Anthony Almada, B.Sc.10.01.03
Immune To Ignorance I. De facto
When white coat knowledge ventures into nutritional science, does Doctor know best?
ByAnthony Almada, B.Sc., M. Sc.
Long has been the fascination with the M.D., the “real doctor,” the white-coated clinician lauded by TV and film. No other health professional among the masses enjoys the same exaltation and reverie for being a font of medical knowledge as the woman or man for which these initials form a punctuated suffix after their surname. Enduring thousands of hours of book, lab and bedside training, often pushed beyond the limits of cognitive endurance and forced to render life or death decisions as somnambulists. Bridging the gulf of self-infection and malpractice, medical doctors are indeed the primary proselytizers of medical and surgical intervention. Despite the continued adulation they enjoy and the rigors of their education and training, I am unaware of any medical school that issues M.D. degrees where the initialism means Master of Diet.
Who made MD’s experts in nutritional sciences—pharmacology, biochemistry and therapeutics? As I border upon the precipice of waxing categorical, MD’s have errantly assumed the rank of nutrition expert despite the modicum of training and research experience they have elected to undertake. Yes, there is a micropopulation of MD’s who are savvy, smart, and indeed informed, but their rarity is similar to the number of persons seen flaunting real fur clothing at a gourmet tofu dinner fundraiser for PETA (People for the Ethical Treatment of Animals). Would you obtain architectural plans for your dream house from a caricature artist at Disneyland?
Imagine a parallel world with a different axial rotation: nurses, dietitians, real nutritional science PhD’s, pharmacists, and even organic farmers write national bestsellers on the latest surgical procedure to correct obesity, photo-aged skin, macular degeneration or myopia. Individuals from the same professions start doing the talk show circuit, advocating the latest prescription drug to treat “your learning-challenged child,” fading memory or recurrent breast cancer. How about midwives describing the newest method to achieve successful in vitro fertilization—after the very first attempt? You gotta love their entrepreneurial spirit! How long would these evangelists and advocates be allowed to seek and create disciples before being publicly excoriated by a myriad of medical organizations (back here on Earth)? I would wager that it would be a fraction of the average time that each MD in North America has invested in formal nutrition training in medical school or during residency…
“A doctor has more credibility,” some may argue. I argue the contrarian position: doctors are typically ignorant of the breadth and depth of nutrition science and its related disciplines, rendering them superficially informed at best. Countless times over the past two decades, either in print, online (more recently) or in person (e.g. trade shows), I have read statements that glaringly exposed the MD author’s ignorance and/or lack of a comprehensive and integrated understanding of the foundational and current evidence base. Far more entertaining have been the seminars wherein both non-academic MDs talk nutrition science to retailers, industry professionals or consumers. Mispronunciations, malapropisms and misinformation run amok but who in the audience is able to discern the lack of veracity? Very few, and these folks usually assume a reticent state.
Am I infected with hubris, attempting to denigrate the medical profession in a public forum and banish them from any role in the nutraceuticals industry? No (at least to the latter clause). I have encountered some ultra sharp MD’s in relation to nutritional sciences (I even have some friends that are MDs…). Granted, a majority of them have been academic researchers, too, but there are a few out there in private practice and clinics that truly are nutrition-brilliant and informed.
What is proprietary about this perspective? Fashion this thought: the real world rarely is “monotheistic” in relation to health protection and disease treatment. Thus, drugs, surgery and physical therapy often rub up against supplements, foods and other “alternative interventions.” The best place for an MD to create value for a branded ingredient or product is to report from the trenches and portray the scenes as they are—in real life. Reality medicine. Reality TV is a certifiable trend. Describing the real world effects and impact of a nutraceutical ingredient/product among persons that are also taking certain medications, exhibit a history of hypertension and/or have an increased genetic risk for a certain disease, adds an element that often is absent from clinical trials. Such observations, if undertaken in a systematic manner, are equivalent to post-marketing surveillance/phase IV trials. These can only further the integration of different modalities of medicine and health protection. “Use with the complementary care of a physician” eclipses the mantra “Use only under the supervision of a physician.” And from the perspective of value addition, the skill-intensive art of medicine is unveiled, magnifying the science of nutrition as demonstrated by those truly skilled and learned in the science (who can also be quite capable value-adders). NW
Next installment: Immune to Ignorance II. Faux “Experts”—Can the “expert” with the academic credentials from Unknown University please spell the word “dissertation?”