the one who first introduced him to the lifestyle.

    Hannah wrote on May 14th, 2011
  19. As a doctor practicing in a massive public hospital, going against the mainstream can be very difficult. When you consider the shear volume of sick patients that need urgent medical intervention, just getting these unfortunate persons well enough to survive is a challenge. Most times, even conventional diet advice is ignored, much less advice that goes against everything they have heard about health! Many times we simply don’t have the time for a prolonged discussion of diet. This sickens me, because it is glaringly obvious that these people never had to get this sick in the first place. The convention places so much emphasis on treatment (absolutely necessary and lifesaving in many cases), but primary PREVENTION is ignored. Unless the message can be gotten out to the masses, this will be a never-ending cycle of illness and death. People need to know that there is hope. Illness is not inevitable! Practically though, this seems an impossible issue.

    Patrice wrote on May 17th, 2011
    • I SALUTE you in your efforts…
      GROK ON>>>

      DAVE PARSONS wrote on May 17th, 2011
  20. Well in 3.5 years, guys, I’ll be added onto this list of primal/paleo docs. First year of medical school and our curriculum is VERY nutrition based, with top notch explanations of ketosis, the benefits of high fat, low carb diets that induce lipolysis and inhibit lipogenesis, eating a rainbow of vegetables, etc. It might just be that my school is very modern, but we constantly get the message pounded into our heads that nutrition plays a key role in health and that we as physicians will have the role of helping our patients realize this.

    Janelle wrote on November 8th, 2012

Leave a Reply

If you'd like to add an avatar to all of your comments click here!

© 2016 Mark's Daily Apple

Subscribe to the Newsletter and Get a Free Copy
of Mark Sisson's Fitness eBook and more!