Just Because A Doctor Said It – A Response

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About a week and a half ago I posted a Facebook status which read, “I’m sorry, but just because ‘your doctor said so’ doesn’t mean you’re right.”

It was in response to an article that Adam Bornstein wrote on Livestrong.com titled The Most Dangerous Diets Ever, where a handful of readers were up in arms that he dissed the HCG Diet.

For those unaware, the HCG Diet is where one injects hormones (derived from the human placenta) into their while following a 500-800 kcal per day diet for “x” number of days…..

……under a doctor’s supervision, of course.

I’ve made it known in the past how I’m not a fan of this “diet”, and that I find it absurd that anyone would think injecting themselves with (EXPENSIVE) hormones while following such a pitifully low caloric intake for an extended period of time is a healthy endeavor.

More to the point, I find it downright appalling that any physician would endorse such a plan and then recommend to his or her client(s) to try it.

Makes me wonder whether they went to an actual medical school or Hogwarts School of Witchcraft and Wizardry.  Hahahahahaha. See what I just did there?  Zing!

That notwithstanding, the main argument for those who defend the diet is “well, my doctor said it was safe.”

Riiiiigggggghhhhhtttt.  Lets not forget that there was a time when doctor’s recommended that people smoke for its health benefits.

To reiterate what I said earlier in the week:

I’m not saying that ALL fall under this umbrella – there are undoubtedly many superb primary care personnel out there – but I find it hard to believe that any doctor would advocate this diet without some monetary kickback or incentive to do so.

It’s a lot easier to tell someone to drop $1500 on hormone injections than teach them proper eating and lifestyle habits, I suppose.

Then again, doctors don’t necessarily practice health and wellness, they practice medicine. If you present with a symptom, they’re going to treat that symptom with medicine. So, I guess I can’t fault those who do advocate this diet. Most get two weeks of course work in nutrition – max – during medical school.  Many think apple juice is the same thing as an apple!

To that end, today I’d like to share a guest post from Joe Lightfoot who, as a current medical student AND strength coach, has a unique perspective on the topic.

Enjoy!

Just Because a Doctor Said It – A Response

Tony’s recent Facebook status update (and blog post) regarding doctors created quite a lot of debate, and a lot of interesting thoughts were expressed. However, I felt the overriding response was one of negativity towards doctors.

It inspired me to write the following blog post. So how come I feel strongly enough about the issues to write about it?

My Story

Well, I’m about to graduate medical school this July and I’m also a coach (currently I work as the S&C coach to the England Under 19 Lacrosse team and I also work with non-athletes too). As I’ve seen it from both sides, I hope I can add a new perspective to the debate.

First off, I agree 100% with Tony’s statement. Just because a doctor does say something it doesn’t necessarily mean it’s true.

But you shouldn’t be surprised or offended when a client has the point of view. Doctors have held, and will continue to hold a position in society whereby the public trusts them (whether rightly or wrongly in certain situations).

Why? I feel it’s due to the differing barriers of entry for both professions. To become a coach or trainer is relatively easy, however to become a doctor you have to complete either five years of medical school in the UK, or a total of eight years in the US counting undergraduate studies and then medical school.

Now the length of formal schooling is not a sure fire test of how correct someone is, but if you were a member of the public with no prior knowledge, who would you trust?

The client doesn’t know that you’re a hotshot trainer or coach who’s well read, takes care of continuing education, and has a wealth of experience. You could be someone who did one certification and professes to know everything.

Furthermore getting a client or athlete to trust you is your job. So whilst it’s damn annoying when someone believes something incorrect just due to someone’s perceived authority, attacking that said person won’t help the matter.

I think by demonstrating credentials, building trust and offering evidence to back up your advice is the best way to have an impact on your clients.

As a coach, I think a doctor’s position of trust is something you should use, not try and dispute. Rather than someone to fight against, that doctor could become one of your best allies in promoting healthy behaviours. I think it all begins with reaching out to the doctors of your clients and forming a partnership, and even offering education on the area of your expertise.

Doctor’s Knowledge Of Lifestyle

So do doctors know about lifestyle advice? The short answer is no. You’d be mortified if I told you how much education and training I’ve had regarding exercise and nutrition.

If I had to sum up my experience at medical school in one sentence, I’d do so like this: I have learned about disease, but I haven’t learned about health.

Doctors need more education on everything to do with lifestyle advice, particularly exercise and nutrition. That is indisputable.

But it isn’t all bad news. I’m currently visiting the US and shadowing a number of doctors in Boston. I recently met one doctor who is currently studying for the CSCS. Her reason? Exercise is one of the most important things her patients can do.

This isn’t a lone example. There is a light at the end of the tunnel.

Why All The Negativity?

Like any profession there are good and bad people. Medicine, like coaching, is no exception.

To say all doctors are egotistical, cheat on the wives, don’t practice continuing education or think critically is wrong, and frankly offensive.

Whilst some are motivated by money and titles, the vast majority of people became doctors because they want to help their patients.

If you took just a snap shot, you could quite easily come to the conclusion that all trainers are just out to sell the latest gadget to make money, and coaches all shout and scream at athletes until they collapse. In fact, the opposite is true, and the industry is full of awesome people who know their stuff and make a major positive impact on people’s lives.

The Future

Mike Boyle has said it; I think I’ve heard Dan John say it: Coaches and trainers are a front line defense against disease and illness, and we’re some of the few professionals practicing proactive healthcare and preventative medicine.

Doctors should welcome coaches and trainers support, guidance and help. Medicine is becoming increasingly multi-disciplinary and I hope to shortly see the day when patients are referred to strength & conditioning coaches.

So what can we do? It all starts with education. I’ve made it a life goal to bring the medical profession up to speed on lifestyle advice, and create a true health service with the Move Eat Treat campaign.

This campaign aims to educate health care professionals on lifestyle advice, including nutrition and exercise. Coaches and trainers have a wealth of information, which doctors need to embrace and understand.

Final Thoughts

Someone once told me that to change a health care philosophy would take 50 years. So I figured we best get started. A major step is getting doctors and coaches to work together, and it starts with mutual respect of each other skills.

Who’s up for creating a proactive health service? I’d love your support for the campaign HERE.

  • http://www.sirenabernal.com/ Sirena Bernal

    Great write up and I totally agree. And I think as coaches (strength, fitness, nutrition or otherwise) it’s part of our responsibility to educate ourselves on lifestyle management, yet we walk a very fine line when making nutrition/lifestyle recommendations, because we can be accused of “playing doctor” when in some cases, not all, a well-educated and experienced coach may actually be able to provide better advice than an MD.  

    Might as well add the feeding tube diet to the list as well! Ree-donk-u-lous!

    • http://www.jplightfoot.com/ Joe Lightfoot

      Thanks Sirena! It can be tricky giving out advice, but like you say coaches can often give better advice than MD’s. I think we forget sometimes how difficult it must be for a patient/client getting information from multiple people – that’s why collaboration and discussion is so important.

      • http://www.theoryofhealth.com/ Graham Lutz

        I think the issue here is that, like tony said, they practice medicine, not health and wellness. In the US, with the amount of debt physicians have, there is an almost overwhelming pressure to pick the treatment that pays the bills as opposed to the one that is the best, short and long term, for the patient.  

  • Barath

    Nice write-up Joe! And wish you all the very best in your final year in med school.

    My experience with doctors has always been positive – partly because I don’t go to doctors asking them how to reduce my weight, what my diet should be etc. It’s a common complaint that western medicine only treats the symptoms – but let’s face it, if you are facing acute back pain and want it gone, you’d rather take a pill than fall back on homeopathy.

    I am also frankly quite surprised that so many people come up saying “My doctor is an ass because….”. I am not discrediting these people (they may well be right), but I’d like to know who these doctors are that give such “horrible” advice.

    Eat healthy, train smart, and learn to “use” your doctor well – seems like the best of both worlds to me!

    • http://www.jplightfoot.com/ Joe Lightfoot

      Thanks Barath! I’m glad you’ve had positive experiences with doctors. There are some fantastic practitioners out there.

  • http://adamrees.blogspot.com/ Adam

    Extremely well put. All of it. 

  • deansomerset

    Absolutely agree with everything said in this post. I’ve had a lot of these discussions with physicians and surgeons, and a lot of the time they can’t spare the additional time to learn about the best way to squat or glycemic load because they’re trying to prevent people from dying today, or from living in agony. We both look into the same room, we just look through different windows and see different things as being important. Excellent post. 

    • http://www.jplightfoot.com/ Joseph P Lightfoot

      Thanks Dean! That means a lot coming from you, I’m a big fan of your work!

      I love the “different windows” concept and I’m definitely going to use that in the future!

      Thanks again.

  • Joaquin

    Excellent post. I work in a physical therapy clinic that also does performance/ corrective exercise work. The majority of my clients who aren’t from the PT side are Doctors and Nurses. Many of them know so much about their field (surgery, trauma, OBGYN etc) that they can’t know anything and everything regarding exercise and diet. Many of them are humble enough to admit it, want to loose weight and get in shape get a QUALIFIED trainer. Want to stitch up your arm or get your gal bladder removed, see a Doctor. Sorry for my rant but I grow tired of out of shape (sometimes overweight/obese) medical professionals giving out poor advice simply because they don’t want to lose face in front of their patient. 

  • http://twitter.com/BenCoker1 Ben Coker

    Excellent work Joe. 

  • Lilew13

    What a wonderful post! I’m interested to learn more about MOVE EAT TREAT. Great job with the website and keep up the great work! 

    • http://www.jplightfoot.com/ Joe Lightfoot

      Thank you!

      You can learn all about the campaign at what we hope to achieve here: http://www.moveeattreat.org/

      I hope you’ll consider signing our petition too!

      For more about the background of the campaign, I talk about that in this interview Kellie Hart Davis did with me: http://www.motherfitness.com/creating-the-bridge-between-lifestyle-and-medicine-an-interview-with-joseph-lightfoot/

  • Cat

    Easy way to point out what a doctor does and doesn’t know about health…. they still think that BMI is the best tool out there for weight/obesity assessment :/

  • http://www.facebook.com/profile.php?id=575852894 Adam Hope

    Nice work, Joe. Keep fighting the good fight!

  • wish9795

    I’m a 16 year old baseball player who trains at CP, and my doctor said no to creatine earlier this year, and that was all that my parents needed to hear to not let me use it. No matter all the credible research  and nutritional consultations we went through at CP, still, the doctor’s word was all that mattered. 

  • http://trainlikeakodiak.wordpress.com/ Brett

    Great stuff Joe, thanks for writing.

    Your local supermarket might have decent food, but if you want great food you could travel to a farmers market. The gym around the corner might have machines, but if you want expert coaching you may have to research your options.

    There are lots of people out there who go above and beyond what’s required of their profession, and they are the great people who will be seeked out.

    However there will also be those who fall below the bar, and they also get highlighted.

    If I was researching an issue I would look at both arguments. I think it’s sensible to visit a doctor, research the issue yourself, and branch out to someone like Tony if needed, then you have the power to make a decision yourself based on professional consultation and your own research.

    • http://www.jplightfoot.com/ Joe Lightfoot

      Thanks Brett! I think what you say is spot on. 

  • Will Levy

    This was outstanding. That is all.

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  • TonyGentilcore

    Really glad to hear that everyone enjoyed this one.  I thought Joe hit the nail on the head!

  • Chris

    Good post Joe.  As a coach who trains doctors, nurses and surgeons, I’m lucky enough to have them realize that they are taught to be the best at their chosen craft in medicine and not about the best way to squat or deadlift.  That’s why they came to me.  They admit they don’t have the time to learn about the nuances of lifting because they are busy saving lives in the ER and the work we do together only strengthens the bond between medical professional and strength coach. 

    • http://www.jplightfoot.com/ Joe Lightfoot

      Great to hear Chris, it sounds like you know some good docs!

  • http://profiles.google.com/dpopetraining Dan Pope

    Great Post Joe.  I’m a physical therapy student right now and a personal trainer/coach.  I wish people put more emphasis on prevention.  We’d save plenty of medical dollars.  Its unfortunate that people don’t care about their health until it’s lost.  I’ll check out your site.

    Thanks

  • RS

    Tony,

    Thanks for this post. Joe nailed it bigtime.

    RS

  • Zach

    Tony & Joe – 

    Outstanding work. Joe, you couldn’t be more right. I’m graduating this month as well, and have been similarly disappointed in the complete lack of education in the USA on this matter. I am glad to hear that there are others who are fighting the good fight from within the (future) MD ranks. An analysis of MD students that would be extremely telling is to measure what percentage has even heard of the word “deadlift”. It would be shameful.  

    I think the topic of preventative musculoskeletal medicine is such an interesting and emerging field. As we’ve seen with the results of recent studies on ACL injury prevention protocols/programs, quantifying and showing benefit from preventative programs is especially challenging. I believe this is where medicine’s dependence on P values hits a wall; some parts of the world have too many moving variables to be able to study effectively using t-tests. As I’m sure you’ve seen, you can’t get MD’s to buy into change without these types of studies and for good reason. The problem is that its not that we can’t show a difference, its that MEASURING the difference becomes tremendously challenging when the geometry of the musculoskeletal system comes into play. Working around that mindset is a huge part of the future. 

    I wish you the best of luck with Move Eat Treat; lofty ambitions but great and very worthwhile goals. 

    Zach

    • http://www.jplightfoot.com/ Joe Lightfoot

      Zach, congrats on your upcoming graduation! Thanks for your kind words. You make some great points and I think you’re right it is really hard to get a balance, and measuring things can be tricky.

      The area of preventative MSK is a really interesting area, and it’s only getting bigger and better. I’d like to see gyms/facilities do their own internal research and audits showing their injury rates and level of prevention. I think it’d throw out some great data.

      Your idea of polling MD students on S&C topics is a really interesting one – I might look into that! It’d be really interesting to get an idea of views on common topics.

      Thanks for your support!

  • Andy

    Awesome stuff Joe :)

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  • http://www.jplightfoot.com/ Joe Lightfoot

    Thank you for all your kind words guys! I really appreciate it. 

  • http://www.facebook.com/people/Marc-Halpern/15714777 Marc Halpern

    Great post, couldn’t agree more.  My fiance had a doctor who after failed treatment for reflux wanted to explore taking out her gallbladder.  I had her try a gluten free diet, and no problems (wonder how many people have had similar issues).  My favorite is when a client has a knee problem and the Dr. says strengthen the quads! I think the problem isn’t with med school or ego, I think it is a lack of networking.  We must make ourselves available and create a system in which a doctor can easily refer someone to us for a lifestyle makeover.  There is no need or time in med school to teach them what we already have spent years studying.  This would let the doctors do their job, and us do ours, with open communication.  Like you said, maybe 50 years from now they will look back and laugh at our current system…. 

    • http://www.jplightfoot.com/ Joe Lightfoot

      Thanks Marc, you make some great points! Creating a system with communication between departments is key. 

  • Marianne Kane

    Agree 100% Joe! Thanks for this :-)

  • Kellie Davis

    Joe, I’m so late to the party, but great write up! Hope you visit the US again soon and we can meet up. You truly are a gift to the medical community. 

    • TonyGentilcore

      Indeed he is! Joe’s actually coming to Boston soon, so I think he and I will be meeting up. Nah nah nah, Kellie.

      • http://www.jplightfoot.com/ Joe Lightfoot

        Thanks Kellie, you’re far too kind! I hope we can meet up soon too. 

        P.S. A doctor wrote a response to my response – definitely worth checking out as he makes some really interesting points! 

        http://www.lift-heavy.com/a-doctors-response-to-a-response-from-a-doctor/

      • Kellie

        I see how you are! Joe, you knew that would light a fire under my tail. I responded in the comments of his post. Maybe I wasn’t playing nice. 

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