The fundamental reason why doctors do not know much about nutrition is because very few of them study much, if not anything, about nutrition in medical school. This is largely because the curriculum is heavily influenced by the food and drug industries. Ray D. Strand, MD, the author of Death By Prescription, punctuates the lack of education about nutrition by saying:
- “In medical school I had not received any significant instruction on the subject. I was not alone. Only approximately 6 percent of the graduating physicians in the United States have any training in nutrition. Medical students may take elective courses on the topic, but few actually do… the education of most physicians is disease-oriented with a heavy emphasis on pharmaceuticals — we learn about drugs and why and when to use them.”
Dr. Strand, also, observed that doctors usually make good teachers, but not good students. Most doctors fear not knowing the answers to medically-related issues and will try to present themselves with as much authority as possible.
Dietary supplements are a very foreign subject for most doctors, and most doctors show no interest in learning more about them. He opines that doctors are not taught much in medical school about the power of nutrition in medicine – only about the power of prescription drugs and surgery as treatment for diseases.
He agrees with our observation that the focus of a medical education is on treatment and not on prevention. According to Dr. Strand, it is this mind set that causes most physicians to be unreceptive to new ideas in medicine. Dr. Strand explains the effect that his medical education had on him for the first 23 years of his medical practice by saying:
- “To be honest, I knew next to nothing about nutrition or nutritional supplementation…. Because of the respect people have for doctors, they assume we are experts on all health-related issues, including nutrition and vitamins. Before my conversion experience with nutritional medicine, my patients frequently asked me if I believed their taking vitamins produced any health benefits…. Handing the bottles back, I’d say that the stuff was absolutely no use at all…. What I did not share with my patients was that I had not spent a minute evaluating the hundreds of scientifically conducted studies that proved the value of supplementation to health’.
- For the first twenty-three years of my clinical practice, I simply did not believe in nutritional supplements. During the past seven years, however, I have reconsidered my position based on recent studies published in the medical literature. What I’ve found is so astonishing, I have changed the course of my medical practice…
- Physicians seem content to allow the pharmaceutical companies to determine new therapies as they develop new drugs… physicians are simply too busy treating disease to worry about educating their patients in healthy lifestyles that help avoid developing degenerative diseases in the first place.
- As I have applied these principles in treating my patients the results have been nothing short of amazing.”
To counter the above argument, Baxter Healthcare Corporation, Bristol-Myers Squibb Company, Central Soya Company, Inc., Clintec International Inc., Dannon Institute, Egg Board, Kellogg Company, National Cattlemen’s Beef Association, National Dairy Council, Nestlé USA Nutrition Division, Quaker Oats Foundation and Wyeth-Ayerst Laboratories funded a survey soaked in self-serving conflicts of interest.
The survey claimed “Our findings proved that nutrition education is an integral part of the curriculum for the majority of US medical schools surveyed.” The survey cited as proof that “A number of medical schools have chosen to incorporate nutrition education into already established basic science and clinical courses.” To say otherwise would be to admit that doctors learn little or nothing in medical school about nutrition, vitamins and minerals. It would also affect corporate donations to medical schools.
Since the survey was sent to the heads of the medical schools, what answer did they expect to receive? This survey is about as independent as asking the fox how the chickens in the henhouse are feeling.
Conflicts of interest are rampant at medical schools across the U.S. In 2008, Senator Charles E. Grassley, an Iowa Republican, exposed conflicts of interest at Harvard Medical School and its teaching facility, Massachusetts General Hospital, when an investigation revealed that psychiatrists Joseph Biederman, Thomas J. Spencer and Timothy E. Wilens failed to report the full amount of their earnings from drug companies over the previous seven years. Dr. Biederman was a professor of psychiatry and Chief of Pediatric Psychopharmacology at Massachusetts General at the time.
Doctors Biederman and Wilens subsequently admitted to earning more than $1.6 million from pharmaceutical companies since 2000. According to the Congressional Record, the doctors had reported their drug company income as a couple hundred thousand dollars.
Senator Grassley revealed that drug companies, including those that make drugs Biederman advocates for childhood bipolar disorder, had paid Biederman $1.6 million in consulting and speaking fees between 2000 and 2007. The total unreported income for the three doctors topped $4.2 million.
As a result of Dr. Biederman’s test studies, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the FDA for that purpose and none of which were approved for children below ten years of age.
Dr. Biederman’s own studies of the drugs he advocated to treat childhood bipolar disorder were, according to The New York Times experts, “so small and loosely designed that they were largely inconclusive.”
Senator Grassley asked Pfizer to provide details of its payments to 149 faculty members at Harvard Medical School. In one case, a Harvard professor disclosed 47 financial relationships. A full 1,600 of 8,900 teachers at Harvard have reported at least one financial relationship in an area related to their teaching, research or medical practice. Harvard had failed to regulate or simply ignored the massive gifts and consulting fees paid to faculty members from food and drug companies.
Meanwhile, Harvard Medical School Dean Jeffrey S. Flier said that he does not want to jeopardize one of the school’s major sources of funding. Food and drug companies contributed more than $8.6 million in 2009 for basic science research and the $3 million for continuing education classes on campus separate and distinct from their direct payments to the doctors and professors.
Most of the money goes to professors at the Harvard-affiliated teaching hospitals and the dean’s office admitted that it does not keep track of the total. Senate investigative reports disclosed 149 Harvard-affiliated professors with financial ties to Pfizer and 130 with Merck. The FDA has yet to determine how much money is contributed to colleges by food manufacturers such as Tyson Foods which built and supports a test center on the campus of the University of Arkansas.
When you see or read of a test from the University of Arkansas regarding chickens, pigs or other livestock, ask yourself, “How much did Tyson Foods pay for that?”
First-year medical student David Tian said, “Before coming here, I had no idea how much influence [drug] companies had on medical education. And it’s something that’s purposely meant to be under the table, providing information under the guise of education when that information is also presented for marketing purposes.” The same pattern applies to food manufacturers that provide funding for agricultural colleges.
For example, Michael Pollan, best-selling author of The Omnivore’s Dilemma (named one of the five best nonfiction books of 2006 by The New York Times), who teaches journalism at UC Berkeley, has become the target of the factory farms and the genetically modified agricultural industry. The food industry would like to stop Mr. Pollan from teaching students the importance of organic foods and sustainable farming.
At the University of Wisconsin and Washington State University, Pollan’s appearances were protested and his readings canceled despite his book being part of a campus-wide reading project. Mr. Pollan notes that “It’s part of what appears to be a more aggressive industry push-back against critics of industrial agriculture.” The industry’s efforts to quash free speech and the open exchange of ideas reach far beyond the classroom.
In 2009, Mr. Pollan faced negative reactions from agricultural business alumni of Cal Poly San Luis Obispo in Central California. When officials at Cal Poly were criticized for scheduling a free lecture by Mr. Pollan, he chose to participate in a panel discussion rather than be canceled.
Mr. Pollan asked this rhetorical question in an interview, “Is the principle of balance going to apply across the board? The next time Monsanto comes to speak at Cal Poly about why we need GMOs to feed the world, will there be a similar effort? Will I be invited back for that show?”
Mr. Pollan raised troubling questions about academic freedom when he said, “It’s an open threat to the university. The issue is really about whether the school is free to explore diverse ideas about farms and farming.” As long as the agricultural industry maintains its economic might, free speech will be limited on campus and a wider range of knowledge on nutrition will be denied to students. It does not bode well for our society when business suppresses or controls ideas.
Students say they are concerned that the same money that helped build their school’s status may be hurting its reputation and affecting the quality of its teaching. The students say they worry that the food and drug industry scandals in recent years which include some criminal convictions, billions of dollars in fines, proof of bias in research and publishing as well as false marketing claims.
First-year Harvard medical student Kirsten Austad said it best, “We are really being indoctrinated into a field of medicine that is becoming more and more commercialized.”
It doesn’t matter what your political affiliation is, this mercenary misconduct just does not pass the smell test. A prosecutor could easily view the incest between medical schools and the food and drug industries to be criminal. We do not understand why persons who flagrantly violate the country’s trust are not sentenced to prison for long periods as an example to others. We also do not understand why Senator Grassley seems to be the only elected official that seems to care.
It is sad that doctors do not receive more education in the basics of nutrition. It is sad that commercial interests have so severely corrupted our educational system that medical students are receiving a limited and controlled education.
It is even sadder that specialists such as cardiologists and internists that treat coronary heart disease and diabetes are not more knowledgeable in the effects that genetically modified foods, factory farmed meats and dangerous chemicals in food ingredients have on their patients. The lack of medical doctors’ knowledge of nutrition has played into the plans of fast food restaurants, people who put more than fifty chemical ingredients in processed foods and the operators of factory farms (CAFOs).
We need to educate every American in the importance of nutrition starting in the First Grade. We need classes on nutrition offered in every grade, even if it is only a fifteen minute a day portion of another class. We need to compel medical schools to teach objective classes (not sponsored by a special interest) that include the importance of organic food and sustainable agriculture.
Education is the key to the future and the U.S. is failing at every level. Much of this failure is the result of poor teaching in medical schools and the political and financial interests of the country’s largest food and drug manufacturers.