Doctors Don’t Know Everything

Young handsome doctor surgeon man

And they really shouldn’t be expected to. They have been trained to diagnose and treat illness, and most are very good at doing just that. But making an informed and experienced  recommendation on the amount and relative balance of fats, proteins, and carbohydrates you should be eating, figuring out why you can’t fall asleep at night, or why your athletic performance keeps declining for no apparent reason lies outside the scope of Western medicine. And it is not only becoming quite clear that they aren’t helping their patients prevent and improve their “health” but that are quite lacking at taking care of themselves.

Is it the system? Is it the training? Is it the type of person going into medicine these days? Most likely all of the above.

And research now shows that becoming a physician in its earlier stages is quite literally causing rapid aging and increased their risk of disease. The facts as published in the journal of Biological Psychiatry show that new doctor’s DNA was found to age 6 times faster than normal within their intern year due to long hours of the intern year that have been associated with accelerated shortening of telomere regions of chromosomes.

And it gets worse for doctors, a wide-ranging physician survey of 17,000 doctors conducted by Merritt Hawkins on behalf of The Physicians Foundation revealed that about half of all doctors are feeling burned out and fed up with the healthcare industry. It also indicates that physician job satisfaction is on the decline, implying that the nation’s ongoing physician shortage may get worse before it gets better.

Let’s take a look at this recent study and see what it means for those of us who are exposed to prolonged stress and months of long hours.

On July 1, thousands of new doctors will begin the most intense year of their training. Between now and this time next year this experience will make their DNA age 6 times faster than normal, and this affect will be the greatest among those with training programs that demand the most hours.

250 interns from across the nation volunteered for the Intern Health Study based at the University of Michigan versus a comparison group of college students had the length of their telomeres measured before and after individuals faced a common prolonged intense experience of residency.

If you recall past posts, research has implicated telomeres, the end cap of our DNA,  as an indicator of aging and disease risk, but these new longitudinal findings advance the possibility that telomere length can serve as a biomarker that tracks effects of stress, and helps us understand how stress gets ‘under the skin’ and increases our risk for disease. In addition, it highlights the importance of studying how telomere changes play out in not only larger groups of medical trainees, but in other groups of people subjected to specific prolonged stresses such as military training, graduate studies in the sciences and law, working for startup companies, or pregnancy and the first months of parenting.

For those who are not aware the current model of intern year training during residency involves sometimes working 65-80 hours a week, frequent nights on call with little sleep and poor access to high quality nutrition. This is a recipe for poor productivity, decision errors and diminished mental health and wellbeing. These results are the first to show that this stress reaches down to the biological level, impacting the well accepted marker of aging and disease risk, telomere length.

Interestingly, the data also showed that many of the new doctors who went into residency had telomeres that were already shorter than their peers and reported those who reported their family environment early in life being stressful. Those scoring high on personality traits classed as neuroticism also had shorter telomeres at the start of the intern year.

Young arab doctor woman

DNA testing at the end of the year only had one factor that emerged with a clear link to telomere shrinkage, which was the number of hours worked each week. On average the interns worked 64.5 hours a week; the more they worked and the more days they put in that were at or above the national limit of 16 hours in effect time the faster their telomeres shrank. The responses given by some of the interns in these surveys indicated that some were averaging more than 80 hours of work a week, those who routinely worked that many hours had most telomere attrition. Those whose hours were at the lower end of the range had less telomere attrition.

The comparison group of 84 first year undergraduate students didn’t experience any telomere shrinkage despite it also being a stressful year of coping with life and situations to obtain elite higher education.

The Intern Health Study has been collecting other DNA samples from more interns, monitoring moods, sleep habits, activity using smartphone apps, and commercial activity trackers with hopes to further study telomeres in future groups of interns to gather more information about how telomeres change over the intern year and how these changes match up with experiences during that first year such as changes in shift time. Those in their first intern year are advised by the researchers to keep focused on their moods, to ensure they get enough sleep, and manage their stress with stress relieving activities as much as they can.

While a very strong connection exists between these issues and dietary choices we make, most conventional medical professionals don’t know enough about nutrition (specifically whole foods nutrition) to provide the kind of guidance and support their patients need. The idea of using dietary and lifestyle choices to measurably improve the body’s capacity for peak health and performance doesn’t fit into current medical model.  

In the conventional healthcare system today, as initiated by their “boot camp” intern training physicians are often forced to limit the length of appointments, spending less time with their patients. Because their focus is limited to the diagnosis and treatment of disease, there’s little room for discussing your general lack of energy, late-afternoon sugar cravings, or poor athletic performance.

Fortunately, as we have discussed you can take your “health” into your own hands and there is a growing legion of health coaches and functionally-oriented physicians who can guide you as far as you want to go with your health and well-being.