Preventive strategies can lower medical costs

Dr. MacCallum

October 20, 2009

"We each need to take more responsibility for our own health problems," Dr. John MacCallum told Putnam Rotarians today. "And if we do that we won't need a lot of the aggressive medical services that we find ourselves asking for.

"And if we can do that across the board, beginning when we're young," he added, "we can end up living longer, living healthier, and living less expensively."

MacCallum is Director of the Center for Alternative Medicine located in Prestige Park (and soon to be the Life Tree Center for Integrated Medical Practice).

A graduate of the University of Virginia with a master's in English from West Virginia University, MacCallum is a board-certified psychiatrist with a medical degree from WVU.

"The more you do to prevent getting old, the less old you feel," he told the group. "We really can't stop the clock, but we can deal with the clock in lots of different ways.

"You've probably noticed that there are people your age in the community who look much older, or much younger, and that is not an accident. It's something that we have a lot of control over when we take time to look at our health and make changes.

"We spend 17 percent of our gross national product on health care, more than any other country in the world. Japan in contrast spends about five percent of its GNP and ranks always among the top in health care. You know where we rank? Somewhere between 25 and 40, but we're certainly not number one.

"We are number one in terms of technology, and medical expertise, but the quality of our health care here is really not where it should be given the other advantages that we have.

"Alternative medicine offers is a less expensive way of providing health care," MacCallum said, "and a way that allows the cost and responsibility for health care to fall more on the individual.

"We focus a lot of attention and time on educating the people who come to see us," he explained, "about how you can take better care of yourself without having to come to the doctor so much. I would rather teach patients how not to come to see me rather than how to keep coming back month after month and getting medicines.

"Let me take an example of high cholesterol: The medical treatment for high cholesterol is statin drugs. Statin drugs have some significant side effects with liver and muscles, among other things.

"We send people home with a new diet. We tell them to stir fish oil in with flax meal. I know that doesn't sound particularly appetizing to you, but if you take some flax meal, some yogurt, and some fish oil and mix it into a hodgepodge and eat it for breakfast every morning, you'll see your cholesterol falling.

"And you'll see other good things happening. Your bowels will be more regular. Your liver seems to work better.

"This is something you can do for a few dollars a month. It's cheap and easy. You can do it all at Kroger's. It doesn't require a prescription. And in most cases after six to eight months we can get cholesterol levels down to where they would be if you took a statin drug -- without the expense or risk of a statin drug.

"Most of the diabetes in this country is caused by what we eat and what we do. It doesn't have to happen.

"Almost all type II diabetes is lifestyle related. So if we can teach people three or four things to avoid -- sugar, carbonation of any kind, processed foods (especially grains) -- if you can eliminate those three food groups from your diet, your blood sugars will fall to normal, your glucose tolerance test will fall to normal. You won't need to take any hypoglycemics or insulin.

So, in most cases, doing things that you can do at home -- not even in a doctor's office -- can make a big difference.

"There has been in the past a great controversy about hormones," said MacCallum, "especially about women in menopause. The controversy basically involves the type of hormone that is used. Most of you have heard of Premarin.

"Premarin is a type of hormone that originally introduced in 1941. And from the 70s to 2002 was the most sold [hormone] drug in this country.

"Premarin has all sorts of side effects, including cancer of the uterus.

"We now have the capability of synthesizing hormones just like the ones your body makes.

"We measure all the hormones for a person, and then we write an individualized prescription that tops off the levels that are down, a prescription made just for your body. And we measure that every six or eight months to make sure that it isn't out of balance.

"Advantages we see include preventing a lot of illnesses that are related to low hormones, including osteoporosis, coronary artery disease, or vascular disease in general, strokes, colon cancer, dementia. We see a lot less of those when the hormones are brought back up to premenopausal levels.

"We see the same changes in men. We can now measure male hormones. We can replace those and bring the level back up to normal.

"Something else we do that I think deserves attention is thermography: Most of you know what a mammogram is. Mammograms are used to identify breast pathology.

"Mammograms cause a certain amount of breast cancer each year. We've known this since their inception. Thermography doesn't cause any cancer or any other harmful effects. In addition, it can see things five to seven years before they appear on the mammogram. So it has the potential actually of preventing some forms of breast cancer.

"It's widely used in Europe; not very widely used in this country. I think we're the only people within two or three hundred miles of here that do this. We've been doing it for eight years now.

"Another thing that we do out of the box is chelation therapy:

"Chelation therapy is the use of an intravenous drip, in essence, to clean out your arteries.

"It does that slowly over twenty-five to thirty treatments. It involves basically pulling heavy metals from the plaque inside your arteries.

"If we can open up a blocked artery, if we can make the block twenty percent less, we can double the flow which means a major change in circulation.

"We use this treatment to treat coronary arteries, diabetes, high lipids, dementias, some cancers, many different conditions each of which has as a deficiency the inability to get enough oxygen to that part of the body.

"Intravenous vitamin C has been demonstrated by people at the National Institutes of Health as being an actual chemotherapy agent. The difference is it doesn't cause any harm. So you can give massive doses of vitamin C intravenously to slow down or stop the progression of the cancer without harmful effects.

"Vitamin D: In the last six to eight years there's been a revolution in understanding of [vitamin] D.

"Those of you who are worried about the flu should go out and get a 5,000 unit of vitamin D and start taking it every day.

"It'll cost you about three dollars a month.

"If you do get sick, then double, triple or quadruple the dose for a week or two, up to about 20,000 units a day. I could almost guarantee your not getting the flu if you do that.

"It's a cheap and easy thing to do.

"Eighty to ninety percent of us in this country above Tallahassee have [vitamin] D deficiencies. So, probably sitting in this room I would guess that maybe I am the only one that doesn't have a D deficiency unless there's someone else who's been taking a large dose."

What about health care reform? someone asked.

"I would generalize insurances across state borders to give competition to the insurance industry," MacCallum responded.

"Secondly, I would look at the amounts of money that are spent on high-cost medical items. I would adjust them down.

"I would include, in some cases, physician's salaries for certain things that they do.

"I would figure out a way to motivate people to be preventive rather than controlling of their illnesses. I would reward them in some way for doing that, either with lower insurance rates or some kind of economic incentive.

"I would avoid giving up complete control to the government," he said, "although I like the idea in some ways of having a government competition.

"Only problem is that Medicare has not been well-managed in the last thirty years, and I don't think [health care] will be if we hand it over."