Wheat "debate" on CBC

"Many Canadians plan warm buns, stuffing and pie for their Thanksgiving meals tonight. But I'll speak with a cardiologist who thinks we have no reason to be thankful for any food that contains wheat. William Davis says our daily bread is making us fat and sick."

That's the introduction to my recent interview and debate on CBC, the Canadian public radio system, aired on the Canadian Thanksgiving. Arguing the other side was Dr. Susan Whiting, an academic nutritionist. (I use the word "arguing" loosely, since she hardly argued the issues, certainly hadn't read the book, but was content to echo the conventional line that whole grains are healthy and cutting out a food group is unhealthy.)

I do have to give credit to the Canadian media, including the CBC, who have been hosting some rough-and-tumble discussions about the entire wheat question despite Canada being a world exporter of wheat. I recently participated in another debate with a PhD nutrition expert from Montreal who, in response to my assertion that the genetically-altered high-yield, semi-dwarf strains have changed the basic composition of wheat, argued that the creation of the 2-foot tall semi-dwarf strain was a convenience created so that farmers could see above their fields--no kidding. I stifled my laugh. (The semi-dwarf variants were actually created to compensate for the heavy seed head that develops with vigorous nitrate fertilization that buckles 4 1/2-foot tall wheat stalk, making harvesting and threshing impossible, a process farmers call "lodging." The 2-foot tall semi-dwarf thick, stocky stalk is strong enough to resist lodging.)

In short, debating the nutrition "experts" on this question has been tantamount to arguing with a school age child on the finer points of quantum physics. There has not yet been any real objection raised on the basic arguments against modern genetically-altered wheat. Modern semi-dwarf wheat is, and remains, an incredibly bad creation of the genetics laboratories of the 1970s. It has no business on the shelves of your grocery store nor on the cupboards in your home.

Comments (29) -

  • Tracey Mardon

    10/11/2011 3:03:04 AM |

    Hello Dr. Davis, I had no idea about either you or your book 2 1/2 years ago when I entirely removed gluten from my diet but I wanted to say I experienced all of the positive responses you spoke about. No more migraines, acid reflux, sore painting shoulder, lost 35 lbs without feeling I was dieting. I was also able to incorporate a morning Yoga program every morning and find that I'm naturally more disciplined in thought and action. I would bet that I'm effectively 20 years younger. Thanks for speaking out, it will be worth it if we can do anything about diabetes!

  • arlene

    10/11/2011 5:17:57 AM |

    I heard this interview!  The "debate" was pathetic. The argument by Dr. Whiting amounted to "but what you are talking about is an Atkins diet, so your conclusions don't matter.  Nothing matters except that you are promoting an Atkins diet"  She had NO new information, and nothing to back up her asertions that you can't be right.  I was embarassed for her, but more convinced than ever that there is no sound arguement to spport eating wheat.
    I gave up wheat in April of this year.  I have lost 35 pounds, and 5 1/2 inches on my waist.  I have been eating more, not less calories.  I went from being almost couch bound several days of the week from severe "fibromyalgia" symptoms, to forgetting I even had problems which left me in a fog most days. I see no reason to eat wheat.  After the fact, I am reading your book and discovering the "why" behind my miracle.  I purhcased your book so I can read it, pass it around to everyone I know, and tell them to buy one and do the same!  
    Thank you, Dr. Davis!

  • Soul

    10/11/2011 11:23:28 AM |

    I'm rather chuckling mentioning this, but as you probably picked up I enjoy the 90s group Nirvana.  What originally attracted me to the group was the band's song writer having a bad stomach problem, similar to mine.  I recall reading after he committed suicide, and by the note he left that was due to the stomach problem and drugs being taken to deaden the pain,  that Kurt had worked on avoiding different foods.  He did this with the hope of improving the condition.  Never did see him mention avoiding wheat.  Oranges were a concern of his as "they made his gums bleed."  There were other items he stayed away from too.

    I recall even then, middle 90s, thinking that Kurt probably was a celiac, could have found some pain relief avoiding wheat, and probably would be with us today if he had done so.  Looking back I should have taken my own advice!  I had tried eating wheat free back then, found some relief, but never enough to continue eating that way I thought.  What I didn't realize was that it took more than a month to find significant gut relief.  And it probably would have helped if I had support encouraging me to continue from doctors and family.    

    So, anyway!   This is the 20th anniversary year of when Nirvana's famous album came out.  And with that has come a release of digitally remastered album plus new songs.  I was laughing at the lyrics to this tune, School.  I can relate when witnessing internet debates!    

    Nirvana - School
    http://www.youtube.com/watch?v=0xCgwXWEQ10

  • Dr. William Davis

    10/11/2011 12:24:02 PM |

    Yes, sad when the solution may have been so simple: Just avoid the food that all "official" agencies tell us to eat more of.

  • Dr. William Davis

    10/11/2011 12:25:06 PM |

    That's great, Arlene! 5 1/2 inches off your waist is fabulous.

    I, too, was kind of embarassed for her. I don't think she knew what she was getting into!

  • Dr. William Davis

    10/11/2011 12:26:58 PM |

    Hi, Tracey--

    I'm happy you've found this solution. However, you and I remain in the minority. There are people struggling with all manner of health problems, sometimes disabling, not getting answers from their doctors . . . and the solution can be as simple as removing all wheat. So this is a message worth repeating over and over and over again.

  • Jom Crawford

    10/11/2011 1:35:36 PM |

    Dr Davis

    Read your book with great interest. I am a type 2 diabetic and have taken all the steps to control levels. (exercise, weight loss, low carb, etc). My one concern is the elimination of oats. I have received excellent H1N results while consuming my favorie morning oatmeal porridge. Should I stop?

    Jim

  • Mary

    10/11/2011 2:26:49 PM |

    I get sad thinking about how so many people in my life have suffered.  My Mother had Parkinsons with dementia diagnosis and suffered terribly for 7 years til she died.
    I suspected Diabetes because she had peripheral vascular disease and poor wound healing but the blood test always showed her sugar within normal ranges.
    She craved pastries and acted like a crack addict begging for them, then would spend hours in a carb induced coma after eating them.  She died at 89 but suffered many years of her life, she tried to commit suicide before I was born and spent a year in hospital getting electric shock treatments.  She had yearly seasonal depression after that, crying for months in the winter.
    My father lived to be 94 but he had 4 major heart diseases and needed 4 nitroglycerine tabs just to get dressed in AM.  He always said he felt best when he didn't eat.  Now in hindsight I know better.  I have struggled my whole life with stomach pain.  I had a small bowel biospsy 15 years ago but it was negative for celiac.  I facilitated a support group for celiac at a local hospital and lived gluten free for several years but was never one hundred percent better, now I realize because I was drinking soda and gaining weight eating all the gluten free products.  I had surgery this past December and had great difficulty recovering, symptoms of fatigue and chronic muscle pain returned to my life again.   Thanks for your book Dr. Davis, it has reminded me to go wheat free for good.  I know I feel better wheat free, dairy free and sugar free.  I gained 20 lbs after my surgery
    due to inactivity from muscle pain and eating fast food carb meals.  I was caught in a vicious cycle of feeling aweful.  Fibromyalgia symptoms to the extreme, my thyroid function is low and my Vitamin D was at 14.  I have started wheat free for a week now, lost 4 lbs and feeling much better but still residual muscle pain.  I have a doctors appointment to persue thyroid treatment, I have been seeing a Natropath who gave me thyroid and adrenal gland supplements and I feel better but not 100% after 2 months of taking them.  Is it possible for thyroid function to return to normal after a time period of staying strictly wheat free?  I hate the thought of taking medicine the rest of my life.
    Everyday I think of a friend, family member or celebrity that has died who might have been spared by going wheat free.  RIP...Mom, Dad, my husband Joe(non smoker lung cancer, major sugar/wheat addiction) Chris Farley, Steve Jobs (an article I read said he didn't eat animal products).Patrick Swazy. Linda McCartney (vegetarian frozen meals).  I know many of these people have had other vices like drugs and alcohol but I strongly believe that wheat is a gateway substance that can lead to addiction.  My husband drank beer every evening and ate ice cream everyday for 26 years that I knew him.  He was thin and worked hard everyday thus didn't ever see he had a problem.  He had chronic pain, allergies, skin rashes. Addicted to beer, could not stop drinking it even with cancer diagnosis and chemo treatments.  Finally quite when radiation tx damaged his throat but was too late for him.  Sorry to ramble on but just am overwhelmed with all the connections I'm suspecting.  Thanks for having a place to vent.

  • Joe Lindley

    10/12/2011 2:41:01 PM |

    Dr. Davis,
    Go get 'em!   Maybe you can get on the Dr. Oz show!  You and Gary Taubes can sit on the couch while Dr. Oz eats whole grain cereal with Soy Milk!

  • Kane Augustus

    10/12/2011 11:50:51 PM |

    Dr. Davis--

    I think someone has taken you up on your book.  Her name is Melissa McEwen.  I read her article this morning.  You might find it interesting: http://huntgatherlove.com/content/wheat-belly

    Take care,
    Kane

  • john townsend

    10/13/2011 5:06:22 PM |

    I struggled my way through this review ... a bewildering rambling rant that goes nowhere with plenty of distracting irrelevant fillers thrown in for good measure. The pervasive derisive mocking tone is also off-putting. It’s this kind of “noise” that blurs and dilutes an important message unfortunately.  One case in point (amongst a myriad) in the review is the dismissive incoherent treatment of the high glucose and high insulin impact of wheat. Personally this is the one key aspect of Dr Davies thesis that really impressed me, after seeing how one slice of wheat bread caused my blood sugar level to go through the roof. I also have plenty of anecdotal evidence (and growing) that Dr Davies is onto something.

  • Cynthia Ledger

    10/13/2011 6:18:57 PM |

    "Attributes" which get cured......

    Have you seen unintended consequences?

  • alex

    10/13/2011 6:58:19 PM |

    Maybe it has nothing to do with any modification of the plant but maybe the plant itself???

    http://www.livescience.com/14194-egyptian-mummy-heart-disease.html

  • Daniel

    10/13/2011 10:34:16 PM |

    I've been a Registered Dietitian for 7 years and I'm appalled when I look back at my incredibly biased education.  An hour on PubMed disproves a majority of the conventional "wisdom" I was force fed, especially the ongoing demonization of saturated fat.  Its a joke. I'm glad to see more medical practitioners like yourself speaking out.  The studies showing the damaging effect of gliadin on the intestenial wall in supposedly health, non-celiac individuals is alarming to say the least. Keep it up!

  • James Buch

    10/13/2011 11:50:46 PM |

    The USDA has just published an evaluation that the "new varieties" of broccoli have the same vitamin and mineral content of the older ones.
    http://www.ars.usda.gov/is/pr/2011/111013.htm

    The headline and first paragraph of the web page are given below. When will they do "wheat"?

    USDA Research Demonstrates New Breeds of Broccoli Remain Packed with Health Benefits
    By Sharon Durham
    October 13, 2011

    WASHINGTON—Research performed by scientists at the U.S. Department of Agriculture (USDA) and published recently in the journal Crop Science has demonstrated that mineral levels in new varieties of broccoli have not declined since 1975, and that the broccoli contains the same levels of calcium, copper, iron, magnesium, potassium and other minerals that have made the vegetable a healthy staple of American diets for decades.

    http://www.ars.usda.gov/is/pr/2011/111013.htm

  • Dr. William Davis

    10/14/2011 12:58:02 AM |

    Good for you, Daniel!

    I am waiting for your and your colleagues to stage a revolt. Let me know and I will hold up the placards and yell with you!

  • Dr. William Davis

    10/14/2011 12:59:06 AM |

    Hi, Cynthia--

    If you mean unintended consequences of wheat removal, yes: the withdrawal phenomenon. This affects somewhere around 30% of people. It is harmless, though no fun to experience.

  • Dr. William Davis

    10/14/2011 1:02:07 AM |

    Hi, Kane--

    I found this about as interesting as saying to someone, "I don't like your face."

    I've stumbled on her blog from time to time and found it interesting and insightful. I was surprised by this blatant "I don't like it because it's stupid" kind of criticism with no real substance. Maybe she had a bad day.

  • Dr. William Davis

    10/14/2011 1:04:10 AM |

    It is absolutely ovewhelming, isn't it, Mary, when you stop and think how many people may have had serious brushes with the wheat demon, yet nobody ever suspected?

    My prediction: Wheat will prove to be among the most powerful provokers of gastrointestinal cancers. Everyone was falsely lulled by comparing whole grains to white flour that showed a relative reduction in risk. Replace something bad with something less bad, the less bad thing looks good. Flawed logic.

  • Dr. William Davis

    10/14/2011 1:05:10 AM |

    Well, it depends on what you mean by excellent H1N (HbA1c?).

    I aim for HbA1c of 5.0% or less, a level at which glycation is not occurring faster than the normal endogenous rate.

  • Cynthia Ledger

    10/14/2011 6:33:14 PM |

    There is a theory that the glutamates in wheat fill a crutial roll in wheat related intestinal porosity .....glutamate prepares epithelial tTg for attachment by wheat-surfafe HWP1.

    Do you have an opinion?

  • Dr. William Davis

    10/15/2011 1:47:16 PM |

    Hi, Cynthia--

    Not being a biochemist, I believe that is true, though I don't believe it is an effect unique to wheat, but shared by other foods.

    Boy, I hope that didn't sound like I was defending wheat!

  • Vasu

    12/12/2011 11:24:39 PM |

    Dear Dr :

    We have been vegans culturally - born and brought up in a Lacto-ovo Vegan society.  Recently, during routine annual blood tests, my husband has been diagnosed with more number of smaller particle sized LDL cholestrol.  He is at 95% level with very high risk.  Rest of the factors - triglycerides, HDL/LDL, overall cholestrol are all normal.  Also, sugar levels are normal.  He has been advised to take the suppressants due to high risk of particle size.  We have never tested this parameter before though.  Wheat, rice and burritos, pizzas and all the stuff you mention here are a part of our daily diet! We also eat Eggs, drink lots of full fat milk, homemade yoghurt .   I also use Coconut oil for most of the cooking which is for most part oil free!  We are worried about whether to wait and watch or start the medication.  If we wait - what is the optimal period to wait and what do we do during the wait period....

    Thanks for any help and a wonderful blog - helps many people like us!

  • Dr. William Davis

    12/14/2011 2:49:09 AM |

    Hi, Vasu--

    The solution for excessive quantities of small LDL particles is diet, not drugs. Please search "small LDL" on this blog and you will see dozens, if not more, posts on just this issue.

  • TheArcher

    1/6/2012 12:40:47 AM |

    I had been trying for a full year to shake free of wheat, but couldn't do it because my fix was always available in the kitchen. My husband, though he has a small wheat tummy, didn't want to quit eating wheat.

    Then we both came down with a gastrointestinal complaint, maybe something we ate? Nausea and loose stools and lack of appetite meant that for several days we drank lots of fluids and only ate to live. We both feel fine now, but thanks to the short period of illness during which time we COULDN'T eat wheat or sugars, we basically skipped the withdrawal period, and we no longer crave wheat.

    I highly recommend quitting wheat during a gastrointestinal illness; for us it was incredibly easy.  Smile

  • Tina Moore

    7/22/2012 3:41:18 PM |

    Dr. Davis:  After reading Wheat Belly and being wheat/glute-free for 2 months.  I've definately noticed less inflammation with my moderate osteoartritis of the knees & less abdominal bloating.  Friend, recently told me about UC Berkeley's Health Newsletter that disputes Wheat Belly.  WHAT DO YOU THINK OF THEIR RESPONSE?  Here's the article:

    Wheatophobia: Will Avoiding Wheat Really Improve Your Health?
      
    Wheat has long been a dietary pariah for the millions of people who have jumped on the low-carb-diet bandwagon or who think they’re allergic (or at least sensitive) to the grain. Now even more people are hesitating about eating wheat after reading the claims made by Dr. William Davis, a cardiologist and author of the bestseller Wheat Belly, which is subtitled “Lose the Wheat, Lose the Weight, and Find Your Path Back to Health.” Not only does wheat make us fat, he says, it is addictive and causes everything from heart disease, diabetes, and obesity to arthritis, osteoporosis, cognitive problems, and cataracts. In fact, it has caused “more harm than any foreign terrorist can inflict on us.”
    Wouldn’t it be great if there was a single villain behind the chronic health problems plaguing us, and if all it took to reverse them was to stop eating wheat? Don’t bet on it.

    Kernels of half-truth
    Here are some of Dr. Davis’s key points—and our counterpoints:

    Claim: Most grains are bad, but modern wheat is the worst because it has been altered over the years via selective breeding and is now a virtual “Frankengrain.” It is loaded with amylopectin A (a starch unique to wheat), which is “worse than table sugar,” Dr. Davis says, boosting blood sugar dramatically and stimulating appetite. Modern wheat also contains other components with adverse effects, and its gluten (a protein) is more likely to trigger reactions than that in older wheat.

    Fact: For well over a century, food scientists have developed hybrid varieties of wheat to be sturdier and have higher yields, better quality, and greater resistance to disease and insects. That’s true of most food crops. There’s no clinical evidence that differences between today’s wheat and older varieties have adverse effects on our health. It’s all supposition on Dr. Davis’s part, and feeds into pervasive fears of modern agricultural methods. We think this particular fear is unfounded.

    Claim: Wheat is the main culprit behind the obesity epidemic.

    Fact: Wheat is a staple in most parts of the world, and there’s little or no correlation between regional intakes (as a proportion of daily calories) and rates of obesity. Per capita wheat consumption in the U.S. has actually dropped since 2000, but there’s no sign that is slowing the expansion of our waistlines. In fact, a century ago Americans ate much more wheat than we do today, and very few were obese (granted, diets and lifestyles differed in many ways then). In any case, the obesity epidemic certainly can’t be attributed to any single factor.

    What about Dr. Davis’s claims that when he told his patients to avoid wheat they lost weight and become healthier? As with nearly all diet books, this is only anecdotal evidence, but it’s not surprising. Had he told his patients to cut out all meat or all sugary snacks, for instance, they might have done as well or better. Nearly all diets work for a while (especially in supervised settings), usually by getting people to avoid whole categories of foods and thus tricking them into cutting calories. Keep in mind, too, that Dr. Davis basically recommends a low-carb diet, and well-designed studies have found that such diets work no better than other diets in the long term.

    Claim: Wheat has played an outsized role in surging rates of diabetes, heart disease, and other chronic disorders.

    Fact: There’s no evidence that wheat bears special blame for these. Blood sugar does rise after eating bread, pasta, and other wheat products. But that’s true of any foods containing carbohydrates—even those in gluten-free products—especially if the grains are refined.
    The effect of carbohydrate-rich foods on blood sugar, which is ranked by the “glycemic index” (GI), depends on many factors, including how much fiber is in the food, how the food is processed and prepared, and what else is in the meal. Wheat ranks moderately high on the GI. But research looking at the effect of a high-GI diet on weight control and the risk of diabetes and heart disease has had inconsistent results.

    Refined wheat, like other starchy or sugary foods, can also have adverse effects on blood cholesterol and triglycerides—for instance, increasing levels of the small, dense LDL cholesterol particles that are most damaging. To avoid this, you needn’t avoid all wheat or go on a very-low-carb diet. Just choose healthier wheat products that are minimally refined or unrefined, and don’t go overboard.

    Claim: Whole wheat isn’t much better than refined wheat, so overweight people and those with chronic diseases should avoid it as well.

    Fact: Many studies have linked higher intakes of whole grains (including whole wheat) with a reduced risk of diabetes, heart disease, and stroke, as well as improvements in blood cholesterol, blood pressure, and blood sugar control. Other studies have found that whole wheat can help people control their weight and/or lose body fat, especially when they eat it in place of refined-wheat products. Thus, the Dietary Guidelines for Americans, American Heart Association, American Diabetes Association, and most nutrition experts recommend foods made from 100% whole grains.

    BOTTOM LINE: Unless you have celiac disease or another type of gluten intolerance or sensitivity (see box above), there’s no reason to avoid wheat. No doubt many Americans eat too much refined wheat, usually in the form of cakes, cookies, pizza, and other foods loaded with added sugar and/or fat (which can double or triple the calorie count), as well as lots of sodium. Cutting down on such wheat products can help people lose weight and improve their overall diet, provided they substitute lower-calorie foods. But 100% whole-wheat and other whole-grain products can fit well into a healthy diet, as can many refined-wheat dishes that include nutritious ingredients, such as pasta with vegetables. As with so many dietary matters, moderation is the key.



    Gluten for punishment
    There’s one very good reason to avoid wheat: if you are allergic to gluten because of celiac disease, also known as gluten-sensitive enteropathy or nontropical sprue. Gluten is a protein in wheat that makes dough elastic and smooth; it’s also in rye, barley, and certain other grains.

    In people with this genetic disorder, gluten provokes an autoimmune response that damages the small intestine and may cause symptoms such as diarrhea, bloating, cramps, abdominal pain, weight loss, fatigue, and loss of appetite. Celiac disease has become more common in the past 50 years for largely unknown reasons. It’s now estimated that about 1 in 100 people in the U.S. and Canada have it. If you have a parent or sibling with the disease, your risk rises to 1 in 22; having an aunt, uncle, or grandparent with it increases your risk to 1 in 39.

    Celiac disease can begin at any age and occurs more often in people of European descent and in women. Many people with it go undiagnosed or are misdiagnosed, however, because there may be no gastrointestinal symptoms—and when there are symptoms, they’re often nonspecific (that is, they could be caused by many disorders). Celiac disease causes malabsorption of key nutrients, notably calcium and iron, so it can lead to osteoporosis, anemia, and other serious health problems. People with it are also more likely to have other autoimmune disorders, such as psoriasis, lupus, Crohn’s disease, and certain types of thyroid disease.

    Confusing matters, about 6 percent of Americans are thought to be gluten-sensitive but don’t have celiac disease, according to the Center for Celiac Research at the University of Maryland. There’s much debate about this condition, sometimes called “nonceliac gluten sensitivity,” and about how prevalent it is. Because so many people now believe they are sensitive to gluten, rightly or wrongly, “gluten-free” has become one of the fastest growing sectors of the food industry.

    Before giving up gluten, get tested
    If you have chronic indigestion or other symptoms suggestive of gluten sensitivity, consult your doctor and get tested for celiac disease before going on a gluten-free diet. (Long-term avoidance of gluten can interfere with the diagnostic tests for celiac disease.) A positive result on the blood test should be followed by a biopsy of the small intestine to confirm the diagnosis. If celiac disease is ruled out and you continue to have problems, you can be tested for nonceliac gluten sensitivity via an “elimination and provocation” diet.

    If you have a family member with celiac disease, you should be tested even if you have no symptoms, since diagnosing and treating the disease can help prevent intestinal damage and serious complications. Many gastroenterologists advise initially having a simple genetic test for predisposition to celiac disease.

    Few people are properly diagnosed for gluten problems, however, according to a paper in the Annals of Internal Medicine earlier this year, which warned that many are undoubtedly going on highly restrictive diets unnecessarily.

    It’s best to consult an experienced registered dietitian if you have celiac disease. You can—and should—eat other healthy grains, including corn, rice, oats, buckwheat, quinoa, and amaranth. Look for “certified gluten-free” on labels, since products can be cross-contaminated with gluten. Keep in mind, most “gluten-free” packaged products are made from refined flour (albeit gluten-free flour) and are not particularly nutritious, and many are junk food.

    For more information, you can contact the Celiac Disease Foundation or the Celiac Sprue Association.
    Issue: August 2012

  • Dr. Davis

    7/31/2012 11:54:36 AM |

    Whoever wrote this clearly did not read the book with an open mind. ALL the questions are addressed in the book.

    This is the stuff that the dietitians are arguing, a "rebuttal" based on conventional notions of wheat.

    Rather that have to pick each argument apart to debate with people who clearly do not want to change their opinions, please just read the book.

  • Christoph Dollis

    8/16/2013 1:10:23 AM |

    I don't know if you're right or wrong (about wheat being worse than other starch sources), but am going to give you the benefit of the doubt, remove it, and see what happens.
    P.S. Listened to the debate between you and Timothy Caulfield. What an embarrassing hack he was.

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A fictional tale of medical economics in heart disease

A fictional tale of medical economics in heart disease

Dr. Robert Connors is the hospital’s most prized cardiologist.

Practically a fixture in the cath lab, he generates more revenues for the hospital than any of his colleagues. Last year alone, he performed over 1500 procedures, bringing in $18 million dollars to the cath lab, $27 million to the hospital. Dr. Connors is very good at what he does: 55-years old, he has been involved in high-tech heart care since the “early days,” 25 years ago, when hospital procedures really began to take off.

Over his career, he has personally performed over 25,000 heart procedures and has built a reputation as a skilled operator of complex coronary procedures. Because of his skills, he enjoys a vigorous flow of referrals for procedures from dozens of primary care physicians. His skill has also earned him referrals from cardiologist colleagues who seek his abilities for difficult cases.

On any day, Dr. Connors typically schedules up to 12 procedures. His entire day is spent in the cath lab, usually from 7 am until 6 pm. He meets many patients for the first time on the catheterization laboratory table as staff shave their groin, preparing for the procedure. Much of the procedure itself is not even performed by Dr. Connors, but by one or another cardiologists-in-training, a “fellow,” or member of the fellowship the hospital proudly maintains as a clinical teaching institution. Nor will Dr. Connors talk to most patients at the close of the procedure. He leaves that to either the fellow or a nurse. Dr. Connors views himself as a procedural specialist, not someone who has to take care of patients. He gave up seeing patients in his office over 10 years ago.

Dr. Connors’ procedural enthusiasm gained him the attention of drug and medical device manufacturers. Because Dr. Connors lectures widely and advises colleagues, his comments can dramatically alter perceptions of the value of a technology. He has, on many occasions, catapulted an unpopular device to most-asked-for among colleagues, bringing millions of dollars in revenues to the manufacturer. One particularly lucrative arrangement he made around 10 years ago involved a “closure” device, a $400 single-use plug used to close the access site made during heart catheterizations. By swaying his colleagues at _______ Hospital, 50 orders per day (one per procedure) tallied $20,000 every day, $7.1 million dollars per year for the manufacturer. Although he’d used other devices on the market, the 5,000 shares of stock he was offered encouraged him to issue glowing comments to colleagues on the superiority of this specific brand of closure device. Now over 90% of all catheterizations at _______ Hospital conclude with the device manufactured by the company in which Dr. Connors maintains partial ownership.

Negative comments, on the other hand, topple other products when Dr. Connors sees fit to pan them. For this reason, device and drug manufacturers run straight to Dr. Connors to gain his good graces as soon as possible after a product is released into the market. Because the competition is just as likely to do the same, it has often come down to a bidding war, the company providing the most lucrative arrangement most likely to win.

Thus, Dr. Connors proudly boasts of how many times he has flown to Hawaii, Europe, and other exotic locations at industry expense. He also boasts of how, for $100,000 paid to him for a “consulting fee,” he can overturn the choice of products lining hospital shelves. As the hospital’s annual budget for coronary devices will top $84,000,000 this year, device manufacturers regard the sum paid Connors as a profitable investment.

Despite his lofty status in the hospital, Dr. Connors has long expressed a love-hate relationship with ________ Hospital. While he enjoys his work and has made a more than comfortable income, he has long felt that the hospital administration didn’t truly appreciate his contributions. Five years ago, he therefore demanded that he be made “Director of Research.” After all, he had hired a nurse to help him coordinate enrollment of patients into several device trials brought to him by medical device manufacturers. When he encountered an initial lukewarm response from hospital administrators, he threatened to take his “business” elsewhere to a competing hospital. Hospital administrators gave in. They provided him with the title he wanted, along with $100,000 annual “stipend.”

Just fiction? Make no bones about it: Cardiac care is business, big business. And there's money to be made, lots of it.


Copyright 2008 William Davis, MD

Comments (2) -

  • Anonymous

    3/23/2008 12:24:00 PM |

    For a chuckle thought to mention a  story this morning.  I pass on to others what you write about heart disease and my father has recently joined me in doing the same.  Dad lives in a small community in Florida and several of his neighbors are doctors.  One retired doctor dad recently met has found what you write of great interest.  After looking at your sight, he was telling my father that long before vitamin D became as popular as it has in the last few years, he had been urging his patients to supplement their diet with D3.  The doctor is apparently famous in his field as he is a pioneer in sex change procedures and medicines, which even though I know is serious for people that feel they need a sex change, I can't help but chuckle like a young boy at his former line of work.  My father was telling me that his doctor neighbor is in his 80s and yet would have never guessed it.  He looks like he is in his 50s or 60s.  The doctor credits taking vitamin D for most of life for his youthfulness.

    I better end this and make the internet rounds.  I have a few exotic car forum to visit.  The Porsche, Ferrari, Lotus, etc. high end car sights is where you find doctors hanging out.  It's like donut shops to cops.

  • Rich

    3/24/2008 5:07:00 AM |

    Dr. Davis: We need to get as many medical journalists as possible to read this and other brilliant posts by you.
    -Rich

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