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Saturday, September 13, 2014

Doctors Need to Learn About Nutrition

Doctors Need to Learn About Nutrition

Tricia Ward, Stephen R. Devries, MD
September 04, 2014 | Medscape Cardiology: What prompted this commentary?
Dr. Devries: It's been clear to me for some time that nutrition has not been high on the radar in clinical cardiology. I know from my own training 25 years ago that I received essentially no education in nutrition in 3 years of internal medicine residency and 4 years of cardiovascular fellowship training. Unfortunately, despite the knowledge gained in the interim about the link between nutrition and health, very little has changed regarding the paucity of nutrition education over the past 25 years.
It struck me as a peculiar paradox that clinical practice guidelines highlight the primary importance of nutrition and lifestyle, yet the physicians who are expected to implement these guidelines receive absolutely no education in these areas during their residency and subspecialty training.

It seems hard to imagine that current accreditation guidelines in cardiology, for example, outline very detailed requirements regarding procedures, yet don't mention a word about nutrition. As I go around the country speaking to this point, the reaction is an incredulous "How can doctors not be required to learn about nutrition?"

Two years ago, I transitioned from a full-time academic practice to become director of an educational nonprofit, the Gaples Institute for Integrative Cardiology. One of our primary goals is to create a space for nutrition education within all levels of medical training programs. This new paper emerged as one of our efforts to emphasize the role of nutrition in medicine. | Medscape Cardiology: What is the relationship between the authors of this paper -- do they represent a particular body or group?
Dr. Devries: Our goal was to bring together as broad a group of physician educators as possible to help strengthen the message. My own work over the years has involved critically evaluating the evidence for nutrition and lifestyle practices, and the authors include many of the individuals I have collaborated with along the way. My personal belief (and a guiding philosophy of the Gaples Institute) is that we can best improve health care and the patient experience by bringing together the wisdom of passionate experts who may not normally be in dialogue with each other. Accordingly, the authors of this work include highly published academicians, natural health advocates, preventive cardiology researchers, directors of residency programs, and a former medical school dean. | Medscape Cardiology: Are you advocating any particular type of diet?
Dr. Devries: We're not aiming to promote a particular diet -- which is reflected in the diversity of authors, many of whom have slightly different takes on an optimal diet. Our message is much bigger: Let's give nutrition and lifestyle the attention they deserve in medicine. The goal is to create a space that doesn't currently exist for nutrition in medical training and practice.
And despite the diversity of opinions regarding diet, it's important to recognize there is a great deal of common ground: the need for greater consumption of vegetables and fruit, preferred intake of whole grains over refined, and avoidance of sugar-sweetened beverages. | Medscape Cardiology: Why do physicians need to learn about nutrition when there are dietitians? Can't they just refer patients to the experts?
Dr. Devries: I'm glad you raised that point. First of all, it's important to acknowledge that nutrition is a group effort and that patients can benefit from a wide range of health experts -- including dietitians, nutritionists, and nurses -- to help with dietary concerns. And certainly it's not realistic to expect that doctors will be able to take the time for detailed nutritional tasks, such as making daily meal plans, especially for those with complex nutritional needs.
Nevertheless, a solid foundation of nutritional knowledge will empower physicians to emphasize to patients that nutrition is a priority, and to encourage patients that the food-based "medicine" they consume is just as vital to their health plan as their medication. When it is apparent that nutrition is a priority for the doctor, it becomes a greater priority for the patient. Making that point doesn't take a lot of time.
Our goal is to leverage maximal impact from the physician's limited time. If only 15 minutes is slated for a return clinic appointment, devoting as little as 1 or 2 of those minutes to nutrition would be a huge advance from the status quo. Spending a couple of minutes to encourage vegetable and fruit intake or to discourage sugar-sweetened beverages is time well spent. And for those who need more extensive counseling, an appropriate referral is ideal -- and probably have all the more impact if the physician has already "premedicated" the patient to appreciate the importance of nutrition. | Medscape Cardiology: You state that nutrition is arguably more relevant to physicians than organic chemistry. How would you like to see it integrated into medical training?
Dr. Devries: The comment we made in the paper about organic chemistry pertained more to the undergraduate requirement for medical school. Although written a bit tongue-in-cheek, it referred to an article written by Drs. Dalen and Alpert[3] in which the importance of nutrition was compared with that of organic chemistry as a preparatory class for entrance into medical school. The idea is that we could begin to marinate future physicians with knowledge of nutrition early in their careers -- information undoubtedly more relevant to their future medical practice than that gained from organic chemistry. | Medscape Cardiology: What would be the timing and context of this education?
Dr. Devries: Currently, an average total of 20 hours is devoted to nutrition education in 4 years of medical school, and much of that time is dedicated to the biochemistry of nutrients and to rare nutritional deficiency states. Unfortunately, the little nutrition knowledge gained in medical school is typically extinguished in later clinical years because it is not reinforced.
Our recommendation is that a meaningful curriculum in nutrition be in place throughout medical training, from the basic sciences in medical school, to early clinical training, and extending into residency and subspecialty programs. Identifying clinical nutrition mentors is a challenge, but one that can only be addressed by a push for more nutrition education -- including education to train the trainers. | Medscape Cardiology: Are you also recommending a continuing medical education requirement?
Dr. Devries: Absolutely; continuing education in nutrition is essential. Looking back at just the past year, key studies have been released on nutritional topics ranging from the Mediterranean diet, all the way to the cardioprotective properties of both blueberries and nuts. Keeping current in clinical nutrition science through continuing medical education is one of our key recommendations. | Medscape Cardiology: One of the frustrations for healthcare professionals is the seemingly conflicting data on nutrition. How can these professionals be assured that they are up to date with the evidence base?
Dr. Devries: That's a great point. Consumers and health professionals alike are understandably confused by seemingly conflicting nutrition studies. The problem is fueled by dramatic headlines in the lay press with new "breakthrough" studies that contradict previous findings. Seeing past the headlines -- and most important, the ability to place the new information into context on the basis of previous knowledge -- requires a solid foundation of nutrition education that doesn't currently exist. | Medscape Cardiology: What can current medical students and practicing physicians do to improve their nutrition knowledge and counseling skills?
Dr. Devries: There are some innovative nutrition educational programs that we referenced in our paper. The Gaples Institute also has some useful information on our site and is working to develop much more. | Medscape Cardiology: Are there novel strategies -- group patient education, for example, or standardized diet-assessment tools -- that are effective and can save time in an already crowded physician visit?
Dr. Devries: The use of a previsit diet questionnaire saves time and can be extremely helpful for evaluation of the baseline diet and to track changes. Working with the patient to identify 1 or 2 especially relevant dietary goals to be followed-up at the next visit is particularly helpful. | Medscape Cardiology: In June 2014, there was a white paper[4] from the Bipartisan Policy Center, American College of Sports Medicine, and the Alliance for a Healthier Generation on teaching nutrition and physical activity in medical school. Do you have any plans to coordinate efforts with these groups, or do you see your paper as a call to action for others to enact upon?

Dr. Devries: Our paper was intended to spotlight the deficiency of nutrition education in medical training, but it's only the beginning. We are also working hard to remove the obstacles to greater utilization of nutrition in medicine, including accreditation and reimbursement issues. The Gaples Institute has met with leaders in the US Congress, the American College of Cardiology, and many other key stakeholders to help shape the future of medicine and realize our vision of making nutrition a cornerstone of medical care.

Sunday, July 20, 2014




I am Sam Sewell. I am a heart patient, not a heart doctor, 
but I can give you information doctors are trying to hide. 
Some of you may know me as the guy who wrote that book 
that started such a stir "I Fired My Doctors and Saved My Life" 
but this blog is not about the book. This blog is about an 
important heart health procedure that is under-utilized, 
because most heart doctors don't want you to know about it. 
I'll tell more about my personal story below, but unlike those 
Internet ads that string you along forever, I will get straight
to the main point by calling your attention to this video:


Thursday, July 3, 2014



The doctors told me that I was not a candidate for stents or open heart surgery.  My heart was in such bad shape that I needed a heart transplant.  Heart transplants cost half a million dollars! There was a double digit chance I would not come off the operating table alive. The quality of life after a heart transplant is poor, and the life expectancy averages 5 years. Without surgery the doctors said I would be dead by Christmas.

My wife and I started researching the possibility of reversing heart disease naturally (which the doctors said couldn’t be done.)   Two years after starting my Total Life Saving Regimen I was walking four miles a day, living a normal productive life, and I never did have surgery.  Here is a link to my Total Life Saving Regimen

We even wrote a book about my experiences.  Now, eight years later, I am still thriving on the solutions we discovered back in 2006.  Here is a link to buy the book, “I Fired My Doctors and Saved My Life”

PDF download copies ($12.50) can be sent instantly to you or to friends, so you can begin reading right away!  
If you would prefer a personally autographed copy, or a MSWord copy of the original manuscript (so you can make your personal notations in the text) please contact us at

View videos FREE of charge at:

A referral about the book written by a fellow professional is at:

Friday, June 13, 2014

“Don’t Shoot the Dog” - Behavior Modification

by Sam Sewell

“Don’t Shoot the Dog”

Behavior Modification - Provided FREE by
Nationwide On-line and Local Counseling and Life Skills
When I was a youngster I spent a good deal of my summer vacations on my grandparent’s farm. The summer after my undergraduate work, I was eager to visit the country homestead once again. When I arrived, I discovered that there was a family crisis in progress.
Grandpa’s dog and hunting partner, Rusty, an Irish setter, had taken on a very bad habit in his old age. Rusty had begun breaking into the chicken coop and eating eggs. Now, the phrase “egg sucking dog” was one of the worst things that could be said in Northern Iowa. To our ears it was a profanity vulgar enough to make women gasp, and could easily start a fight if hurled at another person in anger. Iowa farmers knew there was only one thing to be done with an egg sucking dog; you had to shoot it and the sooner the better.
You see, Rusty and Grandpa were old friends. I had been with them many times as we flushed up pheasants from Grandpa’s corn fields after the harvest. Grandpa sure didn’t want to shoot Rusty, but he knew it needed to be done. Once dogs start raiding a chicken coop there is no way to cure them. No matter how many times you beat the dog, and no matter how many times you patch the latest hole they have dug under the wall into the chicken coop, they doggedly (forgive the pun) keep sticking their noses under hens and stealing eggs. The “egg money” was Grandma’s private income so you can imagine how she felt about the problem.
With the inexperienced confidence of youth, and a brand new “expertise” in the behavioral sciences, I told Grandpa that I thought I could “cure” an egg sucking dog. After all, I had read B. F. Skinner’s work with dogs and operant conditioning. I wanted to at least have a chance to save Rusty’s life, and save Grandpa the seemingly inevitable, heartbreaking chore.
The theory is very simple. One observes the subject animal, in this case Rusty, doing something the right way, and then reinforces the desired behavior.
The reinforcement cycle starts with some action on the part of the trainee (in Skinner's language, the operant). Operant conditioning is therefore always dependent on behavior. So, we have:
dog does something (operant behavior)
dog gets food (positive reinforcement)
Besides, I knew that these farmers almost always applied negative stimulus after the behavior had become a habit, thus reinforcing the very behavior they were attempting to eliminate. So maybe a different method might work.
There was considerable pressure to accomplish what I had told Grandpa I could do. That pressure amplified when Grandpa went into town and told the farmers who gathered at the coffee shop across from the hardware store that “My grandson, the psychologist, is going to cure Rusty so I don’t need to shoot him.” You can imagine the skeptical attitude of Iowa farmers being told that there was a cure for egg sucking dogs. By this time it was too late to tell Grandpa that I had never actually tested this theory, and I wasn’t sure it would really work.
When I had confidently and foolishly announced to Grandpa that I could cure Rusty, I didn’t even have a plan ready. So I began to think. How could I get Rusty to not go into the chicken coop, so that I could then reinforce the behavior I wanted?
I frequently come up with solutions to vexing problems while in that state of mind somewhere between sleep and wakefulness that I call “la la land.” Lying there in bed in my Grandparent’s farm house, listening to the occasional sound of livestock, and cars more than a mile away on gravel roads, I had a eureka moment. I had a plan!
The next morning I broke open six fresh eggs and put them in Rusty’s bowl right at the door to the chicken coop. Here is a principle to remember: Sometimes in order to get the changes going in the right direction you need to do something good for the bad dog. Rusty came along and noticed the eggs. I can imagine his dog brain doing this self talk, “Eggs. Right here. I don’t even need to eat the shells. And I don’t have to put up with those hens pecking at the top of my head. This is a good thing.” He quickly lapped down the eggs and sauntered off for his nap.
The following morning I did the same thing. I put the eggs a few feet away from the chicken coop, toward the back porch of the farmhouse where Grandma usually fed Rusty. The next day I again moved the bowl closer to the house, and added some dog food to the eggs. Every day I moved the bowl closer to the porch, mixing more dog food and fewer eggs. By the time the bowl reached to porch, it was all dog food and no eggs. Rusty had again become accustomed to looking for his food at the back porch of the house, and never again went into the chicken coop.
Please remember this; it is important. If you reinforce behavior that moves you toward a desired goal, and ignore the old behavior, you will change. It is that simple! Looking backward will keep you backward. Looking forward will move you forward.
Here is a FREE 3 minute video by the Directors of Best Self USA explaining how the Affordable Counselor System delivers high quality mental health services in the convenient privacy of your own home or office, in less time and for significantly less money than conventional psychotherapy.

Wednesday, June 4, 2014



Addictions Medicine Specialist

Eugene J. Koprowski, M.D., is an addictions medicine specialist. Trained at the Institute of Psychiatry, King's College, University of London, in addictions, he is also a graduate of the University of Chicago. He completed his undergraduate training at Northwestern University, Evanston, Ill.

Veteran’s Services

There are many problems associated with a veteran’s return to civilian life. Not all of those needs are recognized or adequately addressed by government or conventional psychotherapy services. Veteran (USN 1959-1965) Dr. Sam Sewell, Director of Best Self USA, is concerned and angry about the way veterans’ are treated. Dr. Sam personally leads the Veteran’s Services department at Best Self USA. The Best Self USA staff are able to offer counseling to veterans and active duty personnel in the privacy of their own homes or offices, locally or via the internet. We offer the materials and techniques developed from decades of long distance counseling done at Best Self USA. Contact or contact Dr. Sam directly at

Grief Counseling Services

Grief counseling is highly personalized. People process their grief experiences in unique ways. The need for grief counseling may also appear in circumstances beyond death of a loved one. Children or grandchildren moving out of the area may create a need for grief counseling. Sometimes the death of a family pet can create the symptoms of grief. It takes years of experience for a grief counselor to be skilled and wise enough to handle this very delicate psychological need. Dr. Bunny Sewell is the department head of Grief Counseling at Best Self USA. The Best Self USA staff is able to offer counseling to grief stricken family members in the privacy of their own homes or offices, locally or via the internet. We offer the materials and techniques developed from decades of long distance counseling done at Best Self USA. Contact or contact Dr. Bunny directly at

Clergy and Lay Leader Support

Many times Christian leaders are reluctant or unable to discuss their own stressful situations within their organizations or communities, and confidentiality is of utmost concern. Being sensitive to that reality, Best Self USA has clergy on staff who are able to offer counseling to Christian leaders in the privacy of their own homes or offices, locally or via the internet. We offer the materials and techniques developed from decades of long distance counseling done at Best Self USA. Contact

Sunday, June 1, 2014

Dramatic change in cost and delivery of counseling services

From Dr. Eugene J. Koprowski, MD, MA, LLM 

Dear Friend,

You know my colleagues, Sam and Bunny Sewell, and their pastoral psychotherapy practice, Best Self USA, the leading pastoral counseling clinic here in the Naples area.  (See News Release Below)  Like any practice, the clinic needs to grow to stay strong. We’d like your help with that!

We’re asking our clergy colleagues to refer to us parishioners, or others, who might benefit from counseling, whether it is for marital counseling and executive coaching (two of Rev. Sam and Bunny’s specialties) or drug and alcohol abuse counseling, grief counseling, or counseling of clergy, lay leaders and health care personnel, which are my specialties. We are available to clergy and lay leaders, both locally and nationwide. Many times Christian leaders are reluctant to talk about their stressful situations to fellow members, since confidentiality is of utmost concern.

House Calls – Via The Internet

By asking our colleagues to recommend us to potential new patients we do two things: first, we are able to spend more time on patient support, and second, we bring more people like you into our extended professional family, delivering counseling services to those who might not otherwise seek it out, or those whom you may not feel you have the time or expertise to help. As you know from your ministry, there are many souls in need of help who simply will not ask their own pastor for that help, out of discomfort. Sam and Bunny’s e-Therapy – offered via the Internet and telephone – makes pastoral counseling services available to the patients who need it most in the privacy of their own homes. These have the advantage of old-fashioned house calls, that can be accomplished via telephone or through 21st Century Skype/Internet technology.

Would you be kind enough to recommend us to congregants or friends you encounter who may be in need of pastoral counseling?  We will then send out a friendly letter of introduction, an overview of what we do, and a copy of our news release which is attached to this letter.

I am very pleased to be on board with Best Self USA. I have been a priest and pastoral counselor for more than a decade, with the Orthodox Church (Patriarchy of Kiev and All Russia, Diocese of Chicago.) I am a graduate of the University of Chicago and Northwestern University, and a physician, trained at the Institute of Psychiatry, King’s College, University of London, as well as.

I’ve been a staff clinician at a leading hospital in Chicago, and have also served as a consultant to the U.S. Food and Drug Administration (FDA), and U.S. Army Medical Command.

Working with Sam and Bunny – whom I met through the American Association of Pastoral Psychotherapists –  is  a pleasure. I am very enthused at their model of low-cost, high-impact Skype/Internet-based therapy, which makes pastoral counseling services available to patients at a dramatically reduced cost, and that can be delivered in the privacy of their own homes.

Best Regards, Dr. Eugene J. Koprowski, MD, MA, LLM


No Embargo
Contact: Sam or Bunny Sewell
Press Kits Available for Feature Articles

Please watch this three minute You Tube video as a preview to an eagerly anticipated announcement. Dramatic change in cost and delivery of counseling services

You may also want to access this link that amplifies our therapeutic goal “Nutritional answers to emotional problems

We have been building this major project for many years, and have spent the last 11 months making our training materials available online. Now, we have finally launched the new Computer Assisted Therapy web siteBest Self USA

This revolutionary way of delivering services will enable more people to get the help they need at a dramatically reduced price.  The amount of money clients will save, compared to conventional therapy, is explained in detail on the new website. 

     Computer Assisted Services already available:
*Communications Skills
*Conflict Resolution Skills
*Parenting Skills
*Mood and Stress Management Skills
*Personality Types
*Personality Evaluation

Long Distance and Local Services

*Personalized Counseling with a live therapist
*Private Executive Coaching
*Biofeedback Coaching
*Youth & Student Services (MENSA Gifted Youth Coordinator)
*Marriage & Family Counseling (Husband and wife therapy team)    
*Substance abuse therapy (MD specializing)
*Clergy and Lay Leaders Support
*Grief Counseling
*Support and psychotherapy for veterans.  

And more on the way.

We want the community to know about this revolutionary Computer Assisted Website! Our hope is that it will enable many people to finally get the help that will enrich their lives, at a price they can afford.

Our sincere thanks to you for partnering with us in this important project!

Please help us spread the word by sharing this News Release!

Sam and Bunny Sewell
(Naples, FL) 239-591-4565

The staff at Best Self USA can help you become the best you can be!

Thursday, May 29, 2014



If you have a substance abuse problem - drugs or alcohol - you are definitely not alone. The National Institutes of Health (NIH), the government's leading medical research agency, reports that 23.5 million Americans, aged 12 and older, have a substance abuse problem. Change is difficult, but consider counseling with our clinic if you have experienced any of the following symptoms or signs:

* Inability to stop using drugs/alcohol
* Trouble meeting work, family or social obligations
* Symptoms of withdrawal -- nausea, dizziness, fatigue, irritable mood -- when not using drugs/alcohol.
* Compulsion to drink/use drugs despite any of the above-cited problems.

Best Self USA offers substance abuse counseling for our clients on the phone, over the Internet and in person. Contact us today to start to change your life for the better. Dr. Eugene J. Koprowski, MD, LLM, MA, heads our substance abuse department, and he integrates pastoral counseling with the latest evidence-based medical approaches (Motivational Interviewing, Cognitive Behavioral Therapy, Mindfulness Training, Contingency Management) to heal all of you, soul, mind and body.