Dr Caldwell Esselstyn is a force of nature. At 82, he still directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute, and travels around the US regularly (hopefully he’ll come to Australia one day!), spreading his message that coronary artery disease is a reversible condition, even when it’s so advanced that mainstream cardiologists have given up on you and sent you home to die.
In brief, he teaches his patients to eat a wholefood, plant-based (i.e. vegan) diet with no added oil; no nuts or seeds except a tablespoon of ground flax/linseed each day; no avocado; and no added salt; and with the addition of green leafy vegetables at every meal and snack. You can find all the details in his book Prevent and Reverse Heart Disease, and his wife Ann and daughter Jane have authored several recipe books that teach you how to make this way of eating enjoyable.
But what I really want to discuss in this post is why more people don’t know about his work, and the implications of that ignorance.
Let’s start with a little background. Caldwell Esselstyn has worked at the Cleveland Clinic, one of the most well-known academic hospitals in the US, since 1968. His surgical training was conducted there; he chaired the Clinic’s Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery; he has served as President of the Staff and as a member of the Board of Governors. He received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association in 2009.
He has also served as President of the American Association of Endocrine Surgeons, was cited in The Best Doctors in America 1994-1995 for his surgical expertise in the categories of endocrine and breast disease, and is a Fellow of the American College of Cardiology. On top of all that, he is the author or co-author of over 150 publications in peer-reviewed scientific and medical journals.
I’m telling you all of this to make it clear that Dr Esselstyn is not some underqualified nut-job pushing a half-baked theory of his own creation that has never been tested. (There are plenty of contrasts to him in the ‘alternative medicine’ sphere, such as Dr Natasha Campbell-McBride, who makes outrageous claims for her GAPS diet based on either no science at all, or badly outdated science that has since been disproven, and who has never published a single paper in the medical literature to document her approach).
No, Essy is the real deal – a highly-qualified and well-respected doctor with an impeccable academic pedigree. So why is that the vast majority of people who undertake his program find out about him through friends, relatives or internet searches, rather than being referred to him by their doctors, including cardiologists who work at the Cleveland Clinic and have known of him, and his work, for decades?
Well, as I discovered recently, it turns out that the Cleveland Clinic actually has a policy that no doctors employed by it are permitted to refer patients to Esselstyn’s cardiovascular prevention and reversal program, even though it operates inside the Cleveland Clinic! Ummmm, whaaaat?
It’s simple, really. The average cost for heart bypass surgery in US hospitals is US$117 000, and being a top teaching hospital, the Cleveland Clinic probably charges more than that. The failure rate for this procedure is high (see my article What Bill Clinton’s cardiologist didn’t know (and why you need to know it), so a significant proportion of people will end up back under the surgeon’s knife, or undergoing other invasive procedures. Even if they don’t, they’ll have to come back for regular check-ups and to get their prescriptions updated, ensuring that they become cash cows for the hospital.
In contrast, Essy charges next to nothing to participate in his program, has detailed the entire program in a book that you can buy online for around A$20, and explains how the program works in numerous videos that you can watch for free on Youtube. People who stick strictly to the program are virtually heart-attack-proof, as he has documented in the long-term follow-up studies that he has published, so they have no need to come back to the Cleveland Clinic, or to Essy personally, for any more treatment.
Follow the money, folks. Treating people with surgery, stenting and medication keeps them sick patients for the rest of their lives, which is highly lucrative; while teaching them how to take charge of their health gets them off the medical merry-go-round, saving loads of taxpayers dollars as well as their out-of-pocket costs.