Why do so few doctors order lab work for the above, since I understand they are a better indicator of CAD, as well as for an immediate event, than a lipid profile alone?
4/ 1/10 9:52pm
Finley:
You are right to question this practice. Advanced lipoprotein testing can indeed provide valuable - perhaps lifesaving information. Before I begin, let me say that it is up to you stay informed on health options and take control of your health - What I call Informed Self-directed Healthcare (ISH). But, here is what I believe to be the most complete answer. My "A" observations ar flattering to traditional medicine - my "B" observations take the cynical side!
1A. Medical science is VERY conservative and that is the way doctors are trained. In general, when dealing with important things like lives it makes sense to not take big risks. Consequently, docs are slow to change and require lengthy and rigorous evidence and outcome based data to change their practice.
1B. Some docs are lazy. It is far easier to just "go with the flow." Keep in mind, you don't need to be a rocket scientist to make clinical observations about what seems to work - especially if what seems to work is devoid of signficant risk and side effects. But that would require critical thinking. Remember, docs are trained to regurgitate facts and follow protocols. Inventive thinking isn't on the test nor is it part of the medical business model. "Evidenced based" medicine may be effective for treating the masses (statisically it is) but it is lousy for individualized medicine (treating you). Don't expect a big change for years as the evidence (which you and I can see clearly) reaches the critical mass necessary to move traditional medicine!
2A. When did your doc graduate? Did advanced lipoprotein tests like the Atherotech VAP, Berkeley GGE and LipoScience NMR even exist back then? Docs are busy. They have large patient loads (about to become larger with universal healthcare) and need to treat thousands of different diseases and conditions. It's darn hard to keep up with the latest advances.
2B. The medical profession requires CME credits as part of a commitment to continuing educations but alas, they are often just junkets. You check in, hit the beach, and collect your credits. Many docs just aren't on the cutting edge of medical advances.
3A. The tests you mention are for accumulating preventive data. Doctors have been trained for years (but it is changing) to treat diseases not prevent them. Just as importantly, we as patients have an obligation to practice prevention but often to little research and take even less action. We have been trained to wait until we are sick then see the doctor for a pill.
3B. There is not much money to be made preventing disease but a ton to be made treating diseases. Where is the incentive to order tests to help prevent disease?
That's how I see it. SHAMELESS PLUG ALERT! You can find a ton more info on this advanced lipoproteins at a website called Track Your Plaque. It is a membership-based site but it has a ton of free information, reports, booklets, newsletters, etc. you can get without becoming a member. The site is kind of cluttered but that is because of all the stuff there!
Looking out for your heart health,
HeartHawk
4/ 1/10 9:53pm
Finley:
You are right to question this practice. Advanced lipoprotein testing can indeed provide valuable - perhaps lifesaving information. Before I begin, let me say that it is up to you stay informed on health options and take control of your health - What I call Informed Self-directed Healthcare (ISH). But, here is what I believe to be the most complete answer. My "A" observations ar flattering to traditional medicine - my "B" observations take the cynical side!
1A. Medical science is VERY conservative and that is the way doctors are trained. In general, when dealing with important things like lives it makes sense to not take big risks. Consequently, docs are slow to change and require lengthy and rigorous evidence and outcome based data to change their practice.
1B. Some docs are lazy. It is far easier to just "go with the flow." Keep in mind, you don't need to be a rocket scientist to make clinical observations about what seems to work - especially if what seems to work is devoid of signficant risk and side effects. But that would require critical thinking. Remember, docs are trained to regurgitate facts and follow protocols. Inventive thinking isn't on the test nor is it part of the medical business model. "Evidenced based" medicine may be effective for treating the masses (statisically it is) but it is lousy for individualized medicine (treating you). Don't expect a big change for years as the evidence (which you and I can see clearly) reaches the critical mass necessary to move traditional medicine!
2A. When did your doc graduate? Did advanced lipoprotein tests like the Atherotech VAP, Berkeley GGE and LipoScience NMR even exist back then? Docs are busy. They have large patient loads (about to become larger with universal healthcare) and need to treat thousands of different diseases and conditions. It's darn hard to keep up with the latest advances.
2B. The medical profession requires CME credits as part of a commitment to continuing educations but alas, they are often just junkets. You check in, hit the beach, and collect your credits. Many docs just aren't on the cutting edge of medical advances.
3A. The tests you mention are for accumulating preventive data. Doctors have been trained for years (but it is changing) to treat diseases not prevent them. Just as importantly, we as patients have an obligation to practice prevention but often to little research and take even less action. We have been trained to wait until we are sick then see the doctor for a pill.
3B. There is not much money to be made preventing disease but a ton to be made treating diseases. Where is the incentive to order tests to help prevent disease?
That's how I see it. SHAMELESS PLUG ALERT! You can find a ton more info on this advanced lipoproteins at a website called Track Your Plaque. It is a membership-based site but it has a ton of free information, reports, booklets, newsletters, etc. you can get without becoming a member. The site is kind of cluttered but that is because of all the stuff there!
Looking out for your heart health,
HeartHawk
4/ 1/10 9:53pm
Finley:
You are right to question this practice. Advanced lipoprotein testing can indeed provide valuable - perhaps lifesaving information. Before I begin, let me say that it is up to you stay informed on health options and take control of your health - What I call Informed Self-directed Healthcare (ISH). But, here is what I believe to be the most complete answer. My "A" observations ar flattering to traditional medicine - my "B" observations take the cynical side!
1A. Medical science is VERY conservative and that is the way doctors are trained. In general, when dealing with important things like lives it makes sense to not take big risks. Consequently, docs are slow to change and require lengthy and rigorous evidence and outcome based data to change their practice.
1B. Some docs are lazy. It is far easier to just "go with the flow." Keep in mind, you don't need to be a rocket scientist to make clinical observations about what seems to work - especially if what seems to work is devoid of signficant risk and side effects. But that would require critical thinking. Remember, docs are trained to regurgitate facts and follow protocols. Inventive thinking isn't on the test nor is it part of the medical business model. "Evidenced based" medicine may be effective for treating the masses (statisically it is) but it is lousy for individualized medicine (treating you). Don't expect a big change for years as the evidence (which you and I can see clearly) reaches the critical mass necessary to move traditional medicine!
2A. When did your doc graduate? Did advanced lipoprotein tests like the Atherotech VAP, Berkeley GGE and LipoScience NMR even exist back then? Docs are busy. They have large patient loads (about to become larger with universal healthcare) and need to treat thousands of different diseases and conditions. It's darn hard to keep up with the latest advances.
2B. The medical profession requires CME credits as part of a commitment to continuing educations but alas, they are often just junkets. You check in, hit the beach, and collect your credits. Many docs just aren't on the cutting edge of medical advances.
3A. The tests you mention are for accumulating preventive data. Doctors have been trained for years (but it is changing) to treat diseases not prevent them. Just as importantly, we as patients have an obligation to practice prevention but often to little research and take even less action. We have been trained to wait until we are sick then see the doctor for a pill.
3B. There is not much money to be made preventing disease but a ton to be made treating diseases. Where is the incentive to order tests to help prevent disease?
That's how I see it. SHAMELESS PLUG ALERT! You can find a ton more info on this advanced lipoproteins at a website called Track Your Plaque. It is a membership-based site but it has a ton of free information, reports, booklets, newsletters, etc. you can get without becoming a member. The site is kind of cluttered but that is because of all the stuff there!
Looking out for your heart health,
HeartHawk
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By Finley— Last Modified: 12/27/10, First Published: 04/01/10
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