The Complete Patient

The key to changing America's approach to healthcare from obsessing about curing disease to encouraging robust health as a way to avoid disease is education. The best way to educate people about the problems of our conventional health system may be to regularly expose examples of its contradictions and weaknesses to the light of day. That is what wellness advocate Mike Adams, who calls himself the Health Ranger, is thinking, except he is doing more than thinking about it. He wants to do something, and he's come up with a clever journalistic approach: he is seeking "whistleblowers" among Big Pharma employees, health insurance workers, teachers, patients, and others who are in a position to witness wrongdoing.

He wants to get the word out, so if you think you have a story to tell about wrongdoing in the healthcare system, look at his site and send him your story. He seems a bit dramatic, such as when he states: "The Berlin Wall of medicine, that has for so long isolated people from the truth about health and healing, is about to come crashing down. Now is your chance to leave your mark. Pick up that whistleblowing sledgehammer and help us tear down this wall by exposing the fraud, corruption and criminality in medicine today."

 There's one other thing I don't care for about Adams' approach to healthcare education: his conviction that because he is a physical specimen, everyone else can become a physical specimen. He has posted photos of his impressive physique, along with his admirable medical statistics (cholesterol, blood pressure, etc.) to make his argument. The approach reminds me of entrepreneurs who trumpet their success as evidence that anyone willing to follow their regimen can be similarly successful. But just as not everyone is cut out to be a successful entrepreneur, not everyone is blessed with good health, no matter how well they eat and how much they exercise. Sometimes, genetics and/or environmental factors outweigh all else.

But what the heck. With millions of blogs and sites, you've got to stand out. Let's see if Mike's idea about whisteblowers gets some traction, and helps in the education process.

The thing that bothers me most about Joseph Mercola, the osteopath whose site I criticized in my latest BusinessWeek.com column, is his hypocrisy. He rails on against the tactics of Big Pharma and the medical establishment, and then he employs questionable tactics of his own to feed his business machine.

It's easy to say that if Big Pharma is underhanded in its marketing tactics, sellers of nutritional supplements can do the same thing. Maybe I'm too idealistic, but I think the purveyors of nutritional supplements and related products need to operate at a higher level. Even though such products have been around longer than Big Pharma's, the sellers of complementary products and services are the new kids on the block so far as much of the American public is concerned. Most people have been brainwashed since they were children about the supposed miracles of Big Pharma.

The growing number of consumers nervous about Big Pharma's track record of dangerous and addictive products are open to new possibilities. But when they encounter healthcare practitioners like Dr. Mercola, who appear to operate pretty much like the average automatic-slicer-gadget pitchman, they quickly become skeptical. As well they should.

I still occasionally receive calls and emails from men (and sometimes from their wives), based on my article three years ago about my personal experience deciding on a course of treatment after having been diagnosed with prostate cancer (for more details and a link to the article, see "About me". This past weekend I received one of those calls, from a 72-year-old man who had just received the prostate cancer diagnosis. He was quite anxious, as you would expect, but he was also confused. He had visited with several doctors, and just wasn't sure whether to go with radiation or surgery. And if he went with either one, which doctor and hospital should he select? I repeated the warning I gave in the Boston Magazine article of three years ago about avoiding Boston surgeons, but beyond that, it was difficult to advise him on which approach was preferable. Although I try to avoid being too specific in my advice because I'm not a medical professional, I also know there is much confusion within the medical establishment about what treatments work best in what situations.

Literally an hour after that conversation, the current issue of BusinessWeek was delivered, with this headline on its cover: "Medical Guesswork: From heart surgery to prostate care, the medical industry knows little about which treatments really work." 

The real point of the various articles that comprise this cover section is that doctors tend to recommend the treatments they know best, or those they actually perform, and make their livings from. When you think about it, this makes sense. No one can know everything there is to know about medicine and health, so professionals focus on the area(s) they are most familiar with. The same thing applies to alternative care providers. Consult with an acupuncturist, and he or she will prescribe acupuncture for nearly anything that ails you. Same with chiropractors, or nutritionists.

Bottom line: It's up to you, the patient, to do a lot of homework and determine what the research, and your own instincts, tell you about how to handle a threatening condition. That's what I told the man who called me. It wasn't exactly what he wanted to hear because, like most of us, he'd like to be taken by the hand and led to a cure. But that's the way it is, especially in our super-competitive health-care marketplace.

Wal-Mart is already the nation's largest seller of groceries, but still, there's something disconcerting about the recent news that it plans to introduce a wide range of organic food products beginning this summer. The problem is that when Wal-Mart enters a market, its basic approach is to squeeze suppliers to bring down prices. One of the big reasons farmers have switched to growing organic foods is that profit margins are higher than growing conventional produce. Once Wal-Mart gets through with them, they'll just be selling another commodity. When suppliers get squeezed, they find ways to cut costs, and often quality.

Another disconnect in the Wal-Mart push into organics is that you know Wal-Mart cares not a bit about nutrition. So its suppliers will slap the word "organic" on everything containing ingredients grown without pesticides--including pasta, chips, carbonated drinks, and sweet children's cereals. One of the big attractions of Whole Foods and its reliance on organic food was its refusal to allow Coke, Pepsi, Frito-Lay and Kellogg's into its aisles because of their heavy use of sugar, artificial sweeteners and transfatty acids (even though Whole Foods over the years has become ever more lax in its standards).

A New York University nutritionist quoted in the NY Times story I linked to in the first paragraph stated that the Wal-Mart move represents "a ploy to be able to charge more for junk food." Ah, organic junk food...what a warm, fuzzy thought that is.

I was watching the national news last evening, doing my usual switching among the network programs hoping to catch news on one while advertising was showing on another. Of course, they have it timed so their ads all run at precisely the same times, so I couldn't win this battle. But something else stood out.

Perhaps because I hadn't watched the evening news programs for a few weeks, I was struck by the fact that all the ads, on each of the three network stations, were Big Pharma ads, encouraging viewers to push their doctors to prescribe medications. These have gradually over the last few years been creeping in, but usually they were sandwiched among ads for new cars or for over-the-counter hemorrhoid concoctions.

There were medications to control urination problems (for men and women), to reduce cholesterol, to slow the progression of Alzheimers, and others I can't even remember now. (Maybe I should try that Alzheimers drug!) Each was followed by fast-reading lists of terrible side effects that can result from using the drugs.

I'm not the only one who's noticed. Forbes ran a major feature earlier this month: "Pill Pushers: How the Drug Industry Abandoned Science for Salesmanship".  (It will cost you $2 to see the full article.) It begins by describing a Big Pharma concoction for relieving an annoying fungus that leads to yellow toenails--and, oh by the way, has led to 16 cases of liver disease. The idea is that Big Pharma's single-minded pursuit of sales isn't just distasteful, it's dangerous.

And if today's Financial Times is correct, countries outside the U.S. are tiring of Big Pharma's ongoing pitch to consumers to badger their doctors to prescribe the latest medications. Health care regulators in the UK, Germany, and other coutries are refusing to pay for many of these medications, arguing they are too expensive compared with older drugs that often do the same things. (You can get the start of the article, but unfortunately the Financial Times will push you to take a trial or paying subscription to see the article.) Will U.S. insurers be next in questioning the Big Pharma smorgasborg?