Thanks, I understand.

I’m reposting as my comment vanished. Hope it’s not a double post.

Looks to me like they’re seeking PCP status with federal programs, such as Medicare, Medicaid, active duty military, Tricare, Champus, National Health Service Corps.

The Health Care Safety Net Improvement Act passed a few years ago, includes chiropractors in the National Health Service Corps’ student loan reimbursement program.

There’s a bill now for expanding the National Health Service for primary care. No mention of chiropractors specifically that I saw.

I thought DCs and NDs were already allowed, by license, to act (and, I do mean “act”) as PCPs.

According to this item in DC http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53668 And, I thought NDs in Washington wanted limited prescribing privileges in accordance with their practice as PCPs.

Ah, Newspeak. Calling something “tradition” does not make it so.

There’s nothing in the post-Flexner American medical tradition that has anything to do with Ayurveda. And I suspect that Ayurveda at our modern medical schools shares about as many similarities to subcontinental Ayurveda as a New Hampshire taco shares with food south of the boarder.

Ann Schwentker, Editor and Laura Vovan, Contributing Writer, do not declare their institutional affiliations. This annoys me. I shouldn’t have to Google to find out whether these people are students, MDs, or cult members.

Med students should learn about alt med sects, just as they should learn about parasites. So I don’t object to an overview of what’s out there, even from a credulous promoter. However, woo promotional materials really ought not bear the stamp of a medical society.

Did the Scientologists buy AMSA like they bought CAN?

http://scienceblogs.com/insolence/2008/03/summer_school_for_woo.php

Also, if you think that page on naturopathy was something, read this:

http://www.amsa.org/pdf/comptherapies.pdf

Wow. Just… wow.

Look at the political stuff this organization wants med students to support: anti BigPharma, pro expansion of primary care (code for inclusion of chiropracters and naturopaths as PCPs).

Holy fark!

Reminds me of when Scientology bought the Cult Awareness Network.

We gotta wake the kids up somewhow.

Despite the disparity in their views, they all nodded in agreement with each other.

Frenemies!

Your observation reminds me of Bob Park’s report (in “Voodoo Science” Oxford, 2000) on a 1995 Press conference held in the US Senate office building. There were brief statements by AM proponents concerning what problem each thought was the biggest challenge for health care. Each had his/her own pet notion, as different as “magnesium deficiency” and the need for increased availability of acupuncture. Despite the disparity in their views, they all nodded in agreement with each other.

I suspect that some specialists sometimes don’t understand or appreciate the challenges that GPs face in terms of keeping up to date with ALL of medical research (not just the research in one specialty) and their paperwork. If we think about it for a minute, I suspect we all recognize that general practice in medicine is a very different thing that being a specialist who works in a hospital (with the staff and educational support associated with working for an institution) and who is dealing with people who have been sent to see them specifically (there’s already been a narrowing of diagnostic/treatment focus). As always, being an academic is very different than working in the field too (theory vs practice – they inform each other but can be pretty divergent when real life intercedes).

However, it appears that specialists can also believe. In 2007 we had this MD visit to lecture on homeopathy, with an emphasis on its use in treating otitis media: http://www.healthandhealingny.org/center/staff_gereau.asp
Certified in Reiki, too. I have not yet found a CAM advocate on campus whose enthusiasm is limited to just one controversial modality.

half the time I dont know what the patient has and of those who I do diagnose, often there are only a smattering of published cases to help guide therapy. Then there are the fatigue states and the chronic lyme, and Morgellons and and and

sometimes all I have is an honest I don’t know

It is the job of specialist to be ignorant with style.

You will find that this blog has a specialist/academic slant. Of the contributors it is possible that only Harriet hase had enough experience of everyday general practice to appreciate the frequency with which EBM does not throw up any obvious treatment option for patients requesting our help. Should we be trying so hard to deny patients any small comforts they may derive from “pretend treatments” and how much does it really matter, so long as they are also getting efficacious treatments when it really matters?

Perhaps you’d like to speak with Peter Lipson about the problems of applying science-based medicine in a private practice primary care environment, then, and the supposed lack of representation of general practice on this blog. He is a busy practicing internist and is not an academician, although he is affiliated with a large teaching hospital.

It should not be necessary to lie to patients (see Harriet’s views), and in any case offering a patient the option of a harmless placebo medicine is arguably a better approach to the strong, perceived “need to prescribe” that some patients provoke, than the misuse of potentially more risky pharmacologically active agents such as antidepressants, NSAIDs and antibiotics for minor complaints.

I suspect most general practitioners and some specialists are kidding themselves in this way when they claim they don’t use placebos and/or some not well-proved treatments. Misuse of unnecessarily powerful pharmaceuticals is the worst of all worlds, doing actual harm, as well as reinforcing certain unfavorable perceptions of our profession.

You will find that this blog has a specialist/academic slant. Of the contributors it is possible that only Harriet hase had enough experience of everyday general practice to appreciate the frequency with which EBM does not throw up any obvious treatment option for patients requesting our help. Should we be trying so hard to deny patients any small comforts they may derive from “pretend treatments” and how much does it really matter, so long as they are also getting efficacious treatments when it really matters?

I am sure this a major reason why many doctors turn to CAM.

Hence the recently reported outrage by Harvard students who discovered industry connections among their pharm profs.

LOL. How did the poor innocents imagine stuff was funded?

The person making a claim bears the burden of proof and the cost of proof. Those who develop new drugs and new devices do the science to prove those things are safe and effective. It’s back-breaking, consuming work that might take decades.

Anyone who imagines that a neutral party with no stake in the outcome ought to be doing drug development research needs to ride his trike around the block a couple more times.

The audience for these lectures is mostly first-year and second-year students. During the first two years of medical school (in my experience), most didactic encounters have no room for skepticism or critical analysis. By necessity this part of medical school is mostly about absorbing as much received wisdom as possible from trusted professors and textbooks. (Hence the recently reported outrage by Harvard students who discovered industry connections among their pharm profs.) I plan to write more about this in a future post.

Although my campus has an active student-led CAM group, they appear very supported by a handful of faculty. It’s the faculty participation that really bothers me, not so much the enthusiastic minority of students.

The advertising blitz is also disturbing, especially when it extends to the hospital cafeteria and pharmacy. How can our patients be expected to understand that homeopathy is (at best) controversial if the two-foot color poster presents it as perfectly valid?

As for the placebo question: I would love to have a discussion or debate about the appropriate use of placebos in medicine; there are very interesting ethical and professional issues involved. My problem with the CAM advocates, particularly the MD homeopaths, is that they simply ignore the debate by denying they use placebos! Perhaps placebo effects are stronger if the provider believes as well… For the sake of maintaining standards, however, we professionals need to be honest with each other, even if we decide that white lies to patients can sometimes be appropriate.

Be warned: it’s stupifying.

Ah, patients and URIs. I think many would come around if told that antibiotics cause more resistant critters in their own bodies, so best if we can get by without ‘em.