Tuesday, June 30, 2009

Medical Biases

I recently attended a review course to prepare for the Boards. For 4 straight days we started at 7 AM and finished at 9:30 PM. This intellectual boot-camp took place in Vegas, but the only fun thing I got to do was eat dinner by myself at the Paris buffet; a Japanese tourist and I were the only ones loading up on the veggies and sushi.

The course itself was brutal, but a great way to prepare. Interestingly, a couple of presenters epitomized the state of affairs in non-pharmaceutical medicine; one continually railed against the misguided over-reliance on many virtually ineffective pharmaceutical treatments, while the other reluctantly discussed some herbs and nutrients that have significant evidence and efficacy.

The latter doc warned that the evidence was thin and that there were significant side effects with those natural items. Yet, this presenter did not do likewise when it came to drugs. For example, black cohosh, approved for use in menopausal problems by the American Academy of Ob-Gyn, was said to be worthless and potentially dangerous. Yet, nothing was said about hormonal replacement with estrogen, which has been shown to increase the risk of cancer by the NIH since 2002.

Amazing: estrogen is OK, yet poor little black cohosh, which has never been associated with any cancers, is not.

What is really going on? It is simple; let me illustrate with another example:

Initially it was reported that hip padding/protectors did not reduce the risk of hip fractures in falls sustained by the elderly. Later, it was shown that they DO INDEED reduce the risk of hip fractures by a whopping 50%. It turned out that one of the authors of the negative study had not disclosed his financial ties with hip replacement surgeries.

“Follow the money.”

It is extremely naïve to deny the fact that our beliefs do not influence our intellect.

PS, I do not sell non-pharmaceutical products. Occasionally, I speak for companies that do.

Monday, June 8, 2009

Still around…

Sorry I have not had time to blog.

I have been too busy studying for my Family Practice Boards (every 7 years.) It’s quite an ordeal for me; I have to memorize a lot of stuff (excessive pharmaceutical treatments taking precedence over nutritional, environmental and emotional issues) I don’t emphasize in my practice.

Nevertheless, I must remain up to date for many reasons, one of which is to get reimbursed by insurance companies who continue to dismiss the fact our practice saves them thousands of dollars, even though they have seen the future of health care; more social responsibility.

They are a bit concerned that their golden goose is threatened. Surely you saw right through their attempt to appear cooperative when the met with Mr. Obama last month at the White House, only to later oppose the plans to start a Public Health Insurance. Despite the plan being proposed to increase competition, a word they love, they fear they will be left in the dust.


If they truly believe in competition they would welcome the proposed addition. Perhaps they fear that, just like Medicare, the new plan will have a much lower cost due to lower overhead costs (more efficiency,) like Medicare; that is 5% compared to their bloated 15-25% overhead.

But, back to the Board Exam (next month.)

It turns out that this time around the exam-makers have finally added questions on non-pharmaceutical treatments; the evidence for some of these treatments cannot be denied any longer. They are asking doctors to bone up on treatments like:

Saw Palmetto: prostate problems
St John’s Wort: depression
Bilberry and other antioxidants: macular degeneration
Feverfew: migraines
Omega oils: heart and many other conditions
Sulfur: bladder
Vitamin D: osteoporosis, insulin resistance
Acetic acid, mineral/olive oils: ear canal infections
Capsaicin (red peppers:) shingles, burning mouth syndrome
Glucosamine: bones

Even though this is a very shy list, it is the first time my board exam includes this sort of things. I am sure the list will get longer. Maybe it will even be halfway decent by the time I retire….

Thursday, March 5, 2009

Vaccine Fights

Not a clinic day goes by without a worried mom asking my opinion on vaccinations. They are confused and afraid to do anything that may harm their children. I feel badly for them, victims as they are of mixed data on vaccinations and extreme positions taken by doctors who refuse to admit that there may be significant problems with vaccines and those who advocate that vaccinations are of the devil.

To those moms who are contemplating avoiding vaccinations altogether I tell them that this is not a good idea; our society would again be ravaged by deadly diseases we have forgotten about, like diphtheria, polio, measles, etc. If we lived in a perfect world without stress, overcrowding, unpolluted water and food we might get away without vaccines.

As an imperfect practitioner of the “middle way,” I decided early in my career that such a contentious issue cried out for a compromise until we came up with more rational and clear guidelines that would include not only hard data but the feelings, intuition and wishes of mothers who often get their children’s health issues right before the medical profession does.

Consequently, I have been sticking my neck out advising moms that they could delay immunizations until one year of age to wait for their children’s immune system to mature; then spread out the vaccines. Instead of blasting them with so many shots and challenges to their forming immune system, they could do one vaccine every other month, provided they feed their infants well (no sugar and trans-fats) and keep them out of day care centers.

I did just that with my own daughter who is now 8 years old. So far, I have seen not one case of health issues that might be blamed on this schedule of vaccinations or alleged side effects.

You can imagine my delight when I saw the report in the Salt Lake Tribune (March 4th 2009) reporting that many doctors are asking that the current schedule be reviewed; specifically, the timing and spacing of vaccines. Dr Sundwall, the Utah Department of Health director, Dr. Pavia, the chief of the Pediatric Infectious Diseases at the U. of Utah School of Medicine and 25 other doctors in Utah have expressed their opinion to the upcoming meeting of the Vaccine Advisory Committee in Washington DC later this month.

While most of these doctors are betting that the present schedule is safe, the fact that a dialogue is taking place is encouraging. Some of them apparently believe that the CDC statement that there is no link to health problems like Autism, while supported by present data, has not reassured many mothers who feel that the issue is far from settled.

I side with these mothers. Let us be as safe as possible, until the issue is settled to everyone’s satisfaction. I am afraid that economic interests have clouded the data, which happens too often when profits are to be had, even in the health care field.

Monday, March 2, 2009

Drugs Down the Toilet

(Submitted for publication in the UMA Bulletin; I am an Editorial Board member)

“They have found that a lot of prescription drugs are turning up in our drinking water. People not only pee drugs into in the toilet but they also dump the unused prescriptions in it. They have found hormones, antibiotics and many other kinds of drugs. Depressing news, don’t you think? Don’t worry about it: drink the water; it also has antidepressants and xanax.”

Funny. Not funny. But Leno is right.

Articles like “Drugs Are in the Water” have documented that a significant number of fish in the Potomac and its tributaries are hermaphrodites. Feminization is seen with drug concentration as low as 5 part per trillion. Fish swim in waters where 10+ pharmaceuticals have been detected. Every bluegill, black crappie and channel catfish had levels of antidepressants. A survey of 139 streams showed that 80% contained prescription drugs and fragrances, sunscreens, etc. They survive biodegradation and wastewater treatment.

An AP study showed that most drugs are metabolized only 80% which explains why antibiotics, antidepressants, anxiolytics, anticonvulsants and hormones re found in the drinking water of 41 million Americans. Twenty four major metropolitan areas were surveyed. Philadelphia had 56 types of drugs in its water. Unfortunately, this type of study is rarely made available to the public.

The problem is sure to be widespread since no tests are available to look for the problem. The EPA doesn’t know what to make of the whole thing: “a few parts per million of drugs in the water may or may not be a problem.”

I feel the problem seems obvious but we may be aware of only the tip of the iceberg; the effect of combinations of these chemicals and their additive/synergistic effect are not known. For sure we are seeing more antibiotic resistant bacteria.

In view of this pressing issue the Environmental Committee is contemplating bringing this issue to the floor of our upcoming House of Delegates meeting this year. Your input is welcome; we are not sure what measures we could take as doctors. But, in the meantime we encourage you to visit: http://www.medicationdisposal.utah.gov/disposal_locations_events.htm for a list of places where our patients could drop off unused prescriptions (police stations and pharmacies.) Perhaps we could display said list prominently in our clinics. Maybe we could insist that all pharmacies do likewise. While we cannot tell patients to cross their legs and not pee, we could become more conservative in our prescribing habits.

The JAMA on Drugs

(Submitted for publication in the UMA Bulletin; I am an Editorial Board member.)

“Overdosed America” is a book by Dr. Abramson that documents how doctors are prescribing too many drugs. The Journal of the American Medical Association published an article on February 25th 2009 agreeing with the good doc.

Before you assume that I am blaming doctors let me say that in my opinion they are mostly victims as much as the patients who receive our prescriptions. Of course we all share a bit of the responsibility for the drugging of our society. Doctors have not made a significant effort to learn to treat the roots of diseases (nutrition, environment and Mind-Body-Spirit issues) and patients have grown to expect a pill to manage their every little symptom.

Doctors may excuse themselves by saying that their patients’ genetics are so strong that nothing will change their patients’ tendency to develop a given disease. This is an indefensible position when we study the fields of nutrigenomics and nutrigenetics; yes, nutrition does modulate genetic expression. In fact, toxic environments and relationships also modulate genetic expression.

Patients may excuse themselves by saying it is too hard to change their lifestyle (an opinion shared by most doctors); they just want the latest pill they saw advertised on TV. In fact, in my own practice I have seen patients who feel I don’t listen to them because I don’t prescribe them the latest drugs advertised on TV for their symptoms nor thyroid and sex hormones, amphetamines and the newest psychoactive medications to help them lose weight. Rather than listen to my advice to change their diets, detoxify their environments and their relationships they find a practitioner next door who will eagerly pull out his/her smoking prescription pad.

For these and many other obvious reasons I rejoice in the JAMA’s courage to publish the article “Promoting More Conservative Practices.” So that you rejoice with me I am herein quoting from this article. The implications of the following statements are enormous:

“Although medical and pharmacy curricula and journals are rich with information about drugs and treatment of specific diseases, there is a paucity of education on ways to become effective lifetime prescribers. Two recent reports from the Association of American Medical Colleges (AAMC) lamented the current state of pharmacology teaching and the disturbing extent of pharmaceutical industry influence at all stages of medical education. Given the well-documented prevalence of medication-related harm and inappropriate prescribing, such educational reform is necessary but not sufficient to ensure that patients are optimally treated… trainees need guiding principles to inform their thinking about pharmacotherapy to help them become more careful, cautious, evidence-based prescribers.”

• “These lessons are fundamental for teaching clinicians how to develop excellent prescribing skills, yet such fundamentals are absent or underempahsized in current medical pharmacy education… they also need to be taught a set of skills and attitudes that will help them approach claims for drug
s, especially new drugs, more critically.”

• “Without a more cautious and more skeptical approach to using drugs, prescribers will lack the will and the skills to resist ubiquitous promotional messages encouraging them to reach for newer and often more expensive medica
tions.”

• “Although the attitudes and behaviors recommended in our principles [see box below] should not be terribly controversial, taken together they represent a departure from current practice.”


• “From the founder of modern medicine Dr Osler to leading pharmacology textbooks, taking a more skeptical and conservative approach to pharmacotherapy has a long and honorable history in medicine… Rather than therapeutic nihilism, the approach of these guidelines aims to better respect the limitations of knowledge and more closely align clinicians with the interests of patients.”

Many doctors reading this article are dedicated to these simple principles. While not perfect in their prescribing I would guess they strive to follow the old dictum “primum non nocere” (first do no harm) to the best of their abilities.

Of all the recommendations in the box I would like to emphasize the first 3 under “think beyond drugs.” Many doctors reading this article no doubt have had these simple principles and their desire to implement the best ways to heal patients as the driving forces behind their pursuit of research highlighting nutrition, environmental issues and the Mind-Body-Spirit connection. In my own experience, applying the references I have found in our leading medical journals have helped me avoid and/or stop 80% of the prescription medications commonly used for chronic ailments, a figure that Dr Willet at Harvard Medical School has also documented.

More evidence

Interestingly, the same issue of the JAMA had related articles on how clinical practice “guidelines” are influenced by marketing more than hard evidence and how the “FDA exerts too little oversight of researchers’ conflicts of interest.” The article on the controversy surrounding the cholesterol lowering drug exetimibe/simvastatin is a good example of how prevention and nutrition are seldom part of serious discussions on treating heart disease.

The New England Journal of Medicine last month had an article along the same lines, “The Neurontin Legacy: marketing through misinformation and manipulation.” Before tackling the well-known drug neurontin/gabapentin, the article opens up by reminding us of the shady deals that allowed synthroid-makers to hide evidence that the generic levothyroxine is just as good. Then, it gives pointed examples and direct quotes from pharmaceutical executives who pushed their representatives to drive up sales by hyping neurontin to doctors. The drug reps claimed the drug had benefits that were never shown in their internal research.

The author feels that “drastic action is essential to preserve the integrity of medical science and practice and to justify public trust” and that the public and doctors need “public funding of peer-reviewed pharmaceutical research through a National Institute for Pharmaceutical Research that might be funded by a tax on all drug sales.”

I am sure you will agree with his final conclusion:

“Will our profession soon feel compelled to advocate for such actions to preserve our integrity, our social contract and ultimately our privileges?”

Perhaps the article in the same issue of the NEJM may help us shed some light on the “man behind the curtain:” “Money and the Changing Culture of Medicine.” Again, the article’s implications are so enormous that I choose to only quote from it:

This is the title of a remarkable article in the top medical journal in the world Here are its main points:

“Assigning a monetary value to every aspect of a physician’s time and effort may actually reduce productivity, impair the quality of performance and thereby increase costs.”

• “Even the suggestion of money promotes behavior marked by selfishness and lack of collegiality.”

• “Medicine has marketplace elements that are inherent in any business-a physician receives payment for services. But there is also a communal relationship, an expectation and obligation to help when assistance is needed. In the current environment the balance has tipped toward market exchanges at the expense of medicine’s communal dimension. Many physicians we know are so alienated and angered by the relentless pricing of their day that they wind up having no desire to do more than the minimum required for the financial bottom line.”

The journal feels that the answer is “Patient-centered medical home,” or a “compassionate partnership…. [where] the insurer would pay a set fee for each patient cared for in the medical home to cover what is now not reimbursed time.” In my opinion this means that doctors would now have an incentive to learn about nutrition and motivational techniques to help patients change their toxic lifestyle. This would lead to more emphasis on prevention and a significant reduction in the cost of health care.

“Caregivers should be appropriately reimbursed but should not be constantly primed by money. Success in such a model will require collegiality, cooperation and teamwork-precisely the behaviors that are predictably eroded by a marketplace environment.”

The bottom line is money.

As the economy continues its downward spiral I cannot get enough reading in Economics. The last book I read was Wealth of Nations by Adam Smith (1776.) I highly recommend it, if you are willing to speed-read through the boring parts. The two things that struck me the most was his common sense and wisdom and how both sides of the political/economic spectrum misquote him to justify their own ideologies.

The supply siders (Republicans) emphasize how the invisible hand is going to take care of practically every thing while the demand siders (Democrats) emphasize government regulation. It turns out that Adam Smith wrote that both are necessary: business can only thrive when the law efficiently protects the right of business people to seek profits, but with the limitations necessary to respect labor and the land.

One thing is certain, says Adam Smith: when business people gather, they will always have the tendency to organize themselves to maximize profits even at the expense of the public. This is why regulation is necessary. And regulation of the pharmaceutical industry, particularly of their CME tactics and advertisement is sorely needed.

“The profession of medicine, in every aspect, clinical education, and research, has been inundated with profound influence from the pharmaceutical and medical device industries. This has occurred because physicians have allowed it to happen, and it is time to stop.”

Despite the clear and common sense advise from Adam Smith we will always be polarized when it comes to politics and economics. You would think that anyone interested in scientific reasoning would seek the middle ground he championed. But, it is not inherent in most people to think scientifically or objectively. This is why I enjoyed the article “On Second Thought…

“When politicians [change their mind], they are tarred as flip-floppers. When lovers do it, we complain they are fickle. But scientists are supposed to change their minds when evidence undercuts their views. Dream on…But really, we shouldn’t be surprised. Proponents of a particular viewpoint, especially if their reputation is based on the accuracy of that viewpoint, cling to it like a shipwrecked man to flotsam. Studies that undermine that position, they say, are flawed.”

Which brings me back to us, doctors. You would think that most of us would be ready and excited to accept the scientific evidence in medical journals that highlights prevention, nutrition environmental toxins and the Mind-Body –Spirit connection. But, it seems that the scientific inquiry required to take the time is not in abundant supply. Could it be that Thomas Kuhn was right when he said that a scientific paradigm (i.e., “nutrition is a second class alternative”) topples when the last of its powerful adherents dies? Could it be that money has something to do with what scientists/doctors believe?

Tuesday, January 20, 2009

More on the Economy: Read History

If you are reading this blog you are likely to be a baby boomer as I am. People our age read boring blogs like this one, as well as History books, besides watching the History Channel (a.k.a “Nazis 24/7.”) On the average, I read 1-2 history books a month. You may have read a previous blog I wrote about the tension of opposites between John Adams and Thomas Jefferson. I ended up concluding that Adams got a bum wrap in our history and that Jefferson was over-glorified in our pantheon of Founding Fathers. But, after digging a little bit more and studying the tension of opposites between Jefferson and Alexander Hamilton, I am dully chastised and ready to restore Jefferson to his rightful place in his rotunda by the pond in D.C.

As you recall, Hamilton was the main force behind the creation of our banking system. He said that “No society could succeed which did not unite the interest and credit of rich individuals with those of the state” and that “A national debt, if it is not excessive, will be to us a national blessing.” He was behind the creation of the first National central bank as the first Secretary of the Treasury in 1791, which Jefferson fervently opposed. He knew from European history that a central bank would end up ruling the nation:

“[They] have tried and trodden every path of force in fruitless quest of the same objective, yet we still expect to find in juggling tricks and banking dreams, that money can be made out of nothing… I believe that banks are more dangerous than standing armies; and that the principle of spending money to be paid by posterity, under the name of funding, is but swindling futurity on a large scale… Already they have raised a money aristocracy… The issuing power should be taken from the banks and restored to the people to whom it properly belongs.”

As strange as his statement may seem coming from one who was indebted all his life and died a ruined man (on the 4th of July, 50 years after 1776 and at the same time John Adams passed away) his words still ring true today, as we continue to print money out of thin air, which will fall on our children to pay. Despite his personal issues, Jefferson’s opinion on who really should be in charge of creating money is well addressed in our Constitution:

“To take a single step beyond the boundaries … of Congress is to take possession of a boundless field of power. The incorporation of a bank and the powers assumed by this bill have not been delegated to the United States by the Constitution.”

In other words, only Congress may create and regulate money, according to our Constitution, a point also emphasized by John Adams, who also despised Hamilton:

“Our whole banking system I ever abhorred, I continue to abhor, and I shall die abhorring… Every bank of discount, every bank by which interest is to be paid or profit of any kind made by the lender is downright corruption. It is taxation for the public for the benefit and profit of individuals.”

OK, that is a little too strong; we do need to have credit to start businesses.

Perhaps Adam Smith’s point of view is more moderate: business is a grand and noble enterprise, but it must be regulated because men will have a natural tendency to meet in secret to attempt to maximize profits and forget the public good.

Hamilton’s First Bank of the United States failed. But those who saw a gravy train in his banking ideas tried again in 1816 to create a central bank, which Andrew Jackson did away with, thus antagonizing powerful forces that almost derailed his presidency. He denounced the central bank as unconstitutional, as well as:

“A curse to the Republic; inasmuch as it is calculated to raise around the administration a moneyed aristocracy dangerous to the liberties of the country.”

Lincoln himself may have been killed because of his opposition to another attempt to re-create a central bank, rather than reconstruction and abolition issues. The same is rumored of JFK who had the audacity to print money through the Treasury while bypassing the Federal Reserve.

But, the boys wanting to create money out of thin air finally prevailed: in secret, corporate America and leading bankers gathered on Jekyll Island off the Georgia coast in 1913 to plan the creation of the central bank that now rules our country, the Federal Reserve. They even got Wilson elected, a friend of Wall Street, by splitting the Republican vote; they knew that Taft and Roosevelt would not have allowed such a sneaky play.

This is how we fell in the hands of dishonest bankers who now keep our TARP money for themselves to buy other banks, instead of making our own money available to borrow to meet payroll and overhead in our small businesses, like the clinic I work with. What is the Federal Reserve? It is neither a part of the Federal Government nor a Reserve, unless we are talking about a “Reserve” for the “Moneyed Aristocracy.” Congressman Lindbergh in 1913 said that the Federal Reserve

“Establishes the most gigantic trust on Earth… When the President signs this act, the invisible government by the money power… will be legitimized. The new law (creating the Federal Reserve) will create inflation whenever the trusts want inflation. From now on, depressions will be scientifically created.”

Gary Allen, author of “None Dare Call it Conspiracy” (Concord Press, 1971; page 53) may be easily dismissed as a “conspiracy freak,” but it may be prudent to read what he says before doing so:

“Using a central bank to created alternate periods of inflation and deflation, and thus whipsawing the public for vast profits, had been worked out by the international bankers to an exact science.”

Paul Walberg, one of the founders of the Federal Reserve candidly admitted that that any losses incurred from money created by them is to be covered by taxpayers:

“While technically and legally the Federal Reserve note is an obligation of the United States government, in reality it is an obligation, the sole actual responsibility for which rests on the reserve banks… The government could only be called upon to take them up after the reserve banks have failed.”

Those are fighting words. The number of people who are beginning to understand what is going on grows every day. Soon I hope said number reaches a critical mass, then, the words of Henry Ford may be fulfilled:

“It is well enough that the people of the nation do not understand our banking and monetary system for, if they did, there would be a revolution before tomorrow morning.”

Bankers have created a system that allows them to generate money out of money. Speculation and gambling, backed up by their smoke and mirrors they feel intellectually superior to have created, are nothing by tools of deception. Only hard work is the root of honest money in the long run. Anything else creates bubbles that are bound to pop. But such is the history of money (“The Ascent of Money”, Niall Ferguson; Penguin Press, 2008.)

We are bound to continue such roller coaster that enriches the rich and impoverishes the rest of us. Of course, we are not innocent. After all, we have the government we deserve. Our “affluenza” or the unrestrained consumerism that fails to fill the void within us that only love and fellowship can fill is the other side of the recessionary forces at play. We search for happiness through conspicuous consumption, thus bloating our economy with demands that are unrealistic and unsustainable. Corporations and bankers encourage such destructive habits by providing easy credit even when we don’t have the resources to pay back. Ultimately, it is our children who are left to foot the bill.

Funny money created by greedy bankers and our unrestrained shopping are the forces behind the perfect storm that is buffeting our society today. The same bloating of the economy is reflected in our bloating waistlines and medicine cabinet redolent of drugs that treat the results of such poor lifestyles. And how is it that Americans have been slowly cooked in this messy pot? Just like the proverbial frog in hot water: slowly through history, while we were diverted from these historical facts by the well-proven Roman principle of governance: “bread and circus.” Governments know they can control us by providing plenty of cheap food and entertainment. Given those two things, we are deluded by claims of freedom, when in reality such freedom is limited to choices of junk food and mindless entertainment.

Could we be truly free as we claim to be? Yes, but this takes a committed effort to learning from history, becoming active politically and join like-minded people in implementing changes in our communities. Do we still need banks? Of course, but not the centralized banks that drain money form our local communities. Personally, I fired Chase bank and joined a very solvent local organization, American First Credit Union in Salt Lake City.

Speaking of Utah (don’t read if you are biased against this wonderful state), I have to bring up a matter well-known to us locals: the Book of Mormon. Wait! I am not a Mormon, but I feel it is amazing how that book hits it right on the head when it comes to describing what is happening today. In attempting to describe what created so many bubbles and busts in their history, one of their leaders in that book isolated “secret combinations,” or “Gadianton robbers” as the root causes. He went on to predict that, just like we see in the whole history of mankind, the same “combinations” would be at play “in the latter days.”

Will President-elect Obama fix these basic problems with our system? I don’t believe so, not when he picked the tax-dodging Chairman of the biggest Federal Reserve bank, the New York branch, Mr. Geithner. Now, I am not a Democrat, nor a Republican, but I did vote for Mr. Obama, who seems quite likable and sincere. But, I am afraid that his plans to fix our economy are nothing but new wine in old bottles. We need to get new bottles and do away with the Federal Reserve and foment capitalism with strong regulations.

The health of our economy is in critical condition because we have failed to learn form history.
I fear that our own health may get worse, unless:

  • We become more self sufficient
  • We created local links in our neighborhoods to support one another
  • We stop supporting corporations and consume locally to keep our money in our communities
  • We eat unprocessed food and quit junk food; their corporate ads are practically shoving it down our throats just to maximize their profits
  • We take advantage of this realignment of priorities and consume only what is necessary
  • We become better educated about self-healing modalities that are cheaper and less invasive.
  • We will always need our doctors in times of crisis, but 80% of health problems can be resolved by good nutrition, clean environments and good stress-coping mechanisms, which are primarily good social support networks.

As always, any period of suffering may be an opportunity to change and fix the cause of the suffering. Let us be optimistic about the future as we look at the past and learn its lessons. And let the Federal Reserve have the same fate that befell Hamilton.

Wednesday, December 3, 2008

Fixing the Economy: Fixing Our Environment’s Health with Green Technology

We are anxiously plunging into an uncertain future. We watch the news each evening, soaking in every bit of information about the economy. Some of us read the latest books on the subject, including history books that may shed light on what is happening. Even though most experts don’t seem to be of much help in navigating the complexity of finances and banking, some pearls may be found in their debates. I am betting that Harold Wilson, Thomas Friedman and others who feel as they do are the eggheads with the best insights.

Dr. Wilson and Friedman propose that the 21st Century must be the century of Green Technology, much like the 20th Century was the century of Industrialization, when countries focused single-mindedly on production and utilization of energy and raw materials from the Earth without significant efforts to mitigate and minimize the literal raping of Mother Earth. The 20th Century planted the seeds for not only the environmental problems that are now coming home to roost, but also the economic woes we are having. Ironically, a cooling economy and a warming planet also present us with an opportunity to fix these problems, if we so choose, much like ancient Chinese wisdom tells us: a crisis can also be an opportunity for growth.

Wilson and many others feel that the development of Green Technology (wind power, bio-fuels like alcohol, solar and thermal energy, perma-culture, clean coal, etc.) is a must if we are to make it in the next few years. We have recently become aware of the ecologic imperative to do so; now, we must embrace an economic imperative.

Some economists feel that economies are always going through Bubble and Bust periods, mostly due to human nature and our penchant for spending money we don’t have. The Busts are then nothing but periods of adjustment so that we are forced to face the grim reality that we cannot live on credit from our children’s futures. And the Bubbles are nothing but New Technologies that spur growth that lasts a few decades until everyone has embraced said technologies. For example, the textile industry and the navy fueled the British Empire; the Spanish Empire was built on the riches of their South American colonies, and, more recently, the American Empire was built on not only its WWII victory, but the computer and the dot.com revolution. When those bubbles start to run out of steam, economies try to get cute with shortcuts like bundling bad debts (credit cards, housing, etc) to be sold as legitimate assets (CDOs) to unsuspecting gamblers throughout the world.

In other words, Green Technologies (producing Energy and cleaning our environment) have the potential to spur our economy out of the recession it is mired. The benefits are legion, including improving our physical and emotional health. As Chairman of the Environmental/Public Health committee for the Utah Medical Association I am very interested in bringing to the fore environmental issues that have been thoroughly documented to impact our health. But, I feel it is naïve to work in this often-controversial field without an understanding of the economic and energy issues that are involved. Even our National Security depends on how we manage energy issues in the future: we cannot continue to depend on foreign oil and expect to call our own shots in the international arena.

As physicians we have a duty to help our patients understand these intertwined issues so that they may become involved and a part of the solutions. For instance, the UMA's Environmental Committee has passed resolutions supporting clean air, wind power, and mass transportation in Utah. Concerned doctors like Michelle Hoffman have been working side by side with Mothers for Clean Air; David Jack and Katherine Wheeler have been working with the Adopt a School program to address “other energy” issues (obesity in children); Charles Langelier has been instrumental in starting an Environmental Medicine course at the Medical School, and Bryan Moench has been extremely active with Utah Physicians for a Healthy Environment and their efforts to limit Coal Mining pollution.

Let us be part of the solution: join our Environmental Committee’s efforts to work on all these fronts that have the potential to heal our communities in so many ways.

(Article submitted to the Utah Medical Association Bulletin for publication.)

1 “The Forgotten Man: a new history of the great depression;” Amity Shlaes, Harper Perennial, 2007,
“No Ordinary Time. Franklin and Eleanor Roosevelt: the home front in WWII;” Doris Kearns Goodwin, Simon & Schuster, 1994,
“The Ascent of Money: a financial history of the world:” Penguin Press, 2008
2 “The Future of Life;” Harold Wilson, Knopf Press, 2002.
"Hot, Flat and Crowded: why we need a green revolution- and how it can renew America," Thomas Friedman; Farrar, Straus, Giroux, 2008.