SURPRISE: There is a 15-17 Year Gap Between Discovery and Medical Practice – BUT THERE DOESN’T HAVE TO BE!

It turns out that many if not most significant advances in science take 15-17 years to make their way into the routine clinical practice of medicine. There are lots of reasons for this some of them good and some of them absurd. When something new comes along insurance companies who are often the payors frequently call it “experimental” for as long as they can. This lets them not pay for it.

Medicine is by nature conservative. That is generally a good thing and one of the main tenets of the practice of medicine is “First, do no harm”. So, the system often assumes that anything new has potential harms.  But it is also possible for entrenched interests to not embrace new breakthroughs because they are structurally set up to benefit from the current ways of doing things.

Even academic scholars who are not profiting directly from the old ways are still guardians of their territories. This is how dogma gets to be dogma – it is sanctified by those who defend it because they are its keepers. It is not instinctive to embrace change, it takes a certain type of person to reach for the new.

Take the field of Cardiology for instance.  There has been good evidence in the lab for a number of years that what happens to cause blood vessel disease results from an inflammatory process. A standard medical approach to cardiac disease looks for critical blockages in the artery and to this day will often recommend and do catheterization and stenting procedures to these specific narrowed spots. The problem is that these are not the only spots at risk. Most heart attacks happen when inflamed plaque ruptures causing a clot and blockage of downstream. Just treating the one small area of one or two blood vessels does little to mitigate the risk of plaque rupturing in a lot of blood vessels.

Traditional Cardiology will treat risk factors like elevated cholesterol, high blood sugar and high blood pressure with a combination of medications.  This helps but it is not getting at the root cause of the inflammatory process.

Blood vessel problems tend to be system wide. If you have inflamed blood vessels in your heart you likely have a similar problem in other critical blood vessels as well like those going to your brain or your kidneys. By looking for underlying root causes and aggressively treating inflammation and oxidation damage it’s often possible to put out the fire. Sometimes this is done with diet, sometimes with supplements, and sometimes with traditional medications. The point is to address the system wide problem and the lifestyle factors that led to it in the first place.

Integrative and Functional Medicine doctors, holistic cardiologists like Dean Ornish and even Traditional Western Medicine doctors using treatments such as “The Bale-Doneen” approach have all gotten spectacular results using these more integrated and system wide ways of looking at and treating heart disease. They have stabilized and even reversed heart and blood vessel disease in patients for whom Traditional Medicine said there was nothing that could be done.

Studies like Carotid Intimal Thickness testing and advanced biomarkers to look at inflammation in different layers of blood vessels can find problems at early stages BEFORE something bad happens. Advanced lipid profiles that look at cholesterol particle numbers, sizes, and functionality can also give more detailed predictive information than the usual cholesterol numbers that are measured. When these are combined powerful predictive, preventive and personalized plans can often be developed and implemented for an individual to catch things early and stabilize and reverse blood vessel disease throughout the body.

We think that’s a good idea. Even if you have to pay for it yourself. Most people we know would rather avoid having a major vascular event like a heart attack or stroke than avoid paying for a test that could save their lives. In our practice, we recommend following an array of biomarkers on a regular basis that can guide lifestyle choices and therapies to stay out of harm’s way.  We are betting that if you stay well you will have all sorts of great ideas about fun things to do, places to go, and new areas of life to explore!

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