CARDIOLOGY, PRIMARY CARE AND NUTRITION

Blogpost: I Don’t See You in the Hospital Anymore

As a cardiologist, I have spent decades rounding in the mornings and evenings, doing cardiac procedures at my area hospitals, and taking night call seven days a week. Then plants came along. We started with a test evening nutrition class that gradually morphed into three weekly nutrition classes. Since I am a solo practitioner, I set my own schedule, well according to Barbara, my scheduler extraordinaire. We have never overbooked or double booked so there is always plenty of time with each patient. But after we transitioned to a direct care membership practice, we have seen a marked decline in the need for hospital visits. We had 3 admissions the first 6 months and 4 admissions so far this year. I have not done a heart catheterization in over a year because none of my members are having angina or heart attacks. Granted we have reduced our patient population substantially and will cap the membership soon. However, I still have many patients with heart disease, diabetes, hypertension, and vascular disease. They are doing well on a plant based diet and wellness activity regimen. Many of them are off of their medications and have normalized their laboratories. Others, are steadily improving.

I was speaking to a hospital radiologist, and he mentioned he does not see me at the hospital or the doctors lounge anymore. I have not eaten there in ages, but I did chart there and get a coffee when I was actively rounding. I chuckled and said that I eat the leftovers from my office nutrition class. There is nothing healthy at the doctor’s lounge except for the tiny salad bar that is compromised by tuna salad, cottage cheese, and creamy dressings. I ran into a pulmonologist and he asked if I was back. It was if I had been let out of confinement and was now allowed back to join the other frantically rounding doctors then run back to the office in time to see 20 or 30 patients. The prevailing thought is that hospital, office, procedures, and hospital again during the day kept one from becoming bored just seeing patient after patient. That is quite true, if your are just going from room to room filling prescriptions and ordering procedures. I have heard physicians say on more than one occasion that they handle the system by being good box checkers and good at copying phrases and records from one visit to the next. Gone are the days of talking with patients and getting to know them. In lieu of listening and diagnosing, just order a bunch of tests and something is sure to show up.

So what is a plant based doctor to do? We are focusing on education and motivation. We keep busy preparing new talks and menus each week for three levels of nutrition classes. I spend however long it takes to answer a members question or concern, demonstrate movements that will improve strength and flexibility, and push them to be a little better than they were yesterday. It is a foreign concept for physicians to be proactive in preventing and reversing disease instead of merely diagnosing and treating. Treating is much different than reversing and preventing. Treating is considered successful if the present conditon can be maintained or the delcine slowed instead of reversing and bring health back to what it once was. Diagnosing is a skill that takes time, planning a course of action to reverse and prevent disease also takes time and is even more rewarding.

I often invite physicians to come over and join us for nutrition classes or to sample our plant based foods. Still waiting.

2 Comments
  1. Reply
    Maureen

    Dear Dr Dulaney,

    My sister-in-law and friend is one of your patients. She shared your blog post and she has told me so many great things about you and your practice.
    Would you know of a plant based doctor/practice in New England, especially Massachusetts. Learning about this type of medical practice is amazing!

    • Reply
      Dr. Dulaney

      thank you!

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