Appendix 4 - Food for Thought

[Guest guest]

Appendix 4 - Food for Thought

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

 

 

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The amount of power granted to physicians in our society is obscene.

From an article published in the Journal of Medicine and

Philosophy, " In the case of the United States, the question of how a

profession held in low esteem and mired in a complex and unwieldy

competitive system, managed to create a degree of professional

sovereignty and social authority unprecedented anywhere else in the

world, is a fascinating one. " [65]

 

As reported in Medical Economics in 1998, doctors held on to first

place in ratings of public regard

for 17 occupations. Almost 5 out of 6 respondents saw physicians as

having " very high prestige. "

 

Politically interesting, union leaders

were held among the lowest in public esteem.[66]

 

Quoting from a book entitled Women and Doctors, " No other

professional in America enjoys the degree of authority that

physicians have managed to secure. Almost unquestioned in their

judgments, they have been given the authority to exercise power in

areas that extend beyond their medical are of competence. " [67] Case

in point, nutrition.

 

Physicians are cited as the source of the best, most reliable, most

credible source of information about nutrition.[68]

 

A Dutch study of 600 consumers found that they preferred the advice

about healthy eating habits from their physician over 10 other

potential sources including dietitians, the government, consumer

organizations, etc.[69]

 

The sad reality, though, is that most doctors know next to nothing

on the subject. A study, for example,

in the American Journal of Clinical Nutrition pitted doctors against

patients head-to-head in a test of nutrition knowledge.

 

More than

half the patients scored higher than the physicians![70]

 

This is not surprising given the amount of nutrition training

doctors get. A 1993 report to Congress documented that less than a

quarter of U.S. medschools require nutrition as a separate course.

 

 

[71] And it shows. One 1998 study of medical student nutrition

knowledge, for instance, showed that less than a quarter of students

had any knowledge of the nutritional value of fruit juices and soft

drinks.[72] The stats are similarly dismal in residency programs.

[73] The Committee on Nutrition in Medical Education has concluded

that, " Nutrition education programs in U.S. medical schools is

largely inadequate to meet the present and future demands of the

medical profession. " [74]

 

 

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[65] Pippen, RB. Medical Practice and Social Authority. " Journal of

Medicine and Philosophy 21(1996):417-437.

 

[66] " Shining Brightly Because of Public Gloom Over Managed Care. "

Medical Economics 1998(August 10):29.

 

[67] Smith, JM. Women and Doctors New York: Atlantic Monthly Press,

1992.

 

[68] Fowler, G. " Dietary Advice. " British Medical Journal 285

(1982):1321-1323.

 

[69] Hiddink, GJ, et al. " Consumers' Expectations about Nutritional

Guidance. " American Journal of Clinical Nutrition 65(1997):1974S-

1979S.

 

[70] Lazarus, K, RL Weinsier and JR Boker. " Nutritional Knowledge

and Practices of Physicians in a Family Practice Residency Program. "

American Journal of Clinical Nutrition 58(1997):319.

 

[71] Ockene, JK, et al. " Physician Training for Patient Centered

Nutrition Counseling in a Lipid Intervention Trial. " Preventive

Medicine 24(1995):563.

 

[72] De Villiers, FPR and UE Macintyre. " Medical Students' Knowledge

of Nutrition Still Inadequate. " Education for Health 11(1998):378-

390.

 

[73] Lazarus, K, RL Weinsier and JR Boker. " Nutritional Knowledge

and Practices of Physicians in a Family Practice Residency Program. "

American Journal of Clinical Nutrition 58(1997):319-325.

 

[74] Ammerman, A, et al. " Medical Students' Knowledge, Attitudes,

and Behavior Concerning Diet and Heart Disease. American Journal of

Preventive Medicine 5(1989):271-278.