Letters: World of Medicine

' Fertility & Diet ': Readers of our 'Health for Life' package and cover story on how diet and exercise can help overcome infertility praised self-empowerment, calling medication a last resort. One said, "When we look to medical science to solve such problems as infertility, we avoid making real changes in our lives. Women have a twofold reward: better health and greater chance of natural conception." A doctor concurred. "[For instance,] osteoporosis is almost never found in those who maintain programs of resistance and exercise. Drugs aren't the primary answer."

On 'Is Photography Dead?': "Today's manipulation of images differs from earlier efforts in the tools used and the ease of working, but not conceptually. Saying the medium has 'lost its soul' is a recurring reaction in art. Change is healthy, even if you don't like it."
John Mills, Nashville, Ind.

Conceiving a Better Diet
I Read "Fats, Carbs and the Science of Conception" (Health For Life, Dec. 10) with great delight. You were wise to point out how diet affects ovulation and that male infertility will probably not benefit from dietary improvements. We in the fertility community have been telling patients to limit simple carbs for years. Our motto in Atlanta is "If it's white, it must take flight. If it's brown, it can go down." Unfortunately, the socialization of bad eating habits and the availability of fries and soda conspire to defeat our patients in their fertility quest—as many reject our suggestions as too disruptive to their day-to-day routines. Until we find a way to make fast food desirable and healthful, we are going to see continued growth in our waistlines and waiting lines to see fertility specialists.
Daniel Shapiro, M.D., Medical Director
Reproductive Biology Associates
Atlanta, Ga.

I read your cover story on fertility the week of my second miscarriage after my fourth attempt at in vitro fertilization. For the authors to imply that a woman can overcome a complicated disorder merely by changing her diet is misleading. There have been many diet books targeting infertile couples, and in desperation we try them. When the diet fails, we move on to the next overhyped book. Women with a serious ovulatory problem need a good reproductive endocrinologist, not just a different diet. I know my journey through infertility includes a doctor who can help me. No amount of iron, plant proteins and ice cream will change that.
Kimberly A. Dyer
Lewiston, Maine

Our health-care system cannot improve unless we change the focus (in both direction and funding) toward preventive care by fixing the way general practitioners are reimbursed ("Cures for an Ailing System"). It's easier to be compensated for an amputation and the purchase of a prosthesis than it is for disease prevention and management with a primary-care provider. With payment for primary-care services stagnant or even reduced since 2000, it is no wonder that medical students, who often have large educational debts, are migrating toward higher-paying subspecialties. This trend is being fueled by the Centers for Medicare & Medicaid Services' reliance on a resource-based relative scale determined by federal law. For 2008, this formula will reduce payment to primary-care providers by about 10 percent (unless Congress acts). Commercial insurance companies usually follow the government's lead.
Maurice W. Stutzman, M.D.
Millersburg, Ohio

"Bones of Invention" failed to mention that hundreds of physicians no longer offer bone-density testing and that dozens of imaging centers have closed in 2007, with many more set to close in 2008. This is due to drastic reductions in reimbursement by Medicare and other insurance because of the Deficit Reduction Act, which became effective last January. Just as the epidemic of osteoporosis is being fully recognized, and new drugs and treatment options are available, patient access to these important and valuable treatments is being compromised. I own a company that provides mobile bone-density testing to more than 10,000 rural and underserved patients in the Northeast. If the Medicare Fracture Prevention and Osteoporosis Testing Act of 2007—which would freeze reimbursement at 2006 levels—is not passed, I will be joining the ranks of those centers forced to close, resulting in the loss of jobs and leaving 10,000 people without access to this valuable test. If they aren't diagnosed, many won't be treated with the exciting new drugs your article talked about.
Dan Burneika
Harvard, Mass.

Health-care reform is being addressed on a piecemeal basis, and I doubt any of your article contributors are there at 3 a.m. when the rubber meets the road. As a physician who does get up in the wee hours, I'd like to offer some suggestions. First, add personal responsibility to the equation. I've seen countless patients on Medicaid who smoke and also need metered dose inhalers (paid for by the taxpayers) to treat their "asthma." If your disease is self-inflicted, the primary victim should be you, not the taxpayers. Second, make it easy for health-care providers to volunteer. Medicaid right now is really just obligate charity with legal liability. Drop Medicaid reimbursement to physicians, let them write off the opportunity cost of charity work, provide some legal protection and people will volunteer. Third, make training for a medical degree attractive and affordable. Med-school grads have an average debt of about $150,000. If you want to manage physicians' fees, help alleviate the less-than-subsistence lifestyle of trainees. Finally, don't insult our intelligence by telling us we need to take a pay cut while instituting a boondoggle like Medicare Part D—a transfer of wealth from the young to the retired.
David Stinson, M.D.
Plattsburgh, N.Y.

Let me state what any medical researcher would say when reading the diet "advice" given in the article "Fat, Carbs and the Science of Conception": please! Have any of these doctors treated infertile couples? Have any of these "new" findings ever been proved to help infertile couples? They explain associations found retrospectively between diet and fertility. It's pure data mining, and it is the softest kind of science we have—it is riddled with problems that no statistical models can account for. There is not a shred of evidence to suggest that following the doctors' "guide" will help women conceive. NEWSWEEK should heed the advice of its columnist Jerry Adler, who in "A Big Dose of Skepticism" (Periscope, Dec. 10) pledges to focus on prospective "randomized, placebo-controlled, double-blind clinical trials." Public-health researchers, funded by our taxes, should strive to translate epidemiologic data into clinical trials, not into screaming headlines. If what these researchers believe is true, the government should fund a relatively easy NIH trial before giving false hope to struggling couples.
Benjamin J. Davies, M.D.
Clinical Instructor of Urology
University of California, San Francisco
San Francisco, Calif.

As a mother of four children, ranging in age from 15 to 23 years, I wanted to let you know that I think the naked woman on your cover is inappropriate and unnecessary. It may sell magazines, but it shows no class. Don't get me wrong. I think the pregnant female body is beautiful, but not on the cover of a national newsmagazine.
Cindy Young
Via Internet

While it was encouraging to read "Diagnosis: Same as It Never Was" on the impending changes in the diagnostic manual for mental health, there was a glaring void in the preceding article, "Cures for an Ailing System," about the major issues facing health care. National statistics indicate that one in five Americans is affected by mental-health issues, either directly or indirectly. But mental-health care was not mentioned among the "cures" according to the seven Harvard experts. Mental-health treatments constitute some of the biggest costs facing the health-care industry and employers who provide medical insurance, yet mental-health insurance parity remains a problem. While parity is addressed in several recent bills in Congress, it gets little attention in the current White House race. Until parity is reached, millions will be without affordable access to the continued care they need.
Doug Harpole
Amissville, Va.

Keeping the 'Gates Keeper'
Reading your splendid piece about defense Secretary Robert Gates ("The Gates Keeper," Dec. 10) caused a moderate Republican like me to be thankful for the pressure of the wafer-thin (and admittedly divided) congressional majority that probably made possible his appointment, and to lament that we in America don't follow the British parliamentary model that allows voters to know before elections who will likely serve in senior positions in candidates' cabinets and on the Joint Chiefs of Staff. Your mentions of "containment" and Gen. George C. Marshall remind me how lucky the internationally inexperienced Harry Truman was to be advised by men of the high caliber of Dean Acheson, Chip Bohlen, Dwight D. Eisenhower, George Kennan and Marshall. (Kennan thought the Marshall Plan did more than anything else to keep Russia out of Western Europe after World War II.) It's sad that President George W. Bush waited six years to begin to appoint people as excellent as Gates and Gen. David Petraeus.
Henry P. Briggs
Cincinnati, Ohio

Secretary Robert Gates, the "anti-Rumsfeld," is a desperately needed waft of fresh air in the polluted atmosphere of the Bush administration. As a Democrat who can't wait for the "anti-Bush" on Jan. 20, 2009, I would be delighted if Gates could stay on as Defense secretary in the next (Democratic) administration.
Dorian De Wind
Austin, Texas

Developing New Photography
The fact that photography today is different from when it first began doesn't mean it is a dying art ("Is Photography Dead?" Dec. 10). How encouraging that we can still appreciate the old black-and-whites while finding room for new manipulated digitals and welcoming whatever else creative minds can envision.
Paula A. White
Madison, Wis.

Photography is alive and flourishing in our national parks and wilderness areas, from alpine mountains to desert canyons to ocean shorelines. No amount of digital manipulation or fabrication can improve on the extraordinary beauty that already exists in the natural world. As photographers, all we can do is try to capture it.
Olof Carmel
Truckee, Calif.

Correction
In "The Future of Reading" (Nov. 26), we misattributed the source of a 2004 study which reported that only 57 percent of adults read a book in a year. The National Endowment for the Arts produced the "Reading at Risk" report. NEWSWEEK regrets the error.

Letters: World of Medicine | Culture