By Dr. Ronald Hoffman
July 2014 marks thirty years since I completed my post-graduate training program in Internal Medicine at Manhattan VA Hospital and started out in the private practice of what was then called "holistic medicine."
Before we became The Hoffman Center, my practice was referred to as the Whole Life Medical Center. We were housed in a small brownstone on the Upper West Side of Manhattan. It had a demonstration kitchen downstairs where we offered cooking classes to patients. We had a series of large cabinets for vitamins and herbs, and we offered intravenous vitamin treatments and chelation therapy.
I was the "new kid on the block," virtually unknown, and possessor of a serious phobia about public speaking. I remember my first appearance at a "Whole Life Expo" was an occasion for major stage-fright when I addressed a "crowd" of maybe two dozen attendees in a small breakout room. I practically had to read my entire speech in a stilted fashion from 3 by 5 index cards. I had the good fortune to acquire a column in The Whole Life Times and became the first host of "In the Doctor's Office" which was then on WMCA radio in New York City, and gradually, word got out. As they say, "The rest is history."
It is often said about medicine that the "half-life" of medical knowledge is about 10 years. That means that after 10 years elapses, half of what we once believed is true has turned out to be false with the advance of medical science. This would mean that, 30 years in, only about 1/8 of what I started out doing in medicine would turn out to be correct in 2014.
This may be true about many once-hallowed practices in conventional medicine, a high percentage of which have been discarded on the dust-heap of disproven ideas. But I'm happy to report that as I look back on my career, many of the seemingly outlandish therapies and concepts that I stuck my neck out about decades ago have been thoroughly vindicated by the test of time.
Here's a small sampling:
1) The Primacy of Nutrition in Medicine: Not necessarily a new idea-after all Hippocrates said "Let food be thy medicine and let medicine be thy food" 2500 years ago.
But at the time I left conventional medicine to start an alternative practice, the notion that diet could be the key to healing a considerable number of our complex health woes was almost heretical.
The situation was so bad that doctors who did not "toe the line" with standard medical or surgical answers to health problems were often persecuted by State Medical Boards and threatened with delicensure.
In the movie "Dallas Buyers' Club" which takes place in the 80s at approximately the time I started to practice, the character played by Matthew McConaughey seeks help for his AIDS with an expat American physician in a Mexican border town. "What'd you lose your license for, doc?" McConaughey asks. The defrocked doc replies tartly: "Prescribing healthy foods and vitamins to sick patients."
Fast-forward to 2014 and the media abound with calls-to-action about the American Diet. Where once health devotees sought out soggy sprouts and limp organic carrots in tiny, funky health food stores, now huge conglomerates spin out natural products in profusion and health-conscious consumers flock to the aisles of mega-supermarkets like Whole Foods.
It's hard to deny there's been a revolution in the public's appreciation of the diet-disease connection.
2) Low-Carb Diets: Just like Grunge Rock, the 80s were a time of public infatuation with the low-fat diet. But I'm proud to say I recognized early that fat-phobia was misguided, and I began to be intrigued by the connection of insulin to disease and the Metabolic Syndrome. Soon, I was advocating low Glycemic Index diets to my patients.
Now, Low-carb, Zone, Paleo, South Beach and ketogenic are all the rage, and even scientific consensus is turning away from a starch and sugar-laden diet. I realized long ago that healthy fats and high-quality animal protein were not the enemy.
3) Trans-Fats and Vegetable Oils: Early on, I campaigned against the idea of substituting hydrogenated fats and Omega 6 rich oils for butter and healthy saturated vegetable oils like coconut. Now, the pendulum is swinging toward acknowledgement that loading Americans up on trans-fats and processed vegetable oils was misguided.
4) Vitamin D: I remember testing patients for Vitamin D in the 80s. At that time, it was thought that Vitamin D was very toxic, and that giving patients more than 400 IU per day was dangerous. Well, now we recognize that Vitamin D can provide an important bulwark against a myriad of diseases, and that a very high percentage of Americans have insufficient levels.
5) Omega 3 fish oils: I was an early adopter of Omega 3 fish oils, even in a decade when the traditional wisdom was to "avoid fatty fish." Three decades later, fish oil has surpassed multivitamins as the number one-selling supplement category, and is the supplement most consumed by doctors according to surveys.
6) Gluten: Once thought to be rare conditions, celiac disease and gluten intolerance are now recognized to affect a high percentage of Americans, and "gluten-free" has become the single biggest growth category among natural products. From the earliest stages of my career, it's been a privilege to help patients recognize this problem and transform their lives with a simple diet change.
7) "Nutraceuticals": From the early days, I've championed plant-based nutraceuticals as natural alternatives or adjuncts to drugs. When I started out, we just had teas, tinctures and powdered herbs that were crammed into capsules, but science has progressed to the point where we now have potent, high-quality standardized extracts with well-characterized medical properties. These include curcumin, EGCG, lycopene, lutein, berberine, resveratrol, theanine, sulforophane, DIM, ginkgo biloba and many more-a veritable pharmacopeia that are the subjects of thousands of studies.
8) Chelation Therapy: After learning about chelation therapy soon after I began my holistic practice, I've treated hundreds of patients. For years, this remained a controversial therapy, in the shadows, viewed skeptically by my conventional medical colleagues.
But, last year, in a stunning vindication of chelation, the results of a 30 million dollar National Institutes of Health study showed that chelation could improve outcomes in heart attack sufferers. It worked particularly well in diabetics, cutting repeat heart attacks by over 30%.
Glad I stuck to my guns over all those years during which chelation was derided as an "unproven" therapy!
9) IV Vitamin C: To some extent, intravenous vitamin C therapy, which I've used since the 80s on my patients at the Hoffman Center, has traveled the path of chelation: a therapy widely-embraced by the public and complementary physicians, but without much scientific substantiation. We knew patients with infectious diseases and cancer were getting great results, but research was scant.
Now, new studies are shedding light on the mechanisms by which vitamin C can inhibit cancer growth and vanquish viruses. My grateful patients could've told you that, but now there's proof!
10) The Growth of Integrative Medicine (aka Holistic Medicine, nutritionally-oriented medicine, Natural Medicine, Complementary and Alternative Medicine-CAM): I can't claim to have invented this style of practice-When I first started out three decades ago, there were already perhaps a dozen complementary docs in all of New York City. Each year, there were maybe eight or ten conferences to attend on alternative medicine. There was no internet, and consequently you could listen to cassette tapes or subscribe to the handful of newsletters and magazines that tackled nutritional subjects.
Was "holistic medicine" going to be just a passing fad, a vestige of a less scientific era, a mere footnote to history, easily swept away by the advance of high-tech medicine?
Looking back it's gratifying to see that I have been in the vanguard of a huge growth industry. There are now tens of thousands of complementary practitioners of all stripes across the country and around the world. I'm particularly impressed with the caliber of some of the non-MD/DO professionals who are joining this field, from certified health coaches, dieticians and nutritionists to naturopathic doctors, chiropractors, nurses, PAs, acupuncturists and oriental medicine specialists, they deliver high-caliber healing expertise.
Not a week goes by that there's not a conference on some aspect of CAM-and many sponsored by prestigious universities and medical schools. The public's fascination with this realm has soared, and with the advent of the Internet, there are thousands of websites, blogs, social media hubs and webinars.
Bottom line, as I celebrate my thirtieth year in practice, I look back with satisfaction on a once-risky choice which has certainly stood the test of time!
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