Most Physicians Have Limited Training and Little Experience Regarding Environmental Illness
By Cesar Collado
I receive many emails and comments from mold patients regarding the overall lack of knowledge in the traditional medicine community about mold and environmental illness. Many patients receive little empathy from physicians when they present their symptoms and suggest that mold might be the issue. One reader wrote:
“I have printed it out (article on mold) and will be taking it to my many doctors’ visits for their perusal. Please wish me luck. Even when handed information about mold toxicity, my doctors will barely give it a causal glance. I don’t know why they are (what?) intimidated, perhaps, by new information of something they don’t know or can’t fix with conventional medicine?”
This reader highlights a very real problem with the way that Western medicine approaches illness, because if a patient is not trusted to identify their own symptoms, how can patient and doctor work together to treat and eradicate them?
The bigger picture view is this: We have all grown up to depend on our doctors to find relief when we are sick. What if your physician isn’t following a plan that will clearly identify and address your illness? What if you are treated for specific symptoms rather than identifying the cause of your symptoms?
Preparation is a necessity if you desire to expedite an accurate diagnosis and treatment. This is especially important to patients suffering from mold or toxic chemicals in their home or work environments. A little homework can go a long way to helping your physician identify a potential cause, find the right treatment, or at the very least, make a proper specialist referral.
All Doctors are Not Equal
Medical training is updated periodically to reflect the latest clinical developments in disease states, procedures, and treatments. It is a challenge for any medical school curriculum to keep up. Unfortunately, as science evolves, the tools to identify causal relationships with a patient and their environment become duller. In addition, pressure to meet challenging scheduling requirements while making a differential diagnosis, investigate the cause, and identify the proper treatment makes the job of a doctor a significant challenge. There are also hurdles imposed by insurance companies to ensure optimal reimbursement to doctors who attempt to treat outside of conventional diagnoses.
Historically, environmental inputs relating to human health studied were those of catastrophic proportions. Pollution from chemicals, gases, and heavy metals that find their way into the air and water from an occupational health perspective have drawn the greatest emphasis. Chemical spills, nuclear energy fallout, ozone depletion, and ultraviolet rays have also been key focal points in grant research and publication.
Over the past few decades, there has been a growing emphasis on understanding the quality of the air we breathe, water we drink, and the food we eat This developing understanding has been fueled by a Public Health and Occupational Health focus on toxic chemicals used in the manufacturing of products we use, pollutants in our air from the fuels we utilize, pesticides and hormones in our food, and biological pathogens including bacteria, viruses, and mold. More recently, there is an ever growing understanding of socioeconomic status as it relates to exposure to contaminants. While this is progress, it is not occurring at a rate to impact modern medicine. Even with the catastrophic natural disasters like Hurricanes Katrina and Sandy, the BP Oil Spill, and other events, patients still receive blank or even resistant responses by their physicians when they bring up the possibility of environmental events or triggers as possible causes of illness.
Surprising Facts About Modern Western Medicine
Medical school is a grueling undertaking that focuses all of a physician’s time over many years to becoming Board Certified in any given physician specialty. It is also increasingly expensive and requires incurring significant debt for most students. Once training is complete, physicians are expected to hit the ground running and to begin seeing large numbers of in limited timeframes.
If you believe your environment is making you ill, but are facing the hurdles of finding a physician both trained to and willing to help you, here are some thoughts from experts who believe medical school curriculum reform is needed to consider the environment and nutritional impact on health and healing.
Things to consider prior to visiting the physician:
- “Very few students ever learn how to actually practice medicine in medical school. That comes during residency training and post-graduate practice;”1
- “The medical interview or consultation influences the precision of diagnosis and treatment, and studies have indicated that over 80 percent of diagnoses in general medical clinics are based on the medical history;”2
- “Today, most medical schools in the United States teach less than 25 hours of nutrition over four years. The fact that less than 20 percent of medical schools have a single required course in nutrition, it’s a scandal. It’s outrageous. It’s obscene,” Dr. Eisenberg, Adjunct Associate Professor of Nutrition at Harvard T.H. Chan School of Public Health.3
- “Detoxification is a process that the body performs around the clock utilizing important nutrients from the diet. It’s the process that transforms molecules that need to be removed from the body, or ‘toxins.’ They fall into two main categories: molecules that are made in the body as byproducts of regular metabolism (endotoxins), and those that come from outside the body and are introduced to the system by eating, drinking, breathing or are absorbed through the skin (exotoxins).”4
- “It was not long ago when it was possible for physicians to keep up with the medical literature. A diligent physician who subscribed to the 3-4 leading journals in the field could manage to find the time to read through the titles of each monthly issue, and typically, read many of the abstracts. If a paper was particularly interesting, then you probably read through the main text.” The Author continued, “Top-tier medical research is really hard, but in the past, the effort was worth it if you could have an impact on thinking or on clinical practice. Now much of the literature is replete with data and analyses that are satisfying to the authors, but fall unnoticed as a tree in a deserted forest.”
Thus, modern medicine not only excludes environmental medicine in training, but it has evolved into an issue of physicians who no longer seeking the latest updates in modern medicine on a regular basis.
In addition, upon reviewing several medical school curriculums, it appears that any teaching on mold likely takes place during an allergy rotation during the third year and addresses mold as one of many allergens. Mold does not appear in any if the inflammatory disease or Neurology rotation curriculums.
What all of this means is that you should consider preparing for your next Doctor’s visit with some facts about your environment to share when giving your medical history.
What Can You Do?
Prior to referring patients (severely ill) to Dr. Dennis or to other physicians for mold illness, I recommend the following steps:
- Try to find a physician that specifically treats mold. This may take time. You can always call the office ahead to avoid wasting time and money. More important, you can avoid misdiagnosis and any unnecessary medication and complications that go with visiting a doctor without first doing your homework on them.
- Take a tour of your home to identify any obvious issues that might be related to mold. Dampness, musty smell, leaks, visible mold.
- Take a mold test using EC3 Mold Screening Test plates.
- If you have time, relocate to a safe environment away from your home to see if you feel better.
- Mentally prepare yourself for a situation where you may have to leave your home while it is fixed, if there is a mold issue.
- Document any apparent allergies you have to allergens or foods by writing down reactions, symptoms, etc.
- Make sure you look back into your own history to determine if you have been exposed to any toxic compounds.
- Pay special attention to cognitive symptoms such as brain fog, memory issues, headaches, and pain. T
ry to describe your energy level on a scale from 1-10 (where 10 is healthy and you are able to walk long distances, and 1 is unable to get out of bed) to give the
- physician some frame of reference.
- You can also take a free mold illness survey online HERE. This may help you with addressing the previous points and with preparing your symptom and environmental history for your doctor.
This may seem like a lot of effort prior to seeing a Doctor. The core issue is that there is always
a plethora of physicians you can see. Getting to the right doctor and providing this type of information puts you in control of where the treatment is headed. The average time a physician spends with a patient is less than 15 minutes. Presenting the relevant facts in that time is essential to making progress during the initial visit or avoid unnecessary referrals. While environmental medicine is not necessarily taught in all physician training, the overall awareness of toxins in the body are well known. Your help in identifying them will make the most of your time with your physician and possibly direct them to the right diagnostics to validate or dispel your suspicions about mold causing your sickness.
The take away from this information is that by providing facts about your situation and history and by not trying to educate the already overwhelmed physicians, you can direct their curiosity toward the issue that is making you ill. This is less “offensive” to physicians who complain about the internet availability of information driving patient self-diagnosis. Collecting the relevant facts and focusing on the cause is likely the best first step. With that in place, you have a chance to receive the proper treatment.
- Remakus MD, Bernard, “Doctors Reveal 12 Things No One Tells You About Pursuing a Career in Medicine”, Medical Practice, 12-4-2017
- Epstein MD, Perkin, Cook, et al. Clinical Examination, 4th Ed. (2008). Mosby, Ltd.
- Eisenberg, David, “Doctors need more Nutritional Education” May 8, 2017 on PBS NewsHour
- Foroutan, Robin, “What’s the Deal with Detox Diets?, Academy of Nutrition and Dietetics, April 26, 2017
- Packer MD, Milton, Does Anyone Read Medical Journals Anymore? MedPageToday,March 28, 2018