4 ms·

I have a friend who's a doctor. A few years ago I read a few books about nutrition for laypeople, and when I had questions, I tried asking him. He couldn't te

by dkarl 17y ago

I have a friend who's a doctor. A few years ago I read a few books about nutrition for laypeople, and when I had questions, I tried asking him. He couldn't tell me much. Virtually everything I asked him about, I knew more about it than he did, just from reading a few books. He obviously knew more about enzymes, metabolic pathways, and cardiac arteries than I did, but when it came to practical questions like how much protein I need to consume or how well calcium is absorbed from broccoli and collard greens, he had learned literally nothing in medical school. The closest he came to studying nutrition was when he took a special elective unit on diabetes in rural Hispanic populations. The way he sees it, nutrition is a separate specialty done by people who study less than doctors and get paid less than doctors, and it isn't taught in medical school, so he isn't embarrassed at all by his ignorance. He regularly gives advice to people who have risk factors like high blood pressure or high cholesterol, but the advice he gives them (eat in moderation, eat more vegetables and less junk food, exercise a little) is pretty generic, and none of them follow it anyway.

ericd 17y ago
Doctors are typically educated in how to fix problems, not so much in prevent them. This is unfortunate, since most people think they're experts in everything including nutrition, and treat them as such, but they're really not. Maybe if doctors were paid to keep their patient base healthy rather than just fix them when they're sick, they'd look into more of that.
- marshallp 17y ago
  Most doctors don't fix things - more like pop this generic pill and off you go.
- nradov 17y ago
  Capitation is one approach to solving that problem. http://en.wikipedia.org/wiki/Capitation_%28healthcare%29 http://en.wikipedia.org/wiki/Capitation_%28healthcare%29 Unfortunately the times frames are still fairly short because patients often move around. So even when doctors are compensated through a capitation system, there isn't enough incentive to encourage patients to make healthy lifestyle choices that will only pay off many years in the future.
foldr 17y ago
>He regularly gives advice to people who have risk factors like high blood pressure or high cholesterol, but the advice he gives them (eat in moderation, eat more vegetables and less junk food, exercise a little) is pretty generic, and none of them follow it anyway. Doesn't that kind of justify his ignorance, though? Doctors don't have time to be experts on everything (or on anything, really), and it seems unlikely that an ability to hold informed discourse on the nutritional value of broccoli would have anything more than a marginal effect on outcomes for his patients.
- dkarl 17y ago
  All it means is that patients who are interested in nutrition don't discuss it with their doctors. I think the people who actually ask him for advice on nutrition tend to be older, poorly educated, and very dependent on authority. Everybody else takes it for granted that doctors don't have any useful information on living a healthy life. A doctor is just somebody who diagnoses and prescribes. My friend got his head stuffed chock full of arcane knowledge in medical school, and he gets a torrent of "education" from drug companies, but when it comes to the effect of lifestyle on health, he's less educated than most of my yuppie friends. This is a waste, because the people who are in the best position to understand and evaluate information about living a healthy lifestyle have no influence on the production or consumption of this information, except when they themselves get in on the business.
  - foldr 17y ago
    > I think the people who actually ask him for advice on nutrition tend to be older, poorly educated, and very dependent on authority. But the generic advice you described is perfectly adequate for these people 90% of the time.
    - dkarl 17y ago
      He could do better, though, not just with nutrition but with other lifestyle factors. For instance, he could explain to older women that doing weight-bearing exercise will reduce their risk of osteoporosis, and he could tell them how to get calcium if they have problems with dairy products. But my point was that very few people even bother asking him for guidance. It's silly that educated people just assume that by reading a little in their spare time they can acquire a better practical knowledge of nutrition than a professional with four or more years of intense training in human medicine. It's mind-boggling that they're right. For instance, if my friend could name a couple of high-calcium non-dairy foods -- which I'm not confident he could -- it's only because he read some diet books looking for ways to lose weight. He could probably name more symptoms of Chagas disease than dietary sources of vitamin D.

by dkarl 17y ago

ericd 17y ago

Doctors are typically educated in how to fix problems, not so much in prevent them. This is unfortunate, since most people think they're experts in everything including nutrition, and treat them as such, but they're really not. Maybe if doctors were paid to keep their patient base healthy rather than just fix them when they're sick, they'd look into more of that.

marshallp 17y ago
Most doctors don't fix things - more like pop this generic pill and off you go.
nradov 17y ago
Capitation is one approach to solving that problem. http://en.wikipedia.org/wiki/Capitation_%28healthcare%29 http://en.wikipedia.org/wiki/Capitation_%28healthcare%29 Unfortunately the times frames are still fairly short because patients often move around. So even when doctors are compensated through a capitation system, there isn't enough incentive to encourage patients to make healthy lifestyle choices that will only pay off many years in the future.

foldr 17y ago

>He regularly gives advice to people who have risk factors like high blood pressure or high cholesterol, but the advice he gives them (eat in moderation, eat more vegetables and less junk food, exercise a little) is pretty generic, and none of them follow it anyway. Doesn't that kind of justify his ignorance, though? Doctors don't have time to be experts on everything (or on anything, really), and it seems unlikely that an ability to hold informed discourse on the nutritional value of broccoli would have anything more than a marginal effect on outcomes for his patients.

dkarl 17y ago
All it means is that patients who are interested in nutrition don't discuss it with their doctors. I think the people who actually ask him for advice on nutrition tend to be older, poorly educated, and very dependent on authority. Everybody else takes it for granted that doctors don't have any useful information on living a healthy life. A doctor is just somebody who diagnoses and prescribes. My friend got his head stuffed chock full of arcane knowledge in medical school, and he gets a torrent of "education" from drug companies, but when it comes to the effect of lifestyle on health, he's less educated than most of my yuppie friends. This is a waste, because the people who are in the best position to understand and evaluate information about living a healthy lifestyle have no influence on the production or consumption of this information, except when they themselves get in on the business.
- foldr 17y ago
  > I think the people who actually ask him for advice on nutrition tend to be older, poorly educated, and very dependent on authority. But the generic advice you described is perfectly adequate for these people 90% of the time.
  - dkarl 17y ago
    He could do better, though, not just with nutrition but with other lifestyle factors. For instance, he could explain to older women that doing weight-bearing exercise will reduce their risk of osteoporosis, and he could tell them how to get calcium if they have problems with dairy products. But my point was that very few people even bother asking him for guidance. It's silly that educated people just assume that by reading a little in their spare time they can acquire a better practical knowledge of nutrition than a professional with four or more years of intense training in human medicine. It's mind-boggling that they're right. For instance, if my friend could name a couple of high-calcium non-dairy foods -- which I'm not confident he could -- it's only because he read some diet books looking for ways to lose weight. He could probably name more symptoms of Chagas disease than dietary sources of vitamin D.