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On Having Letters After Your Name

This one might ruffle some feathers. I’m usually biting my tongue because I like confrontation about as much as I like giving up coffee. #hatehatehateloatheentirely. But this has come up in some recent conversations, and I feel the need to address it, if only for myself. (Yes, I like to start my sentence fragments with “But”. Get used to it.)

When you’ve been toeing the murky line between mainstream medicine and functional/lifestyle/holistic medicine as long as I have, you learn stuff. A lot of it is practical, concrete information about how to better treat illness and support health. A lot of it is rapidly advancing theory about causes and mechanisms of disease, including environmental factors that weigh in.

You also learn a lot about people—not just how the brain and the body work together, but also how people form beliefs, respond to health-related information, and interact with health-care practitioners.

I find it fascinating that many people are more interested in someone’s “official” credentials than their demonstrated knowledge and expertise. I have to admit that I once was.

Why would I take health advice from someone without an MD? Why would I take dietary recommendations from anyone but an RD? Who knows how to move better than a doctorate-level PT? Can anyone cure anxiety or depression without a PsyD?

Letters, in themselves, mean very little. Licenses, even less. I understand why they exist from a safety standpoint. You can’t have Average Joe seeing patients, prescribing them dangerous drugs with narrow therapeutic windows, and expect everything to go swimmingly. I don’t want a fecal microbiota transplant from some random lady with a garden hose in her back yard. (That’s apparently your only option around here. Shudder.)

But there are doctors who know scarily little about the subjects for which they are considered experts. After all, half of all doctors are below average. #themoreyouknow. There are RDs who know very little about optimal nutrition. Like the one ten years ago who asked me about gluten.

The person who has helped me understand the most about my own epigenetics and biochemistry? Not an MD, not a PhD biochemist. The people who have helped me learn the most about biomechanics and postpartum recovery? Not licensed physical therapists. Where did I get the help I needed to exclusively breastfeed two babies? Not a certified lactation consultant. And, perhaps most notably, my best sources for dietary information and nutritional recommendations? Not registered dietitians.

It’s not that I specifically set out to “buck the system” and find this information from alternative sources. It’s that when you truly listen to what people have to say, you can start to tell who has the research and RESULTS to back up their claims. I feel like I spend a lot of time trying to find the same information coming out of the mouths of “qualified” individuals to convince other people of its truth.

I wholeheartedly support what Dr. Kelly Brogan has to say about “mental illness”. I often quote her to others not just because I believe what she has to say but because she has more traditional qualifications than most other sources (combined). Degrees from the most elite schools, board certified psychiatrist, etc. And yet, she deals with an absurd amount of trolls because of her holistic message. I guess even the appropriate letters don’t appease everyone.

How about Chris Kresser, arguably one of the most influential people in functional medicine? Are we going to discount his massive impact in educating patients and practitioners? Oh, he’s “just” an acupuncturist. [Insert eye roll here]

Letters are not a bad thing. I have a few, myself. But I put a lot less stock in them nowadays.

Sure, degree programs can be a great starting point for background knowledge. It’s helpful to able to understand what I read when I search PubMed. It’s good to be vaguely familiar with biochemical pathways when I talk to people who really know their SNPs. It’s nice to know some basic anatomy when I’m learning how to restore my core muscles after diastasis recti.

But I’ve learned so much more by doing my own research (and LIVING that out) than I ever did in school–where I learned for a test in which I colored millions of bubbles with my #2 pencil. There is something to be said for personal motivation, critical thinking, and problem solving skills. (And, honestly, desperation.)

People often degrade others for “consulting Dr. Google” or “getting their MD from Google University”. Instead of making that into some kind of insult, I think we ought to acknowledge that people are TRYING to get answers to their health problems.

Have we considered why they are attempting to get this information online? Could it be because their own doctors are not listening? Even if they are listening, are they capable of solving the root cause problem? Why is it a terrible thing for a patient to be his or her own advocate and researcher?

Sure, the internet can be full of crap. It can also be full of useful but not-well-known information that has a long journey to make before it gets to the mainstream.

The internet can also connect those of us with similar experiences. Community and shared experience hold a power that is largely left untapped. Dr. William Davis, author of Wheat Belly, shares his fascinating perspective about this in his book, Undoctored. And yes, he is a “legit” cardiologist.

SO where am I going with all of this? (Your guess is as good as mine.)

This PharmD, BCPS is encouraging you to keep an open mind about letters, whether your own or others’. I do not think they mean what you think they mean. #namethatmovie.

Don’t get on your high horse simply because you have letters. (I’ve never done that, LOL. That poor medical assistant at my former doctor’s office… You don’t mess with a PharmD with boob thrush. #justsayin #futurepost). It’s ok to be proud of your hard work to earn them, but if you have letters, please be able to both back them up with experience and admit you don’t always have all the answers.

And if you don’t have the “right” letters? Don’t get discouraged. You can learn and make a huge difference in our collective health.

Love,

Lindsay, Pretty Hot And Rockin’ Mama Dearest (AKA, PharmD)

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