For Part 1 click here For Part 2 click here Today's article is the third…
Penalties for Doctors who Refuse to Sell Cholesterol Drugs
On Wednesday July 9,2008 the Garden Island Newspaper published my Letter To The Editor (Thank you Garden Isle)I feel my patients and the people of Hawai‘i have the right to know some of what goes on behind the scenes at HMSA, our island’s number one health insurance company. This week, I will participate in a teleconference about a new initiative program created by HMSA as part of what they call “quality of care.” If you have diabetes, your doctor will be paid more if he or she convinces you to buy a cholesterol-lowering pill. How much more? If I get all my diabetics on these pills, I calculate that I may earn up to $20,000 more next year. Sounds great for me, and you might think I’d be an idiot to question such an easy cash gift. But I don’t think I’ll go for it. I don’t think there is enough scientific evidence that this practice will help all my diabetic patients, and I can’t justify such mindless, mass prescribing. For more information on what’s happening behind the scenes, check out www.drcate.com And if you are a paying customer of HMSA, you might want to join the discussion by contacting HMSA’s vice president/medical director John Berthiaume. Catey Shanahan, M.D.
On Friday, HMSA Fired Back:Pills recommended for a reason A recent letter (“Recommending pills to pop,” Letters, July 9) discussed the use of cholesterol-lowering drugs, called statins, by people with diabetes. Statins have been shown to help diabetic patients reduce their risk for stroke and heart attack and are recommended by the American Diabetic Association and the American College of Cardiology as a “best practice.” The HMSA Practitioner Quality Service Recognition program rewards doctors who follow such best practices because the appropriate use of health care services benefits our members, the health care delivery system and the community as a whole. Ron Fujimoto, D.O. HMSA Medical Director
This Irishwoman loves to get the last word, and I didn’t like the insinuation that I wasn’t aware of what doctors are being told to do by organizations like the ADA and the ACC. So I sent one more letter to the Garden Island Newspaper. But no luck this time, they didn’t print it. Here’s what I wrote:
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NBA baskeball player
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Broadcaster / The Megyn Kelly Show
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Fox News Primetime host
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My waist is four inches smaller. I feel great and many of the minor aches and pains that I had (knees and lower back) are gone. Also, my muscle tone is amazing, even though I have not increased my workout routine.
Completed Dr Cate's online course
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Dismantles the lie
Dr. Cate dismantles the lie that seed oils are healthy, which may the biggest lie about nutrition and health because it’s so insidious.
Ken D Berry, MD
Author of Lies My Doctor Told Me
She knows the chemistry
Dr. Cate alerts us to the harms of seed oils and she’s convincing because she knows the chemistry better than anyone.
Dr. Drew Pinskey, MD
Globally recognized internal medicine and addiction medicine specialist, media personality, LoveLine Host, and New York Times bestselling author
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Physiotherapist coach and New York Times and Wall Street Journal bestselling author
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Dr. Shanahan has had a significant impact on my practice of medicine. I am known as a Low Carb Doctor, but I never really appreciated the negative effects of processed seed oils on the health of my patients. I highly recommend The Fatburn Fix to my patients and have a loaner copy in my waiting room. It is amazing how quickly blood sugars and overall health improves with cutting seed oils. It is not just about the carbs!
Dr. Brian Lenkzes, MD
CEO of LowCarbMD San Diego, co-host of Low Carb MD Podcast and host of Life's Best Medicine Podcast
Respected in the sports world
Dr. Cate reordered my diet when I was with the L.A. Lakers, and the benefits, for me personally, were felt immediately and have served me to this day. I’ve come to take real food so seriously I started a small family farm. I know of no M.D./nutritionist more respected in the sports world than Dr. Cate Shanahan.
Brought seed oil issue front and center
Cate brought the seed oil issue front and center. Healthy fats matter. So much so that I created an entire product line to swap out bad fats with good.
Founding Father of the Primal/Paleo Movement
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Attribution author of The Whole 30
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Dr Grewal Internal Medicine, MD, author of Genius Foods
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Author of the Bulletproof Diet
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Saved my life
I would like to thank you for literally saving my life. Back in February, I had to be hospitalized while on vacation in Phoenix with an A1C of 11% and had to start taking 2 types of insulin and 2 other meds. I read the Fatburn Fix in April, and followed the program to a tee, and I’m down by 15 pounds, 6.8 A1C, and only one once weekly diabetes medicine.
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I thank Dr. Fujimoto from HMSA for responding to my letter. As trained medical practitioners, we doctors are capable of reading the research and drawing our own conclusions – but we must read the data first. HMSA’s medical directorship outsources this responsibility to consensus panels and organizations such as the American Diabetic Association and the American Heart Association – and that’s a problem. These organizations have strong financial ties to industry and their conclusions are far from unimpeachable. The conflicts of interest run so deep that they have been repeatedly exposed by major players within the medical establishment, including The New England Journal of Medicine’s editor Dr. Jerome Kassirer, Harvard University’s Dr. John Abramson, the Center for Medical Consumers, and many others. Patients are best served when doctors read the research themselves and remain free to make decisions without corporate interference from insurance plans.
I’ve read the research data on the use of statins in diabetics in all its monotonous detail, not just the consensus panel summaries. The data shows that some diabetics benefit and some are harmed. There’s no such thing as a drug without side effects, and statins may cause memory loss, depression, nerve damage, bacterial sepsis, muscle damage (including heart muscle) and cancer. To say that all diabetics will benefit is truthiness, not the truth. In my opinion, this national trend toward paying some doctors less than others for treating patients in accordance with the best available scientific data will lead to predictable harms.
Catey Shanahan, MD
West Kauai Clinic Kalaheo
Here are a links to some of the people who inspired me to think for myself:
Ray Moynihan and Alan Cassels, Authors of Selling Sickness
And the creators of this video:
And for any doctor out there who wants to know why a growing number of scientists and physicians are skeptical of the benefits of these medications, a few more links:
Dr. Duane Graveline, author of Statin Drug Side Effects and many articles. This site is full of technical and interesting information that doesn’t make our medical journals.
Cardiologist Peter H Langsjoen, MD, FACC