Article: For-Profit Health Care: More than one way to scan a CAT

Since just about every refrigerator automatically comes with a meat drawer, butter shelf, and egg rack, it should come as no surprise that most homes are predictably equipped with a medicine chest. Taking such inevitability further along its natural progression, those in the health care...I mean, disease care field fully expect to be regularly treating patients with a fair amount of body fat.

Case in point: About six years ago, my wife Michele began experiencing severe abdominal discomfort-in the lower right quadrant. Ever cautious about subjecting herself to the demoralizing disease care labyrinth, she was in no hurry to visit our local emergency room. However, when the pain became too much to ignore, the emergency room is precisely where we ended up...at nearly midnight.

A male complaining of pain in the lower right abdomen would've garnered an almost immediate diagnosis of appendicitis. For women, it requires further testing. This reality became particularly germane when we realized that the Computed Axial Tomography (CAT) Scan technician was not on duty so late at night and the attending physician could not prescribe a painkiller until a diagnosis was made (which, of course, required the CAT Scan technician). Not exactly Grey's Anatomy or ER, huh?

Roughly twelve agonizing hours later, a scan was finally performed...but shortly afterwards, a doctor came to speak with me. It seems the test results were, shall we say, inconclusive.

"Your wife is too thin," the man in the white coat told me. "Her body fat is so low that we can't get the contrast we need on the scan." Just perfect, I thought to myself. I t's absolutely ideal that a defective system like this is designed to deal specifically with those who have bought into the standard American diet/lifestyle.

Michele's family had arrived by then and thought it was amusing to remark that the body fat/contrast conundrum proved that she needed to change her vegan eating habits. After what turned out to be seventeen hours of waiting in misery until finally being scheduled for an appendectomy, Michele was clearly in no mood to laugh.

I'll tell you what else isn't comical about the disease care cartels: nutrition training at America's medical schools. An April 2006 study, published in American Journal of Clinical Nutrition, found that "the amount of nutrition education in medical schools remains inadequate" and 60 percent of medical schools in the United States are not meeting minimum recommendations for their students' nutrition education. Only 32 of the 106 schools surveyed (30% percent) even required a separate nutrition course. Thus, even the most well-meaning and diligent physician is often ill equipped to offer legitimate help within the structure he or she was trained in.

"Doctors typically aren't given much training in nutrition and some so-called nutrition experts are not well qualified in that field," says Neal Pinckney, M.D., author of The Healthy Heart Handbook. "A large sample of physicians was asked how much training they got in nutrition in medical school. The average was less than three hours, with many having only one hour or less. That's out of nearly 3,500 hours of medical training. The truth is that doctors may get their nutrition information from the same newspapers and TV programs we do, and unless they have taken extra training in nutrition, they may not know much more about nutrition than the rest of us."

No wonder hospital food is so, uh, frightening. The Physicians Committee for Responsible Medicine reviewed hospital menus in 2005 and found that "on many days at some hospitals, patients and visitors cannot find a low-fat, cholesterol-free entrée in the main cafeteria or restaurant. Fewer than one-third of hospitals surveyed offered either a daily salad bar or a daily low-fat vegetarian entrée" (17 percent of the responding hospitals had a fast-food establishment on the premises). When asked for their "healthiest entrée" recipe, 62 percent of these offerings derived more than 30 percent of calories from fat, and a few derived more than 50 percent of calories from fat.

Hey, I guess they're just making sure those expensive CAT Scans can find contrast.

Mickey Z. is the author of the forthcoming novel, CPR for Dummies (Raw Dog Screaming Press). He can be found on the Web at http://www.mickeyz.net.