1. Doctors spending more time with patients
The average office visit for established patients in most practices runs 7-15 minutes, and 30 minutes for new patients. That is barely enough time to get right down to business, do a cursory exam and write a prescription, with no opportunity to learn about the patient’s lifestyle, family difficulties and other stresses. Physicians may be scheduled to see 30-40 patients a day. Being in such a rush stresses the doctor, leads to wrong diagnoses and wrong therapies. It also leads to more drug prescribing and more tests, as the quickest way to dispose of a patient is to write a prescription or order a test. Discussion invariably suffers from neglect.
Our regular office visits last 30 minutes, and new patients receive one hour. Sometimes it is during the last five minutes that patients come out with what is really troubling them. Certainly we arrange enough time to make patients comfortable, to find out about them and their families, and to create a relationship. It is this relationship that fosters healing, an opportunity for the doctor to assert an intention to improve the patient’s well-being.
Electronic medical records have further aggravated the situation, as physicians sit in front of their computers, typing away, scarcely looking at the person in front of them.
The issues we deal with are often sensitive, difficult for patients to express. They deserve, at least, the doctor’s full attention, with eyes on the patient and not on the clock.
2. Better research on nutritional therapies
The quality of nutritional research leaves a lot to be desired. The conclusion reached is often that a nutrient has no effect on a particular outcome. Doses employed in the studies are often low, lower than we employ in our practice, and frequently not obtained from the same source for all patients. The source of the vitamin should be constant, the dose should be substantial, and blood levels should be measured.
Regarding vitamin C, it has been demonstrated that the anti-cancer effect requires a high dose, only achieved through intravenous administration. Also, the effect of folic acid in preventing fetal malformations increases as the dose is raised.
With conventional drug studies, it is established that 80 mg of Lipitor is far more effective than 20 mg in preventing cardiac events. This approach, of using higher doses and comparing them with lower doses, should be employed in nutrient research. There is the further benefit that nutrients are generally safe in high doses. (more…)
The Food and Drug Administration (FDA) has proposed restrictions on the use of nutritional supplements that may go into effect on October 1, 2011, unless sufficient opposition is offered. The plan is to classify supplements introduced after October, 1994, as “new dietary ingredients”, subject to expensive and prolonged testing and verification.