Dr. Nathan Goodyear, MD

We are just days away from putting on silly hats, drinking champagne, and kissing the one we love as we bid goodbye to the year. What an amazing year 2011 has been and how quickly it has come to an end! Soon, we will wake to January 1, 2012 resolving to do something new, to do something better. We will all take the plunge into New Year’s resolutions.

So, why do we make resolutions?

The need for a resolution implies that a problem exists. That a need for a change of directon is required. With a resolution, we have a resolve or determination to do something better. The way I see it, we should be focusing on solutions. And in the battle for our health, we need a solution-focused approach.

To find a solution, we must define the problem. The greatest obstacle to health today is disease. The problem is that our current health care disease model doesn’t work for health or health restoration. It does do a good job of managing disease, but we are not interested in disease management, as it relates to obesity. We are interested in disease resolution.

So, what does the research say in response to the above statement?

The future health of Americans is bleak. According to a recent article from the world’s leading general medical journal, The Lancet, 50% or more of Americans will be obese by the year 2030. The same article showed that 12 states have an obesity rate exceeding 30%. The healthiest state was Colorado, but its obesity rate just clipped the 20% mark. In fact, no state had an obesity rate less than 20%. Another article from The Lancet revealed that 86% of American adults will be obese or overweight by 2030.

We need a resolution to focus on solutions, not band-aids.

But, according to the Organization for Economic Co-operation and Development, it will happen before 2030. The OECD says that 75% of Americans will be obese or overweight by 2020. And it is worse for men, where 82% are estimated to be obese or overweight.

The impact of obesity? According to the International Diabetes Federation Foundation, 1 in 10 adults will have diabetes by 2030. That equates to 552 million adults worldwide. In the US, money spent or lost on obesity has reached an estimated 1% of GDP (Gross Domestic Product).

What has our current disease-model paradigm done for the obesity battle? If you look at the statistics, nothing. In fact, we are losing the battle. Yet we continue to pour money into a failing medical model for obesity, that studies have shown doesn’t work.

What we need is a solution-focused approach to the obesity epidemic. We need a resolution to do better as a medical community. We need a resolution to focus on solutions, not band-aids. We need a resolution to focus on health and health restoration, not on disease management.

At Seasons Wellness Clinic, our approach to wellness is solution-focused and addresses the obesity epidemic head on. We work every day to offer our patients and clients the tools they need to pursue wellness. Questions? Spend some time on our website getting to know us and what we do. Then call 318.255.3223 and speak with one of our Patient Relations Specialists. We look forward to a New Year full of health, wellness, and solutions!

Seasons Patient, Kathy Burns

“My mother has osteoarthritis. When I began to hurt and swell, I just thought it had to be genetics – thanks, mom! I sought treatment for my pain so I went to a General Practitioner. As the pain progressed, I went to a Rheumatologist. The pain continued to grow and so did the amount of prescription pain medication I was taking. I was on my way to getting hooked on pain medicine, and I knew there had to be another way.”

“I asked my physical therapist about alternative ways to treat my pain. That’s when she told me that she was a patient of Dr. Nathan Goodyear at Seasons Wellness Clinic and referred me to him. I made an appointment with Dr. Goodyear and I’ll be honest, I was pleasantly surprised. Dr. Goodyear never herded me in and out like cattle. I would come in his office and we would talk, actually discuss things going on with my health. I could tell that he genuinely cared.”

“Dr. Goodyear designed a custom plan to get my health back on track. Throughout my visits we did blood work, testing, detoxification, and I had B vitamins through IV. Along with seeing Dr. Goodyear, I also saw Valerie Costanza, the Dietitian at Seasons. She taught me what and how to eat. And she taught me what would agree with my body. And as I began to follow what she was telling me, I saw almost immediate results. The swelling in my hands began to go down and my knees stopped aching. My shoulders and my lower back are almost pain-free. It is amazing what the right nutrition can do for you. And as an added plus, I lost weight!”

“I have been feeling better for 8 months now and it is just wonderful. It is a whole new me and a whole new way of life! I wanted to share my story because I know there are others out there that hurt just like I did. There are middle-aged women out there that think their pain is just a part of growing old. But you don’t have to put up with it. You don’t have to take pain medication to feel good. There is another way!” – Kathy Burns

Our goal is to restore our patients’ health by offering a more holistic approach along with cutting edge advancements in traditional medicine all in a comfortable environment. We are dedicated to providing individualized treatment and improving our patient’s quality of life by providing the best complementary and integrative medical treatment available. Our mission is to transform lives, one patient at a time. For more information about becoming a patient at Seasons Wellness Clinic, visit our New Patient Page or contact our Patient Relations Specialists at 318-255-3223.

Valerie Costanza, RD

Staying well during cold and flu season is hard to do but with a little nutrition know-how, fighting a cold or the flu is a little easier.

There are several important things to remember when you are trying to prevent a cold. First of all, sugar suppresses the immune system and hinders your ability to fight off the sickness. It is good practice to avoid sugar as a prevention and especially during a cold. A good multivitamin is a must to take every day for prevention of colds. And last, if not restricted by medicine, grapefruit is perfect for providing vitamin C and detoxifying the liver to keep you well.

If you currently have a cold and are in dire need of relief, remember these points to help your body fight the cold faster:

• Drink plenty of fluids. Water and a small amount of fresh fruit juice are best.
• Avoid dairy which has been shown to increase congestion.
• Avoid diuretics such as coffee and tea.
• Avoid alcohol which depletes stores of vitamin C.
• Eat light with focus on easily digestible foods such as broths, vegetable soups, salads, fish and chicken.
• Chicken soup actually does work! Researchers say that the cold-fighting powers are from the vegetables that are part of the stock and that it helps relieve symptoms especially congestion. Make a batch of chicken vegetable soup and freeze to thaw when you are fighting a cold.

GRANDMA’S CHICKEN SOUP

Grandma’s Chicken Soup Recipe

Ingredients :

• 1 young (3-4 lb.) chicken
• 1 tbsp. salt
• 2 qts. water
• 2 med. onions, whole
• 4 med. potatoes, sliced
• 1 tsp. pepper
• 4 carrots, scraped or diced
• 3 stalks celery, cut in 2 inch pieces
• 1 parsley sprig
• 1 parsnip, pared, if desired

Preparation :

1. Clean chicken and cut into serving pieces. Place chicken in pot, cover with water and cover pot. Bring to full boil, then reduce heat and simmer for 30 minutes. Add whole onion and simmer 30 minutes more. Add salt and pepper and simmer 15 minutes more.
2. Meanwhile, wash vegetables and cut into bite size pieces. Add in 15 minute intervals in this order: carrots, celery, parsley and parsnip. Cook until chicken is tender.
3. Before serving let soup cool, then skim off fat. If allowed to chill several hours, fat will rise to top and solidify for easy removal. Strain soup, if clear broth is desired, discarding any vegetables you do not like. Return chicken to soup or serve separately.

Note: If a creamier soup is desired, mash potatoes and then add to soup, also discarded vegetables can be pureed until smooth and returned to broth.

Click here for more information.

This Nutrition Update is brought to you by Valerie Costanza and Seasons Wellness Clinic. For a personalized nutrition consultation with Valerie Costanza, call Seasons at 255-3223 and schedule an appointment.

Need inspiration? Information? Accountability? Join some of North Louisiana’s top physicians, nutritionists and personal trainers for the 2012 Healthy Woman Wellness Challenge. Each FREE session offers you the opportunity to accomplish your nutrition and fitness goals for the new year. The reward? A healthier you, goodies, door prizes, and much more! This year we have added a 30 minutes workout to the end of each session. So bring your water bottles and let’s get going!

Healthy Woman Wellness Challenge Session #1

The first session of the 2012 Healthy Woman Wellness Challenge will be held on Tuesday, January 10th from 5:30pm – 6:30 pm at the Lincoln Parish Library Community Room. We will be conducting optional weigh-ins and measurements at the end of each session so please come prepared to exercise and dress comfortably.

Our first session will include:

• Meal plans
• Strength workouts
• Recipes
• Time Management | Making time for yourself
• Prepping for our 5k run with Maryanne Smith
• Optional weigh-in and measurements (5 – 5:30 p.m. and 6:30 – 7 p.m.)

To register, you must first join our Healthy Woman program and then click the link to RSVP. Please note: you must RSVP for each session after you have joined.

Healthy Woman Wellness Challenge Session #2

Join us for the second session of the 2012 Healthy Woman Wellness Challenge on Tuesday January 24, 2012 from 5:30 PM to 6:30 at the Lincoln Parish Library Community Room. Don’t forget we will be exercising and doing weigh-ins at the end of this session. So, come prepared to workout and dress comfortably. You can still attend this event even if you are not participating in the Healthy Woman Wellness Challenge.

The focus for this session will be:

• “Knees, Knees, Knees!” | Orthopaedic Surgeon, Major Blair, M.D., will discuss ways to avoid injury while exercising.
• “Getting down to the basics: Nutrition” | Registered Dietician, Jessica Hood, RD, LDN, will give nutrition advice and tips on staying on track with your diet.

You must be a member of the Healthy Woman program to participate in this event. If you have not joined already, click here. Membership is free, and the benefits last a lifetime. You must RSVP for each session of the Healthy Woman Wellness Challenge that you would like to attend.

Healthy Woman Wellness Challenge Session #3

Our 3rd session of the 2012 Healthy Woman Wellness Challenge will take place on Tuesday February 7, 2012 from 5:30 PM to 6:30 at the Lincoln Parish Library Community Room. Don’t forget, we will be working out and breaking a sweat for the last 30 minutes of the session. We will also be doing weigh-ins and measurements. So, dress comfortable!

The focus for this session will be:

• “Hello, dont forget about your heart!” | Interventional Cardiologist, Michael Langiulli, M.D.
• Heart Health Recipe Fun

To join Healthy Woman or RSVP to this event, click here. Membership is free, and the benefits last a lifetime.

Healthy Woman Wellness Challenge Session #4

Session #4 will be our final session of the Healthy Woman Wellness Challenge. This session will take place on Tuesday February 21, 2012 from 5:30 PM to 6:30  at the Lincoln Parish Library Community Room. 

Our focus for this session will be:

• Staying on track… You CAN do it!
• Accountability = Stability

To RSVP for this session or to Join Healthy Woman, click here.

For more information about the sponsors of the 2012 Healthy Woman Wellness Challenge, please visit their websites.

• Northern Louisiana Medical Center 
• Body Back by Maryanne Smith  or on Facebook
• Seasons Wellness Clinic and Seasons – The Spa or on Facebook and Twitter
• Sharon Jackson’s Personal Training Services or on Facebook

Click here to see out photos from a previous Healthy Woman Wellness Challenge 5K!

Dr. Nathan Goodyear

Dr. Nathan Goodyear of Seasons Wellness Clinic will be speaking at the ZRT Laboratory Conference for The Balance For Health & Wellness on November 4-5, 2011 at the World Market Center in Orlando, Florida.

“Featured at the conference are world-class experts presenting evidence-based science focused on prevention, diagnosis and management within a broad range of health and wellness topics inside hormone replacement therapy, anti-aging and functional medicine” [zrtlab.com]. It is an extraordinary honor to be asked to speak at The Balance For Health & Wellness Conference and Dr. Goodyear is looking forward to the event.

“My hope is to continue to lead metabolic medicine to the forefront, to bring new physicians into the metabolic medicine field and to help lead the health and wellness revolution,” said Dr. Goodyear. “This gets to the heart of the reason why I went into medicine – to reach true healing and obtain real prevention, not just early detection, and to look to God’s creation to discover true wellness through health restoration.”

Dr. Goodyear will be speaking on the following topics: male Metabolic Syndrome, Polycystic Ovary Syndrome (PCOS), PMS, infertility, and fatigue. He will provide insight on various health imbalances, symptoms and disease states. He will also discuss case studies demonstrating evaluation, treatment options, and follow-up for different imbalance states. In addition to Dr. Nathan Goodyear, the two day conference features three other expert speakers: Alicia Stanton, M.D., David Zava, Ph.D., Jim Paoletti, R.Ph.

ZRT is a diagnostic laboratory dedicated to supporting consumers and healthcare professionals in health management through accurate, convenient and innovative lab testing. Established in 1998, ZRT Laboratory is a CLIA certified saliva hormone testing facility serving the global community utilizing the most advanced technologies to help providers and patients detect hormonal imbalances, and Cardio Metabolic risk, while also providing testing for Vitamin D and Iodine deficiencies. “The mission of the The Balance For Health & Wellness Conference is to provide continuing education which will improve, promote and enhance clinicians’ competence and performance as well as patient outcomes” [zrtlab.com].

Alicia Stanton, M.D. is one of the world’s leading specialists in hormone therapy. Dr. Alicia Stanton focuses her practice and research on preventative medicine, anti-aging and maintaining health through fitness, nutrition, and bio-identical hormone therapy. By using hormone treatment and other alternatives to prescription medicine, Dr. Stanton has been able to help men and women make a lifestyle change through a holistic approach that leads to a healthier, happier life. Dr. Alicia Stanton is co-author of the book Hormone Harmony: How to Balance Insulin, Cortisol, Thyroid, Estrogen, Progesterone and Testosterone To Live Your Best Life. Hormone Harmony addresses millions of women who are struggling with hormone imbalance. Follow Dr. Stanton on Twitter @AliciaStantonMD for tips on nutrition and how to lead a healthy and happy life.

David Zava, Ph.D.

David Zava, Ph.D., is the President and Director of ZRT Laboratory in Portland, OR. He is a Ph.D. graduate in Biochemistry from the University of Tennessee with extensive experience in breast cancer research. He  is an internationally known speaker and leading expert in the field of hormone health. Over the past 25 years, he has published extensively on basic and clinical research relating to the effects of estrogens and progesterone on breast cancer. Dr. Zava is co-author with Dr. John Lee of the breakthrough book on preventing breast cancer: What Your Doctor May Not Tell You About Breast Cancer: How Hormone Balance May Save Your Life.

Jim Paoletti, R.Ph.

Jim Paoletti, Pharmacist, is the Director of Provider Education at ZRT Laboratory. Jim has over 25 years experience in bioidentical hormone therapies both in clinical practice in retail pharmacy, as a pharmacy consultant, educator, and educational program developer. Jim was instrumental in developing a compounding laboratory at the Medicine Shoppe, Beavercreek, Ohio. As the Vice President/Director of Continuing Education for Professional Compounding Centers of America, Inc. (PCCA), Jim developed and implemented Continuing Education programs for doctors, nurses, and pharmacists. He also consulted with compounding pharmacists located throughout the United States, in Canada, Australia, and New Zealand, helping them to solve patients’ unique medication problems. Follow Jim on Twitter @JimPaoletti for updates on his speaking events and news on bioidentical hormone therapies.

Dr. Nathan Goodyear

Dr. Nathan Goodyear is the founder and lead physician at Seasons Wellness Clinic and is dedicated to offering the latest advancements in traditional medicine with the most holistic approach to treatment possible. Dr. Goodyear received his Bachelor of Arts from Louisiana Tech University and Doctor of Medicine from LSU Health Sciences Center. He is Board Certified in Gynecology and a Fellowship Trained Metabolic Specialist (Anti-Aging/Regenerative Medicine). He recently completed his Master of Science studies in Anti-Aging and Regenerative Medicine.  Follow Dr. Goodyear on Twitter @drgoodyear and Seasons @SeasonsWC for the latest news on health and wellness.

Valerie Costanza, RD

Summer is in full swing and with the hot weather comes delicious fruits and vegetables! We have an abundance of fresh, local harvest here in North Louisiana. You can get these foods directly from local farms or from the farmer’s market (see the map below for directions or visit the Ruston Farmer’s Market website). When preparing your fruits and vegetables, you can be creative while keeping it simple. Here are my top 10 ideas on how to enjoy the wonderful flavors of summer:

1. Blueberries: best when eaten fresh or on top of salads and oatmeal

2. Zucchini: cut in strips, season, cover lightly with oil and bake for fries

3. Tomato: what can you not do with tomato?

4. Eggplant: slice lengthwise in ½ inch strips, season and grill. Top with sautéed tomato

5. Green beans: sauté in oil, water, onion and seasonings

6. Cucumber: slice and place in a pitcher of water…very refreshing!

7. Bell peppers: stuff with beef, rice and tomato

8. Peaches: peach salsa with tomato, onion, bell pepper, jalapeno, cilantro and lemon juice

9. Squash: slice, steam, season and mash

10. Okra: sauté with tomato

Visit the Ruston Farmer’s Market for fresh, local produce!

One word can sum up the root of most illnesses in America today. And the word is…stress!

Stress can cause a variety of problems from wrinkles, to ulcers, to more severe illnesses such as cancer. At Seasons, we offer services to help manage stress including Facial Reflexology. Not only is Facial Reflexology relaxing, but it is a natural way to improve the body’s function and appearance from the inside out. A soothing Facial Reflexology treatment is performed by the practitioner applying pressure on different points of the face and scalp, as well as massaging specific areas searching for deposits or “knots” under the skin. These deposits will reveal problematic areas that can act as the base of future treatments. Symptoms can be treated over time through working with these deposit areas. Each client is unique and some treatments are recommended through a series of 4 or more treatments.

Bethany Cox, LMT & Certified Facial Reflexologist

“Following a Facial Reflexology session, most clients feel deeply relaxed with a healthier complexion. Individuals should get plenty of rest and consume plenty of water to support the body in its transition.”  – Bethany Cox, LMT & LFR

What is Facial Reflexology?

Facial Reflexology combines the modern science of neurology with ancient therapies of Traditional Chinese Medicine, South American Zone Therapy, Vietnamese face maps, and Acupuncture points. This technique of Facial Reflexology was developed by Lone Sorenson. Sorenson’s technique is based around the idea that by using finger tip pressure, you can stimulate a release of endorphins and serotonin, leaving the face feeling relaxed and rejuvenated. This stimulation sends impulses through the central nervous system and the meridians to the physical body and the major organs. Sorenson’s technique of Facial Reflexology stimulates blood circulation and lymphatic drainage in addition to balancing hormones and leveling emotions. The technique calms the body and allows it to heal naturally.

Want more information about the benefits of Facial Reflexology? Check out our other blog posts:

• 10 Natural Ways to Cure Your Bedtime Blues
• Top 10 Pregnancy Tips
• The Proof Is In The Practice – A Journey to Reflexology
• Treat The Inner and Outer You with Facial Reflexology

To schedule your Facial Reflexology session or a consultation with our Facial Reflexologist, call Seasons – The Spa at 318.255.1155.

Vacation is a time for rest and relaxation but it shouldn’t mean abandoning all of your healthy lifestyle choices. Here are 5 travel essentials that will help you feel and look your best.

Clarisonic Mia. It is very important to clean your face daily. The skin can absorb toxins in new environments, and you want to make sure your face stays clean. If you are traveling somewhere warm with a high level of humidity, reduce trapped dead skin cells by using your Clarisonic Mia. Bonus: This skin care must-have includes an international charger and comes in a variety of colors!

Sunscreen. No matter where you are traveling, sunscreen is a must! Seasons has ‘the super-duper sunblock’, Sun Shield SPF 50. Obagi Nu-Derm Sun Shield SPF 50 combines UVB absorption and UVA blockage for a high level of sunscreen protection. (If you don’t have an SPF with both UVA and UVB protection, you aren’t really doing your skin any favors.) Sun Shield SPF 50 is sheer, PABA free, and fragrance free for all skin types. Bonus: Not only is Sun ShieldSPF 50 great for all skin types, it is really light and doesn’t leave your skin with the “white SPF face”. It’s a beach bag must have!

Water. Staying hydrated will do wonders for your skin! Keep a bottle of water with you at all times and drink as much as possible. Whether you’re boarding a plane or taking a long road trip, you need to keep your body and skin hydrated. All the cream in the world will never keep your skin moisturized if your body isn’t hydrated. Skin that is dehydrated will look dull and dry.

Multivitamins with Omega 3. Omega 3 fats play a significant role in reducing inflammation in our bodies which is extremely beneficial to the skin. Fish oil has polyunsaturated fats which help replenish fats lost in the skin (a loss in these fats can cause excessive dryness and flakiness). It is important to buy the best quality supplements, like Xymogen Daily Essentials available at Seasons Wellness Clinic, $57. Bonus: Daily Essentials come in packets that make them easy to pack! Along with keeping your skin beautiful, your multivitamins may assist your digestive function, boost brain function, give you added energy, help with weight management, and increase your immune resistance.

Lip Balm. Traveling into different climates will take a toll on your lips. Bring lip balm and apply it regularly to keep your lips healthy and avoid dryness. Bonus: Stop by Seasons – The Spa before your trip and we will give you FREE Seasons lip balm with SPF 15! Lip balm with SPF is the ultimate way to protect your lips against sunburn, dryness and windburn.

We would love to hear your tips on staying healthy and beautiful when you are on the go. What do you do to keep your skin hydrated, healthy and on its best behavior when you’re traveling?

Historically, relying on a consensus statement to treat or not to treat a particular patient has been shown to result in poor care and, as such, society consensus statements and practice guidelines are considered to be worst level of evidence in support of a particular therapy or treatment. A number of organizations, including the World Health Organization and others, have ranked the strength and accuracy of various types of evidence used in the medical decision process. In all scoring systems, the highest strength of evidence is randomized control trials and meta-analyses, with lower scores for other types of evidence. All grading systems place consensus statements and expert opinion by respected authorities (societies) as the poorest level of evidence, because historically they have failed to adopt new concepts and treatments based on new knowledge or new-found understanding demonstrated in the medical literature (1-6).

For instance, a recent study published in the 2009 Journal of the American Medical Association studied the evidence supporting the practice guidelines and consensus statements published by the American College of Cardiology and the American Heart Association. It was found that only 11% of the recommendations, practice guidelines and consensus statements were based on quality evidence and over half were based on poor quality evidence that was little more than the panel’s opinion. The review also found that even the strongest (Class 1) recommendations, which are considered medical dogma, cited as a legal standards and often go unquestioned as medical fact, were only supported by high quality evidence 19% of the time and not revised based on new evidence (6).

Similarly, the Endocrine Society, the American Association of Clinical Endocrinologists and the American Thyroid Association also have a long history of guidelines and recommendations that are not supported by the medical literature and fail to adjust or abandon recommendations when new understanding and knowledge contradicts their recommendations. A case in point is the recommendation by these societies that a normal TSH adequately rules out thyroid dysfunction, despite massive amounts of literature that demonstrate this not to be the case (see Diagnosis of Hypothyroidism) or that T4 only replacement is adequate for most patients. A doctor who simply follows outdated society treatment guidelines that relies on a simple laboratory test and ignores the clinical aspects of a patient is not practicing evidence-based medicine. (1-7). Such doctors may be adequate as lab technicians, but as doctors and clinicians they fall short (1-7). This method of practice is consistently rebuked as improper and poor medicine, but has become the standard used by a large percentage of endocrinologists and physicians who feel medicine can be related to simply reading “normal” or “abnormal” in a laboratory column.

Discussing the lack of scientific basis of most medical society’s consensus statements and treatment guidelines in Internal Medicine News, Dr. Diana Petritti states, “Expert opinion and consensus statements can be quite misleading when used as the basis for a practice. Expert opinions imply that there is something that the experts know that clinician doesn’t know. I don’t think it’s always appreciated that it’s only opinion. There is a tendency to make guidelines and recommendations seem authoritative. I believe that physicians think that there is a great deal more behind authoritative recommendations than there might be when you lift the lid of the box and see what’s underneath(8).”

There has been significant concern by health care organizations and medical experts that physicians are placing too much reliance on consensus statements and failing to learn of new information presented in medical journals. Thus, they lack the ability to translate this new information into treatments for their patients. The concern is that doctors fail to practice evidence-based medicine, erroneously relying on what they have previously been taught and on “expert” societies instead of changing treatment philosophies based on new information as it becomes available. This is especially true for endocrinological conditions, where physicians are very resistant to changing old concepts of diagnosis and treatment — despite overwhelming evidence to the contrary — because it is not what they were taught in medical school and endocrinology residency.

This concern is particularly clear in an article published in the New England Journal of Medicine entitled “Clinical Research to Clinical Practice: Lost in Translation” (9). The article was written by Claude Lenfant, M.D., Director of National Heart, Lung and Blood Institute, and it is well supported. He states that there is great concern that doctors continue to rely on what they learned 20 years before and are uninformed about scientific findings. According to Dr. Lenfant, medical researchers, along with public officials and political leaders, are increasingly concerned about physicians’ inability to translate research findings in their medical practice to benefit their patients. He says that very few physicians learn about new discoveries from reading medical journals or by attending scientific conferences; thus, they lack the ability to translate new knowledge in the field into enhanced treatments for their patients. He states that a review of past medical discoveries reveals how excruciatingly slow the medical establishment is to adopt novel concepts, noting that even simple methods to improve medical quality are often met with fierce resistance. “Given the ever-growing sophistication of our scientific knowledge and the additional new discoveries that are likely in the future, many of us harbor an uneasy, but quite realistic suspicion that this gap between what we know about disease and what we do to prevent and treat them will become even wider. And it is not just recent research results that are not finding their way into clinical practice; there is plenty of evidence that ‘old’ research outcome have been lost in translation as well (1).”

Dr. Lenfant discusses the fact that the proper practice of medicine involves the combination of medical knowledge, intuition and judgment and that physicians’ knowledge is lacking because they don’t keep up with the medical literature. He states that there is often a difference of opinion among physicians and reviewing entities, but that judgment and knowledge of the research pertaining to the patient’s condition is central to the responsible practice of medicine. “Enormous amounts of new knowledge are barreling down the information highway, but they are not arriving at the doorsteps of our patients. (9).”

These thoughts are echoed by physicians who have researched this issue as well, such as William Shankle, M.D., Professor, University of California, Irvine. He states, “Most doctors are practicing 10 to 20 years behind the available medical literature and continue to practice what they learned in medical school….There is a breakdown in the transfer of information from the research to the overwhelming majority of practicing physicians. Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not (10).”

This view is echoed by the Dean of Stanford University School of Medicine who states that in the absence of translational medicine the delivery of medical care would remain stagnant and uninformed by the tremendous progress taking place in science and medicine (11).

This concern has also received significant publicity in the mainstream media. An example is an article by Sidney Smith, M.D., former president of the American Heart Association, published in 2003 in the Wall Street Journal entitled “Too Many Patients Never Reap the Benefits of Great Research.” Dr. Smith is very critical of physicians for not seeking out available information and applying that information to their patients, arguing that doctors feel the best medicine is what they’ve been doing and thinking for years. They discount new research, Dr. Smith says, because it is not what they have been taught or practiced, and they refuse to admit that what they have been doing or thinking for many years is not the best medicine. He states, “A large part of the problem is the real resistance of physicians…; many of these independent-minded souls don’t like being told that science knows best, and the way they’ve always done things is second-rate (12).” The National Center for Policy Analysis also expresses concern for the lack of ability of physicians to translate medical therapies into practice (13).

A review published in The Annals of Internal Medicine found that there is clearly a problem of physicians not seeking to advance their knowledge by reviewing the current literature, believing proper care is what they learned in medical school or residency and not basing their treatments on the most current research. The review found that the longer a physician is in practice, the more inappropriate and substandard the care (14). Thus, it is not a surprise that the scientific evidence as expressed in the literature is often opposite to what is continually repeated as dogma by most physicians and those considered to be “experts.”

Another example is a study published in the Journal of the American Medical Informatics Association (15). In reviewing the study, the National Institute of Medicine reports that there is an unacceptable lag between the discovery of new treatment modalities and their acceptance into routine care: “The lag between the discovery of more effective forms of treatment and their incorporation into routine patient care averages 17 years.” (16) In response to this unacceptable lag, the Business and Professions Code passed an amendment relating to the healing arts. This amendment — CA Assembly Bill 592; An Act to Amend Section 2234.1 of the Business and Professions Code — states: Since the National Institute of Medicine has reported that it can take up to 17 years for a new best practice to reach the average physician and surgeon, it is prudent to give attention to new developments not only in general medical care but in the actual treatment of specific diseases, particularly those that are not yet broadly recognized [such as the concept of tissue hypothyroidism, chronic fatigue syndrome and fibromyalgia] (17).

The Principals of Medical Ethics adopted by the American Medical Association in 1980 states that a physician shall continue to study, apply, and advance scientific knowledge, make relevant information available to patients, colleagues, and the public (18). This has, unfortunately, been replaced with a goal of providing merely “adequate” care. The current insurance reimbursement system in the United States fosters this thinking, as the worst physicians are financially rewarded by insurance companies. While it is true that the best physicians are continually fighting to provide cutting edge treatments and superior care that the insurance companies deem not medically necessary, even these physicians eventually get worn down and are forced to capitulate to the current system that promotes substandard care.

This was clearly demonstrated in a study published in the March 2006 edition of The New England Journal of Medicine entitled “Who is at Greater Risk for Receiving Poor-Quality Health Care.” The study found that the majority of individuals received substandard, poor-quality care, and that there was no significant difference among different income levels or whether or not the individual was covered by insurance. It used to be the case that only those in low socioeconomic classes without insurance received poor-quality care. But insurance company restrictions on treatments and diagnostic procedures have made the same poor care afforded to those of low socioeconomic status the new standard-of-care for society at large (19). An example of this is a physician’s failing to spend the time to adequately assess a potential hypothyroid patient and instead simply does a TSH test.

Most physicians will satisfy their required amount of continuing medical education (CME) by going to a conference a year, usually at a highly desirable location that has skiing, golf, boating, etc. Physicians are rarely monitored as to whether or not they actually showed up for the lectures or went skiing instead. One must also understand that the majority of conferences organized by medical societies are in fact sponsored by pharmaceutical companies. These payments by pharmaceutical companies are called unrestricted grants, so that the society has free reign to do what they want with the money and thus can claim there is no influence of lecture content by the companies. The problem, however, is that if the society wants to continue getting these “unrestricted” grants, they must think twice about providing content that the sponsoring pharmaceutical company might disapprove of. Consequently, ground breaking research that goes against the status quo and does not support the drug industry receives little attention.

Evidence-based medicine involves the synthesis of all available data when comparing therapeutic options for patients. Evidence-based medicine does not mean that data should be ignored until a randomized control trial of a particular size and duration is completed. A physician who tries to avoid the need of being a physician and is fine with just being a technician or health care provider will adamantly defend the “one-size fits all” method of diagnosis and treatment. But the best doctors who truly practice evidence-based medicine and not merely the perception of such will not rely on consensus statements to best provide their patients. Instead of relying on old dogma, the best physicians will seek out and translate both basic science results and clinical outcomes to decide on the safest, most efficacious treatment for their patients. Further, the best physicians will continually assess the current available data to decide which therapies are likely to carry the greatest benefits for patients and involve the lowest risks.

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