I read with great interest the response to your article on functional medicine by Dr. Robert Schulman. I found what he wrote to be not only highly accurate, but written in concise and easy-to-understand language. As one who treats people using lifestyle interventions for diabetes, high blood pressure, stress and other medical maladies, I have to work with many of my clients’ doctors and it is so incredibly pleasing to me to hear of doctors, such as Dr. Schulman, who use interventions such as diet and exercise along with — or even perhaps instead of — pharmaceutical treatment when possible. Too many physicians who care for my clients are “drugs only” in spite of the clear-cut evidence that is “proven” beyond a doubt, through countless large studies with good controls, that lifestyle interventions to reduce stress or using exercise to cause a positive physiological or psychological response is indeed part of medicine today.
Dr. Schulman also writes: “Just about everything we do has been subjected to controlled studies.” I think this needs to be addressed, also. “Just about everything” isn’t everything. There are problems with many of the studies that “prove” things. Only the big pharmaceutical companies have the means to fund large studies and can taint the studies because of possible financial benefit. While there are many examples of this, including studies whose results were only later termed “tainted” by critical review, many physicians follow the results anyway. Do we have absolute proof that high cholesterol causes heart disease or, more specifically, heart attacks? Do statin drugs, with all their potential side effects, really prevent heart attacks and strokes? Fifty percent of Americans with high cholesterol never get heart disease and 50 percent of people with heart disease don’t have high cholesterol. The NNT number (number of people you have to treat with any drug for one person to benefit) for statins is 104. So a doctor has to give 104 people a drug that can cause muscle pain, memory problems and raise their risk of diabetes because one person may benefit.
I wish doctors like Dr. Robert Schulman and his wife, Dr. Susan Schulman, continued success in treating their patients, helping the klal in the many ways they do, and setting the good example they do for all medical professionals.
Alan Freishtat, Yerushalayim
Hamodia Columnist for Health and Lifestyle, Certified Wellness Coach and Certified Personal Trainer