As a member of the pharmacy profession, I can become very discouraged by the standard medical approach of using medications to treat the symptoms of diseases that are caused largely by lifestyle choices. That is why I am so excited and encouraged by recent reports of doctors who are treating patients by “dispensing” produce.
Standard Medical Practice
In my pharmacy training and continuing education, great importance has been placed on various markers of health, such as blood pressure, cholesterol levels (total cholesterol, high-density lipoprotein cholesterol [HDL or “good” cholesterol], low-density lipoprotein cholesterol [LDL or “bad” cholesterol]), and blood sugar levels. Although hypertension (high blood pressure), elevated cholesterol, and type 2 diabetes are all highly influenced by lifestyle, using lifestyle changes to address these conditions is not emphasized. Although lifestyle changes are mentioned, the recommendations are not adequate, and it generally is assumed that patients will be unable and unwilling to make substantial changes. So minor, passing lip service is given to lifestyle recommendations, and then it’s on to the algorithms for step-wise pharmaceutical care to get the patient’s parameters into the target ranges.
The implication is that getting these numbers into the desired ranges with multiple expensive, side effect-ridden medications is going to create the same health outcomes and quality of life as would occur if the patient used exercise and a whole foods, plant-based diet to achieve these numbers. This cannot possibly be true, and this approach to health care is also not financially sustainable.
U.S. Health Care Costs
Health care expenditures in the United States are astronomical, but the state of our nation’s health is nothing to brag about. In 2013, the U.S. spent 2.9 trillion dollars on health care, which is about $9,255 per person.[i] This figure accounted for 17.4% of total spending; according to calculations by the CMS Office of the Actuary, health care spending in the U.S. is predicted to almost double by the year 2023, reaching $5.2 trillion and 19.3% of the economy. Despite these expenditures, in a ranking of 133 developed countries, the U.S. ranks 30th in life expectancy, 35th in the rate of premature deaths from non-communicable diseases, and 55th in women surviving childbirth.[ii]
Fortunately, greater emphasis is beginning to be placed on preventive care through lifestyle changes, especially a whole foods, plant-based diet. Two of the physicians who recently have made news with their plant-based nutrition focus are Dr. Garth Davis and Dr. Robert Weiss.
Dr. Garth Davis’ Produce Prescriptions
Dr. Garth Davis is a weight loss surgeon based in Houston, Texas, who has become a strong advocate of plant-based nutrition. He has exhaustively evaluated the medical literature to come to his current recommendations, and he recently authored the book Proteinaholic: How Our Obsession with Meat is Killing Us and What We Can Do About It. With support from the Memorial Hermann Memorial City Medical Center Hospital and the Memorial Hermann Foundation, Dr. Davis has teamed up with Kristina Gabrielle Carrillo-Bucaram, founder and chief co-operator of Rawfully Organic, a nonprofit organic food co-op based in Houston, to open a “Farmacy Stand” in the hospital.[iii] The stand dispenses boxes of fresh, organic produce for $25, with patients receiving a $10 refund if they present a prescription for the produce. Dr. Davis, who so far writes the majority of the prescriptions, works at the stand himself once per week. It’s great to recommend eating a plant-based diet, but to actually write a prescription and provide fruits and vegetables directly to patients sends a powerful message!
Dr. Robert Weiss’ Farm-Based Practice
After selling his New York medical practice, Dr. Robert Weiss has built what may be the first ever farm-based medical practice.[iv] According to recent reports, his 348-acre farm has close to 100 families who pay a membership fee and volunteer time working on the farm picking weeds and harvesting vegetables. Dr. Weiss recommends a diet focused on grains, greens, and fruit, and he also believes that being involved with food production is helpful to get people more interested in their diet as well as providing healthy activity. One of Dr. Weiss’ patients, a 90-year-old woman who presented with congestive heart failure, high blood pressure, and diabetes, began following a nutritious plant-based diet. Her medical conditions resolved and she was able to begin walking around town; according to her daughter, who also started the diet and lost almost 40 pounds, her mother was able to stop taking her high blood pressure medication within 2 weeks of changing her eating habits.
Of course, anyone who is taking medications should continue taking them as prescribed until they receive instructions from a qualified clinician to decrease or discontinue them. In addition, it is advisable to inform your clinician if you make any changes to your diet so that he or she can more closely monitor your health conditions and make treatment changes as needed. Also, I am not suggesting that conventional medicine, including medications, should never be used; for acute conditions, infectious diseases, and many non-lifestyle-related diseases and conditions, modern medical treatment is highly effective and appropriate. What I lament is the sole reliance on prescription medications to treat the symptoms of chronic diseases for which lifestyle changes can address the root cause.
It is exciting and encouraging to see physicians like Dr. Davis and Dr. Weiss following in the footsteps of pioneers such as Dr. John McDougall, Dr. Dean Ornish, Dr. Neal Barnard, Dr. Caldwell Esselstyn, and Dr. Joel Fuhrman, and joining peers such as Dr. Robert Ostfeld, Dr. Joel Kahn, Dr. Michael Klaper, and Dr. Michael Greger. I look forward to the day when it becomes standard medical practice to teach patients the importance of a whole foods, plant-based diet for optimal health!
[i] “Here’s exactly how the United States spends $2.9 trillion on health care” by Jason Millman, The Washington Post
[ii] “Health Care Spending vs. Health Outcomes in the United States” Berkeley Wellness
[iv] “Medical Doctor Sells Practice, Opens Up “Farmacy” Using Food as Medicine” by Justin Gardner, The Free Thought Project