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Important Lessons from Natalie's Case

Important Lessons from Natalie's Case

David Tener, DC 

1) Multiple Symptoms, Multiple Doctors, Multiple Treatments

An all too common scenario...

It is not uncommon for patients at The Goldberg Clinic to have been diagnosed with multiple conditions. They see their Gastroenterologist for their digestive issues, their Rheumatologist for their joint pain, their Dermatologist for their skin issues and if that weren’t enough, their Integrative Doctor for “Natural Remedies” to add to the mix. They come to see us with bags full of medications, supplements, and alternative treatments, all prescribed by different doctors managing each so called “disease.” What the patient and their doctors fail to recognize is that each symptom or condition is a not separate and distinct issue, but rather a manifestation of causes that have not yet been addressed.

Natalie’s case clearly illustrates the connection between chronic digestive issues, skin problems such as Eczema and Acne and Chronic Fatigue Syndrome. As Natalie’s digestive function improved, her skin and energy level followed suit….all without treating symptoms but rather by addressing root underlying causes and employing the proper health promoting behaviors for function to be restored.

2) The Treatment Train

The medical management of Natalie’s symptoms involved repeated courses of antibiotics. This approach not only failed to address the causes of her health problems but also contributed to the development of secondary issues over time including frequent Urinary Tract Infections for which more antibiotics were then prescribed (See cartoon below). As her condition worsened over time, Natalie's medical doctor's recommended surgery to remove her gallbladder.

3) Bumps on the Journey, Trusting the Process and The Will to Get Well

Natalie’s road to recovery was not easy. She had to endure periods of discomfort (Bumps on the Journey) as her body performed its work in “purging” (Natalie’s words) old materials and waste products that had accumulated in her system over time. Despite outside pressure from friends and family, Natalie trusted the process and noticed her overall health improving significantly following each healing crisis. Periods of detoxification and renewal gradually resulted in a 90% overall improvement in a period of 90 days. Natalie earned back her health with hard work and persistence. She had, as Dr. Goldberg calls it, “The Will to Get Well."

4) “Real Healthcare is Self-Care”  ~Dr. Paul Goldberg

At the Goldberg Clinic it is our goal to assist patients in getting well while at the same time teaching them how to stay well so that they can begin to take care of themselves in the future. We worked closely with Natalie as we do with all of our patients to teach her the proper health promoting behaviors to maintain the improvements she’s made and continue to build upon them over time.

No one should have to rely on doctors of any kind (including those at the Goldberg Clinic) for the rest of their lives. Real healthcare is self-care. 



Health is largely dependent on the environment in which we live. Be mindful of how your actions affect the planet, the creatures that live on it and the health of future generations. 


The Cost of Chasing Cancer

Dr. Goldberg has been educating patients and students for over 35 years regarding the hazards associated with cancer screening and treatment methods. These often unnecessary, costly and sometimes harmful medical tests and treatments do not improve health outcomes as illustrated in article below. The following article is from the March 10th edition of Time Magazine. It was written by Dr. Marty Makary, a cancer surgeon at Jonh's Hopkins Hospital and an associate professor of health policy at the John's Hopkins Bloomberg School of Public Health.  

Why Excessive Screening can Cause Unintended Harm, Stress and Waste 

As a surgeon, I’m trained to crush cancer. For many years, every tumor I palpated and family I counseled drove me to hunt for cancer with a vengeance, using every tool modern medicine has to offer. But recently, one patient reminded me that the quest to seek and destroy cancer can produce collateral damage.

The patient’s story began with a full-body CT scan–a screening test used to detect tumors–that revealed a cyst on his pancreas. Some 3% of people have these cysts, and they are rarely problematic. Based on the cyst’s size and features, there was no clear answer as to what to do about it, but he was given options.

The patient tossed and turned at night, agonizing over stories of pancreatic cancer tragedies, consumed by the dilemma of whether to risk surgery to remove the cyst or leave it along. The conundrum strained his marriage and distracted him from his work.

Months before I met him, the patient underwent surgery, which revealed that the cyst was no threat to his health. The operation was supposed to cost $25,000 and require eight weeks off work. But the toll was much greater, including a debilitating surgical complication.

I thought, This is why he shouldn’t have had a CT scan in the first place. Screening made him sick.

New research finds that some Health-screening efforts have gone too far. A recent study found that yearly mammograms do not prolong the lives of low-risk women ages 40 to 59. Following more than 89,000 women for 25 years in a randomized controlled trial (the gold standard of science), the study is as methodologically impressive as they come. As hard as it is for our pro-screening culture to believe, the data are clear. We are taxing far too many women not only with needless and sometimes humiliating X-rays but also with unnecessary follow-up surgery.

The annual mammogram is not the only vintage medical recommendation under scrutiny. Another large study found that among low-risk adults, taking a daily aspirin–a recommendation hammered into me in medical school–can cause significant gastrointestinal or cerebral bleeding that offsets any cardiac benefits. Doctors are also re-evaluating calls for regular prostate-specific antigen tests and surgical colposcopies after “borderline” Pap smear results because of the risks of chasing false positives and indolent disease.

The problem of unintentional harm is far bigger than many suspect. The Office of the Inspector General for the Department of Health and Human Services reports that among Medicare patients alone, it contributes to 180,000 deaths annually. On a national level, if unintentionally harming patients in the process of trying to improve their health were a disease, it would rank as the No. 3 cause of death in the U.S., using Centers for Disease Control and Prevention stats.

In this era of rising medical prices, cutting waste should be the top priority, especially when that waste pulls doctors away from the important work of caring for sick patients. A 2012 Institute of Medicine report concludes that Americans spend as much as one-third of their health care dollars on tests, medicine, procedures and administrative burdens that do not improve health outcomes.

The patient I met also taught me about another negative outcome, one that does not show up in the national stats: emotional trauma from false alarms. The patient recounted feeling tormented by the idea that he might be harboring a precancerous time bomb. His distress arose not from cancer but from medicine’s limited ability to interpret a normal variation of anatomy discovered by new technology.

The good news is that a grassroots movement within medicine is identifying unnecessary tests and procedures to educate doctors and the public about them. The American Board of Internal Medicine Foundation has been asking medical-specialty associations to name the five most overdone tests and procedures within their specialty. The campaign so far includes more than 60 doctors’ societies.

Reducing overdiagnosis and overtreatment will require broadening medicine’s focus beyond hunting and killing disease to sound research and education on appropriate care. We all must come to grips with the public’s expectation for more medicine. New research is capturing what individual stories, like that of my patient, have been trying to teach us: we have a quiet epidemic of unnecessary, costly and sometimes harmful medical care.

Also see related articles by Dr. Tener:


Happy Cows

Be mindful of how your food choices affect the environment, your health and the lives of these beautiful creatures that run, play and love just like our beloved pets at home. 


Mammogram Study Sparks Debate in the Healthcare Community

Dr. H. Gilbert Welsch of the Dartmouth Institute for Health Policy and Clinical Practice explains why the American College of Radiology's two main arguments against the Canadian National Breast Screening Study are incorrect as he explains in the video below.

(See Dr. Tener's recent article on Mammograms: Click here)