Letters to the Editor

Reader comments on the role of ancillary services in an internal medicine practice, and on the need for attention to nutrition and lifestyle in caring for rheumatoid arthritis.

Taking IM seriously

The article on a start-up practice [“Start-up practice uses ACP's marketing guides for quick growth, “ ACP Internist, April 2010] was most disconcerting.

Photo by Valueline
Photo by Valueline

The “advantage” Dr. Saltzman enjoyed of a husband who had experience in start-up businesses and who owned a building is exceptional. Most doctors who start a practice start with a prayer and $30,000 if that and a second job until the practice starts working.

Internal medicine is not spa medicine. It is not a fitness studio or personal training. These are all legitimate avenues in their own right, but none of this is medicine and any serious medical internist does not have time to fritter on these sidelines.

As for the comment by ACP's senior associate Ms. Williams that these are ancillary, this is wrong; ancillary to medicine is having your blood drawn.

Please take the genuine practice of medicine much more seriously. It is of itself a full-time, greater than full-time, undertaking.

Spas belong in the dustbin with the so-called boutique practices that are only thinly disguised ways to filter out people who cannot pay through the nose for instant “care”—à la Hollywood. Further, these only propagate not health care but extreme narcissism.

Helen May, ACP Member
Bronx, N.Y.

Diet for RA

I read with great interest the article on rheumatoid arthritis [“Rheumatoid arthritis hurts the whole body, “ ACP Internist, July/August 2010]. It had much good information on inflammation and vascular disease and treatment issues. One area that was left out of the article was the potential useful effect of healthy nutrition on rheumatoid arthritis.

One major issue that disempowers patients in modern health care is the strict focus on pharmaceuticals for therapy. I have facilitated since the early 1990s both cardiac and cancer support groups, and it is not uncommon for patients with both classical inflammatory and even osteoarthritis (which also has inflammatory components) to improve their arthritic symptoms when they go on vegan diets for heart disease or cancer.

Practitioners and patients alike need to hear that nutrition and lifestyle can make a difference in improving symptoms and outcomes. Adding that information to articles in ACP Internist can help to make a difference.

Harvey Zarren, ACP Member
Swampscott, Mass.