Are Doctors stupid or afraid?

It's common to hear that "doctors aren't taught about nutrition in medical school". Does that mean that everything a doctor knows was learned at medical school? Did the professors teach how to fish, repair cars, write novels, play a guitar? Of course not.

The idea that a doctor is somehow deficient because he/she didn't learn about nutrition in medical school is just an excuse. Essentially, "The poor dolt wasn't taught about nutrition, exercise, clean water or even probiotics, so we can't expect her to know anything - or do anything - other than what they were taught in medical school."

At times I've been guilty of this myself, but I want to stop using that kind of statement to either justify ignorance or explain why this or that doctor always falls back on what they were taught - how to read lab tests and prescribe drugs, surgery, or radiation treatments.

 Starting from the premise that doctors are intelligent, I must accept that they are capable of rational thought and using reason to arrive at answers - ones that agree with their medical school professors, and ones that don't.

A mature rational person reacts in certain ways when confronted with information that conflicts with their education and experiences. They can ignore the new information. They can use their reasoning skills to refute it. They can even evaluate the new material and begin a process for changing their old belief based on the new findings and rationale.

In all three of those possibilities, the intelligent person can still decide not to change their actions. In the case of a doctor, she can decide to not move away from what she's been doing, regardless of the contrary evidence. Why would she do that?

One reason might be comfort. She could say, "I've been doing it that old way for decades and I don't see any reason to change my practice." That's the response we would expect from a lazy person. Some people are lazy. Doctors are people. Therefore...

I suggest that a more powerful reason for not changing is fear. We can all be driven by fear. Doctors are fearful of being sued, of losing their well-paying job, of being disrespected by their peers, of being branded a rebel and not fit for promotion, of not being able to purchase liability insurance. There are probably other fears, but it seems reasonable that fear is a very powerful motivating force. Still, fear is not an appropriate motivator for a rational person who claims to be a professional and who holds the safety of another human in their hands.

People who impact doctors (administrators, lawyers, insurance salespeople, drug representatives, etc.) know that they can use fear to their advantage. An insurance salesman can tell the doctor that their company won't cover him in the event there's a problem related to something outside usual and customary. Someone could explain that the "way we are doing medicine" is considered by professionals - and the law - to be the golden

standard of practice. To do anything other than this standard of practice is to technically and legally engage in MALPRACTICE - and we all know what happens to doctors in a malpractice suit. They "will probably lose everything they've worked for".

A SHORT STORY: A famous doctor - the head of a department at a large teaching hospital, was lecturing at a multiple sclerosis conference. Almost one thousand people were in attendance, including me. During the QA part of the presentation a woman asked about a treatment that was becoming popular. The famous doctor put on a politely quizzical face and claimed that he hadn't heard of it but that he would check into it. The person who had invited me to the meeting had to physically restrain me from jumping up and screaming. You see, that very doctor was ordering the treatment in question - from me. I had even talked to him several times about it and how so many people were pleased. He lied in front of crowd of people because he was cowardly and fearful. Most of all, he was completely unprofessional. I see this kind of thing often and it makes me sad and angry.

It is time to stop giving doctors a pass for being cowardly and/or fearful. They should live by higher standards of conduct than the average "Joe". They have a professional ethic to uphold and any suggestion that "lack of training in medical school" lifts their responsibility to do their best for their patient is nothing more than a lame excuse. They are obligated to live and learn. Even their associations insist on continuing education, ostensibly because the doctor must be up to date with current ideas. Sadly, they often continue their education at the feet of the very people who use fear tactics to keep doctors in line with "the way things are done around here."