CAMLAW: Complementary and Alternative Medicine Law Blog

Super-Size Me: McCleveland Clinic and the Cardiac Care Followup Nugget

Should hospitals care what their patients eat in the hospital cafeteria after a procedure? Once the tubes and carefully monitored, insurance-reimbursed pharmaceuticals are poured into the veins, is it okay to slather corn syruppy tomato sauce on a Chicken McNugget?

Or is nutrition in hospitals one of those subjects that will have to wait some decades for a Congressional investigation? The story below suggests that some are waking up to the fact that what goes in, must come out (unless it stays there and causes trouble); while others simply feel that caveat emptor means shoving down the consumer's throat whatever someone is willing to (pay for) and consume.

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CLEVELAND - Andrew Hudnall stared at his lunch and agonized about whether his doctor might be unhappy with him. The 57-year-old heart patient had just bought a chicken sandwich from McDonald's -- in the food court of the Cleveland Clinic, renowned for its research into heart disease. Even so, he said he agrees with efforts by the clinic's leading doctors to get some fast-food franchises out of the building.

Pizza Hut has already left. Nine others remain, including McDonald's and Subway. At a time when two-thirds of American adults are overweight or obese, putting their hearts and arteries at grave risk, health officials and physicians are urging people to be watch their weight and eat healthier.

"People are here for heart problems, including me. I get in here, and this is tempting," said Hudnall, who was in a hurry and didn't want to fight the crowd at other restaurants or the clinic cafeteria.

Having french fries at a leading center for treating heart disease sends the wrong message, officials of the Cleveland Clinic believe.

"We are hoping we are setting some kind of a trend ... about wellness," said Angela Calman, Cleveland Clinic spokeswoman. "We're not singling out McDonald's. We're looking at every vendor on campus and asking if this represents what we are trying to present to our patients."

The Cleveland Clinic's patients have included royalty and leaders of foreign countries, and some of the nation's most prominent heart researchers and surgeons work there. Its heart center sees more than 205,000 patients a year and performs thousands of heart procedures annually, including more than 3,800 heart operations.

Representatives of the clinic and McDonald's met recently to try to work out a compromise. Neither side will discuss details, saying only they plan to meet again soon.

Nationwide, there does not seem to be much of a trend toward ejecting fast-food companies from hospitals.

"We are in about 36 hospitals right now and have been for quite some time," said Ken Barun, McDonald's Corp. senior vice president who oversees the company's "balanced lifestyle initiative," which promotes healthy food choices and physical fitness.

The head of the American Association for Health Care Service Administrators said she is unaware of any other hospitals following Cleveland Clinic's lead.

"It becomes a philosophical question that has to be answered in every hospital. Do we serve healthy foods because we're in a health care facility, or do we serve what the customers are interested in having?" said Joyce Hagen-Flint, president of the AAHCSA. "There are hospitals all over the country that have fast food outlets."

It's not uncommon for hospitals to earn money by leasing space to food court companies or restaurants. The clinic would not comment on details of its leases, including how much money it might lose if McDonald's leaves. The franchise serves 12,000 people annually.

McDonald's has served up Big Macs and fries at the hospital for a decade, and has 10 years left on its lease.

The hospital's cafeteria is going through its own menu makeover.

Citing the continuing negotiations with McDonald's, Cleveland Clinic officials rejected requests for interviews.

The clinic's chief executive, Toby Cosgrove, has said the hospital is trying to pay more attention to the food choices it offers. He told the Washington Post recently that McDonald's is "symbolic as much as anything else. It is not associated with heart-healthy food; neither is Pizza Hut."

Barun, the McDonald's executive, said he met with clinic officials in June 2003 and at the time believed they were comfortable with the corporation's commitment to community service and determination to add foods such as salads and lowfat yogurt to the menu.

"We take this issue very seriously," he said. "Our role, when we saw this as an emerging issue, was to become part of the solution." One solution, he said, is an adult "Happy Meal" offered at some locations featuring a salad and a pedometer.

From: Associated Press (AP)

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According to theories of Ayurvedic medicine, improper digestion is the root cause behind many, if not most diseases. Bluntly put, we humans are all about assimilation and elimination -- what we take in, and what we put out.

But clearly Ayurveda is not on the mainstream list of cardiac care therapies at the Cleveland Clinic or most other hospitals. This critique is not to single out the Cleveland Clinic, a very fine institution (where I once spent a week in a program known as the Medical Institute for Law Faculty -- you can read about the experience in Beyond Complementary Medicine). Considering CAM therapies--including various theories of nutrition--as part and parcel of the medical experience makes sense, otherwise we may be undoing and unraveling with our willpower (and hands and fingers) the very sutures our saavy technological has pulled together in hopes of keeping our bodies and minds whole.

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Michael H. Cohen, Esq.; 468 North Camden Dr. | Beverly Hills, California 90210 | 310-844-3173