We received this letter from our HMO the other day and I was interested (but not surprised) to see that they are still stuck in the Great Cholesterol Fear campaign. There is so much information available now about all the problems with this simplistic approach that nothing that I can say is going to convince anybody in any new fashion that Kaiser is completely wrong here. But I like a good rant as much as the next pirate (even if I don’t rant quite as well as Pirate Ben’s grandmother) so I’ve posted this as a companion piece to the tribute to Kaiser Permanente which I ran when I started this blog.
The problem with Kaiser is that it is completely governed by committee thought, and that does not make for good medicine. The use of medical guidelines to determine health care treatments is, in my opinion, one of the worst things that has happened to us – what are you supposed to do when you know the guidelines are wrong? This puts you in a terrible position, because you can no longer trust your doctor. That the staff at Kaiser is overworked and overbooked only adds to the difficulty; you get about 15 minutes with somebody…if you are lucky. And of that 15 minutes, how much of it is actual face-to-face conversation? And since the doctor is so pressed for time now, she has to spend the entire visit typing on her keyboard, which means she can’t even look at you beyond the initial greeting. Tell me that the visual aspect of a doctor visit is not important.
I think western medicine is great if you have a trauma issue or an infection. But the number one problem in our society now (speaking in medical terms) is not infectious diseases like it was 100 years ago, it’s chronic conditions. And most of those are caused by lifestyle choices we make or which, unbeknownst to us, are made for us. Diabetes, obesity, arthritis, I don’t know where to begin – an entire list would be enormous. As Sarah Ballantyne points out, you can start with these as having inflammatory causes which are strongly related to what you eat:
Amyotrophic lateral sclerosis (ALS; aka Lou Gehrig’s disease)
Chronic fatigue syndrome
Chronic obstructive pulmonary disease (COPD)
Dercum’s disease (aka Adiposis dolorosa)
Opsoclonus myoclonus syndrome
Progressive inflammatory neuropathy
Some forms of cancer
Ballantyne lists several pages of such conditions in her book The Paleo Approach: Reverse Autoimmune Disease, Heal Your Body. Friends, this is the book to have handy if you need biochemistry to back up your arguments! (Mini review: great book for dealing with autoimmune conditions or just understanding how your body reacts to various inputs, very tech heavy through the first section, somewhat spoiled by almost complete reliance on boring stock photographs; except for the occasional headshot of a quoted person all the photos are generic images from stock agencies and they could go in any medically related book at all. Too bad, because otherwise it is a good book.)
My point here is that while western medicine is great if you break a leg and need it set, or if you need surgery for an acromial impingement (like I did), it is mostly ineffective when it comes to managing conditions which are food or lifestyle related. The discouraging thing is that most doctors don’t seem to think this is a problem, so maybe all it means is that I don’t know what I’m talking about and I should shut up and listen to them. After all, they are the experts with degrees, aren’t they?
Problem is, these same people are the ones who told me for thirty years that I either had imaginary problems, or that I was depressed, or that I had problems of idiopathic origin (which just means that they don’t know what the problem is but it sounds a lot more official, doesn’t it?), or that I should try an anti-dandruff shampoo (I’m not kidding). And *I* am the person who found out on my own what the real problem was; it was the damn wheat I had been eating all my life. So why in the world should I take these people seriously when they tell me now that elevated cholesterol can increase my risk of heart attack when this time I know it simply is not true? I’m not the totally uninformed patient I was a few years ago, guys. I’ve read enough comments by doctors on their own blogs about how patients are getting more involved in their care and I can see how, from the doctors’ point of view, this could be a problem when everybody is questioning their treatment, but in this case I think the doctors have nobody but themselves (as a profession) to blame. If they hadn’t been so enamored of fright-based messages like ELEVATED CHOLESTEROL CAN INCREASE YOUR RISK OF HEART ATTACK then perhaps we might have a bit more trust in their diagnoses and treatment.
So now I know that the Earth is still flat according to Kaiser, and I still stand by my original assessment of the organization: