Life-saving reasons to see your PCP vs. a specialist

I recently read a very insightful column by cardiologist Milton Packer, M.D. who set out to discover how primary care physicians feel about medical specialists.

Apparently, according to Dr. Packer’s informal survey, primary care doctors aren’t too fond of specialists — especially cardiologists like himself. (And you certainly know my view on them!)

“Actually,” Packer said, “they detest them.”

Pretty strong language about the most prestigious — and most highly compensated — of all the medical specialties.

One primary care doctor responded, “You are joking right? I hate specialists, especially cardiologists. They are so arrogant. They think they know everything… They don’t really want to help people. They just want to make money. I hate referring patients to them.”

And there’s more.

“When I call a specialist because I want their advice, all they want to know is whether the patient needs a procedure. If I ask them about the use of medications, they have no time for me. Maybe I’ll get connected to one of their nurses. In any case, it’s a terrible experience.”

Dr. Packer was stunned.

While on the topic of medications, Packer asked if primary care physicians, as a whole, are concerned whether or not they’re actually providing all the best new drugs to their patients. Especially considering the wide array of newly formulated drugs for diabetes and heart disease.

One primary care doctor responded, “New drugs? There are lots of new drugs. But I am certainly not going to listen to the propaganda of the pharma company representatives. They’re just as condescending as the specialists!”

Dr. Packer then retorted, asking how primary care doctors keep up with all the latest news, if they don’t speak with specialists. The primary care doctor continued, “Keep up? There is no way. Too many articles. Most are biased. Most get contradicted by another paper later on. Where I am going to get unbiased information?”

Where do doctors turn for unbiased advice?

As you know, I bypass the mainstream press and go straight to the science. I keep up on all the key studies of interest published in the Journal of Natural Medicines, the Journal of the AMA, the New England Journal of Medicine, and Lancet, for example.

But most doctors who see patients every day just don’t have the time to read all these medical journals. So where do they turn for unbiased advice?

I find myself referring more and more to the guidelines published by the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP). Both organizations seem to take a sensible approach to heart health. For example, they both now advise allowing systolic blood pressure levels (the first number) up to 130 or 140 in older Americans based on the evidence.

This approach makes perfect sense to me, as slightly higher blood pressure improves circulation of blood, oxygen, and energy into tissues to support brain and heart health, especially as you get older.

The ACP represents approximately 200,000 internal medicine physicians, more than any other medical specialty. And these physicians closely resemble the general practitioner of yesteryear, with added training.

They provide primary care on the front lines every day. And they provide ongoing care for the vast majority of patients with chronic diseases.

Frankly, I’m not surprised these primary care physicians look with horror at cardiologists and other medical specialists who recommend using more and more drugs to lower blood pressure and cholesterol. The specialists’ guidelines seem to be designed to sell drugs rather than heal patients.

In fact, I recently reported on the American Heart Association and the American College of Cardiology’s misguided recommendations to aggressively lower blood pressure targets in adults. They based their recommendation on a flawed study from two years ago that was never even completed.

More advice to avoid new drugs

Dr. Packer had one more question about diabetes and heart disease: “So, all these new advances in drug therapy…are you using any of them for the good of your patients?”

The reply was sharp and swift, “We have a rule in primary care. Don’t use a new drug until it has been on the market for at least seven years. After seven years, we will know if it is safe. And at that time, the drug will be generic and we won’t need the paperwork, or the specialists.”

And, as you know, that’s always been my prescription.

Avoid specialists.

Avoid dangerous procedures.

Avoid new drugs.

For most people with chronic conditions, primary care doctors provide comfort, understanding, and support to the patient and the family.

And, like you, dear reader, these doctors understand the problems with the modern healthcare system. They can help you prevent and manage chronic conditions. And, often, they’ll also support your use of natural approaches, as I advocate every day.

If your primary care doctor wants to learn more about natural approaches, recommend she or he check out my free Daily Dispatch e-letter and Insiders’ Cures newsletter. (Simply send them these links.)

In the meantime, here’s my promise to you: I’ll continue to report on the growing science that shows you can prevent — and even reverse — chronic medical conditions using natural approaches. Including conditions like heart disease, dementia, diabetes, and even certain cancers.




“Patient care vs. primary care: Is there a problem here?” Medpage Today ( 10/11/2017