Leveraging The Doctor As A Trusted Authority

I was on the phone with my good friend Bill Bestermann MD yesterday.  Dr. B, a preventive cardiologist who is passionate about the underlying mechanics of cardiovascular disease and the horrific toll the American diet and lack of exercise is taking on everyday people, lives in spectacularly beautiful, rural Kingsport TN. He told me he was driving through town, channel surfing on his radio, and he happened upon the station that broadcasts information for the local schools. They were announcing the menu in the school cafeterias. He said it was appalling. "Honeybuns and processed foods. It was all the stuff I tell my patients to avoid."


Never one to shrink from suggesting that other people embark on courageous courses of action, I urged him to ask for a meeting with the School Board to lay out what the long term effects of this diet are on the children of the region. "Think in terms of leveraging your credibility as a trusted authority," I advised.

Many school boards have defaulted to whatever's most financially expedient in their school cafeterias. They take money from junk food companies and, in exchange, give the firms free access to the kids with vending machines and ads. They ignore the rising tide of obesity and chronic disease that threatens the kids and their future.

Imagine if a doctor or, better yet, a small army of local doctors, waltzed in and explained the impacts of the school menu to the Board and, if possible, the community, through the local newspapers, TV and radio stations. Then they could make recommendations for a diet that would be acceptable to kids while providing actual nutrition. (And while they're at it maybe they could explain why getting rid of gym and other physical activities is moronically penny-wise and dollar foolish.)

Physicians shouldn't underestimate their power in this. While physician credibility has waned in recent years as the health care crisis has intensified, a 2003 study found that Americans still trust their physicians more than any other relationship outside of family.

It's not like this is a small problem. In my talks I flash my favorite obesity slide, an image generated by the gifted illustrator Wellington Grey. (When it comes up on the screen and the audience begins to absorb it, you can always hear embarrassed laughter ripple through the crowd.) It shows the percentage of adults over age 15 in a variety of developed countries with a body mass index over 30 (that is, who are obese). Americans, at 31%, are far and away the fattest people, with Mexico and the UK trailing distantly at 24% and 23%, respectively. The French, Austrians and Italians are at 9%, and the ridiculously trim Koreans and Japanese are at 3%.

This slide tells us everything we need to know about America's future competitiveness. If obesity is a general predictor of health, health is related to productivity and productivity to competitiveness, we're toast.

To turn this around, we need leadership. If not from doctors, our most trusted professionals, then from whom? This is really a problem that local medical societies ought to wave the flag on. It might create the impetus for real change, and remind people that their doctors do really want what's best for us all.