David Donohue is a primary care physician in Wilmington, Delaware, and one of only 280 board-certified lifestyle medicine specialists in the United States. As David points out in our conversation, that's fewer than one for every million Americans.
I wanted to talk with David about the successful and innovative Cure Diabetes program that he's run over the past year, but we quickly started egging each other on (is there a vegan egg-replacer metaphor for that phrase?) to describe our pet peeves about the current medical system.
David is not only a doctor, but a computer coder/developer, and this means that he sees the world in terms of systems that can be optimized. And the medical system, in his view (and mine as well), is one giant system optimized to produce pretty much the opposite of health and value for consumers. As he points out (and people have been saying for three decades now), it's bloated, ineffective, and unsustainable – and must be reformed or replaced.
David's got strong opinions about medical education – and regular K-12 and college education – that had me nodding Yes so hard that my headphones nearly fell off a few times.
If you are a doctor, or know a doctor, or go see a doctor, or studiously avoid doctors, this is a must-listen podcast. David is funny, smart, compassionate, and driven to make the world a better place.
We covered:
- “studying the classics while Rome is burning”
- when have I ever needed to calculate the area under a curve?
- we make 200 food decisions each day
- medical education has it backwards: you can't learn about kidney disease until you learn about nephrons
- lip service to Motivational Interviewing, but not part of what doctors “are supposed to do”
- the internal medicine boards questions – all about drug protocols, nothing about lifestyle change
- the Cure Diabetes program
- the power of group dynamics
- lifestyle medicine isn't radical – recommended by United States Preventive Task Force for coronary patients as first line treatment
- the danger of a non-supportive partner
- adding the Power of Purpose to the intervention
- adding Moral Support to the intervention
- the importance of easy recipes and cooking demos: “this is easier/tastier than I thought”
- we often adopt self-defeating narratives when we get medicalized
- the department of internal medicine holiday party food spread: two tables of sausages and a table with chocolate dipped bacon
- electronic medical records are largely for billing and regulatory compliance, not patient care
- the biomarkers that do and don't work for showing disease reversal
- creating a crowdsourced wiki of effective behavior change strategies and techniques
- and much more…
Enjoy, add your voice to the conversation via the comment box below, and please share – that's how we spread our message and spread our roots.
Links
Want to work with David? Email him here:
dr*******@gm***.com
Overdiagnosed, by Gilbert Welch, Lisa Schwartz, and Steven Woloshin, MDs
The Citizen Patient, by Norman Hadler, MD
Gregory Walton's Wise Interventions
the Dominion documentary trailer
the Direct Trial on reversing diabetes through dietary caloric restriction
Bactrim (not azithromycin) leads to death in 3 of 1000 patients taking certain ACE inhibitors
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Your spam filter seems to be overly sensitive and incorrectly blocking my attempted messages to you. Dr. Greger has a video on how to find out if your doctor took drug company money.
Keep up the great work!
Thanks,
Kip
Thanks, Kip! I apologize for my itchy spam filter – it tries its best, but definitely can get over-eager.
Do you have the link for that Dr Greger video? I know of the Pro Publica database: https://projects.propublica.org/docdollars/ Is there another source that I should know about?