I was in my late 20's when I walked into a dialysis clinic for the first time. The interior of the waiting area was worn, with beige paint peeling off of the walls. As I waited awkwardly to find out where my patient was my attention was drawn to a sign that read, "Did you know that [a popular fast food sandwich] contains 1020 milligrams of sodium?"
Salt can be bad. But it sure tastes good. Ask the millions of Americans who consume large amounts of salt in their diet, much of it from processed foods.
Sodium consumption in excess is linked with a number of health problems, including high blood pressure, kidney disease and various forms of heart disease.
New Yorkers have recently learned about the detriments of salt. Mayor Bloomberg has launched an initiative to reduce the amount of sodium that people get from restaurant chains and food producers by asking them to voluntarily cut the amount of this now ill-thought of mineral. When in New York City a couple of weeks ago, my husband and I could tell that restaurateurs are listening to Bloomberg. When eating out, we noticed that our food was, well, less tasty.
But maybe it is worth it. A recent New York Times article, which summarized findings from The New England Journal of Medicine, suggested that if Americans reduced salt intake by a half a teaspoon a day the nation would save 24 billion in health care costs. In the current political climate, many of us are acutely aware of issues related to the rising costs of health care. But is government intervention the best way to proceed?
Although a government middleman might be a good option, I wonder why we aren't putting more pressure on physicians to counsel their patients on dietary strategies to reduce sodium intake. Research suggests that American physicians are less likely than their European counterparts to discuss behavioral interventions with patients and are more likely to rely on the prescribing of medications. Regarding diet and hypertension, a recent study suggests that physicians offer little counseling on how to lower blood pressure numbers through lifestyle changes.
Not only do discussions regarding health behaviors result in patient satisfaction, such discussions comprise the inherent values of doctor-patient relationships. We seek medical care not only for lab results and prescription refills; we look to our doctors for advice and support. However, in a day and age in which technology and insurance mandates are interlopers in the patient-physician dyad, we have lost the personal connections and source of wisdom that people often crave.
In fact, the relationship between many of us and our physicians is dysfunctional. Doctors are overwhelmed and receive less respect than ever before in the history of modern medicine. As patients, we have submitted ourselves to the less personal nature of medical encounters. Maybe if we demand additional support from physicians (and advocate for additional backing of our doctors regarding the freedom to make medical decisions and limiting intrusion by managed care companies) we can get what we need in order to change our behaviors. Of course, we are all ultimately responsible in how we choose to care for our bodies. But maybe if we can learn to trust our physicians again (and they work to earn that trust), we don't have to reduce healthcare issues and healthcare costs in this country to something like eating salt.
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