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David Katz, M.D.

David Katz, M.D.

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Health Promotion: Practice What You Preach

Posted: 04/ 7/11 03:40 PM ET

Al Gore has famously -- or, if your world view differs, infamously -- made personal investments in companies advancing the "green economy" agenda for which he has long been an ardent champion. This has prompted some to levy charges of conflicted interest against him -- to contend that he is, in fact, espousing such causes as green energy for personal gain.

But such charges resonate with truth only in a parallel universe (impervious, presumably, to human-induced climate change) where effects precede causes. Because it is a matter of public record that Gore was advocating for a green economy long before he made any such investments; long before, in fact, there were many relevant companies in which to make such investments. He applied his mouth to the issue long before his money.

And then ... he put his money where his mouth was. He practiced what he was preaching.

Aren't we supposed to do just that?

I strive to make my own health promotion efforts fully in the public domain whenever possible
. Much of what I do is freely available to all, and provides no profit for me, or anyone involved.

But there are times when the only expedient way to advance the mission is via public/private, academic/business partnerships. And then, inevitably, there is money in play.

But in our still-capitalistic-last-time-I-checked society, is it, in fact, a "conflict" to become personally and financially involved in the very things we are telling people they should become personally and financially involved in? Isn't doing otherwise a failure to practice what we preach, hinting at hypocrisy?

There are, to be sure, many opportunities for true conflicts of interest in the world of business; and the entire domain of opportunity is rife with slippery slopes. But as long as honest means are applied to honorable ends, where is the conflict? Are we opposed to doing well by doing good? If so, I never got that memo. If one invests personally in a cause one has long championed, does it not make one's interests more confluent?

The issue comes up often as a tacit debate among academics about degrees of purity. So I thought this was grist deserving of the kind of diligent milling only the Huffington Post can provide!

What do you think: conflict, or confluence of interests for mouths and money, practice and preaching to align in health promotion, as in other endeavors? I look forward to comments.

-fin

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

 

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thebigbike
ran away to be a cowboy
09:25 PM on 04/19/2011
If the public might perceive that your credentials - if any - confer an implicit moral requirement to act entirely in their interests ( like what is called all too laughably "fiduciary duty" in the financial and legal world ) when you "advocate" and promote actions or sales of product in whose success you have a personal financial stake..... then, in my opinion you should refrain from... either investing in such promotions or products while you advocate them - even if you TRULY -- and without ANY consideration of financial gain or loss believe they are the BEST possible path, because, no offense, why should I trust you any more than General MotorsHalliburton BPEnronGoldmanSachsBearStearnsLehmannBrothersCountrywide or ANY big pharma company?

IF you so truly believe it's the BEST as a medical/health program, then spend your own money to provide it free past the point where you are out of pocket. That way you'll support the productprogram you believe is BEST, and I'll have real reason to hope if not quite believe you're not just another moneygrubbing slimebag. Not that YOU would ever be of course. (Your even asking this question IS a GOOD SIGN!)
09:29 PM on 04/13/2011
Thanks. That was a thought provoking read!

I think there are clearly problems with both approaches under various circumstances. It would be difficult to place much confidence in a personal trainer that didn't appear fit and healthy. On the other hand, the corruption that is all too common when power over outcomes is combined with personal gain makes a powerful argument for keeping such things separate.

At any rate, it's an issue worth taking a long serious look at to determine if our policies are in line with reality and with how we want our society run.
10:51 PM on 04/12/2011
I have been a personal trainer for over 15 years and if I didn't practice what I preach I would have never lasted this long in the industry. How many people would put their trust in a a trainer who is out of shape. It has always amazed me how many doctors and even my own doctor, who are really out of shape. I just feel I am obligated to stay fit for my job and my life. Now, if I could only earn a doctor's salary! Have a healthy day!
http://exerciseandnutritiontips.com
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w84it
05:39 PM on 04/11/2011
"But as long as honest means are applied to honorable ends, where is the conflict?"

I think that's the tricky part. Whenever something becomes popular...the money makers want a piece of the action. I think that is where things go wrong. It goes from "how can we help?" to "what can we sell?"
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David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
06:12 PM on 04/11/2011
I agree this is where things can, and all too often do, fall apart.
12:04 PM on 04/11/2011
This is a very important topic! We have to practice what we preach. We have to be our own leaders for the life we want to live and it may be that the nay-sayers are just articulating reasons to not change their own behavior. It takes a whole village and that includes entrepreneurs. We discussed many of these issues including how to empower consumers to take personal responsibility for improving their health through education, interactive tools, and incentives--here http://www.hopestreetgroup.org/docs/DOC-2480
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YoniFreedhoff
Obesity med. doc, blogger, author, speaker, dad.
08:01 AM on 04/10/2011
Thanks for this David,

In 2004, frustrated and frankly disgusted by the Ottawa's predatory commercial weight loss industry, I decided to do better and founded an inter-disciplinary behavioural weight management program. My patients enjoy 6 months of unlimited one-on-one consultation (and a minimum of 5 hours) with RDs who work with them on balanced deficit diets with nutritional guidance from Willett's Healthy Eating Pyramid. Patients enjoy 6 months of thrice weekly fitness classes led by personal trainers, and also spend 3 hour with trainers one-on-one to work on the design of home programs, or the sleuthing of enjoyable functional activities. Patients see medical doctors every 2 weeks for behavioural counseling. Nutritional supplements aren't sold. No one particular "diet" is prescribed. We deliver these services as a cost less than half of the hospital's gruesome all liquid diet program, and we offer a follow up year long maintenance program that still includes unlimited one-on-one attention for less than the cost of a latte a day at Starbucks.

All that said, some certainly look down their noses at my venture. Why? Because as you said, physicians apparently aren't supposed to be financially involved.

What rich hypocrisy. Every physician I know is a business unto themselves where they're selling their services to their patients.

I'm damn proud of the services we provide, and had we not made a formal business out of it, I would never have had the resources to provide them.
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w84it
05:49 PM on 04/11/2011
You should be proud of the services you provide!
10:07 PM on 04/07/2011
One of the first questions investors ask about new ventures is, 'how much of your own money do you have in this product?' It is remarkably difficult to raise additional funding without it. So one is compelled to invest in technologies they invent. The same logic should be applied to technology you champion. In order for it to succeed in raising additional funding people must invest more than their mouths in it. Your investment leads to more investment. Now for the good part, there are still no guarantees of success. For every venture that succeeds many more fail. Does the court of public opinion prefer success or failure. Why complain about success that leads to positive outcomes for society. People who work hard and champion innovation should be allowed to live with the fruits of their labors sans grilling in the press because they also bear the brunt of their losses. Perhaps the issue is the appearance of undue influence... how silly. You have no influence if you perform valueless service. In a country where entrepreneurship was once king, and led to almost all new employment such arguments though interesting are really self defeating and frankly silly. And knowing David he is likely correcting my grammar as he reads this :)
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David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
07:11 AM on 04/10/2011
Grammar looks good, Dave- thanks! I think this post may be a bit hard to find- was hoping for a real volume of comments here. But I appreciate yours- hope all is well!
10:11 AM on 04/10/2011
:) Indeed a bit hard to find. It is surprising there are not more folks willing to express an opinion. It is an important topic and one worthy of national debate. Every other entrepreneur is applauded for investing, having skin in the game, why when it comes to health is this not the case? Frankly it points to an area of research for a clever PhD candidate. Why is it one form of entrepreneurship is good and another bad?