Apr 11 2009
Modern shamanism—naturopathy for hypertension
I’m a primary care physician. What I, other internists, pediatricians, and family medicine docs do is prevent and treat common diseases. When we get to diseases that require more specialized care, we refer to our specialist colleagues. There is a movement afoot to broaden the role of naturopaths to make them primary care doctors. The big difference between naturopaths and real primary care physicians (PCPs) is that naturopaths haven’t gone to medical school, completed a post-graduate residency program, and taken their specialty boards. Why is this important? If a naturopath wants to be a PCP, then they must provide the same services as other PCPs. They do not. What, you don’t believe me? The thing is, naturopaths have an incorrect understanding of human biology and do not understand how this is applied in a science-based fashion to prevent and treat human disease.
Naturopathic “physicians” claim that “the human body has an innate healing ability” and that they “teach their patients to use diet, exercise, lifestyle changes and cutting edge natural therapies to enhance their bodies’ ability to ward off and combat disease.”
I must admit that I don’t get it. As a primary care physician (the real kind) I talk to my patients every day about diet, exercise, and lifestyle changes. I’m not sure what “natural therapies” are—all of the medications that I prescribe are “natural”. What is the opposite of natural? Unnatural? Supernatural?
As a primary care physician, I see a lot of common, serious problems, like diabetes and hypertension, and coronary heart disease. Coronary heart disease (CHD) is the biggest killer of Americans, and hypertension (high blood pressure) and diabetes are two of the primary causes of CHD. The next most common killer of Americans is cancer. If naturopaths want to be allowed to practice primary care medicine, they better be prepared to diagnose and treat these conditions in a way that is proven to help patients.
Let’s take a look at the website of their main professional organization, and see what they recommend for, for instance, hypertension. I’m choosing hypertension because their website doesn’t have a section on diabetes or on disease prevention.
First I’ll tell you a little bit about how doctors approach hypertension. High blood pressure leads to heart attacks, strokes, kidney failure, and blindness. Untreated hypertension is one of the biggest health problems in North America. Because hypertension is so common and has so many disabling and deadly consequences, it has been studied quite well. We have learned over the years which type of patients benefit from which blood pressure goals and from which interventions. For example, the ALLHAT trial was released a few years ago. This study followed tens of thousands of people with hypertension and found that a simple and inexpensive intervention (a thiazide-type diuretic pill) was very effective at preventing serious coronary heart disease.
When I tell a patient that they should start a blood pressure medication, they are often hesitant. They often ask if there is another way to lower blood pressure. This has been studied as well. For example the DASH diet has been found to lower blood pressure significantly (from about 4-7 mmHg for the systolic pressure). If I have a patient with mild hypertension, this may do it, if they can stick to the diet. However, most of my patients don’t have stage I hypertension (a systolic BP from 140-159), and even in those who do, the gains from following the DASH diet are minimal. If I get a patient to really stick to it, maybe I can get their BP from 158 down to 152. That’s not very good. Most practicing PCPs know that diet and exercise will achieve good blood pressure goals in a minority of patients. Still, when it’s safe, and the needed goals are modest, we recommend it as first line therapy, especially for pre-hypertension.
In summary, the evidence tells us that we must lower blood pressures to save lives, and that diet and exercise are good enough in a small percentage of patients. We screen for hypertension and its complications, and then prescribe diet, exercise, and/or medications to lower our patients’ risk of becoming ill.
What do naturopaths have to offer? It’s not clear to me from reading their literature how they approach screening, but let’s say they have identified a patient with hypertension.
The website of their national organization gives some good information about what hypertension is and why we should care. What it doesn’t do is explain how they will effectively treat it.
To treat hypertension, naturopaths might counsel patients on eating a healthier diet. Following the DASH (Dietary Approaches to Stop Hypertension) diet includes lowering sodium intake and eating nutrient-rich foods like fresh fruits and vegetables, low-fat dairy, and eating a diet rich in potassium, magnesium, calcium, and fiber. Again, prominent national studies have shown the DASH diet has been shown to be as effective as drugs at reducing blood pressure.
Well, real doctors make those same recommendations. The last sentence is simply false. DASH is not as effective as medication for many hypertensive patients. For some, sure, for others, not at all.
Supplements are also a low-cost and effective way to reduce high blood pressure. Natural diuretics, dandelion and parsley can be used to control blood pressure, although evidence suggests they must be taken in high doses to be effective, (Alternative Medicine Review, 2002). Increasing potassium consumption has shown to reduce the risk of stroke in patients with hypertension by 41 percent (Journal of the American Nutraceutical Association, Houston study, 2002).
Let’s review our goal here. Our goal is to treat hypertension in such a way as to reduce the risk of cardiovascular disease and death. This needs to be done in a way that is proven to work, and is tolerable to the patient. Here, rather than recommend medications that have been proven in large, randomized controlled trials to not only lower blood pressure to to actually achieve these goals, they recommend “natural diruetics”. I also reviewed the article that is (barely) cited. The article is a review of hypertension and the naturopathic approach to its treatment. It is frankly quite frightening. It reviews the biology, and then makes fantastical claims. For example, it ironically compares various nutrients in their ability to “mimic” various classes of blood pressure medication. Then, rather than comparing the efficacy of the supplement to the known efficacy of the drug, it simply recommends using the supplement. If a real doctor did this it would be called “malpractice”.
I can find no naturopathic references that explain what the “doctor” should do when the unproven concoctions fail to control blood pressure. Does this mean that their potions work on everyone, that they have no failures? More likely, they have nothing to offer. Perhaps the good ones refer to a real doctor at this point.
This brings up an important question. If a naturopath wants to be a primary care physician, and yet must refer patients to a real doctor for common problems, what’s the point? A PCP must be able to effectively treat common conditions such as diabetes and hypertension. If they can’t, they’re in the wrong field.
There is no justification for allowing naturopaths to be primary care physicians, and if what they print is accurate, there is no justification for them to treat any patient for any condition. Naturopathy is modern shamanism, and should be banned.
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230 Responses to “Modern shamanism—naturopathy for hypertension”
“Natural” is a philosophical claim. It means, as far as I can tell, minimally altered by industrial processes, based on the notion/feeling that industrial processes are the source of modern illness.
There is some validity to that claim in the big picture but what they can do about it in the “little” picture is the question.
The NDs are busy performing a valuable procedure called a wallectomy.
“If a naturopath wants to be a primary care physician, and yet must refer patients to a real doctor for common problems, what’s the point?”
No kidding. Someone recently posted a great link demonstrating that chiropractors want to wear this same “primary care” hat. Some of the services chiropractic already claims to offer I find rather Kafkaesque. A quick Googling reveals a number of chiropractic clinics who have hung out their shingle with some variation of the name “primary care” on it.
Pinch me, but there seems to be an evolution of tactics of nomenclature surfacing from alt-med, making me wonder what grand hubris is in store for us next.
I think naturopaths and other “alternative” practitioners and their clienteles have (and give) the impression that these guys use methods that, for reasons that have entirely to do with differences in personal and professional culture, allopathic docs don’t know or have access to.
However, the pattern that I keep seeing is, if a method looks like a CAM, walks like a CAM and quacks like a CAM, but still shows a significant benefit in a well-designed study, the allopaths take it to their nerdy bosoms, which should (theoretically) extract all the alternativeness right out of it.
“Stop eating so much crap and try to get some exercise” sounds like a naturopathic prescription (and also like my mom), but MD clinicians say that sort of thing every day (as you point out). The efficacy of niacin for blood lipids has all the earmarks of a CAM–cheap, over-the-counter, practically a home remedy–but no, the NHLBI did the research there (and also found out that it works even better if you add a statin). (1) It’ll take some work to convince people that naturopaths and their ilk basically have the same therapeutic chops as, say, Grandma.
Basically, the alleged advantages of naturopathy are based on a put-down: MDs, (presumably) are squares, (2) much too brainiac to appreciate Nature in All Her Wise Simplicity. This appeals to the kind of people whose idea of a scientist is Lex Luthor. But there are a lot of those around too.
(1) There’s been a lot of NCCAM-bashing in this blog, but they do have it tough; any off-the-wall therapy that actually works gets investigated by the relevant Institute; NCCAM gets stuck with all the dogs.)
(2) Not you.
A thought that has been running through my head recently is the idea of “holistic” treatments. To be “holistic”, a treatment has to treat the “whole” individual. That means treating the physiology too. CAM practitioners don’t have a clue as to the physiology of humans. They may understand patient psychology (or maybe not), but treating only the psychology of patients with placebos is not treating the whole patient.
Even if “energy therapy” was something real, treating someone only with energy therapy is not treating the “whole” person. People have material bodies too, and if one doesn’t have the knowledge or doesn’t do the tests to find out how to treat those material bodies, one cannot be doing “holistic” treatment.
Dang it. I thought ‘holistic’ meant you treat the hole in the middle of the person. You give medications and exercises that affect the alimentary canal.
Great post, and very timely. British Columbia just yesterday expanded the roles of naturopathic ‘doctors’ to prescribe meds.
http://www.cbc.ca/canada/british-columbia/story/2009/04/10/bc-naturopaths.html
The same legislation also permits midwives to treat labour pain with acupuncture. All very troubling, and batshit crazy…
[...] Here is a tidy article that discusses the role of naturopaths as primary care physicians. (Science based medicine) [...]
I think that this article by an MD-turned-IMist actually kind of explains the mentality (bold mine, hope I’m not quoting too much):
Leaving aside the empirical claims which I see are well-discussed on this blog, the bolded segments I think reflect the mindset of IM supporters. Phrases like “symptom after symptom”, “wisdom of the body”, and the “word Soul.” “HEALING.”
Ah, the IM docs are Jedi Knights.
Fantasyland is a nice place to visit but I wouldn’t want to live there. It always seems like fun and games… until someone loses a clitoris.
When you leave science behind, you’ve no rational argument against candles in your ears, clitorectomies, or human sacrifice.
The Farce is strong with you, Dr. Benway.
DrBenway:
This is not quite true. There is a bulwark in the IM philosophy against things like clitoridectomies—a general horror of altering the things we were born with to achieve some other result (and the concomitant belief that medicine is too free with this). They would consider clitoridectomies to be an extreme that is morally contiguous with mainstream medicine.
This general horror has a deep philosophical roots, some of which are defensible moral positions. The application of sound science has not always been morally guided, and examples of this are painfully obvious around us. The fallacy they entertain is to connect this to the epistemological standpoint of science, which some blame for creating a culture of destructive knowledge.
In other words, alternative medicine in its most sincere incarnation is actually a facet of the search for an alternative epistemology, under the belief that scientific epistemology is insufficiently protected against abuse. Truth and methods of truth-finding are seen as non-neutral and re-perceivable in a better moral framework.
I wonder what epistemology is sufficiently protected against abuse? How is it possible to know it non-scientifically? Merely believing it is enough?
Meanwhile, back on early in 2009, where modern day medicine uses the best of scientific knowledge to deal with ‘the thing itself’…
a) ‘Allopathy’ has been bandied about a lot in the comments, and I’d just like to emphasize that modern medicine isn’t allopathy, and labeling it so is incorrect.
To label it [falsely] so is quite a win for the health sectarians — after all, allopathy is a term originating from homeopathy, that wacko belief system which gives sick people empty remedies and calls it medicinal.
It is how they fallaciously attempt to level the playing field: such sectarian posturings are basically arguing for knowledge relativism and blending / conflation, but [and I'm not punning]:
we don’t call Einstein’s accomplishments in physics “Jewish physics” and we don’t call modern geography ’spheroidism’ [in terms of acknowledging the earth being roundish].
The labeling of modern medicine as based on allopathic belief is the same sort of error / strategy that creationists perpetrate when they say that evolution is ‘just a theory’: the claim is that other ideas are equal in status — since all are supposed [when not all of such type].
b) ______-pathy in healthcare is most often a BELIEF SYSTEM: suffering due to ______.
Etymologically, because this is a post about naturopathy, I must point out the great ‘blending’ thing that is their essence, per the term naturopathy, at its core coincidentally:
-path is Greek, natur- is Latin. It is exceptionally rare that Greco-Roman terms are hybrid: either the classical representation is all Latin, or all Greek in science, law, medicine, and technology.
Somebody correct me if I’m wrong, because I’m not a classicist.
Paralleling this in terms of language, I’m quite sure — having lived it — that naturopathy ‘in action’ is a hybridization of science and belief.
You can’t make this stuff up!
c) AND, I cannot see how modern medicine is a belief system, overall — it may be more scientific in some matters than others, but I don’t see how this ND fabrication of ‘MDs only treat the symptoms and not the underlying cause’ [per naturopathic claim] is true.
But, keep in mind, their underlying cause is imaginary, strongly believed to be TRUE: that a ‘purposeful life spirit’ is in charge of physiology, per naturopathic doctrine. That giest is their central precept.
That is, boil it all down, their underlying cause. Be careful that they don’t disguise that fact, as they often do, and pretend to be experts in physiology.
They seek to be physicians, but they are METAphysicians [per metaphysicalisms like their sectarian beliefs].
-r.c. [wow, a comment without links]
[that's earth, not 'early]!!!
And one last thing, a question:
who’s up for NDs getting to call themselves primary care metaphysicians?
There’s another term for that…
shaman – so, PCMP aka shaman.
And they’d get to where some kind unique of ministerial uniform:
priests, nuns & such got black nailed down,
Jedi Knight’s got their light saber and flowing ocher-brown robes,
perhaps an appearance, and I’m not kidding because ‘green is all good, and lifely’, like the Green Knight
http://cchs.shcsc.k12.in.us/academic/HONORS12/project/gawain.htm
who is a hybrid of wilderness and humanity.
And, like naturopathic competence regarding medicine……….a figment.
-r.c.
[that's wear not 'where]
I think the NDs and homeopaths really think they are still living in the 19th century when allopathy was still around. Nowadays allopathy clearly belongs to CAM just like them.
Regarding the statement above that naturopaths are in some instances obtaining prescription authority, here’s a (heavily loaded) question and economic analysis for the crowd:
Question: Given that the ostensible goal of this blog and movement is to establish the use of scientifically proven treatments contra “alternative” medicine, why not maximize penetration of these treatments by doing away with prescription requirements entirely?
Economic analysis: You wish to create a situation where “correct” behavior reinforces itself, where “good medicine” is used, and “bad medicine” abjured. It seems to me that maintaining a monopoly grant over the provision and rationing of medicine runs counter to this goal: ceteris paribus, a more available treatment (”leaves and twigs”) will be more frequently used than a less available treatment (”Dynamethahydropornazine, a blockbuster direct renin inhibitor from LillyGlaxoSmithPfizerZeneca!”), even if that less available treatment is substantially more effective.[1]
Suppose that I, Patient X, have a choice between L’n'T Medication N, and badass space-age medchem product P. I can actually *get* N for a reasonable price (say, $25/bottle of 30) at my local supermarket while I’m shopping, whereas obtaining P requires that I block out time for a trip to the doctor, explain my ailment, see if he agrees with me, pay the man ($100+ for an office visit, at least, not counting opportunity cost for lost time), and then go to the pharmacy, have the prescription filled, and pay for it (anywhere from $4-$150 for a month’s supply of whatever I’m getting). P loses on time, convenience, *and* cost, and this is very nearly always the case. It is far simpler to obtain N. I lose less if I try N and it fails to work (the rate of failure is beside the point; the placebo effect applies, if nothing else, and the effect itself *is* real). Why is it, from my perspective, more difficult to obtain the more effective P? This difficulty is invisible to medical practitioners – MDs have drug manufacturers dropping off cartons full of samples in their offices, RNs and techs get them from the MDs, nobody *within* this system suffers any inconvenience at all, nor scarcely ever real cost, in obtaining these goods. The rest of us do, however. Can anybody provide a good reason for why I shouldn’t be able to simply walk down the “Health Products” aisle of my local Kroger’s and pick up an attractive glossy cardboard box with Pantone-colored surrealistic outdoors scene silkscreened on the outside containing Dynamethahydropornazine (from LillyGlaxo…Zeneca!), with the option *if I so choose* to bounce this off the doctor and see if I really need it, or if I should really be using Pornamethahydrodynazine from AstraGlaxoWellcomeMerckDow instead? Can this be reasonably justified with a straight face?
[1] Psychic Prediction: Somebody’s going to trot out that tired, patronizing old “self-medication” canard and piously declare that it is the doctor’s duty to stand firm between the imbecilic patient and free access to medications on the theory that the idiot (sorry, “patient”) may give himself an owie with whatever he’s taking, as though that stops him in the first place, or as though it’s okay if the doctor gives him the owie instead. Just, um, don’t. Not in the mood. Try something different, please.
“psst! buddy! you want some beta-blockers? I got some right here, primo grade!”
-SD
There is a problem with SCAM as “Schroedinger’s Medicine.” In the end, all of the “alternative ways of knowing” still ultimately collapse their wave functions when someone does an unambiguous measurement: “is she still breathing?”
We’re left with a long trail of cancer quacks who died of cancer, atherosclerosis quacks who died of MIs and CVAs, acupuncturists who nonetheless ended up using opiates for pain control, etc.
The bottom line on “alternative ways of knowing” is that in the end, the reality check is going to go in for collection.
I find allopathy to be a pejorative term that attempts to make it sound like modern medicine incorporate some type of belief system. Creationists call scientists “evolutionists”, because they want it to appear that evolutionary biology is based on a belief set.
As for blood pressure, I have so many friends with everything from mild to very high hypertension, and they all believe with a bit more exercise, better food, and cutting out coffee (apparently, the bane of all evil) will lead to lower BP. I’ve pointed out the DASH studies too, knowing in my heart that there is little shot that they’ll actually keep to the diet, finally convincing them that if all goes well, they’ll cut their BP from 165 to 155, which will kill them fairly quickly. At that point they listen.
With the University of Google out there to educate them, everyone seems to miss the scientific facts, and move to the easier choice. They think that walking a mile will help (it will, but not enough). They think that take a few pills from GNC will help. It won’t. Everyone wants to take the easy way.
SD,
What you want is the patient to prescribe for himself? If so, I do have a canard for you that may apply. The doctor who treats himself has a fool for a patient.
weing,
Would you trust a doctor that draws conclusions not in evidence?
When did I say that I “wanted” anything? I seem to be having trouble finding the portion of my post in which I expressed a “want”.
I asked a question (”does this not seem counterproductive to you?”), made an observation about human behavior (”people prefer, ceteris paribus, to do easier things than harder things”), and suggested a cheap and easy remedy that enures to the benefit of science-based medicine (”remove the ‘prescription’ requirement for drug purchases, thereby making access to science-based treatments easier, thereby encouraging their acceptance”).
Note carefully that you are assuming a second fact not in evidence, as well: you are assuming that “unrestricted access to medications” == “self-prescription”. I gently suggest that while these two activities may overlap, neither can be credibly claimed to be a proper subset of the other, and furthermore, that this is entirely secondary to any conceivable point that you might be able to make. That it may be folly to treat yourself – a fact itself not in evidence, as this is not a statement of fact, but a pithy bon mot (who else is more motivated than you to get well?) – has absolutely nothing to do with whether or not it is a good idea for a prescription to be a prerequisite for access to treatments which are said to be critical, lifesaving, and superior to their alternatives.
If we are going to diverge from discussions of fact to discussions of inferred intent, we might profitably ask why my suggestion – at the risk of repeating myself, “dispensing with prescriptions and restoring the right of unrestricted access to medications” – is total anathema to the supermajority of MDs, to the extent that broaching the idea is met with incredulous laughter and fatuous mouthings (e.g. “the doctor who treats himself has a fool for a patient”). Should we have that discussion? I have plenty of really neat guesses as to why MDs don’t like that idea. Or would you prefer to stick to facts?
“choose… but choose wisely.”
-SD
A timely piece! I’m also PCP living in a place overrun with sCAM
Also, I can’t believe I had to find out about British Columbia’s enhanced privileges for Naturopaths and Midwives in this blog!
http://www.cbc.ca/canada/british-columbia/story/2009/04/10/bc-naturopaths.html
The Health Minister, George Abbott as much as admits the decision was based on surveys of what people wanted, not science. This is populism.
The government released this decision on Thursday, just before the long religious holiday weekend. Co-incidence? I don’t think so.
When the new privileges were first being offered as legislation, last December, (hmmm. Isn’t there some sort of religious holiday event then too?) it was announced after the close of Legislature and just before the long Christmas break. There was no warning, and no prior consultation with any of the physicians groups.
Again,a religious holiday, and again the Legislature is closed. This means there can be no Question Period, a time honoured parliamentary procedure where the government has to face the opposition (literally) on any topic.
Soon there will be a campaign underway for a provincial election, May 12. Other issues-the economy and the environment-will be getting all the attention.
Government employees of course, get BOTH Friday and Monday off, so there’s nobody available until Tuesday to take calls. That’s 4 days for people to forget about it, and then the campaigning starts.
I’ve sent Mr Abbott an angry email, which I’ve copied to JREF, so hopefully they may run with it and publicize this travesty to a wider audience.
SD,
I take that to mean that you didn’t like my old canard.
Why do you equate a taking a medication with science based medicine? Just because a medication was produced using the tools of science? If you think that it’s all there is to science based medicine, then be careful what you wish for.
[...] section of this blog post for more commentary. Apparently “evidence-based medicine” is not honored in the US or in South [...]
Michael’s Insight wrote: “They think that walking a mile will help (it will, but not enough). They think that take a few pills from GNC will help. It won’t. Everyone wants to take the easy way.”
Actually those are NOT the easier way. Easier way is to take science-based medicine to really lower your BP to a healthy level.
Not so easy (but, oh so empowering) is special trip to GNC to pay OOP for what is likely to be an onerous schedule of several different supplement pills several times a day. Not “a few pills from GNC” because many different “systems” need to be “enhanced” or “supported” or “boosted” or “balanced” and the supplements are natural, blah blah. Lots of bottles. All OOP.
And if you are one of those at the edge of woo, the “can’t hurt, might help” conventional wisdom masses, beware. The “few pills from GNC won’t work even as a placebo because part of Big SCAM’s marketing is that more is always better, and if you don’t do as much as possible, you are shortchanging yourself. In other words, you can buy ALL the woo, but when you sicken it will be your fault anyway. You didn’t take the right dose, you didn’t use all the adjunct therapies, you didn’t have faith, you only ran 4 miles a day, you ate meat, you didn’t eat meat, not enough red brocade in your prosperity corner…and so on.
(If you want to walk some more, nice. Do it for pleasure, not puritanism.)
SD,
Are there any modern examples (i.e., since the advent scientific medicine, not in the era of “allopathy”) of such an unregulated or lightly regulated health care market as you imagine? I can appreciate in theory that markets are efficient, but I’m nervous about the human costs of that efficiency.
In any event, I do sympathize with your arguments about the possibly overlooked costs to a patient of seeking SBM-quality care. I also agree with skeptyk that CAM-style advice can be even more costly, though it has better marketing. Here’s an interesting take on the costs of preventative care from an economist who does cost-effectiveness analysis: http://nchc.org/documents/nchc_report.pdf
There sure was, right here in the USA! Before the creation of the Food and Drug Administration, there was essentially no regulation of drugs. Patent medicine sellers could basically sell whatever they wanted and make whatever claims they could get away with. Quackery was rampant and legal.
SD ponders the idea of letting patients self-prescribe what are now prescription medications. An interesting proposition…..
The only problem I can see is this. How will the patient – who we must assume is as medically ignorant as the average citizen, know which of the myriad drugs to take?
Now, you can argue that with all of the pharmaceutical advertising on the telly these days, the “average consumer” will have the knowledge they need. Once untied from their dependence on physicians (and naturopaths, in many states and provinces), pharmaceutical companies will no doubt flood the media with advertising aimed at helping the consumer make a reasoned choice.
Just like the automobile companies.
Of course, that presumes that the consumers know what their medical problems actually are and that they aren’t mistaking angina pectoris for esophageal reflux (Zantac will do nothing to help cardiac ischemia). But I’m sure that a simple sort of Wikipedia will manage that (”If the pain radiates [see: pain, radiating] into your jaw or left arm, it may be a sign of cardiac ischemia [see: ischemia].”)
In Mexico, when I last visited, it was possible for non-physicians (i.e. average folks) to purchase a wide variety of pharmaceuticals without a prescription. The exceptions, as I recall, were narcotics and stimulants. But anybody could walk into the Pharmacia and buy antibiotics, statins, even injectible drugs that are available only in hospitals or doctors’ offices here in the US.
This pharmaceutical egalitarianism had some “interesting” effects. Not the least were the higher rates of antibiotic resistance seen in community-acquired bacterial infections. Another “interesting” effect was the large number of renal failure cases from using aminoglycoside antibiotics without proper monitoring. I’m sure there were other “interesting” findings that I was not privy to.
But the most interesting part of this discussion is the part that – until now – hasn’t occurred.
Why would naturopaths want the privilege to prescribe nasty artificial “drugs”, anyway? If their leaf-n-twig juju is so strong, why do they need to prescribe real pharmaceuticals?
Could it be that they realize – under their bluff and bluster about “natural” this and “holistic” that – that their leaves and twigs don’t do squat?
Or, could it be that they’ve come to the realization that the few “natural” remedies that do work are more toxic and less effective than the “un-natural” (?) and “artificial” remedies that real doctors use?
Finally, since the naturopathy curriculum doesn’t include anything even remotely similar to the degree of pharmacology that the average medical student has to learn, why do lawmakers (and, for that matter, the naturopaths, themselves) think that naturopaths are capable of safely (let alone effectively) prescribing real drugs?
Prometheus
You know, it’s interesting. For a blog full of doctors – ostensibly trained in logical thought, doubly expected due to the nature of the blog – there appears to be an appalling lack of reading comprehension and/or lack of critical analysis.
When did I say anything about an “unregulated” health-care market, Mr. Krieder? Cde. Gorski? I’m quite sure that neither that word nor that concept passed through my fingers. You can reread my posts above to verify that (spoiler: it isn’t there).
For people who bloviate at length about the virtue of seeing what’s really there, you appear to avoid doing so when the answer is not to your liking. I suggest some careful self-examination about why precisely that is.
I proposed no such “madness” – as such it would no doubt be styled – as obstructing the role of the FDA in “regulating” drugs. (That would be a different post.) That you suggest this as an endpoint is a twisting of the actual question. The question, again, was: “If your desideratum is increased use of science-based treatments, then why not ensure that those treatments are easier to obtain, by supporting the removal of the artificial added costs of prescription and other obstructions standing between patient and treatment?” In other words, “Why the hell should I *have* to see a doctor to obtain a prescription for something? Why can’t I just buy it?” This says nothing about the FDA or other agencies controlling purity, quality, or efficacy.
I defy you to refute the idea that the added costs (financial and opportunity) of obtaining prescription medication – again, I stress, a problem that doctors and other medical practitioners *do not generally have*, being immune to it by circumstance and their position within the health-care system – do not deter ordinary patients from seeking other treatments, regardless of how efficient those treatments are.
Can you answer those questions? (I already know these answers – most of the crowd does, actually, whether they want to admit it or not – but I would be extremely gratified to hear them verbalized, because, well, it’d be funny.)
“heads, I win…”
-SD
Well, the quest is really to increase the importance of science-based medicine, and encourage its dominance in medical thinking and practice. It’s not just “increased use”. Your argument is going the way of “well, if you want to increase the use of steel frames in buildings, why not simply make steel girders more widely available?”
This begs a number of questions. Is there really an “artificial added cost of prescription”? Is that what stands in the way of SBM?
No.
What stands in the way is infiltration of non-SBM. The reason drugs are prescribed is not so that non-SBM practioners are limited, nor is it to add costs. It is to keep biologically active, potent, and potentially dangerous chemicals from being improperly used by people who are untrained in the necessary profession, medicine.
My bad if I put words in your mouth, but to this economic layperson:
“doing away with prescription requirements entirely” = “lightly regulated health care market”
I was honestly curious about your position, not hostile.
No, Tim, I’m fairly certain he’s using a rhetorical device whereby he lures you into making a logical assumption that he can then deny, and then castigate you for being such an idiot. It’s a pretty sadistic and nasty type of discussion.
Gee, SD – I thought I did answer your question. Was my delivery too subtle? Or was it that I didn’t provide the answer you wanted?
Let me see if I can boil it down to a few bullet points, so that you won’t accue me of “bloviating”:
[1] The “average person” isn’t educated, trained or experienced enough to know what their symptoms mean, in terms of a diagnosis. Nor are they able to accurately diagnose their friends or family members.
[2] Without an accurate diagnosis, it is very unlikely that the “average person” could choose the correct medication.
[3] Even with an accurate diagnosis, the “average person” won’t know which medication – if any – is appropriate. They would be at the mercy of “Wikipharmacopeia” and drug company advertisements to guide their decision.
As it turns out, the “artificial added cost of prescription” are not artificial, added or cost. A physician takes a history, does an examination, makes a diagnosis and prescribes treatment. This is a “holistic” process that cannot be “deconstructed” into its parts.
The “cost” is the same whether they write a prescription or not. If you doubt that, refuse the prescription at your next visit and see if that lowers your bill.
I have to wonder why you would want to self-diagnose and self-prescribe unless you feel that the physicians’ skill are over-rated. If so, try your hand at it for a while. Let us know how you do.
Prometheus
Thank you for your clarification and making it clear that you’re not against a lack of FDA regulation; rather you’re against the government determining what drugs do and do not require a prescription. Of course, in practice yours is a distinction without a significant difference.
You’re just playing rhetorical tricks.
That’s exactly what SD’s doing.
I’ve been blogging for over four years now and before that I was a regular on Usenet for five or six years. I’ve seen it before numerous times.
“SD ponders the idea of letting patients self-prescribe what are now prescription medications. An interesting proposition…..”
Quite.
“The only problem I can see is this. How will the patient – who we must assume is as medically ignorant as the average citizen, know which of the myriad drugs to take?”
Who knows? For that matter, who cares? Maybe the patient is a doctor with a license violation. Maybe she’s a librarian, perhaps a savant. Maybe he – gasp, horror – *actually went to the doctor anyway* to find out what was wrong. Nothing in my question suggested that this could not happen, only that it doesn’t *have* to happen. How the patient selects the treatment is irrelevant to the question.
“Now, you can argue that with all of the pharmaceutical advertising on the telly these days, the “average consumer” will have the knowledge they need. Once untied from their dependence on physicians (and naturopaths, in many states and provinces), pharmaceutical companies will no doubt flood the media with advertising aimed at helping the consumer make a reasoned choice.”
… And selfless doctors like you will make blog posts in your spare time describing in which general cases particular treatments are appropriate (always with the caveat, “GO SEE YOUR DOCTOR”, in big bold letters on top). Perhaps there will be a Wikiesque phenomenon, where patients can click and see basic globally-assembled information about the drugs in plain language, when they can probably be used safely, when they should be buttressed by diagnostic tests (and which tests), perhaps which specialist consults are required to effectively use them…
Provocative observation: In the age of the Internet, a reasonably intelligent and moderately-educated layman with access to Google knows as much about what a given drug will do as most non-specialist physicians.
“Just like the automobile companies.”
Cute, and nice try at a cheap shot, but completely irrelevant. Also, incoherent. What do the automobile companies have to do with anything? Are you suggesting that consumers have “improperly” purchased automobiles? (Next question: “Which ones *should* they have purchased?”) Are you suggesting that the automobile companies bought things under the influence of media advertising? (Next question: “Are you all fucked up on little pills right now?”)
This bears the stigmata of a thought-terminating cliche, a soundbite that you hope will score some kind of telling point without actually saying anything meaningful. I prefer meaningful conversation. Stick to the point, please.
“Of course, that presumes that the consumers know what their medical problems actually are and that they aren’t mistaking angina pectoris for esophageal reflux (Zantac will do nothing to help cardiac ischemia). But I’m sure that a simple sort of Wikipedia will manage that (”If the pain radiates [see: pain, radiating] into your jaw or left arm, it may be a sign of cardiac ischemia [see: ischemia].”)”
There is a fallacy embedded in the questions I’m being asked, and that is the fallacy of equivalence; the assumption is that Joe Blow will act the same way for, e.g., chest pain or general malaise as for a snot-filled head or hypertension.
Now, frankly, even in the presence of an all-night all-you-can-buy pharmacy stocking everything from nitroglycerin to carbamazepine on the shelves with convenient self-checkout kiosks in the front, most patients confronted with crushing chest pain aren’t going to self-diagnose a heart attack and go to the pharmacy to get some nitro, because they’ll be too busy panicking and calling the ambulance. The idea that critical emergency situations will be affected by Freedom of Purchase (abbreviated FoP for short) is, um, laughable.
Next up: non-critical acute situations. Here we’d have angina, say, or REALLY bad heartburn. Assuming that you’re dealing with someone who doesn’t know the difference between heartburn and angina, he’ll probably find out in short order when the Zantac doesn’t do anything. Could this lead to a bad end? Yes, if we are assuming that the angina, after ineffective treatment with Zantac, is immediately followed by a massive MI, as opposed to the patient going “Well, that didn’t work”, and trying something else. That *could* happen. Question: How many “what-ifs” are we prepared to base policy on?
Antibiotic resistance may be a sticking point, of course. I would say that we need significantly better fact-based justification than the possibility of increased future antibiotic resistance to justify the continued difficulty of access to science-based treatments, however. I also remind you that resistance applies to antibiotics, not all medications.
Next up: critical chronic conditions. Let’s say, arguendo, that we were going full-bore, and that *everything* was available on the shelves. I gently suggest that the idea that someone is going to buy a half-dozen badass chemotherapy agents – oh, hell, let’s go for one of those nasty platinum salts, maybe cisplatin – and try a home-brew lymphoma cure even if they already knew they *had* lymphoma is, um, not plausible. The idea that someone would do so when they had no idea is, um, really not plausible. Yes, I’m sure there would be one, and it would be a tragic case. Outliers are not a good justification for establishment of rules, something which (as a scientist) you should appreciate.
So what do we have left? Non-critical chronic conditions. These are the usual ones, the bread-and-butter of modern medicine, the biggest bang for the buck (or so is the story told). The example used was hypertension, so let’s stick with that one for a moment.
Hypertension is something that *can* be self-diagnosed. I find a blood-pressure cuff, I look at the “recommended” reading ranges (up to 120/80), and pop it on my arm. Numbers greater than 120/80 indicate the likelihood of a problem unless there’s a good reason for them. Numbers greater than that for an extended period of time indicate a problem that needs to be fixed. I don’t think there’s anybody who’s not a Mongoloid or coma patient in the US that hasn’t gotten that message: “HIGH BLOOD PRESSURE KILLS, AND IT KILLS IN NASTY WAYS.”
So how do we deal with an epidemic of high blood pressure?
At present, I need at least two doctor’s office visits (initial visit + 24-hour BP monitor + followup), *and* a prescription, just to get the treatment. In order to continue it, I need continuing visits essentially forever (recurring followups being the price for prescription renewals), whether or not those visits have any probative value for my treatment. I could spend fifty bucks on a decent automatic BP cuff and know – with the same certainty as the doctor – whether or not the medications are doing the job, or if they needed to be changed or augmented. I could change my dosages myself (I can sort-of do this now, but only with difficulty); I could add or subtract medications myself. Further, I could do so in ways that I will assert are materially identical to the ways in which an MD would change my treatment (”X doesn’t work, increase X; if it still doesn’t work, add Y; u.s.w.”) What’s more, anybody could do these things, and for significantly less expense and inconvenience than is now required.
However, as it stands now, we *cannot* do this. The doctor serves as gate-guard for this treatment, and he demands recurring payment for what is styled the privilege of doing business with the companies that make what are purportedly the only effective treatments for whatever ails you, and the vig for that access is eye-poppingly huge. All this is ostensibly for my own good and worlds better than all other arrangements, assertions of which I remain dubious, as they appear to enure only to the benefit of select others, and not to me or the general public in any non-risible way. The solution to the “problem” of competing treatments offered here is – with all pretense and euphemism ripped away – “Shoot the providers of those competing treatments in the neck”, broadly speaking. I suggest that there may be a better and more civilized way of accomplishing the same goal, albeit a slightly less (ahem) personally lucrative one. And so, I ask: Why *not* support the free sale of science-based treatments?
There are greyish areas here, of course – antibiotics form one such area, psychiatric medications another. (That last may not, however; patient compliance is a major issue with a wide variety of medications, innit?)
“In Mexico, when I last visited, it was possible for non-physicians (i.e. average folks) to purchase a wide variety of pharmaceuticals without a prescription. The exceptions, as I recall, were narcotics and stimulants. But anybody could walk into the Pharmacia and buy antibiotics, statins, even injectible drugs that are available only in hospitals or doctors’ offices here in the US.”
This pharmaceutical egalitarianism had some “interesting” effects. Not the least were the higher rates of antibiotic resistance seen in community-acquired bacterial infections.”
Hm.
I think, Prometheus, that I will ask for an actual study detailing this assertion, broad and nebulous as it is. Which antibiotics? Which bacteria? How much higher?
“Everybody knows” that antibiotic resistance is rampant in Mexico, of course. What I find when I look at the NHSN for 2008 and compare it to some results for UTIs in Mexico City is resistance to fluoroquinolones at ~25% in the US on average and ~32% in Mexico City, not exactly a smoking gun.
(Granted, this is not an ideal comparison – I have limited data to work with, and limited interest in the topic – but the notion that FQ resistance is a sort of apple-to-apple off-the-cuff comparison of resistance rates is not prima facie unreasonable.)
I will then also ask about its comparison in toto to antibiotic resistance seen in nosocomial and iatrogenic infections in the US. Using resistance allegedly generated by free access to antibiotics as an argument for restricting access to antibiotics does not make sense if the only thing it accomplishes is to “push” all the resistance generation from the home to the hospital without a significant change in resistance change rates, in that there is no qualitative difference in my dying of some loathsome disease whose origins were originally an ICU instead of a brownstone on Fifth Avenue.
In other words, while the topic is plausible, it is not a universal refutation, and needs much more evidence even to be a particular refutation of the principle of FoP applied to antibiotics.
“Another “interesting” effect was the large number of renal failure cases from using aminoglycoside antibiotics without proper monitoring. I’m sure there were other “interesting” findings that I was not privy to.”
Again, study? Or statistics? Differences between total renal failure rates in controlled aminoglycoside prescription regimes vs. free-access?
Asserting that you’re sure there were other findings does not mean that there were any.
Individual self-inflicted tragedies do not justify bad policy.
“ballroom blitz!”
-SD
SD,
When did you stop beating your wife?
“No, Tim, I’m fairly certain he’s using a rhetorical device whereby he lures you into making a logical assumption that he can then deny, and then castigate you for being such an idiot. It’s a pretty sadistic and nasty type of discussion.”
No, Peter, I’m not. I have not asked anybody to make any assumptions at all. What I have done is, again, *ask a question*, and moreover one that is in closed form and easily understandable. What I’m doing right now is using a rhetorical device to split the audience and to highlight a particularly loathsome type of avaricious hypocrisy.
Nobody – and I mean nobody – has brought forth anything even resembling a refutation of my main point, which is that cheaper and easier access to proven treatments (we will take this, for the time being, to be a synonym for “SBM” treatments), ceteris paribus, means greater adoption of those treatments. That’s because there is no such refutation, because that observation is irrefutable. It is an observed, immutable law; easier things happen more frequently than harder things. This principle stretches all the way from physics to psychology.
Can we accept this as true, then? Good.
I have highlighted one way in which SBM’s adoption may be increased with respect to CAM – make it easier to get to SBM. One major added cost to SBM is the requirement that one go through a “gatekeeper” to get it, even for something as simple as hypertension medication, something for which better access and use could purportedly save many lives. Economics lives on the margin: there do exist those whose hypertension remains untreated because the added cost (in time and money) to run that gauntlet exceeds their tolerance for that cost, with all known and believed future sequelae factored into that decision. “Yeah, I might go blind fifty years from now”, thinks the 30-year old construction worker, “but who fuckin’ cares? I can’t afford the $100 or the time off work to go see the doctor. Screw it.” Those costs keep those people from this treatment. From this smaller pool of people, there are some that will follow that thought by: “… but my wife says that this one Indian guy she reads on the Internet says that high blood pressure is caused by caffeine and bad juju, and that taking St. Juan’s Venereal Wart will drop my blood pressure, and it only costs $10 for a bottle. Screw it, I’ll give that a try instead. Might work.”
An honest SBM practitioner, observing this state of affairs, might commence a thought process that looks something like this: “Hypertension is bad. Even though it would be a better idea for this person to go see a doctor and get his treatment titrated to him personally, on the off chance that there’s something weird about him that would dictate the use of a different medication or combination than he would choose himself, the odds are pretty good that, given the types of medications available, he’ll be able to find something that works, especially if a few basic guidelines are published in unambiguous language that highlight Stupid Things To Not Do. This is an acceptable solution, *although it means that I will not personally reap the benefit of being in a gatekeeper/rent-seeker position, controlling access to treatments*. Perhaps I shall have to reduce my fees to encourage more people to seek me out before commencing treatment, since, ceteris paribus, *lower costs tend to increase demand for a good*. But that is a small price to pay to serve the purpose of Public Health. And it means that people will have less incentive to try bogus treatments, instead getting something that actually works.”
Do we hear this? Nope. What we do hear: “DESTROY OUR COMPETITORS!” This is proposed not through improvement of services or reduction of costs, i.e. by efficiency improvements, but by coercive fiat, i.e. concerted efforts to legislate those competitors out of existence. To say that this leaves a bad taste in the public mouth is to put it mildly, and to say that it does not optimally serve the public’s interest is a comedic masterpiece of wry understatement. The situation speaks for itself: given the choice between SBM treatments and CAM, the public chooses CAM, and in increasing numbers. Whether CAM is bullshit or not is irrelevant. The public can afford more attempts to get bullshit to work than it can afford to run the SBM gauntlet. This gets more true the more the economy contracts. A plan of action that involves squeezing the public harder by excluding competitors rather than by improvements of service is doomed to spectacular failure.
Of course such improvements of service by cutting unnecessary beak-dippings sounds like a bad idea to a doctor. It is a formula to reduce the prestige and income of a doctor from that of a CEO to that of an ordinary craftsman, more or less. As such, only a homeopathic percentage of doctors would acquiesce to such a plan. While this is not unexpected – I understand that my audience thinks that this is craziness! preposterous! inconceivable! – it amuses me to highlight this hypocrisy in the hopes that it dilutes further arguments from these sources and along these lines.
“looking for an honest man”
-SD
Govorit’ my old droogie Cde. Gorski:
“Thank you for your clarification and making it clear that you’re not against a lack of FDA regulation; rather you’re against the government determining what drugs do and do not require a prescription. Of course, in practice yours is a distinction without a significant difference.
You’re just playing rhetorical tricks.”
Christ’s wounds, how hard is this? Are you people educated, or not? I seem to recall reading something about that being a requirement for doctorhood, somewhere. Might have been on the Internet. I forget.
Is the “ready-fire-aim” principle a staple of medical curricula these days? Do you, on the basis of ten seconds’ glance at a patient, infer that he requires cardiac bypass surgery and slam him on the operating table? (Please don’t answer that.) Do you read all the tests, then ignore them and make a diagnosis based on what you think is really going on? (Again, now that I type that, please don’t answer it.)
I am asking a *question*. They are easily identifiable, owing to the squiggly mark at the end of the sentence, and their purpose is to invite the reader to answer them. Occasionally – as in this case, apparently – that invitation strives in vain and dies alone and unrequited, for want of companionship in the form of an answer. Questions are not statements. Questions are questions. Statements are statements. Learn the difference, please.
Again, I did not say that I am against the government determining what drugs do or do not require a prescription. Whether I am or not is, again, irrelevant. What is relevant is the question: “If you would like more SBM, why not make it easier to get to?” That question has an infinity of possible answers, which I am interested in hearing verbalized. If you are capable of so doing, I invite you to do so at your leisure.
I am playing rhetorical tricks – see the other message for details – but see no reason why that is an impediment to answering this question.
Provocative question: What studies exist to demonstrate favorable outcomes from the requirement of a doctor’s exam and prescription vs. free access to medications? One would assume that somebody has done a study to verify this article of (ahem) faith.
“groundhog day”
-SD
“Gee, SD – I thought I did answer your question. Was my delivery too subtle? Or was it that I didn’t provide the answer you wanted?”
No, you’re not subtle, and no, you are not answering the question. (I will refrain from restating the actual question, it’s available above.) What you are doing is answering a straw-question with straw-answers, which, while a curiously symmetric juxtaposition, does not provide much valuable insight.
“Let me see if I can boil it down to a few bullet points, so that you won’t accue me of “bloviating”:
[1] The “average person” isn’t educated, trained or experienced enough to know what their symptoms mean, in terms of a diagnosis. Nor are they able to accurately diagnose their friends or family members.”
‘Everybody is an idiot. Well, except me.’ Okay, got it.
“[2] Without an accurate diagnosis, it is very unlikely that the “average person” could choose the correct medication.”
Um, how many options do they have? Is there a forest of thousands of medications for each ailment, all of which are indistinguishable? Does only one of them work? Is this one of those “try-to-find-the-True-Grail” situations, where if I pick the One and Only Right Treatment, I live, but if I choose wrong I die a horrible, grisly, instant death?
Let’s go back to the primary example, hypertension. What classes of drugs are available to treat it? Not that many, I can count the big classes on one hand. Which ones are preferred within each class? Again, not that many. A reasonable pharmaceutical intervention treatment tree for hypertension could fit on an 8.5×11″ sheet of paper, with room for broad caveats (”diabetics should pick an ACE inhibitor”, that sort of thing) and dosing recommendations on the back. The manual for picking which drugs are good choices would be smaller than the one for picking which headlights go to which model car.
(Keep being obtuse, and I’ll pull out one of my favorite dirty tricks: the surprising success of relatively simple medical expert systems, and the differences in computing power between now and when those expert systems were developed.)
You’re assuming that someone’s going to try to treat their own disease with the average incidence and criticality of those featured on “House, MD”. I gently suggest that outliers of this type are not a good basis for policy. You are further suggesting that there is only one treatment that is effective (false), that there are too many to choose from (false), and that the patient’s odds of finding the right treatment in the sea of wrong treatments is astronomical (false), thereby meaning that the convergence time on the *right* treatment is somehow negatively impacted (arguable, probably false), all presumably with a really cool CGI “Nazis-opening-the-Ark-of-the-Covenant” mental movie of the failure-mode for choosing the wrong treatment or treatment(s). Yeah, uh, what happens in the real world: patient tries one or two treatments, and they either work (so the patient keeps doing it, indicating that the patient chose correctly; whether this is accidental or not is irrelevant, since I doubt that you’d argue that being treated properly by accident is a bad thing) or the patient gives up and stops (putting us back to the same place we were before – “patient not treated” – with some extra information about what didn’t work, meaning no net negative), or the patient goes to see the doctor with complaint and a list of stuff that didn’t work (a net positive, since the doctor now has information about what treatments didn’t work, presumably aiding diagnosis and future treatment).
Somebody who has a brain tumor gets headaches, which they treat first with aspirin. When aspirin doesn’t cure the headaches – i.e. when self-treatment fails to be effective – then they go to the doctor. Somebody who has a gaping wound in their leg puts gauze and Neosporin on it. When the wound turns green and starts oozing pus – i.e. when self-treatment fails to be effective – then they go to the doctor. Why is the patient assumed to be competent to self-treat in some cases, but not in others? What is the difference – moral or practical – in self-treatment in one instance, but not in another?
“[3] Even with an accurate diagnosis, the “average person” won’t know which medication – if any – is appropriate. They would be at the mercy of “Wikipharmacopeia” and drug company advertisements to guide their decision.”
WOOT!
BREAKING NEWS BREAKING NEWS BREAKING NEWS BREAKING NEWS BREAKING NEWS
PSYCHIC PHENOMENA VERIFIED AT SKEPTICS’ BLOG! FILM AT 11!
BREAKING NEWS BREAKING NEWS BREAKING NEWS BREAKING NEWS BREAKING NEWS
Recall the original post, ladies’n'gents:
“[1] Psychic Prediction: Somebody’s going to trot out that tired, patronizing old “self-medication” canard and piously declare that it is the doctor’s duty to stand firm between the imbecilic patient and free access to medications on the theory that the idiot (sorry, “patient”) may give himself an owie with whatever he’s taking, as though that stops him in the first place, or as though it’s okay if the doctor gives him the owie instead. Just, um, don’t. Not in the mood. Try something different, please.”
Damn. I am good. GOOD, I tell you. Nailed the tired part, the patronizing part, the part about how the patients are idiots… YES! Eat it, James Randi! I’m comin’ for that check, baby!
(Disclaimer for the irony-impaired: the above is tongue-in-cheek, and to be taken with a grain of salt, not that this will stop anybody from making some kind of jackass comment about it.)
(Second disclaimer: “irony-impaired” does not mean that you are anemic. There is no need to ask your doctor about it.)
Ahem.
Anyway.
Question: Exactly what’s wrong with Wikipharmacopoeia + drug-company adverts? Do you mean to tell me that this differs in any material way from the way treatments are selected now, except in the sense of who’s doing the selecting? Do you mean to tell me that trial and error isn’t a major part of treatment titration? Is there some magical doctor-juju without which the medication won’t work? Do you mean to tell me that it isn’t possible to develop a reasonable recommended universal treatment plan that is simple to apply and works in the majority of cases?
“As it turns out, the “artificial added cost of prescription” are not artificial, added or cost. A physician takes a history, does an examination, makes a diagnosis and prescribes treatment. This is a “holistic” process that cannot be “deconstructed” into its parts.”
Ohhhhhhhhh, okay. It’s *holistic* and *mysterious*. It’s *magic*. Laymen cannot be expected to understand it, or to draw basic, generic knowledge that can be understood easily and commonly applied, because each snowflake is *different*.
Well, that puts me in *my* place.
(Disclaimer for the irony-impaired: the above is not tongue-in-cheek, but a cryptic observation about similarities between Prometheus’ defense and a popular justification given by the Lords of Woo when questioned.)
(Second disclaimer: “irony-impaired” still does not mean that you are anemic.)
Question: What if I am reasonably sure that I have hypertension, being sufficiently numerate to read the numbers “160″ and “100″ on my WizBang BP WristCuff, and wish to skip participating in this “holistic” process and go straight to a personal (yes, N=1) trial of a treatment that is statistically demonstrated to be effective in most cases, like an ACE inhibitor or HCT?
Question: In how many instances would the outcome of a random choice from the current first-line treatments for hypertension differ substantially from the outcome of this doctor’s office visit in their outcome? An order-of-magnitude guess is reasonable.
Yes, the cost stated is artificial – the only reason the cost exists in the first place is a law which stipulates that FDA-approved medications may not be dispensed except by prescription.
Yes, this cost is added – it increases the total cost of my access (sigh, *again*, including *all* costs, to include actual dollar costs, opportunity costs [time spent at the doctor cannot be spent working, for example], &c.) to medication.
And yes, there are costs. Are you insane? Is a trip to the doctor “free”? On what planet?
(Christ. I feel like I’m dealing with Archimedes Plutonium here.)
“The “cost” is the same whether they write a prescription or not. If you doubt that, refuse the prescription at your next visit and see if that lowers your bill.”
Way to not understand the point, jackass.
The difference in cost described involves the difference between “just getting the drug” and “paying the doctor and spending the time so I can get a note from my mother[delete]doctor to give the pharmacist so that I can just get the drug”.
If you do not think that this cost drives people away from science-based treatment to alternative treatment, then you are a fool. If you think that raising the cost of alternative treatment by legislative fiat or increased regulatory pressure will encourage more people to seek science-based treatments, then you are an even bigger fool. This does not surprise me, of course, but it is a mitzvah to at least make an attempt to dissuade the fool from his folly, never mind that he returneth to it as a dog to its vomit…
“I have to wonder why you would want to self-diagnose and self-prescribe unless you feel that the physicians’ skill are over-rated. If so, try your hand at it for a while. Let us know how you do.
Again with the “want”. When did I say I “wanted” something?
“simple man, simple questions”
-SD
And here we see the Naked Truth, or some strategic parts of it, anyway:
“Well, the quest is really to increase the importance of science-based medicine, and encourage its dominance in medical thinking and practice. It’s not just “increased use”.”
Ah.
‘increase the importance…’
‘encourage its dominance…’
So, in short, you want to “win”, to crush your enemies and to see them driven before you, and to hear the lamentations of their women… Well, at least you’re honest. Do you admit any moral or practical limitations on the means and methods by which you can “win”, or is it “anything goes”?
“Your argument is going the way of “well, if you want to increase the use of steel frames in buildings, why not simply make steel girders more widely available?”
Er, no. There was no argument made, I stress. (God, that’s getting tiresome to say. Why, God? Why? Do they know not what they read?) The *question* – again, let me say that word again, *question* – rephrased as a construction or engineering question, would be more like “If you are worried about the use of Styrofoam and balsa-wood ‘alternative’ structural building materials in construction, then doesn’t it make it sense to avoid a requirement to get a consultation with a licensed architect just to *buy* steel structural building materials?”
“then why not ensure that those treatments are easier to obtain, by supporting the removal of the artificial added costs of prescription and other obstructions standing between patient and treatment?”
“This begs a number of questions. Is there really an “artificial added cost of prescription”?”
Uh, yes, there is. Barriers to trade impose both direct and opportunity costs. If they don’t, then there is absolutely no point to the legislation compelling those barriers. QED. Thanks for playing.
Another thing barriers to trade do: create large favored groups who profit directly from the maintenance of those barriers.
“Is that what stands in the way of SBM?
No.”
Well, it’s certainly one thing that doesn’t help, I’ll put it that way. In fact, it is one non-trivial component of the reason people *choose* CAM in the first place.
“What stands in the way is infiltration of non-SBM.”
Yes, those infiltrating enemies. From within. Like a Fifth Column, and stuff, like termites, eating at the foundations of the people’s progress, there must be a Solution to these subhuman vermin, sneaking in the dark, if only we have the will…
*shakes head* Oh. Sorry. Picked up an odd memetic harmonic, there. Infiltration, you say? (Yeah, that doesn’t sound paranoid or anything.) But even “infiltration” (*chuckle*, *snort*) doesn’t explain why people pick CAM in the first place. Nothing explains that, not even the usual self-stroking explanation, “Well, everybody’s just dumber than we are”, because single explanations don’t cut it, because there are a multitude of reasons why people choose to do things, not all of which are easy to describe in closed form. Without reservation, however, one can say that *one* reason why *some* people may choose CAM over SBM, and one reason that makes it *easier* for people to choose CAM over SBM, is that CAM, and particularly self-prescribed CAM, is easier, and in many cases cheaper, to get to.
“The reason drugs are prescribed is not so that non-SBM practioners are limited, nor is it to add costs.”
Yes, it’s all for the best of reasons, I’m sure. Did I *ask* “why”?
I can state with equal authority that the reason drugs are prescribed is to maintain a profitable monopoly for the benefit of the prescribers, which is called “rent-seeking” in the technical sense, or several colorful adjectives in layman’s terms. Again, do we want to talk about “why”? I assure you that my explanation is about a million times more believable, and more popular.
“It is to keep biologically active, potent, and potentially dangerous chemicals from being improperly used by people who are untrained in the necessary profession, medicine.”
I hate to tell you this, but untrained people use biologically active, potent, and potentially dangerous chemicals every day. Housewives have entire gas chambers’ worth of these things under the kitchen sink. Somehow, most people get through the day without dying.
(Christ, take a look at what some people use to prepare some exotic or ethnic foods sometime. Take one look at lutefisk. Okay, so this perhaps does not buttress my point that unrestricted access to dangerous chemicals is a good thing, but at least nobody usually immediately dies during a Lutefisk Experience, which is the important thing to take away from this.)
Your statement is not an argument, it is another thought-terminating blandishment, meant to evoke the idea that there are some things that only The Experts among us can and should dole out, and that it is right and proper to maintain this privilege in their hands and theirs alone, and to pay handsomely for it. Surprise: CAM has flanked you on this front, in a colossally amusing fashion, by correctly ascertaining that nobody believes this line of bullshit, because its utterer is statistically guaranteed to be a Bernie Madoff character using it to reel in a sucker for a good screwing. Until you realize how Madoffian some of your positions sound and remedy this state of affairs, you are doomed to proposing bad policies that at best can be forced on an unwilling public, later to invite backlash. (And one such backlash we are *already* seeing, in the current ascendancy of CAM after the quackhunts of the early 20th century.)
“say no to medical bailouts!”
-SD
SD,
Come on answer.
When did you stop having sex with sheep?
I have something to add for all of you who bash acupressure ect.
I had an issue not far back and no doc i went to was able to
help fix my problem.
I went to an asian healer and let him do some acupressure
on me and oddly enough it seemed to fix the problem.
I know some of you prolly think cause im not a doc or did
not go to med school its prolly the placebo effect, but all i can
say is im not suffering anymore with the problem i was having.
I am a person who is pretty well in tune with my body as well.
None of your meds worked, but yet this man was able to fix
me in a 20 minute session involving acupressure.
And whats even more funny is all he had to do was put a few
fingers in a few spots and he knew where i was hurting and
what my problem was.
Im not saying that these folks should be able to shell out
meds or anything like that but what i am saying is from what
i seen with my own 2 eyes there are some people who can
help using this method.
Thanks for all of your time!
weing,
“Stop”? Why would I stop having sex with sheep? I am unfamiliar with this concept.
Seriously, way to fanboi, there, weing. Way to lame-flail the opposition without actually doing all that hard work of, um, you know, “reading”.
Keep up the good work. You are an example to everyone on this blog.
“barbie sez, reading is *hard*!”
-SD
SD,
I was serious. You are one sick person. You have shown that you have difficulty reading. I never asked you to stop having sex with sheep. Where did you read such nonsense? Please read the question, if you can, and answer it.
weing,
I was serious too. Why would I stop having sex with a sheep? I am married to a sheep, sir, and resent the question about whether I ever stopped beating her. It. Whatever. The point is that we’re in love, dammit, regardless of your scorn. How dare you mock our love!
(Hint: if you think my humorous and unexpected exposition on the topic of bestiality is sick, then perhaps you shouldn’t have dragged it into the discussion to begin with, even as a half-assed ham-handed attempt at making something that you thought resembled a point? And incidentally, trying the “ask-a-question-then-burn-the-other-guy-for-not-answering” trick works better if you (a) do it properly, (b) identify when the question is actually unanswered, (c) have some rudimentary grasp of humor, and (d) are not a complete idiot. Now, I’m not saying anything; I’m just sayin’.)
(Note to the irony-impaired: no, I am not married to a sheep, nor do I have sex with them.)
“baaaaaaaaaaaaaaad to the bone”
-SD
You still refuse to answer the question. I did not ask whether you are married to a sheep. I did not ask whether you has sex with them either. Can’t you read? All you do is attack me in order to avoid answering a simple question.
An unlicensed builder might put up a structure according to code. But many do not. Communities generally want all buildings to meet certain standards. And thus we license builders.
A non-MD might prescribe for himself or others appropriately. But many would not.
I get it now – “SD” has all the answers and simply wants to let the experts “humiliate” themselves trying to assail his massive intellect (ego?).
Well, all-mighty and all-powerful SD, what is your answer? You’ve had your fun twisting and straw-manning your way through other people’s arguments, now it’s time for youi> to put your cards on the table.
Why is it a good idea to let everyone buy the medications they think they need without the need for a prescription? How would this improve health care and/or reduce health care costs?
Be specific – and be prepared to justify your answers.
Oh, and just in case you were planning on saying “I’ve already answered that question – see above.”, that isn’t an answer; it’s a dodge.
You’re up.
Prometheus
He won’t be able to. The reason, I suspect, is that he’s approaching it from an ideological viewpoint, namely libertarianism, rather than a scientific viewpoint. (SD’s been around SBM before.) Consequently, very likely it wouldn’t matter to him whether eliminating the need for prescriptions actually improved health care and/or reduced costs. I suspect that’s not the crux of his objection to the government’s possession of the power to determine what drugs should require a prescription and what drugs should not. I also suspect that, to him, any damage that would be caused by deregulating prescription drugs would be worth it in the name of “freedom.”
This guy is equating prescription medications with science based medicine. He asks a loaded question and throws a hissy fit when clarifying questions are asked. His goal is not to shed light but to generate heat.
I think what i see is both sides dancing around the questions
and issues at hand.
You’re both bitching about him dancing around yet i see all the
same from everyone else on here.
Be fair people! You’re both in the wrong so lets get some
straight answers!
“I think what i see is both sides dancing around the questions
and issues at hand. ”
What do you think the questions and issues at hand are? Are prescription medicines equivalent to science based medicine?
Really?
How about some specifics?
I see why SD gets so frustrated. You really need me to point
out the fine lines? I do not think i need to. You are all grown
big boys/girls on here i think you know what im talking about.
You do not need me to point out both sides are dancing around
the issues and no one seems to want to stay with the focal
point of the conversation.
Last thing i want to do is get into
some useless argument with some docs on this site here.
What is that going to get me or you? Come on people!
Even if i make a good point its not gonna matter to you
cause your a doctor, and i respect that. At the same time
your opinions are not going to mean much to me either
because i see the point i am making and really, lets face it
guys, sometimes we only read or hear or see what we want to
see.
All i was doing was pointing out the fact that you’re both
avoiding answering question or even making any relevant
points to each others questions, hence everyone contributing
to the problem of people doing to much talking and not enough
listening.
Anyways my original post was that i had some acupressure
done and it worked better then your “SBM”. Placebo effect
or not it worked and i am no longer in pain.
Can anyone answer why this might have worked yet your
SBM did not? I have seen many people go to this asian healer
for acupressure and have great success. I believe the focal point
of this entire blog in the first place was does this really work
and should they be able to proscribe meds to their people
whom get treatment from them.
If you all seem to think this is bullcrap, then please offer to
me a reason why for some people it does work?
This man can place his hands on someone without knowing
them and tell them where they are hurting without any prior
knowledge of the issue.
How is he able to do this? lucky guessing himself for over 30 years? I really want a good answer from someone who practices
meds not some bullshit answer, i want something solid!
Prove to me that acupressure does not work! Tell me i am insane for feeling better after leaving this mans office with
my mind blown!
Sorry if my comment posts twice, having issues posting!
>>>
“No, Tim, I’m fairly certain he’s using a rhetorical device whereby he lures you into making a logical assumption that he can then deny, and then castigate you for being such an idiot.
That’s exactly what SD’s doing.
I’ve been blogging for over four years now and before that I was a regular on Usenet for five or six years. I’ve seen it before numerous times.”
——————————————————————————–
+1
I’d say SD is making a lame attempt to use the Socratic method of philosophical inquiry to lure people into creating a straw man for him to burn down.
Look your all grown folks on here so i dont need to sit here
and point out whats going on. Its a waste of time and what
are we getting done by going back and forth?
Anyways my original post was that i had some acupressure
done and it worked better then your “SBM”. Placebo effect
or not it worked and i am no longer in pain.
This man can place his hands on people without prior knowledge
of the issue and tell them where the pain is. How does he do this? Can someone offer a good explination?
Weing
“What do you think the questions and issues at hand are? Are prescription medicines equivalent to science based medicine?”
Does my opinion really matter to any doctor on here?
It does not matter what i think and on top of it i was never
trying to argue this point so why ask me?
vargkill,
To beat a horse that was dead on this site long ago,
Are you sure he had no prior knowledge of the issue?
Did you just walk into his office and say, “Guess what my problem is.” or “give me some acupressure for no specific reason.”?
Is there any chance you unintentionally gave him knowledge of your condition without realizing it? Could he have done some cold reading on you without you realizing it?
Mentalists are pretty good at extracting information from people without them even realizing it, just ask James Randi.
“The first principle is that you must not fool yourself and you are the easiest person to fool.” -Richard Feynman
Thanks to Dr. Lipson for his essay. It’s timely for us SBM-types in Colorado where the state Senate will vote on a bill that would regulate “degreed” NDs. As opponents likely will only have three minutes each to testify, I will only have time for a few sound bites and I will shamelessly lift a few of the zippier lines used here. By the way, the Colorado Medical Society (CMS) is not only continuing to support ND licensure, the traditional NDs claim that CMS leadership is trying to convince them to support the bill, as well. CMS is telling them that while the bill would prohibit the traditional NDs from doing “naturopathic diagnosis AND naturopathic treatment,” it would not pose a legal problem for them if they did “naturopathic diagnosis OR naturopathic treatment”! Naturopathic diagnosticians?
Someone above mentioned chiropractors also going after PCP status. Actually the “mixer” chiropractors are very similar to naturopaths.
I’ve lived in some Latin American countries where prescriptions for most drugs are not necessary. However, the pharmacists in these countries tend to take a much larger role in treatment and recommending medications. Not ideal, but a help. Also, hospitals may be able to afford their own pharmacies. In areas where I worked, someone having surgery would need to have his family go outside the hospital to buy all the necessary supplies. I once took a woman who needed a cesarean to a hospital with a bag of supplies, including size 7 and 8 gloves, from a clinic where I worked. The doctor, idle at the time, wouldn’t do the surgery until I got size 7 1/2 gloves for him, which took me a couple hours.
I’ve been very disappointed with libertarians who have a terrible track record when it comes to science and medicine, but they shouldn’t because they’re supposed to be strongly anti-fraud. Instead, they have actually gone to bat for the worst of the quacks, as the Kentucky Libertarian Party did for Hulda Clark not long ago.
Dear Karl Withakay
No he did not have any way of knowing.
For someone who has been doing this for 30 + years
im sure hes that good at playing the guessing game?
Naw man theres no way for him to know and iv seen him
do it to many people. You sit down in his office and he begains
to examine you mostly by placing his fingers in places on the
hear or neck, he then told me where i was hurting and basically
what my problem was. On top of it, the issue seems to be 100%
fixed so how do you explain that?
I almost forgot to mention…
Im not a fucking dumb ass ok, i would know if there was
tricky involved and on top of it this man travels around the
country and treats many people.
Why is it that some people just cant admit that science cannot
explain everything? If it cured what ailed me then whats the
big deal? The man didnt offer me drugs or say he could. Nor
did he claim to be a doctor.
The fact is science cannot disprove acupressure and until you
can then your opinion or your quotes from dead people make
mean nothing to me.
Funny thing is, there is science to say it works and science
to say it does not.
Kinda like God, cant prove it and cant disprove it.
vargkill,
I’m a student and only a recent contributer to the site, but I’ll take a shot at your question.
Bloggers here can talk about why acupressure likely does not work, but it’s not possible for anyone to say why acupressure seemed to work for you in this instance. We could offer guesses to explain your experience, but there’s no way to know for sure. Similarly, there’s no way to know for sure that a conventional therapy actually does what we expect in a particular instance; maybe a usually useful drug had no effect this time, but luckily the symptoms vanished for another reason. People are different, the butterfly flaps its wings, etc.
However, the responsibility of a physician is to use those treatments that have been shown to work reliably and reproducibly. Medicine is an art of applying population data to individuals, and we must take great care in how we generate that population data. Personal stories like yours or the fact that acupressurists stay in business seem compelling, but they are not acceptable as scientific evidence because we know that even honest, well-meaning personal stories can be misleading (think UFO sightings, or witness testimony overturned by DNA evidence) and that businesses can persist despite not really working (weight loss industry, 12-step programs, psychics). The best way we humans have to sort out what reliably works from what seems to work is the scientific process.
Of course science cannot be used to prove that acupressure doesn’t work, but it can still do a lot. Scientific theories about physiology and pathology can be invoked to explain why acupressure is not expected to have particular effects. Scientific evidence (meaning controlled and hopefully blinded) can be wielded to show that the practice has specific effects, or a lack of positive evidence can strengthen the suspicion that no such effects exist. If a practice is very old and yet does not have a firm base in scientific theory or evidence, then physicians should be very cautious about accepting it.
If seeing your acupressurist makes you happy and is worth the cost, then by all means do it. I won’t speak for my fellow bloggers, but I have no interest in crusading against acupressure in the marketplace. What upsets me is if acupressure is incorporated into medical education or physicians’ practice without meeting the same rigorous standards that we try to apply to all non-CAM therapies.
Hence outrage over naturopaths presenting themselves as “primary care physicians” if their practice depends on nonscientific ideology.
I agree with you that there is a fine line between practicing
an art and trying to be PCP. I am not advocating to make
Naturopaths PCP’s but i am trying to say that its rather obtrusive to think that just because it does not fallow what
we learned in med school that it does not work.
You seem to have a good sense of understanding and i like
that about you because you face the question head on and
dont like to beat around to make it seem like i am wrong.
I in fact do have plently of medical knowledge under my belt
so your not talking to a medically ignorant person. So needless
to say i know it worked for me and many many other people.
Its amazing to say the least.
vargkill
I didn’t accuse you of being “a fucking dumb ass”, however the conceit that you would know if there was trickery involved could be part of the problem. Frauds like Uri Geller thrive on people who are convinced that they would be able to tell if trickery was involved. People more intelligent than I am have been fooled by cold and hot reading con-artists.
I did not in any way address whether the treatment you received was effective or attempt to explain the nature of your relief and whether the effect was due to placebo or not; I dealt exclusively with your claim, “This man can place his hands on someone without knowing them and tell them where they are hurting without any prior knowledge of the issue.”
I suggest you do some research on randi.org and elsewhere to see how you might have been tricked into believing he figured out the problem entirely on his own without any input from you.
vargkill
I didn’t accuse you of being a f’ing dumb ass, however the conceit that you would know if there was trickery involved could be part of the problem. Frauds like Uri Geller thrive on people who are convinced that they would be able to tell if trickery was involved. People more intelligent than I am have been fooled by cold and hot reading con-artists.
I did not in any way address whether the treatment you received was effective or attempt to explain the nature of your relief and whether the effect was due to placebo or not; I dealt exclusively with your claim, “This man can place his hands on someone without knowing them and tell them where they are hurting without any prior knowledge of the issue.”
I suggest you do some research on randi.org and elsewhere to see how you might have been tricked into believing he figured out the problem entirely on his own without any input from you.
I understand where you are coming from and i do respect
your point, however if you just walk into a place and the
only thing you know about each other is he sees you in
his resturant once and awhile, how could he be able to
tell so many people what their issues are and be correct
100% of the time? He knew my friend had a female issue
her whole life, he didnt suggest anything nor did he play
any kinda game other then touch my face and head in a few
places and tell me what the issue was.
Trust me, I know how people are able to coax others and
play mind games ect. And for someone who has seen and
been through a lot in my short life i can assure you this
was and is the real deal.
Do you think this form of practice can or does work if the
person know what they are doing? Do you admit that
there is a possibility? Or are you one of these narrow minded
Doctors who thinks your training is the end all be all of medicine?
Im not even sure if you are a Doctor, but ill just assume.
As i stated before, there is no scientific evidence that can disprove acupressure. I also admit there is not enough evidence
to say it really does work and so there is no happy medium
hence they issue we are having. All i can say is Doctors follow
the science in which there practices apply. The flip side is, this
science still cannot disprove that alternative medicines work
which should maybe suggest us to all keep an open mind
and maybe try it yourself to develop a proper opinion.
You know, more and more doctors are starting to practice
acupressure ect. They are even offering it to med students
here in WI as part of medical training being optional. I believe
there are those whom are good enough and know what they
are doing to be able to provide real results for people who have
problems. I also believe there are people whom practice
this form of meds and dont have a clue what they are doing
and those are probably the kinda people who think they deserve to be a PCP. These kinda people i would stay away
from because they have no clue.
“People more intelligent than I am have been fooled by cold and hot reading con-artists”.
Was i supposed to know how “Intelligent” you are?
“I get it now – “SD” has all the answers and simply wants to let the experts “humiliate” themselves trying to assail his massive intellect (ego?).”
… And I’d like to hear the answers, don’t forget that part. (Though not from you. You are dumb. I am sorry.)
Unlike you, I admit the possibility of changing my mind, although that requires a convincing argument.
“Well, all-mighty and all-powerful SD, what is your answer? You’ve had your fun twisting and straw-manning your way through other people’s arguments, now it’s time for you to put your cards on the table.”
My cards already are on the table, and are apparently being ignored. Well, okay, I guess.
I defy you to show at which point I engaged in a twist or straw man, too.
“Why is it a good idea to let everyone buy the medications they think they need without the need for a prescription?”
“How would this improve health care and/or reduce health care costs?”
I take some exception to this; I am being asked to justify the abolition of a cozy rent-seeking niche, an act that frankly *needs* no justification, and whose opposing principle (”keep that tit a-flowin!”) is justified more or less by being fait accompli. I further note that there is a certain hypocrisy in demanding that I answer your questions while repeatedly refusing to answer mine.
You are under the mistaken assumption that I am here to convince you of something. I already know that that is impossible, having read sufficiently to convince me that this blog is populated by equal portions smarmy ideologues and shrieking latahs, whose sacred cows and shibboleths are every bit as untouchable as those of, say, a hardcore alternative-medicine practitioner. No, Prometheus, I am not here to convince you; I am here to provide you the framework upon which to embarrass yourself, and you are performing right on cue. If I do convince you of anything, it is purely by happenstance, I assure you.
Here’s a question (not that you ever read or answer them): Go up and read the responses to the original post; isn’t this a topic that you would expect some neutrality and impartiality on? It isn’t as though “get rid of prescription-based drug availability constraints” is a clarion-call to burn down the edifice of modern medicine, is it now? It’s amazing how people here see a plan that suggests maybe not filling certain people’s rice bowls quite so full and immediately equate it with Satan-worship and a confession of baby-eating.
“Be specific – and be prepared to justify your answers.
Oh, and just in case you were planning on saying “I’ve already answered that question – see above.”, that isn’t an answer; it’s a dodge.”
Yes, I am, and no, it isn’t. It’s an invitation to read what I actually wrote, instead of glossing over it, and throwing out some keyword-based non-sequiturs. I have no hope that you will do this, of course. Working the “patients are idiots and might hurt themselves with drugs if we didn’t control them” trope is not an answer, it’s a soundbite.
Here’s a hint: This began with a question. Answer the question. Then I’ll answer yours.
Here’s a question: Why does this idea bother you so much? What *scientific* basis do you have for supporting the status quo? For that matter, what moral basis do you have for doing so? Do you have one that doesn’t partake of the notion that patients are children to be supervised?
“all-mighty and all-powerful”
-SD
Cde. Gorski:
“He won’t be able to. The reason, I suspect, is that he’s approaching it from an ideological viewpoint, namely libertarianism, rather than a scientific viewpoint.”
Your faith is touching.
I suppose you’re right; I probably cannot justify the idea of unobstructed access to medicine in any way that would be considered legitimate to this audience. I doubt I could justify it to the satisfaction of anyone here even if I had a ten-foot stack of studies unambiguously demonstrating that conclusion, because it cuts a ragged path straight across the prestige, power, and income streams of a majority of MDs, and would be fought on that basis alone. I do not know if this study has been done. (Note carefully that a question regarding extant studies on this topic – supporting *or* refuting this hypothesis – has gone unanswered.)
I suspect that this study has *not* been done, as it is presumably considered to be pointless, since “everyone knows” that rationing medications by prescription is the best thing to do, right?
I note that other countries do not appear to have problems with unfettered access to medications. I note no major exterminations in Mexico, Canada, or Europe, where medication availabilities vary drastically from the US. Perhaps there are statistics of epidemics of ACE-inhibitor abuse and insulin-huffing (or whatever) in these countries that I am not aware of. Seeing no evidence of it, I will ask for proof, in the form of credible hard numbers.
“Consequently, very likely it wouldn’t matter to him whether eliminating the need for prescriptions actually improved health care and/or reduced costs. I suspect that’s not the crux of his objection to the government’s possession of the power to determine what drugs should require a prescription and what drugs should not. I also suspect that, to him, any damage that would be caused by deregulating prescription drugs would be worth it in the name of “freedom.”
Well, now, here’s where we get into a forest of sticky wickets. You are assuming that (a) there would be damage, and (b) that the damage would be greater than any benefits obtained. (You also assume that freedom is valueless, a belief I shall not even try to dissuade you of.)
Now, we can go back and forth on this issue. You will say, “Patients could hurt themselves!” I will say, “Some patients might hurt themselves, but the majority would not, and the majority reaps benefits in lower costs for medical treatments.” You will say, “There’s no evidence of lower costs!” I will say, “Yes, there is – getting rid of prescribers’ monopoly grant for control of access to treatments will force them to charge lower prices to encourage patients to seek what valuable services they do provide, in addition to making that added cost of a doctor’s consultation optional instead of mandatory.” You will say, “We don’t know how many people will be damaged by self-treatment of the wrong condition due to a lack of proper diagnosis!” I will say, “We also don’t know how many people might benefit anyway from cheaper access to the treatments for common ailments (e.g. hypertension), even if they are selected somewhat randomly; nor do we know how many fewer people might be damaged by fewer physicians treating the wrong condition due to a lack of proper diagnosis, i.e. in how many instances the patients will get it right where the doctors would have gotten it wrong. There have been studies in disparate fields involving complex and subtle phenomena (e.g. finance) suggesting that in not all cases does expertise translate to competence or to successful outcomes. Medical studies about self-treatment outcomes, by design, exclude the possibility of the patient having access to the same range of treatments that a doctor has access to, forcing the patient into a choice between less effective treatments (e.g. CAM), thereby introducing a bias that leads to an improper evaluation of the concept of self-treatment.”
We can go back and forth on this all day long, in other words. I don’t want to, because I’m tired of the “patients are stupid” trope. This invites a response of “doctors are assholes”, and encourages patients to find ways to fuck doctors over, individually and as a group. I can guarantee you that that is where you will wind up – wished away to the political equivalent of the Cornfield – if you don’t clean up your bad attitude and start finding ways to support the demystification, propagation, and frank economization of your treatment methods *without* indulging in the false victory of political domination of your enemies. That means that you don’t get to suck the tit any more, my son, I’m sorry. You don’t get to beg the omnipotent State for favors, either. I know you want to, because I know that you worked hard for your knowledge and it seems amazingly unfair that people who *didn’t* get to profit from flogging bullshit to the credulous, but most of your reward for having knowledge is just to have it. And that’s the way the world works, unfortunately.
Just for shits’n'giggles, let’s restrict the scope of the argument slightly. Instead of saying that *all* drugs should be available without prescription, let’s narrow our focus a bit and say that *just* the following classes of medication be exempted from the requirement for a doctor’s prescription:
(a) Hypertension medications
(b) Diabetes-control medications, including insulin
(c) Cholesterol-lowering medications, including statins
Now, these are three popular targets for CAM, one might almost say their bread and butter. This is not a surprise, because these illnesses are highly prevalent. Bigger market == bigger money.
So what SBM treatments are available for these?
(a) Hypertension:
* ACE inhibitors
* ARBs
* Beta-blockers
* Calcium-channel blockers
* Diuretics
(b) Diabetes
* Thiazolidinediones
* Sulfonylureas
* Insulin
* Those new protein thingys (ex. Byetta)
* Misc.
(c) Cholesterol-lowering medications
* Statins
* Absorption inhibitors (although these got a solid nutshot not too long ago in a study)
* err, one other class that inhibits cholesterol synthesis, ISTR
I’ve missed some, but these are very probably the most popular. I can find out more in about twenty seconds with Google. Wiki shows me a whole slew of diabetic medications, for example, that I missed. So does the PDR. Oh well.
So here are a few critical points:
(a) *EVERY SINGLE ONE* of these conditions has a non-weaselable test to determine whether the condition is present.
(b) *EVERY SINGLE ONE* of those tests is available at reasonable cost to individuals without recourse to a MD. In at least two of those cases, reliable home testing kits are available.
(c) *EVERY SINGLE ONE* of the recommended lab values for those tests is widely known, in fact, is hammered on a regular basis in all media sources, with changes being broadcast regularly. (ex. new recommended targets for blood pressure)
(d) *EVERY SINGLE ONE* of those conditions is bad news.
(e) *EVERY SINGLE ONE* of those conditions is ostensibly permanent; once you start exhibiting symptoms, you’re on the Medication Train for life, usually.
So you stand a pretty good chance of knowing, with some degree of certainty and without much outlay, whether or not you have one of these conditions. Pop a high blood sugar? Yeah, that’s not supposed to happen, ever. Show 160/100 two or three times in a day? Probably a good idea to figure out a depressurization strategy, then. These are not the Ineffable Mysteries of the Universe, they’re something that can be figured out by a mouth-breathing beer-sponge with a 3×5″ instruction card using rudimentary electromechanical devices fabricated in China, which are, coincidentally, precisely the same tools and information that doctors will use to determine the presence of these conditions and to monitor them. Does the doctor add value to this process commensurate with his cost?
Well, what about the side effects of these treatments? Yeah, there are some, that’s true. You can get pretty well jacked-up on any one of these medications, sometimes in some really ugly ways. However, you can also get jacked up on Claritin, acetaminophen, Epsom salts, or any of the fifty thousand other things sold on the shelves. The possibility of self-damage with these medications is relatively remote (isn’t that why we use them, because they’re safer than the alternative of the disease?), is detectable in most cases *by the patient* before damage is done (”I don’t feel so good”), and can be summarized neatly (”If you take this statin and your muscles begin to hurt, STOP TAKING IT AND GO TO THE ER.”) While it is profitable to contact an expert to have some idea of what’s happening while you’re taking these medications, and it’s probably a good idea to have some monitoring, is monitoring a *requirement*? Is it better to have “treatment and no monitoring”, or “monitoring and no treatment”? If you want to eat your cake and have it too – “treatment *and* monitoring” – then at what cost do we enforce monitoring?
I will now drop the “question” portion of this exercise and move to the “soapbox” phase, where I suggest that *requiring* a visit to a doctor in order to access the above medications is practically a criminal enterprise, in that it *unjustly* increases the costs necessary for the afflicted to obtain the treatments for these conditions compared to a situation where they could simply buy the treatments without intervention by a doctor. I don’t think that you would argue that a diabetic or hypertensive patient stands to be more damaged by the process of self-treatment and trial-and-error with these medications than they are now, where patients remain untreated due to opportunity and inflated dollar costs of these treatments. I don’t think you can argue against basic supply-demand mechanics, which lead us to the conclusion that cheaper treatments are more widely adopted, unless you’re planning on writing your own Bailout Economics textbook and going for the Sverige Riksbank Nobel prize. I don’t think you can argue that it is better to require $500 worth of lab tests and office time to diagnose a condition that a patient can catch and treat earlier at home with a $25 BP cuff, even if a patient screws it up once in awhile. Hell, I don’t think you can argue that a diabetic or hypertensive stands to be more damaged by unrestricted trial-and-error with SBM medications than with trial-and-error-and-error-and-error with CAM medications, can you?
Screwing up and mistaking a zebra for a horse – a statistical unlikelihood – can be expected to occur with much less regularity than the current situation where patients pretend that horses don’t exist because they can’t afford the existence of a horse in their lives.
I will suggest that giving the general public the tools to defeat flocks of deadly rampaging wild horses (hypertension, diabetes, heart disease) is justification enough for the free sale of these medications. Cutting off CAM’s air supply is, from your perspective, just a free added bonus.
Is that justification appealing? (Psychic Prediction #2: “NO.” Whyzzat, Cde.?)
“…and I’m not gonna take it any more!”
-SD
Dear DS
Asking for a serious response on this board is like asking a kindergarten class to discuss the theory of relativity.
This board i have noticed not everyone but is inhabited
by a core group of arrogant, sarcastic, sardonic, immature,
and anal retentive prick doctors or other people with opinions
larger then themselves.
Their idea of answering a question only seems to be achieved
by dancing around the questions and trying to answer a simple
question with nothing more then expletive laced diatribes.
My point is, why even try? You can plainly see for a bunch of
educated people somewhere somehow they seem to have
lost basic conversational skills.
Good luck!
Oh, SD, you’re so funny!
Let’s say a new hypertensive comes to see me. ALLHAT data suggest that a thiazide type diuretic would be a good first choice. Of course I’d have to check their creatinine and potassium first.
But let’s say i dip their urine and there’s protein? Well, then, perhaps an ACE inhibitor is a better choice. But I still need those labs.
But wait, my physical exam reveals a quiet abdominal bruit. Not so fast. What if they have renal artery stenosis? Hmmm…better get a doppler first.
Srsly, this is the kind of thinking that goes on for even one little decision.
vargkill,
What was your diagnosis? I don’t see how you had SBM if there was no diagnosis. My take is that you had some undefined issue that resolved after you had some acupressure done. Post hoc ergo propter hoc. How the hell are we supposed to know what the problem was? That reminds me of the time a guy fell off a ladder at home and his wife called the ER. The doctor asked a few questions that she relayed to her spouse and he answered. Questions like does it hurt when you hurt your head, chest, arm, belly, legs. The guy answered yes to all the questions and an ambulance was sent for the critically injured gentleman. The ER valiantly evaluated him, splinted his broken finger and sent him home.
I know. SD is depressing me with his arrogance of ignorance.
He’s also annoying me with this outrageously blatant straw man:
Uh, no. Where did I ever say or imply that freedom is “valueless”? SD seems to have conflated overall freedom with the ability to get basically whatever drug he wants without having to get a prescription. I love the overwrought hyperbole, though. I point out that his belief that his not being allowed to procure nearly any drug he wants (or even just antihypertensives or diabetes drugs) for purposes of “trial and error” self-treatment without first seeing a doctor is, as he put it most recently, a “criminal enterprise” happens to be way off the plantation and based on libertarian ideology rather than science. SD’s response? That I must therefore consider freedom “valueless”!
Priceless. Dude, step away from the hyperbole.
Of course, the really amusing thing is that, by saying what he did, SD only helped confirm what I said about him, namely that his views are indeed based far more on ideology than any sort of science. I’d also point out that Mexico is not exactly the nation we’d want to pattern our drug safety and prescription laws after. There’s a reason why quack clinics flourish in Tijuana. I also find it rather amusing that he also references Canada and Europe, which do allow more drugs to be available over the counter, but also have what’s anathema to SD (if I recall correctly from previous encounters), government health care. Tell you what, SD, we can appropriate Canadian and European laws on medicine, but how about we also appropriate their universal health care? Just a thought.
SD,
If you get rhabdomyolysis from a statin, why bother going to the ER? Why not just to Wikipedia and treat yourself? Order a home dialysis machine and do it yourself.
I don’t know if it’s true but there is a story about Tesla where he was asked to consult on a machine that wasn’t working. He took a look, took out his sonic screwdriver and turned one of the screws and the machine worked just fine. He submitted his bill for $1 million. The factory owner demanded an itemized bill for such a simple procedure. It came out to be 1 cent for turning the screw and $999,999.99 for knowing which screw and how much to turn it.
vargkill,
“Trust me, I know how people are able to coax others and
play mind games ect. And for someone who has seen and
been through a lot in my short life i can assure you this
was and is the real deal.”
So you couldn’t be fooled, and you’ve figured out the trick to every magic trick you’ve ever seen?
Barbara was also likewise convinced the Uri Geller was the real deal, and that it wasn’t possible she was being hoodwinked.
http://www.randi.org/site/index.php/jref-news/513-randi-speaks-conjuring-with-barbara-walters.html
“Do you think this form of practice can or does work if the
person know what they are doing? Do you admit that
there is a possibility”
I consider it possible that every single proton in the universe will instantly and simultaneously decay into positrons and neutral pions, but I also consider this extremely implausible and improbable. I’m not really talking about POSSIBILITY, I’m talking about PLAUSIBILITY and PROBABILITY.
“The flip side is, this
science still cannot disprove that alternative medicines work
which should maybe suggest us to all keep an open mind
and maybe try it yourself to develop a proper opinion.”
Science can show that various alternative medicines have no effect greater than placebo, which is effectively the same as showing they don’t work.
Do you have an open mind that will allow you to consider that alternative medicines might not work; do you have an open mind that will allow you to consider you might have been fooled?
If you think you really do have an open mind, please watch the following video and at least consider to the message:
http://www.youtube.com/watch?v=T69TOuqaqXI
“Was i supposed to know how “Intelligent” you are?”
Was that supposed to be some sort of veiled insult? I can’t expect you to accept that I am very intelligent, but my point was really that I am at least intelligent enough to understand my own limitations, and understand that I can be fooled.
Regarding the notion of freedom being valueless……
Freedom is extremely valuable. But unregulated medicine, counter-intuitively, does *not* give us freedom. It may give us the illusion of freedom, and certainly those wishing to profit off of patients like to encourage that illusion. But it is just an illusion, as the time before the FDA demonstrates so brilliantly.
There are serious consequences to using the wrong treatment, or to not getting treatment at all. Is it freedom when you are persuaded that you do not need to see a doctor, but instead can just believe everything Quack A feeds you, devote yourself entirely to his regimen to cure your disease, and then find yourself penniless and dying of cancer a few years later?
The most dangerous drugs should be kept prescription only. This is not because people are stupid. It is because people are *trusting*, and there are those who will (and in fact do) take advantage of that to their own profit. In order to minimize abuse, the most dangerous drugs need to be kept prescription only. This is not so much because patients are stupid but so that there is a means of stopping the abusers. Unethical doctors can be stripped of their privilege to prescribe medicine. This is too important to throw out in the name of “freedom” or “choice”, which, as history shows us, really only improves the freedom of those who aren’t constrained by ethics.
How free are you, really, if you are addicted to cocaine or morphine, as happened all too often in the pre-prescription days?
So dizzy – must get oxygen….
Freedom is just another word for nothing left to do.
They may take away our ability to buy any drugs we want without a prescription, but they’ll never take away our freedom! (Paints face blue and white.)
I just thought of a better, more concise way to put my argument, and one which should resound with the CAM-types, if they are willing to listen.
Medicine is regulated not because we distrust the patients. It is regulated because we do not trust the doctors/nurses/Big Pharma/etc. Society therefore requires that they prove themselves worthy, and retains the right to strip them of their privileges should they later prove otherwise.
I say give this patient a barrel full of pills. She has metabolic syndrome, which has led to type 2 diabetes and hypertension, caused by physical inactivity and addiction to refined carbohydrates. It’s obvious she will never stop eating processed junk food, and of course she will never have the discipline to exercise. So just pour drugs into her.
Ok there is a lot to address here. For lack of time i will get right
to the point.
Weing,
SBM, My symptoms showed 2 things, Acid reflex persisting for
2 weeks, along with other symptoms which could have been
a number of things including a very common Hiatal Herrnia,
which included pains moving to the upper chest and down the
arms and only releaved with painful BM’s and or cutting wind.
Which indicates GERD or some form in that family. Hard to tell
without tests but any educated person in medicine would know
the likelyhood of it being a combination of all of the above
would indicate just that. Again your talking to someone with
extensive medical knowledge here. If you had these symptoms
you might not treat yourself but then again why have someone
else diagnose you if you know what it is? Is there a need for
me to have gone to a doctor? Did i really need to have them
refer my to a specialist and give me a bunch of tests?
Again if you walk up to someone and they figure out what
your issues are and what your pain is without you telling them
how is this possible? How can you trick someone to know where
the pain is? He told me flat out and then fixed the problem.
Why are more and more doctors starting to practice alternative
medicine? Im not advocating these people be able to proscribe
meds or become PCP’s do you understand this? Just to make
sure we are on the same page. If it was the Placebo effect
then what i do know is it worked. I also know other things i was
having issues with got fixed in the process, so again doctors
cant fix, acupressure fixed. what other conclusion am i left with?
Karl Withakay
Science can show that various alternative medicines have no effect greater than placebo, which is effectively the same as showing they don’t work.
No Karl, That just like saying because science cannot prove
the existence of God he does not exsist. If it did not work then
Your science should be able to disprove it beyond a shadow
of a doubt. I respect where you are coming from on this
but at the same time why can we not admit there is a little
more to life then just what we can prove. sometimes that
is the only thing that makes life a lovely thing. Is there are
things we cannot explaine.
I do believe there are people who are good enough to be
effective in there field. I think the man i seen was one of the
few people around here that can do what he does and be very
effective at it.
You keep bring up the “you might have been fooled” argument.
Again fooled is when you call a phychic hotline and they make
assumptions based on a question asking bullshit process.
Again time and time again a man examining people and being
correct 100% of the time. Not asking but telling you where
and what hurts or what the issue is. With all due respect you
still have not convinced me that he has any way to trick
people into lucky guesses. It would be one thing if he asked
questions or made suggestions. But this is not the case.
Peter Lipson
You know hypertension is the most overrated diagnosis
in the medical field today. Lets get everyone filled up with
beat blockers which in a lot of cases dont do a fucking thing.
Some have even proved to be no more effective then a placebo
pill. Im sure many of you know about this. Lets say you take a
man with a reading of 160/80 what if that was his bp almost
his entire life? Lets not forget the white-coat syndrome. why
are we not taking readings when a person is at home relaxing?
Why is it in my study i seen a drop in bp and normal ups and downs at different times of day in many people?
Like i said overrated! If you really want to argue this with
me i have tons of facts im ready to throw your why.
“Uh, no. Where did I ever say or imply that freedom is “valueless”? ”
Right here:
‘I also suspect that, to him, any damage that would be caused by deregulating prescription drugs would be worth it in the name of “freedom.”‘
Note the quotation marks around “freedom”, indicating ironic intent. (To the audience: for optimal understanding of the semantic content of this sentence, picture Cde. Gorski flashing a pair of air-quotes and a wry smirk around the word “freedom”.)
Having read your writings, and in the same way that you correctly observed that I am informed by libertarian beliefs, I observe that you are significantly informed by collectivist beliefs and practices, which beliefs by their very nature consider individual freedoms to be negotiable depending on the needs of the group (”needs” being indistinctly and mutably defined according to the whims of the moment).
“SD seems to have conflated overall freedom with the ability to get basically whatever drug he wants without having to get a prescription.”
There is no conflation. Freedom from interference in private dealings *is* freedom. I wish to buy directly from the people who produce pharmaceuticals, without paying the “prescription tax”. They own the pills; I own the money; I want to trade my money for their pills. This is a basic and fair trade, in that it does not materially affect anybody else, no fraud is involved, and in that I do in fact and can reasonably, as an adult, be presumed to stand fully-informed of the consequences of making an error, and have available ample opportunities for assistance should I choose to avail myself of them. Why can I not do this? Why is this trade verboten?
“For my own good”?
Loaded questions to illuminate this issue by way of analogy: Do I have the right to refuse treatments that you, as a doctor, *know* will cure me? Do I have an unlimited right to do so, or can it be overridden by external agency? Do I have the right to choose between two treatments of unequal efficacy, even if I select the one that is less likely to work? How do these rights differ in any material way from being able to select my own treatment without recourse to a doctor’s opinion? How much autonomy do I get to have, guys? Where does my right to self-determination end? Riddle me that.
I am told, by some on this blog, that it isn’t freedom if I believe a quack who recommends a bad treatment. Assuming that that incoherent thought means anything in the first place – spoiler, it doesn’t – then is it freedom when I am only “free” to be treated if I ask you nicely first, and have only a choice of the options you provide me or “nothing at all”?
“I love the overwrought hyperbole, though. I point out that his belief that his not being allowed to procure nearly any drug he wants (or even just antihypertensives or diabetes drugs) for purposes of “trial and error” self-treatment without first seeing a doctor is, as he put it most recently, a “criminal enterprise” happens to be way off the plantation and based on libertarian ideology rather than science. SD’s response? That I must therefore consider freedom “valueless”!
Priceless. Dude, step away from the hyperbole.
Of course, the really amusing thing is that, by saying what he did, SD only helped confirm what I said about him, namely that his views are indeed based far more on ideology than any sort of science.”
Not to put too fine a point on it, it seems that your views on this topic are every bit as lacking in scientific support as mine, and without even the benefit of a plausible a priori argument in their favor to boot. I note that again that some questions I have asked have not been answered:
“Precisely what *scientific* evidence do you have to support the status quo? What study or studies support the notion that obstructing free access to medications with prescriptions leads to a better result than self-treatment? Are there any such studies? Were there any such studies when the law was enacted? Have you ever read these studies, or is this just one of those things that ‘everybody knows’?”
The plural of anecdote is not data, Cde. Gorski.
“I’d also point out that Mexico is not exactly the nation we’d want to pattern our drug safety and prescription laws after.”
Why the hell not? Mexicans generally don’t have problems with counterfeit drugs; they sell them to the Americans instead. Why do they sell them to the Americans? Because it’s cheaper and easier to buy them from Mexico than it is to get them from the pharmacy. One part of that cost is the “prescription tax”. (There are others, of course.)
Here’s an observation about drug safety: A major problem with the pharmaceutical supply chain is that it includes multiple middlemen. In the United States, between the pharmaceutical company and the customer, there are at least two entry points for counterfeit drugs: at least one distributor and a pharmacist. Typically there are multiple distributors. Now, in this age of the Internet, it seems reasonable to me that one could, say, open a store – call it “merck.com” or whatever – that featured a nice slick SSL-enabled “click-to-buy” interface with FedEx shipping, and get this, this is the important part, *straight from the manufacturer to the customer*, eliminating the possibility of counterfeiting, or at any rate reducing it to the absolute minimum. That seems like it would cut down on that pesky counterfeiting and safety problem, by enabling the customer to get it *directly from the manufacturer*, with the nice added bonuses of reducing patient cost and increasing pharmaceutical company profit margin. How’s that for a win-win, huh?
Except that we can’t do that, because the logistics of working around this whole “prescription” thing are, well, too complex. How would we get the Mother-May-I note from the doctor to the company? How could we verify that the patient really had permission to treat himself for his ailment? How would we ensure that the doctor got paid[delete][delete]was able to ensure that the treatment was appropriate?
“There’s a reason why quack clinics flourish in Tijuana.”
So what? In what way do prescription laws materially affect the availability or prosperity of “quack clinics”? There’s a reason why tea is popular in China, too. If you don’t understand what that has to do with the point, well now, how does that feel?
At least those “quacks” are making use of something approximating an efficacious treatment, even if misapplied. I note that – again, *sigh* – my question was not answered: “Which is better: treatment and no monitoring, or monitoring and no treatment? If we choose both – monitoring *and* treatment – then at what price monitoring?”
Shit, every other post on this blog laments the increase of “quack clinics” in America and/or Great Britain, except that they happen to be handing out granola bars instead of Coreg. Good thing we have those prescription laws to put some speed-bumps in the way of that quackery, huh?
“I also find it rather amusing that he also references Canada and Europe, which do allow more drugs to be available over the counter, but also have what’s anathema to SD (if I recall correctly from previous encounters), government health care. Tell you what, SD, we can appropriate Canadian and European laws on medicine, but how about we also appropriate their universal health care? Just a thought.”
No, for the same reason that appropriating Soviet chess curricula does not mean that it is a good idea to appropriate their penal system. It is possible to get one thing correct (or correct-ish), and get the rest of it wrong, a fact with which I am certain you are well-acquainted by long practice of half-cockery and hipshooting.
Christ, I feel sorry for your patients. Do you have any left, do you just teach other would-be doctors the finer points of smarm these days?
“clowns to the left of me, jokers to my right”
-SD
As I predicted, SD simply said “read my posts” instead of giving his answer in a concise, coherent fashion.
He also stated that he was waiting for my/our answer, which was already given.
My provisional diagnosis is that SD is the type of troll who just likes to tell people how “stupid” they are, but doesn’t know enough about the topic to actually contribute.
Well, I went back and read all of SD’s posts. I’m still trying to figure out what he’s on about. Maybe I’m just too thick to “get it”, but I can’t find a coherent response.
So, SD, if you have something to contribute, how about a concise and coherent answer? Tell us what you think.
In case you’ve forgotten the question, here it is again:
If you can’t answer that one simple question without a smokescreen of pseudo-righteous indignation, I’m going to assume that you don’t have an answer and that you’re just “stirring the anthill”.
Prometheus
vargkill,
You’re remarkable close minded about things. You seem absolutely convinced of your positions and the infallibility of your own powers of observation and recollection.
“No Karl, That just like saying because science cannot prove
the existence of God he does not exsist. If it did not work then
Your science should be able to disprove it beyond a shadow
of a doubt.”
You apparently don’t understand how science and the scientific method works; science doesn’t disprove things beyond a shadow of a doubt. Science can not prove there are no purple cows; it can only say that none have ever been observed, no known means of producing purple cows exists, and there is no basis for believing in purple cows. If I were to tell you that I have a tiny elf living on my shoulder that cannot be detected by any means known to man, could you disprove this position? The point is that I cannot prove or provide evidence that this elf exists and there is therefore no reason for anyone to believe this it does.
While the existence of (scientifically undetectable) Chi or life energy is implausible, the possibility that acupressure is genuinely effective beyond placebo is less implausible. I haven’t yet come across any good quality evidence that shows it is effective beyond placebo, but I can’t say it’s impossible.
Also, you have gone way beyond claims of clinical efficacy for acupressure and claimed 100% reliable paranormal diagnostic powers for this acupressure healer you describe.
Are you actually claiming this man is correct 100% of the time, and that this is not an exaggeration? Why is this man with such an amazing, 100% reliable gift for diagnosing ailments without input world famous?
“Oh, SD, you’re so funny!”
I know, but looks aren’t everything.
“Let’s say a new hypertensive comes to see me. ALLHAT data suggest that a thiazide type diuretic would be a good first choice. Of course I’d have to check their creatinine and potassium first.
But let’s say i dip their urine and there’s protein? Well, then, perhaps an ACE inhibitor is a better choice. But I still need those labs.
But wait, my physical exam reveals a quiet abdominal bruit. Not so fast. What if they have renal artery stenosis? Hmmm…better get a doppler first.
Srsly, this is the kind of thinking that goes on for even one little decision.”
I’m sure it is. And this is to your credit as a physician, that you do the ground work to reduce the odds of making a bad treatment decision.
However, you’re still thinking about this incorrectly. I assume you are familiar with the concept of “triage”? Sometimes we don’t get to have the perfect, and we must take care not to make the perfect the enemy of the good.
We’ll craft an example case to illuminate this point: Bob, a 40-year-old man, tests his blood pressure four times in one day, randomly, with a store blood-pressure cuff. Each time, it comes up over 160/100. The store owner checks it, and the machine appears to be calibrated properly.
This is *all* the information available.
Now Bob, watching the news on occasion, knows that a high blood pressure is bad news. While he realizes he should go to the doctor – this is option (a) – *for whatever reason*, he is not inclined to do so. This may be due to cost, inconvenience, personal dislike, whatever.
Given that that option is off the table, then what is Bob’s next-best move?
(b) Treat himself by selecting a common first-line therapy without a doctor’s supervision
(c) Remain untreated
(a) is better. You think (a) is better. I think (a) is probably better in most cases too, with some qualifications, although that betterness does not to me imply moral justification for exclusion of option (b). That’s beside the point – Bob doesn’t think (a) is better. Bob’s the patient. It is Bob’s ass. Tough luck, doc. But what about Bob? What can we do for Bob?
Given that in at least some instances Bob will select (b), what are his odds of getting it wrong? Moreover, how can those odds be improved cheaply? Let’s say that Bob lives in Freedonia, where his local supermarket has a “Blood Pressure” section in the medical aisle. Let’s say that there are two of each of the following classes of medication available (doctors in the audience, please fill in blanks for recommended first-line therapies):
(a) ACE inhibitors (Lisinopril, ???)
(b) ARBs (Valsartan, ???)
(c) Calcium-channel blockers (???)
(d) Beta-blockers (Metoprolol, ???)
(e) Diuretics (HCT, ???)
You provide a portion of the decision tree here:
(a) You suggest HCT is a good option, generally speaking, except that it can cause potassium loss, and may be a problem in patients with kidney disease. Okay, so that’s two lines on the outside of the box: “(1) This medication may cause low potassium, a potentially dangerous condition. Ensure that your potassium intake is adequate by eating foods rich in potassium, such as potatoes, bananas, and oranges. If you feel faint, ill, or weak, or develop cramps, chest pain, or palpitations (irregular heartbeat) while taking this medication, discontinue use and seek medical attention immediately. (2) Seek medical advice before taking this medication if you have or may have kidney disease.” (1) is the same warning that comes with the prescription instructions. (Why is it considered sufficient to warn the patients with a paper insert in prescriptions and other OTC medications, but that this is considered insufficient for the medications under discussion?) What are the odds that someone self-dosing with HCT will develop serious hypokalemia with (or, hell, even *without*) those two warnings attached? What are the odds that they won’t figure that out until it does serious damage?
(b) You suggest a urine dip for protein, as an ACE inhibitor might be a better idea in that case. Okay, so an ACE inhibitor might be better (but see below), but is that a contraindication for a thiazide, or is a thiazide a “reasonable” choice for hypertension in this instance when compared with “nothing”? Fine: the thiazide gets a fifty-cent urine dipstick in it, with a third line on the box: “FOR YOUR SAFETY: Please follow the instructions inside to perform a simple urine test with the enclosed strip. If the strip turns blue, then there is a chance that you may have kidney disease. It is recommended that you seek medical advice before taking this or any other medication, as kidney disease is a serious medical condition, and another blood-pressure medication may be more suitable for your use.”
(c) An ACE inhibitor may toast your kidneys if you have an undiagnosed renal artery stenosis. Okay: How often is that the case? What is the prevalence of hypertension secondary to renal artery stenosis rather than some other cause? P(patient has renal artery stenosis) * P(ischemic damage to kidneys due to ACE inhibitor treatment in the case of undiagnosed renal artery stenosis) * P(patient selecting ACE inhibitor as treatment) * P(patient doesn’t stop treatment before some undesirable endpoint) == X. How big is X? Let’s say that X is large enough to be concerned about. Proteinuria is common in ischemic kidney damage, yes? That means you package your ACE inhibitor with a package of thirty urine dipsticks with a big bold line on the outside of the box: “FOR YOUR SAFETY: Please follow the instructions and the enclosed dipsticks to test your urine on a regular basis while taking this medication. If any strip turns blue, then there is a chance that this treatment is damaging your kidneys due to an pre-existing undiagnosed condition. Discontinue use and seek medical attention immediately.” How often will this fail to catch damage? (Hell, how often would this catch a stenosis that was missed during a physical examination?)
Sure, lab values are a great idea. (Ask me sometime about what I think about the requirement for a doctor’s prescription for lab tests.) If a patient isn’t going to permit a doctor to do the workup anyway, then moral considerations of liberty aside, why not let that patient at least *try* to benefit from self-treatment with proven medicines? (And if the patient is going to ask the doctor first *anyway*, then what does the law accomplish in the first place?) I submit to you that for almost any constellation of “maybe” you can come up with that leads to Bob damaging himself with these medications owing to an incorrect guess about the nature of his condition or the presence complicating factors, there are simple mitigations that substantially improve his odds of getting the right answer, *or* the odds of that constellation occurring are so small as to be negligible compared to the benefits. You add value to this process, but nothing near what you cost, I’m sorry to say, and that cost is only justified if people are *freely* willing to pay it. Evidence suggests that people are disinclined to pay it in increasing number, because they (a) can’t afford to and (b) smell something intrinsically wrong with ths situation. That last is common among Latinos, who quite properly wonder why the hell they have to pay the doctor every time they want to get a treatment for something they’re already pretty sure they have, and conclude that while this makes sense to the doctor, who wants a good income, it does not make quite as much sense to them, who want to simply get treated and get on with business.
Finally, keep in mind one thing: I didn’t say that he *can’t* go to the doctor. I said that he didn’t *have* to go to the doctor, although the assumption was that he didn’t want to anyway. That may not seem like much difference to you, but in the words of the immortal XKCD, “it is the difference between thirty seconds and a glass of wine with your daughter, and a bottle of gin and a night with her”.
“split a bottle of gin, my dear?”
-SD
You keep saying if such and such develop seek medical attention. Where? Why not do it yourself? Why not run your own tests and treat yourself as you self-diagnosed?
“As I predicted, SD simply said “read my posts” instead of giving his answer in a concise, coherent fashion.”
That was a clear, concise answer. That you didn’t like or weren’t able to finish the reading assignment isn’t my problem.
“He also stated that he was waiting for my/our answer, which was already given.”
Yes, you gave exactly the answer that I excluded from consideration in the first post. Yay, reading comprehension.
Why did I exclude it, you wonder? Because I’m tired of hearing it, and because I would expect that such a brilliant idea as a rent-seeking privilege grant from the State would have more than one decent answer in support of it, and particularly one of better quality than “We have to do it this way because people are stupid”. Wow, I guess that showed me, huh?
Although I knew that there would be no such thing as impartiality on this topic – discussing ways to break a man’s rice bowl doesn’t lead to rational discussion – I’d hoped that at least some here would approach the question from a scientific perspective, maybe invoking things like “studies” and “statistics” instead of “how I’m an ideologue” and “how stupid SD is”. Gee, I guess that showed me, huh? >;->
“My provisional diagnosis is that SD is the type of troll who just likes to tell people how “stupid” they are, but doesn’t know enough about the topic to actually contribute.”
I note that for people who are capable of contributing, there is a surprising dearth of answers to the volume of questions I’ve asked. Most responses have been some variation on “Pshaw, what a CAMtard! You want to self-medicate! You want people to die!” The number of assertions I’ve seen about things I haven’t written has been astonishing.
“Well, I went back and read all of SD’s posts. I’m still trying to figure out what he’s on about. Maybe I’m just too thick to “get it”, but I can’t find a coherent response.”
Very simple: it started with a question, “Why not end the requirement for a prescription to purchase effective to medications?” That’s pretty simple for even someone as thick as you to “get”, huh?
“So, SD, if you have something to contribute, how about a concise and coherent answer? Tell us what you think.”
Uh, wow. I’d think that was fairly obvious by now, but I guess there’s no accounting for some people’s impermeability.
“In case you’ve forgotten the question, here it is again:
“Why is it a good idea to let everyone buy the medications they think they need without the need for a prescription? How would this improve health care and/or reduce health care costs?”
… Because it isn’t your job to tell other people what they can sell, or what they can buy, because you are not their daddy?
… Because it *especially* isn’t your job to make money by interfering in that transaction with the threat of force, because in any other context, that’s called “extortion”?
… Because, contrary to your operating hypothesis, patients are neither morons nor your wards?
… Because nobody suggests that you not be available for consultation, or that it’s a bad idea, only that it not be a statutory requirement?
… Because it gives SBM a strategic and moral victory over CAM, denying them important ground to occupy, and provides momentum to SBM treatments without taint of profiteering or persecution?
… Because nobody so far has produced any credible scientific evidence that the prescription requirement is a good idea, instead basing their defense solely on the fact that it’s fait accompli and a stream of “Well, what if [bad thing] or [bad thing] or [REALLY bad thing] happened, huh? What then, huh?” Neologism/portmanteau: “The plural of ‘What if?’ is not ‘data’.”
… Because nobody has produced any *moral* justification that does not draw from the poisoned aquifer of slavery (one good definition for which is “denial of self-determination”), instead producing a stream of blandishment about how it’s really better for your options to be limited because you might hurt yourself by choosing the wrong one, a well-known, well-trodden, and highly-polished cobblestone on the road to Hell?
“If you can’t answer that one simple question without a smokescreen of pseudo-righteous indignation, I’m going to assume that you don’t have an answer and that you’re just “stirring the anthill”.”
Clearly you didn’t read my response. I invite you to do so again. Spoiler: I don’t care *what* you assume. You bore me, fanboy. Go away.
“wishing that the gods really *could* chain people to rocks and have a giant eagle gnaw their livers for eternity”
-SD
Karl Withakay
First lets address the acupressure guy. Yes the man is known
and travels around the US treating hundreds of people at a time at seminars. His name is Sik Kin Wu. If you’re ever in
Wisconsin and would like to put his skills to the test then
ill glady share his contact info with you. Why not try it for
yourself Karl? At which point you can contact me and let
me know what you think.
Some people who are good at what they do might not wish
to be in the spot light as much as other people.
I think you where missing my point about the science of it.
Science can disprove things and has been proving and disproving for a long long time now. If things can be proven
then things can be disproven. If you want to put it into terms
of Purple Cows and Elfs on your shoulder then its a nice
metaphore but theres no need for it because i get your point
yet i feel like your not trying to get mine. I fully understand
your reason for not believe it can work yet this situation made
a believer out of me. My point in the whole science things is
that just because science cannot confirm this does not mean
it does not work. Yes i know typical response right? As you
pointed out in your metaphore. But there are a lot of people
who are finding relief from this form of practice. What could be
the reason? Maybe its not that there is the whole “Chi” thing
but that the acupressure helps by doing other things with
the body.
Heres a good example, If your head hurts why does pushing
the web of the thumb or the area between the eyes help?
You get where im going with this?
I still would like you to respond to this question so i can make
my point.
I am suprised that you did not address the fact that more and
more doctors are practicing alternative medicine. What are your
thoughts on that?
“I haven’t yet come across any good quality evidence that shows it is effective beyond placebo, but I can’t say it’s impossible”.
You admit that you cannot say its impossible right?
Im telling you that yes the man can diagnos 100% of the time.
Example, I have a female friend with a cyst on her Ovaries.
How is it that when he put his hands on her stomach that
he said in broken english…
You have a female problem… You have a bump on your ovarie.
Tell me how he was correct? Or that he not only knew i had
a bad knee but knew what the problem with it was and right
away knew what knee it was.
What form of tricky was involved with this?
PS
The man also has studied modern medicine as well.
Oh, yes, forgot a couple of things, Cde. Gorski:
(a) Wow, my prediction was right. (SD’s Wayback Machine: “(Psychic Prediction #2: “NO.” Whyzzat, Cde.?)”) Two in a row, huh? I’m a shoo-in for that fat check from Randi and company, huh?
(b) You know, you totally buffaloed me. It’s like magic, y’know, I’ve, like, never seen the tactic of reading a long post, picking one sentence out of it – in this case, my statement about your assumption that freedom is valueless – and harping on it while ignoring all the other points in the post. That makes you look like a total badass, Cde. I am so totally not bullshitting you right now. No, seriously. I am totally seriously right now, guys. Cde. Gorski is, like, totally the winner. srsly.
“shocked and awed”
-SD
“SBM, My symptoms showed 2 things, Acid reflex persisting for
2 weeks, along with other symptoms which could have been
a number of things including a very common Hiatal Herrnia,
which included pains moving to the upper chest and down the
arms and only releaved with painful BM’s and or cutting wind.
Which indicates GERD or some form in that family. Hard to tell
without tests but any educated person in medicine would know
the likelyhood of it being a combination of all of the above
would indicate just that. Again your talking to someone with
extensive medical knowledge here. If you had these symptoms
you might not treat yourself but then again why have someone
else diagnose you if you know what it is? Is there a need for
me to have gone to a doctor? Did i really need to have them
refer my to a specialist and give me a bunch of tests?”
I can’t tell what you had based on that. Some of it sounds like GERD. Some sounds like diverticulosis and flatulence. You had empiric treatment for GERD that didn’t work? Makes GERD unlikely. You are correct that it is hard to tell without tests but if you are going to try to indict SBM, then you have to follow its rules and get a diagnosis. Anyway your symptoms resolved with acupressure, which to me means it was a self-limited condition that spontaneously resolved. I doubt there is anything I could tell you that would change your mind that you were cured by a miracle worker. You suffer from conviction or should I say you are enjoying it. Just one doc’s opinion.
No, it means I’m tired of your trolling nonsense. Nothing more, nothing less.
“I just thought of a better, more concise way to put my argument, and one which should resound with the CAM-types, if they are willing to listen.”
Don’t mistake me for a CAM adherent. While I don’t care what they do, and do not a priori exclude the possibility that they may be right in some instances (though what instances those are elude me), I don’t buy it.
On the other hand, I don’t think doctors and organic chemists are quite as clever as they make themselves out to be; there are a lot of demons and surprises in the areas of human physiology that we know less than nothing about, and half of the things we *think* we know are probably wrong. Complex systems have a habit of resisting pat answers, and we are still basically at a half-assed “sticks-and-stones” understanding of complex chemistry (i.e. “life”). This is not an attack on life sciences; we’re doing the best we can, but we are not in any realistic sense at a level where we can claim “good” understanding of life processes and their failures yet. It is this fact which makes me skeptical when I see people bloviating about things they “know” with a certainty that a half-inch piece of rebar could be bent around – e.g. some of the posters here – because I am ever mindful of the old saying that pride goeth before a fall.
Nobody else has to believe that, of course. It is a free-ish country, after all. >;->
“Medicine is regulated not because we distrust the patients. It is regulated because we do not trust the doctors/nurses/Big Pharma/etc. Society therefore requires that they prove themselves worthy, and retains the right to strip them of their privileges should they later prove otherwise.”
You are thinking in terms of groups. Think in terms of *people*. There is not a “we”, incidentally. I do not consider myself part of a “we” involving anybody on this blog in any meaningful fashion. I do not care about “society”, because I have never seen “society”; what I have seen is “people”. People, as individuals, have rights. One of those rights commonly-infringed, but no less a right – is the right to trade freely amongst themselves without fear of force or fraud. This right does not absolve them from the duty to exercise due diligence in savvy trading, however. There is no fraud in selling someone a medicine which *may* help them, *if* the purchaser is made reasonably aware of the possibility of failure. There is no fraud in selling someone a medicine which may harm them, *if* they are reasonably aware of the possibility of harm beforehand. People buy and do things regularly that may not help them, and may in fact harm them. They use things that they do not possess full understanding of the operation of. So what? Are they to debarred the use of those things because they *may* be harmed?
On this theory – that the public needed protection from “harm” – was the modern medical regulatory framework erected. This framework has, mirabile dictu, provided the support for assaults on SBM, which we see on this blog on a regular basis. Exactly how good an idea was that, then? Perhaps a change of operating theory to one that reaffirms the patient’s fundamental rights – the right to be free of coercion, in *all* its forms – and pushes the realm of combat from squabbles over regulatory leverage to a plain competition of the cold, hard facts is in order?
(Yeah, I know. “What is this madness? What language is he speaking? I cannot fathom this insanity!” Yeah, okay, whatever. You don’t have to believe my recommendations for, ahem, “treatment”, of course. It is a free-ish country. Just remember that I suggested this course of action to you.)
If you don’t trust the doctors, nurses, Big Pharma (God, I loathe that term), or whoever, then the solution to their untrustworthiness is to remove them from this process as controllers and gatekeepers and return them to their rightful role as *consultants* and *advisers*. Access to medicine is something that is wholly under the control of doctors, by legislative fiat. Removing this obstruction to treatment, among other things, minimizes doctors’ attractiveness to Big Pharma as targets for advertising and bribery into overprescription of medications, since there is no requirement that a doctor’s recommendation be followed. (It will in most cases by default, but it’s not a requirement.) Doctors therefore become more impartial, having no control over this process: “Well, I *think* you should do X, but Y might work too. Pick one and let me know how it works. I suggest the following labwork so we make sure it’s working and not making you sicker. It’s your body and your health, so it’s your call.”
Note that I don’t like licensing either – licensing accomplishes nothing, basic English tort law principles cover medical malpractice more than adequately – but abolition of prescription law has absolutely nothing to do with physician licensing. That you do not require a physician’s permission to purchase medication does not imply that anybody else can recommend treatment to you; the two principles are separate.
“what is this ‘we’, white man?”
-SD
Govorit’ Cde. Gorski:
“No, it means I’m tired of your trolling nonsense. Nothing more, nothing less.”
Actually, you *love* it. It feeds into your Remnant fantasy: “We, the elect, the scientists, laboring tirelessly to bring light to mankind, are persecuted and hunted, but we shall triumph over the forces of darkness one day, oh yes, we shall, we shall overcome… but they pursue us and hound us, attacking us ceaselessly, yerhonor, we’re just *defending* ourselves…” This “hold the last bunker” mentality is not healthy, because it refuses to acknowledge the possibility of error, or even of a better strategic plan than you currently operate from. Open the bunker doors; it’s the last thing your enemies expect.
You *personally* operate with an steel-reinforced sense of certainty, and refuse serious challenges or even the most cursory discussion of your articles of faith, preferring to dismiss them with – dare I say it – “cheap rhetorical tricks”. This is the behavior of a man who knows that his beliefs will not stand the test of the fire of inquiry. That means that, as a scientist, you are functionally already dead, and probably sucking the life and genius out of some lesser-known junior to maintain your status until you can retire comfortably. (I don’t know that for a certainty, of course, but I don’t doubt it; the pattern is prevalent enough that it wouldn’t surprise me. Epidemiology of scientific senescence, one might say.)
I note that your philosophy seems to be that “if you know you’re right, then there is no point in arguing”; what does that say, then, about your participation in this blog, where you *virtually* argue with CAM practitioners on a regular basis? Why not stick to your knitting, secure in the knowledge that your enemies will prove their own undoing?
I am well aware that *I* might be wrong. Can you convince me of that?
“let he who is without Error…”
-SD
weing
Where is i believe the man helped me im still not open minded.
I will admit there is a chance it was right place at the right time
thing going on. but what i do know is it resolved as soon as i
walked out.
Now Weing how do you explain everything else i posted
in the last post?
PS
I went to med school myself so your not talking to a medically
ignorant person.
“You keep saying if such and such develop seek medical attention. Where?”
… Uhh, at the doctor’s office, or the hospital? Or somewhere else that you’d find a doctor?
Why do you assume that a lack of coercion to use a particular alternative equals a lack of use of that alternative? Must people be forced to do everything that they do?
“Why not do it yourself? Why not run your own tests and treat yourself as you self-diagnosed?”
Why not, indeed? At the present time you can’t just go and pay the lab and get a test, like you could in a civilized country, but if we’re going to assume that medications have been freed of any obstruction to their use, why not assume that labs have been opened up too?
And who says that one *has* to self-diagnose, not that there’s anything wrong with the idea? I’ll jerk out that dirty trick now: tests of diagnostic automation tools (i.e. medical expert systems) in the 80s were astonishingly successful within the small domains in which they were applied. (MYCIN, anyone? CADUCEUS?) Interestingly, the chief constraint of those expert systems was computing power, in which the difference between technology available in the early 80s and today is, um, astonishing. Want to guess how well a *modern* medical expert system with full user interaction would perform, and how frequently it would get the right answer, especially compared to a human PCP, or even a specialist?
“at 7:30am, on October 12, 2009, Docnet became sentient…”
-SD
Dear SD
you have some bad ass english!
I like lack of eveyone elses ability to make their point around you.
vargkill
“Some people who are good at what they do might not wish
to be in the spot light as much as other people. ”
I must be psychic because I predicted you would say something similar to this.
The only Sik Kin Wu I could find in WI was this guy, who I assume is not your guy:
http://cases.justia.com/us-court-of-appeals/F3/81/72/530648/
“Why not try it for yourself Karl?”
Well, I don’t anticipate getting anywhere near Wisconsin anytime in the foreseeable future, but are his services free of charge for at least a trial demonstration?
“If things can be proven then things can be disproven.”
I maintain that this illustrates your lack of understanding of science and the scientific method.
“But there are a lot of people who are finding relief from this form of practice.”
That’s not a scientific claim, it’s an anecdotal claim, and it’s not even a particularly good claim. If I throw a thousand dice, a lot of dice will come up sixes. What percentage find relief? What percentage don’t? How many would or wouldn’t experience relief from a treatment or placebo treatment if put to a controlled trial?
His diagnostic skills would be quite easy to put to a scientific test. The James Randi Educational Foundation will award him $1,000,000 if he can do what you claim. Many who refuse to take the Randi challenge claim it’s not about the money and they don’t want the money, but none of them ever offers to take the challenge and donate the $1,000,000 to the charity of their choice which they deem most worthy.
“What could be the reason?”
Placebo response, self limiting conditions, natural remission, etc, or it could be actual effectiveness of his technique; we really how no basis for drawing any conclusions beyond some people who have been treated by him perceive that they are better off.
“Heres a good example, If your head hurts why does pushing the web of the thumb or the area between the eyes help?”
Uhh…it doesn’t help me, but if it helps distract you from the pain or otherwise works for you, more power to you.
“You get where im going with this?”
Uhh…If it seems to work for you, it must be for real, and work the way you suppose it does?
“I am suprised that you did not address the fact that more and
more doctors are practicing alternative medicine. What are your
thoughts on that?”
(I would guess that you were actually disappointed, and not so much surprised, but I could be wrong)
The term “more and more” might be misleading. It does not necessarily mean that alternative medicine is being practiced be even a significant percentage of MD’s. Also, I hope you don’t count diet, nutrition, exercise and other lifestyle changes under the umbrella of alternative medicine.
My thoughts on “more and more” MD’s embracing ideas and practices not scientifically validated is that I find it reason for concern. It makes me wonder what these doctors’ criteria is for determining what is an acceptable method of treatment.
“You admit that you cannot say its impossible right?”
I admitted that universal spontaneous proton decay is also not impossible, but is also extremely implausible and improbable.
“What form of tricky was involved with this?”
I don’t know. I don’t know how James Randi does most of the tricks he does, that just means he’s better at trickery than I am at figuring trickery out. It doesn’t make him a physic or wizard.
“I still would like you to respond to this question so i can make
my point.”
What is the exact question you would like me to reply to?
It seems to me that this argument is never going to be won one way or another. I also live in Wisconsin, and in fact, have gone to see Mr. Wu for a number of different ailments. I have been healed by him with some, and others I have only gotten temporary relief, but what I will say is that I am not someone that is easily convinced about ailment relief, and placebos have not worked on me in the past. I can’t account for any western scientific method, and I know too little about eastern medicine to argue it without sounding like an idiot, but I can say from personal experience that this guy is the real deal. He could tell me things wrong with me without me saying a word about what was bothering me, and it wasn’t like I was bleeding or limping. I would love a scientific explanation for how he diagnosed me and how my treatment made many of these ailments go away.
Karl Withakay
Thanks for getting to the point of everything in what i had to say.
“I maintain that this illustrates your lack of understanding of science and the scientific method”.
I would like to say that it does not illustrate a lack of understanding. The case and point is prove it! Or prove it not.
Im sorry if i am speaking in terms you are having trouble understanding. Its simple, offer evidence that cannot only
convince me but everyone else.
“That’s not a scientific claim, it’s an anecdotal claim”
Ok you can throw a thousand dice for anything and see how
many sixes you get right? Do you really think that is a good
metaphore for getting your point accross? You could say that
since meds didnt help a thousand people with the same infection that they cant all be sixes right? That is called playing
the odds. How do you think that argument or method of thinking
is going to really apply to this nature of the conversation?
Thats no funnier then the metaphore i used. Try again!
“Placebo response, self limiting conditions, natural remission, etc”
Ok now i will use your dice metaphore…
So i guess for all of the people i know who have been treated
by Mr Wu are just the few sixes in the thousand dice rolls?
Way to play the odds hey? I guess Mr Wu is really should
go to vegas and try his luck on the tables? Ill make sure i
tell him to try his luck next time i go in to see him.
“(I would guess that you were actually disappointed, and not so much surprised, but I could be wrong)
The term “more and more” might be misleading. It does not necessarily mean that alternative medicine is being practiced be even a significant percentage of MD’s. Also, I hope you don’t count diet, nutrition, exercise and other lifestyle changes under the umbrella of alternative medicine.
My thoughts on “more and more” MD’s embracing ideas and practices not scientifically validated is that I find it reason for concern. It makes me wonder what these doctors’ criteria is for determining what is an acceptable method of treatment.”
How obtrusive of a thing to say! Acceptable method of treatment? Did you ever consider there might be a reason
why more doctors are embracing alternative forms of medicine?
So i guess i pulled that one out of my ass right? Do some research on the matter and tell me if im wrong. I dont come into
this making false statements to have fun, this is based on things
i have read or know for a fact.
Fuck james randi, if he makes a living off of debunking others
then fine thats ok with me.
If you want call him up and have him get ahold of Mr Wu, but all
i can say is if people go to him with a problem and he makes it
better or fixes it then how can anyone agure that? Like i said
give me a call if you come to WI we can go visit him and he will
gladly examine you for no charge, ill even buy you lunch in his
restaurant which i might add is some of the best chinese food
this side of the mid west.
Best get them dice ready and lets see how many sixes you
can roll!
i almost forgot.
I notice when my head hurts that applying pressure to the web
of my thumb or doing the same between the eyes helps rid
the pain.
This seems to help a lot of people, so i was going to make
the point of if it works why could other points on the body
help do the same for other things.
Marius-9 said “I can’t account for any western scientific method, and I know too little about eastern medicine to argue it without sounding like an idiot, but I can say from personal experience that this guy is the real deal.”
First, if you are ever in the “East” and get really sick be prepared to be treated with real, er “western” medicine. If you want to be completely accurate both the chicken pox vaccine and many statins can be considered “Eastern” medicine since they were both developed in Japan! Remember the silliness that is called “homeopathy” is from Germany, which is typically considered to be located in the “West”.
Now that the stupidity of trying to divide a sphere into “East” and “West” has been dealt with… here are some reading recommendations:
1) get a hold of R Barker Bausell’s book “Snake Oil Medicine” and actually read it
2) do the same with Sherry Seethaler’s “Lies, Damned Lies and Science”.
3) and, of course… the Singh and Ernst book “Trick or Treatment”.
You never mentioned your “ailments”, but unless they were real chronic conditions like diabetes, a broken bone, hypertension or a missing limb — the symptoms may actually wax and wane naturally.
Oh, and about your question, “I would love a scientific explanation for how he diagnosed me and how my treatment made many of these ailments go away.”
It is called “cold reading”… you may think you did not tell him anything, but you probably did during an intake interview. The other scientific explanation is known as the “placebo effect.” Don’t diss it, it is a real thing. It has also been shown that more expensive placebos work better than cheap placebos. See “Predictably Irrational” by Dan Ariely (who was very happy to get an Ignoble for this study!).
vangkill said “I notice when my head hurts that applying pressure to the web
of my thumb or doing the same between the eyes helps rid
the pain.”
Those are called “sinuses”… if you have a sinus headache you can relieve pain with pressure on the area. What I found even more effective was learning how to avoid blocking the sinus cavities by preventing allergic congestion with seasonal allergy medication (benadryl at night and Allegra during the day), or if that fails (depends on the season) by taking a little sudafed.
HCN
Im telling you that you dont have to tell this man anything, and
there is no interview, you go to him and say, can you examine me, he has you sit down and does his thing.
HCN
Thats fine dude but if your like me and dont want to pump
chemicals into your body with over the counter meds then
your going to search for an alternative. or better yet try to
get to the root of the problem instead of making the symptoms
go away.
Look man im not saying i believe in everything “alternative”
but i am saying i believe that some people can provide this
type of practice and be effective at it.
So instead of making lame brained comments, try adding
something of value to the conversation.
“Those are called “sinuses”… if you have a sinus headache you can relieve pain with pressure on the area”
really HCN? i have no idea thats what they where called
but if applying pressure to the area makes the pain go away
or helps the pain would that not say applying pressure to
other areas of the body might do the same hence acupressure
really maybe doing something that works?
As i said before, expression with expletive laced diatribes!
Lord help me!
Okay, HCN, If you want to be an Jerk, let me tell you a thing or two about what I do know:
First off, that which is commonly referred to as “eastern Medicine” is more specifically called Traditional Chinese Medicine, which encompasses accupunture, accupressure massage, and herbal holistic therapies. I am not a huge expert on the matter, as in I didn’t finish school.
What I can tell you is that my knee experiences chronic pain from a hereditary form of loose joints, as do my shoulders and ankles, but knees mostly. Furthermore, I didn’t say I word, I just said “I need help” and he found these problems, so eat your own words.
I will also say that I teach both Kung Fu (Chinese Ko Shu, not Wushu) and Ba Gua Zhang (Pa Kua Chang), and I have had many students who have suffered anything from migranes to chronic depression to yes, type II diabetes, and have been able to get off of the chemicals making them well, and just able to do it themselves, through the movement I have taught and been taught. Testimonials can be found if you type in “Oriental Health Methods” in a google search in quotations to find the exact web address.
I am not trying in any way, shape or form to credit or discredit anyone’s education here, I am just saying that maybe you need to look beyond all of your facts and more into your intuition on matters. Then maybe we wouldn’t have over medicated, under treated people based on ten misdiagnoses to find one real problem.
*A
Reading through this whole blog now I feel as though I am trapped with a bunch of Simpsons’ “Comic Book Guys”
On that note, keep squabling amongst yourselves until the end of time when these arguments are still neither proven nor disproven.
Marisu-9, you should not have commented until you had read those books. Seriously.
I hate the “west” vs. “east” crap. If you really understood what I had written you would understand it is a false bit of crap. Especially since some crap sold as “Traditional Chinese Medicine” here in the USA has had real pharmaceuticals like Viagra added! Don’t even go into the mercury and other heavy metals found in Ayurvedic meds!
Stop being a sap… I take Eastern medicine, it is a compound derived from red rice yeast that was developed in Japan, it is called simvastatin. I really really wish my kids had had the Eastern vaccine developed years before my kids suffered through chicken pox.
Plus, when it comes to medicine, Google is not your friend. You would be better off using http://www.pubmed.gov (and it even includes “Eastern” medical journals from China and Japan!).
vargkill,
Confirmation bias.
You can google cognitive bias and find a whole list of them and take your pick to see how you can be led astray.
SD: Thank you for reading my comment and responding! While I wasn’t speaking directly to you when I mentioned CAM-adherents (you’re approaching this from a libertarian angle, not a “magic medeicine” angle), obviously anybody can have an opinion about my argument, and I am flattered that somebody read it.
What, precisely, is the difference between “groups” and “people”? Or “society” and “people”? I think the distinction between your perspective and mine may simply be semantic. I definitely believe that society is made up of individual people; if I didn’t, I might not care so much about it.
The right to trade freely without fear of force or fraud is abridged when the con-artists are allowed to operate with no repercussions. Go back a century; doctors certainly wrote prescriptions, but you didn’t need a prescription to get any medicine. You could just as easily ask the pharmacist to mix something up, and more often than not, they’d do it.
Were people better off? No, because although they were free to choose any medicine they liked, market forces ensured that the ones most available were the fraudulent ones. Mrs Winslow’s Soothing Syrup is one of the more famous examples. Even well-educated folks poured this stuff down their baby’s throats with nary a thought as to its contents. Of course, they probably didn’t realize that it had morphine in it.
You have argued that all we really need is proper labeling, but is that really an adequate protection? Labeling laws in the early 20th Century were the first attempted defense against the widespread fraud in the medical industry. They did little to stop it, and today, an entire industry has built up around carefully wording one’s labels to avoid prosecution. This does not serve the consumer, because the products in these categories are not sold honestly.
I would say that if all pharmaceutical manufacturers and physicians were honest, and had the best interests of their customers in mind, your model would work, SD. The problem is that they are not all honest, and they do not have the best interests of their customers in mind. We are not free as consumers if we are vulnerable to fraud.
The same argument applies to why we need regulation of the banking industry, law enforcement, and waste disposal rules. It’s because it is unrealistic to expect everybody to be both altruistic and wise, especially in a system that rewards competitiveness. (Don’t get me wrong; I think competitiveness is a good thing, and one of the great strengths of capitalism. But it has a price.)
weing
“Confirmation bias”.
Im not here seeking your approval. Last time i checked i had
the right to not only form my own opinion based upon what
i have seen and been through but also because i just do not
fit the cookie cut out that so many of you have been molded from. It makes life rather boring and less exciting.
The medical field was not for me. Everyone has a calling in life
and perhaps it is wrong to ignore your calling to do something
else that you would not be happy doing, hence my leaving med
school because i thought there might be better practices or
dare i say better alternatives.
So in your eyes “Comfirmation Bias”. confirmation bias, the tendency to interpret new information in such a way that confirms one’s prior beliefs.
So you in my eyes are – “correspondence bias”
in which people tend to explain others’ behavior in terms of personality, whereas they tend to explain their own behavior in terms of the situation
On top of it you are also arrogant and prickish.
Your also arrogant and probably still believe your methods of
treating Hypertension are still acceptable along with most
other doctors who often confuse ones normal bp for high bp
then throw some beta blockers at them.
Well i guess if i was making over 80,000 a year i would not
care about the well being of the people only my damn pay check
and what kinda IN the people have.
With all do respect Show your Comfirmation bias and stick
it you faggot!
Very illuminating. I learn something new every day.
Not to throw a wrench in the machine (and by doing so receive a long winded and inflated answer), but I was wondering if anyone would care to comment on the legal ramifications for the docs who will be treating the “minority” of patients who do diagnose and treat themselves incorrectly and end up in a worse situation than before. Since the doctor will end up with a patient who has a more severe condition, the treatment is likely to be more extensive/ invasive/riskier and may have a worse outcome than the treatment for the original condition. This will inevitably, in the society we live in today, lead to more lawsuits for physicians who are just treating what comes in regardless of what lead up to the visit.
Hey Vargkill-
I was actually impressed with some of your discussion until you started using profanity and name calling. Also you get a bit more respect when you use spell check. *)
Or correct grammer and punctuation.
“Ok you can throw a thousand dice for anything and see how
many sixes you get right? Do you really think that is a good
metaphore for getting your point accross? ”
Yes I did,but it obviously was wrong because you didn’t get my point. Vague terms like “more and more” are loaded and meaningless. Even hard numbers aren’t useful. What one needs is rate information. It doesn’t matter if 1000 widgets are blue, what matters is what portion of widgets out of the total sample is blue.
Your response to my “Placebo response, self limiting conditions, natural remission, etc…” reply left ignored the part where I said, “…or it could be actual effectiveness of his technique; we really how no basis for drawing any conclusions beyond some people who have been treated by him perceive that they are better off” I actually acknowledged the possibility that the man’s treatment could be for real.
“So i guess for all of the people i know who have been treated
by Mr Wu are just the few sixes in the thousand dice rolls?”
That’s one possible explanation, among many, for at least some of the successes.
“Did you ever consider there might be a reason why more doctors are embracing alternative forms of medicine?”
No large group will ever be totally homogeneous. I could easily say that “more and more” doctors are writing bogus prescriptions to supply steroids to athletes or pain killers to drug addicts, that isn’t a sign that it should become an accepted practice. If the fact that some doctors are embracing alternative forms of medicine could be considered support for the practice of said modalities, why doesn’t the fact that the vast majority of MDs are not embracing alternative forms of medicine hold at least equal and opposite weight? Heads you win, tails I loose? Obviously those doctors who embrace “alternative medicine” have their reasons, but you seem to assume they must be good, well supported reasons by default- argument from authority/popularity.
“So i guess i pulled that one out of my ass right? Do some research on the matter and tell me if im wrong. I dont come into
this making false statements to have fun, this is based on things
i have read or know for a fact.”
I never accused you of making any false statements, and to clarify, I do not believe you are lying about anything, other than the possibility that you are exaggerating the 100% number at least a little.
“Fuck james randi, if he makes a living off of debunking others
then fine thats ok with me.”
Constructive dialog is, apparently, not foremost on your mind, and I am starting to grow a little tied of playing the Tireless Rebutter, so please keep it civil if you really wish to continue this dialog.
By the way, I am intrigued by your silence about the Sik Kin Wu of WI who was convicted of tax evasion.
http://cases.justia.com/us-court-of-appeals/F3/81/72/530648/
Was I wrong, and this is actually the same man of which you are speaking?
Please see this excellent post by Harriet Hall regarding the “Traditional” nature of Traditional Chinese Medicine
http://www.sciencebasedmedicine.org/?p=252.
Dr. Skeptizmo said
It seemed to go downhill as the timestamps got later at night. I suspect some self-medication.
“Ok you can throw a thousand dice for anything and see how
many sixes you get right? Do you really think that is a good
metaphore for getting your point accross? ”
Yes I did,but it obviously was wrong because you didn’t get my point. Vague terms like “more and more” are loaded and meaningless. Even hard numbers aren’t useful. What one needs is rate information. It doesn’t matter if 1000 widgets are blue, what matters is what portion of widgets out of the total sample is blue.
Your response to my “Placebo response, self limiting conditions, natural remission, etc…” reply left ignored the part where I said, “…or it could be actual effectiveness of his technique; we really how no basis for drawing any conclusions beyond some people who have been treated by him perceive that they are better off” I actually acknowledged the possibility that the man’s treatment could be for real.
“So i guess for all of the people i know who have been treated
by Mr Wu are just the few sixes in the thousand dice rolls?”
That’s one possible explanation, among many, for at least some of the successes.
“Did you ever consider there might be a reason why more doctors are embracing alternative forms of medicine?”
No large group will ever be totally homogeneous. I could easily say that “more and more” doctors are writing bogus prescriptions to supply steroids to athletes or pain killers to drug addicts, that isn’t a sign that it should become an accepted practice. If the fact that some doctors are embracing alternative forms of medicine could be considered support for the practice of said modalities, why doesn’t the fact that the vast majority of MDs are not embracing alternative forms of medicine hold at least equal and opposite weight? Heads you win, tails I loose? Obviously those doctors who embrace “alternative medicine” have their reasons, but you seem to assume they must be good, well supported reasons by default- argument from authority/popularity.
“So i guess i pulled that one out of my ass right? Do some research on the matter and tell me if im wrong. I dont come into
this making false statements to have fun, this is based on things
i have read or know for a fact.”
I never accused you of making any false statements, and to clarify, I do not believe you are lying about anything, other than the possibility that you are exaggerating the 100% number at least a little.
“F— james randi, if he makes a living off of debunking others
then fine thats ok with me.”
Constructive dialog is, apparently, not foremost on your mind, and I am starting to grow a little tied of playing the Tireless Rebutter, so please keep it civil if you wish to continue this dialog.
By the way, I am intrigued by your silence about the Sik Kin Wu of WI who was convicted of tax evasion.
http://cases.justia.com/us-court-of-appeals/F3/81/72/530648/
Was I wrong, and this is actually the same man of which you are speaking?
I’m afraid there might be a double-tap coming. If so, I’ve figured out why: I need to stop quoting other people’s profanity when I reply to them so my replies don’t get held up for moderator review.
Sorry, folks for the double post if it shows up.
.
“I am just saying that maybe you need to look beyond all of your facts”
I think that about sums it up.
Karl Withakay
Ok ok im sorry for calling you names. that was not right on my part. You are 100% correct and i should have been a bit more
professional on the board.
Dr. Skeptizmo
im not here to impress the crowd, i could take the time to
get every last detail correct as far as grammer ect. but im trying
to come as straight forward as i can. I also have a lot more going on in my life then to sit on here all day but thanks for
playing the role of grammer cop. Please don’t take me to jail?
Karl Withakay
““more and more” doctors are writing bogus prescriptions to supply steroids to athletes or pain killers to drug addicts”
Dude you are comparing apples to water melons here.
Just because some do it does that mean every doctor who
practices or becomes interested in alternative medicine is
going to write bogus treatments. There is a time and a place
for everything right? But the benefits are becoming more and
more clear.
“why doesn’t the fact that the vast majority of MDs are not embracing alternative forms of medicine hold at least equal and opposite weight”?
Let me ask, as far as we all know, how long has alternative
medicine been in the mainstream? Would it not make sense
that as time goes on it is going to become more and more so?
My concern is people being able to practice alternative meds
who have no clue what they are doing or being able to claime
the status of calling themselves a PCP. I am not in support
of that simply because any good practice is going to know when
someone needs to be treated within a means they cannot support. If someone goes to a acupressure clinic after cracking
thier head open im sure any good person would know acupressure is going to do little to save the brain from major
damage. Thats the point im making.
You have to remember that the weight is still leaning in
the corner of doctors not embracing alternative form of medicine.
So again good metaphore on your part but now that the weight
is slightly shifting you just had to play the oppisit on that one
right?
As for the link, i dont think this is the same Mr Wu. If it is then
i would never be able to tell he had or delt with that much money.
Chris
“It seemed to go downhill as the timestamps got later at night. I suspect some self-medication”.
Ill bet you really think you just contributed something great
with that comment right? Let me ask, how much thought did
that really take? Im sure you feel much better about yourself
now. Nice lack luster effort to add something worth while!
Karl Withakay
Sorry for not being able to address everything you said prior
i did not read through it enough therefor i did miss a few
things and i will admit that yes you indeed did admit it could
be the effectivness of his skills.
Sorry i missed that part.
Not to “shill” for my other blog, but I have a wrap up of this multi-part discussion over at my other place, if anyone’s interested.
http://scienceblogs.com/whitecoatunderground/2009/04/naturopathy—a_final_word.php
“Dude you are comparing apples to water melons here.
Just because some do it does that mean every doctor who
practices or becomes interested in alternative medicine is
going to write bogus treatments.”
I think you may have missed my point here. I was not saying alternative providers would write bogus prescriptions, my point was that just because “more and more” doctors do something is not justification for their doing it, analogous to the fact that “more and more” MD’s write bogus prescriptions, but that doesn’t make it OK. If the “fact” that “more and more” physicians are incorporating alternative treatments into their practices were justification for their doing so, that would be circular logic, and ANY modality would be acceptable as long as you could convince enough people to start practicing it.
I’ll also add that I don’t give much credit to the argument “if there wasn’t something to it, it wouldn’t catch on” I believe Dr Gorski and other can point to examples even in the medical world outside of CAM where popularity drives practice before the science fully justifies the practice. I don’t feel like taking the time to find the post, but I recall a post regarding some new laporoscopic surgical procedure for something like a spleenectomy maybe? (I hope I spelled those right, my spell checker is flagging them, but it has no recommendation for a different spelling.)
vargkill,
Because more doctors are embracing alternative medicine, we should all jump on the bandwagon? Sorry, I would need a lot better reason to abandon science based medicine.
Well, I’m not sure it was worth the wait – or the gratuitous attempts at abuse – but SD has finally given a fairly concise – if not entirely coherent – explanation of his position.
Some of SD’s responses were a little puzzling until I realized he thought I was a physician and therefore had “a dog in the fight”. Sorry, SD – I’m just a humble biologist who doesn’t treat patients.
Another misconception that SD has is that I am somehow inflexibly opposed to the idea of people buying whatever drugs they care to without a prescription. I think the idea has certain merits. So does the USFDA – they regularly “convert” prescription drugs to “over-the-counter” once they’ve been shown to be safe enough to be used without close physician monitoring.
The only problem with this position is that it negates any sort of consumer protection. If people cannot be told what they can and cannot sell (or buy), there is no authority to prevent people from selling contaminated, outdated or mislabeled pharmaceuticals.
However, SD has already claimed that he doesn’t rule out entities like the USFDA that would mandate quality controls. But that sounds a lot like telling someone what they can’t sell and, coincidentally, what they can’t buy.
I guess SD would see taking money from people with a threat of force – like Income Tax – to be extortion. I can’t say I disagree with him too much, especially today (15 April).
However, all laws are based on the threat of force, so every law that involves a fee, fine or requirement that a third party be involved – like when I had to get my engine fixed by a mechanic in order to get my auto license tags – is the same in that respect.
What about sales tax, in which the state makes money by interefering with a transaction – in this example, without even providing any direct service to the purchaser? And if you think that isn’t done under the threat of force, try not paying sales tax.
In the case of physicians, they don’t actually make money from the prescription. They charge for diagnosis and any treatments (like surgery) they personally carry out.
They don’t charge for prescriptions or for prescription refills (if you don’t need an office visit). If they do require an office visit, the purpose of that is to monitor the condition the drug was prescribed for. Of not, some of the office visits physicians require to get prescription refills are mandated by state or federal law.
Unlike CAM practitioners, SBM practitioners don’t sell the drugs (or medical equipment) they prescribe. In most states, they are legally barred from selling prescription drugs or equipment to their patients.
That was an obvious straw man, since I never said patients were “morons” or “my wards”. I did say that most people lack the training or expertise in diagnosing and treating medical disorders.
This is no more an indictment of the “average person” or “patients” than saying that most people (myself included) cannot fix their own cars, beyond routine maintenance and minor repairs.
Not having a certain set of skills does not make a person a “moron” or indicate that they are in need of guardianship. This is not only a straw man, it is a juvenile straw man.
Why would anyone want to consult a molecular biologist with a medical problem? On the other hand, I don’t believe that I (or anyone else) stated a concern that physicians would be put out of business.
On the contrary, if people were allowed to self-prescribe, I suspect that most would continue to go to their physician and probably would still want to get a prescription. After all, a prescription is simply a note telling them what medication to get and how to take it.
In fact, I suspect that physicians would make even more money (or, at least, have more business) dealing with people who thought they had X disorder and took the medication for that, all the while actually suffering from Y disorder.
The thing about science-based medicine is that it doesn’t need strategic or moral victories because it actually works. I’ve never seen any of my CAM-friendly neighbors fail to eventually see a real doctor and get real treatment if they had a disorder that wasn’t self-limiting.
The legal requirement for a prescription did not simply appear out of a vacuum. In fairly recent times – not quite within living memory, but almost – anybody could and did pop into the chemist’s shop and purchase whatever they thought they needed.
If they had a prescription, it was to instruct the chemist in how to compound and label the drug – not a “permission slip”.
This practice was gradually eliminated, not because drugs became more dangerous – you could buy strychnine and arsenic in the chemist’s shop “back in the day” – but because of a growing awareness that it was safer to require a prescription. Not foolproof or absolutely safe, just safer.
SD probably sees this as just another encroachment of the “nanny state”. Perhaps he’s right. He also probably doesn’t feel that this sort of historical process reaches the level of “data”, and he’d be right about that, too.
However, we also don’t have much data to support the idea that requiring a driver’s license reduces car crashes. We’ve come to accept that requiring testing and licensing of drivers was a “good” thing, despite the coercive nature of the requirement.
It’s a bit of a stretch to link prescription drugs to slavery, but let’s run with that one for a while.
If not being able to buy whatever drugs (or medical equipment) you want is akin – in some small measure – to slavery because it interferes with self-determination, then all laws are equally offensive. Face it, the purpose of a law is “denial of self-determination”.
Such is the price of living in society.
As a friend of mine used to say, “That was a long run for a short slide!” After all the insults, the playground taunting and the coy teasing, this is SD’s “big truth”? He feels that laws are coercive (they are) and that not being able to buy prescription drugs without a prescription is interfering with his self-determination?
No doubt, he’ll have many more cutting remarks about how I clearly don’t understand his answers. So be it. I’m really not that interested in hearing what he has to say, now that I know he has so little to say.
Prometheus
weing
“Because more doctors are embracing alternative medicine, we should all jump on the bandwagon? Sorry, I would need a lot better reason to abandon science based medicine”.
When did i ever say anything about abandoning the practice
of SBM for alternative medicine? All i said was more doctors
are starting to embrace it. Nothing ever about switching all
together.
Karl Withakay
I think you read a little to deep into my last response.
I was taking your anology and challenging it with my own.
Get it now? The point i was making is that not everyone is
going to embrace alternatives but that more are adding it
to thier practice.
Who are you to say what is good justification
for a doctor to embrace other alternatives? If you have such
an issue with this indeed being a fact, then why don’t you take
that concern to the medical board of what ever state you practice in? Bottom line, if you see no reason to do so yourself
then why is it wrong for others to do so? You cannot speak for
every doctor who indeed does start to embrace other alternatives.
If you knew for a fact that a treatment did not work would you
continue to provide the treatment for the people who come
to see you? Well what if doctors who are embracing other
alternatives are seeing real results with their embrace of
alternative treatments?
I Could find links and other sources but maybe later im not in
the mood to go hunting right now. Case in point, whats good
for the goose is not always good for the gander.
Some will some wont, if it works for some and the success rate
supports the growth then why not right? Im sure with its growth
will come more and more testing to see what the cold hard
truth really is. Until then we can debate this all day and night
and have no real winners.
From my point of view alternative medicine is quackery, there is no science behind it, and embracing it is tantamount to abandoning science based medicine. Those docs that I’ve seen embrace it are doing it for the money. They are selling snake oil to patients. They cater to the worried well. What they are doing is exploiting these patients. Do those patients deserve being exploited? Did Bernie Madoff’s clients deserve it?
weing
So one bad apple ruins the bunch?
Thats an argument a 5 year old child cannot get away with.
This is America and you have the right to feel and to practice
what you would like and i am in full support as well as respect
of your opinion. However that does not change the fact that
some doctors might truly see the benefit in alternative medicine.
Just because one choses to embrace such practices does not
mean they are in it for the medicine. Where you think this
argument gives you solid ground is beyond my ability to understand and for an educated man you seem to be really
lacking in your skills as a person of understanding.
The science behind alternative medicine is that if it provides
relief for a number of people it must be doing something right?
Im sure you can google that and come up with an explination
as to why. With all due respect weing i think you are a moronic
tool!
This is being reposted to correct my mistakes in my last post.
weing
So one bad apple ruins the bunch?
Thats an argument a 5 year old child cannot get away with.
This is America and you have the right to feel and to practice
what you would like and i am in full support as well as respect
of your opinion. However that does not change the fact that
some doctors might truly see the benefit in alternative medicine.
Just because one choses to embrace such practices does not
mean they are in it for the money. Where you think this
argument gives you solid ground is beyond my ability to understand and for an educated man you seem to be really
lacking in your skills as a person of understanding.
The science behind alternative medicine is that if it provides
relief for a number of people it must be doing something right?
With all due respect weing i think you are a moronic
tool!
vargkill said <blockquote.The science behind alternative medicine is that if it provides relief for a number of people it must be doing something right?
What science?
Oh, wait I found some:
Snake Oil Science
and
Predictably Irrational
Chris
Get in where you fit in you clown.
Is that all you have to bring to the table?
You just don’t the point im making, funny thing is there is
science and then there is science to say it bull crap so who wins?
You are a moronic tool and unless you’re going to add anything
besides a few one liners you have no point of refrence.
One liners? I believe each of those books consist of several lines, and actual several chapters.
Still have not seen much science from you.
Chris
Oh, wait I found some:
Snake Oil Science
and
Predictably Irrational
Is what im talking about, nothing better to add to the conversation? You gotta do better then that.
Chris i wanted to ask, How many of these doctors dicks did
you have in your mouth when you posted that?
For everyone else im sorry to have to say what i said to
Mr Tool over here, but nothing bothers me more then someone
posting who has nothing better to offer other then a few lines
of bull crap!
Least some of the other people on here who seem full of crap
have worth while things to say even if they conflict with the
thoughts of others. I to am not perfect but at least i try to talk
to people and gladly admit when someone else has made a good point.
If you put your mouse pointer over the words you will see a little hand show up, that means they are hyperlinks (created with HTML tags, it involved some “less than” and “greater than” brackets, the letter “a”, an “href” and some quotation marks). If you push the left hand button of your mouse it will take you to a page of a major online book store… You can either order the book, or read about them and then place a hold at your local library.
You see, I have actually read both books, along with several others. That is because I am literate. Something you might notice since I use real punctuation and know how to spell.
It is about time for some of us to tuck ourselves into bed and go to sleep, and I suspect our little friend “vargkill” has indulged in some self medication when he decides to write for all to see some absolute idiocy like
Now I ask again, what science? Have you read Dr. Bausell analysis of the the studies on acupuncture? What about his instructions on how to find a “qualified” quack? What did you think of Ariely’s study that showed more expensive placebos work better than cheaper placebos?
You see Chris, the issue i have with you is its ok for you to
make smart comments but when i do it in a way that is not
to your liking you call it idiocy. Funny indeed. You’re the kinda
person i would slap if i met you in person.
Chris so im supposed to go read your links when thats all
you have to say is a cheap line and then add some links
to the bottom? Or did you ever consider that i might have
read books like this already? Or perhaps you think that i believe
all doctors are just overpaid meat magicians?
“Now I ask again, what science? Have you read Dr. Bausell analysis of the the studies on acupuncture”?
First off, i went to med school and as i have stated in earlier
posts, medicine was not for me. I realized i wanted to do something else with my life. So i don’t know about you but
i do have medical knowledge, its not like im in here at age
17 making assumptions based on what i think is fact, and for
your info im a grown man so the whole bed time bit, pretty
original! How long did that take you? Or better yet, your little
analogy on the hyperlinks! Is that the same as hypertension?
Second, are you a doctor? I would assume so since you seem
to be taking your rhetoric to such a challenging level.
Have you ever experienced any sort of alternative medicine
for yourself? If you would have experienced what i did you
might be a little more supportive of it. I have seen this man
Mr Wu on so many occasions do what he does. No intake
interviews, no way of tricking the person. Yes Chris i know
what you guys all mean with the whole mind trick or cold
reading stuff. Again i guess there is no way to convince
anyone else, but i know what i have seen with my own two
eyes!
Its one thing to go based on what you have read but its
another to experience it for yourself. Placebo effect or not
it still does not explain how Mr Wu is able to diagnose in the
fashion he does. Im not sure how long you have been with
the entirty of the conversation, but in case you did not read
earlier posts i explain all of this.
The placebo effect is really a medical phenomenon! What gets me is if thats all it takes for some people what can people really
do for themselves? After all it can sometimes improve a patient’s condition simply because the person has the expectation that it will be helpful.
My point is i believe even though we are prolly years away
from developing this awareness, perhaps humans can heal
themselves naturally? If we can trick ourselves into making
a condition improve then what does that say?
Im not stating this as a fact but imagine the possibilities?
Hence why i believe the alternative medicine to be a bit more
then just “quackary”. I believe there are some people and i stress some! Who have the ability and i know that i know one
personally.
“Again i guess there is no way to convince
anyone else, but i know what i have seen with my own two
eyes! ”
Coming in late — I’m entirely in sympathy with you until you start to make somewhat improbable scientific deductions from what you have experienced.
With regard to your symptom improvement, I accept it as a valid observation. But it could be either coincidence or a placebo influence, as you know. Any symptom occasionally goes away for no obvious reason or for reasons less obvious than current therapy.
Any placebo influences would have been enhanced by the mystique of the apparently miraculous diagnosis and high expectations of this renowned healer. There is no real mystery or conflict with known science in this. We already know that acupuncture “works”, but mainly as a placebo.
The apparently mystical powers of diagnosis, are a far less likely phenomenon. We would have to test this out more rigorously. You yourself will know that guessing that a young otherwise healthy looking woman is consulting about female problems will be right in excess of fifty per cent of the time. And you may only need a strike rate of perhaps 20% to gain the reputation you describe. Any misses would be quickly covered up and forgotten, or presented as yet to be experienced health problems.
But you seem to already know all this.
Its an interesting thing is it not? I like the way that you
decided to approach this conversation.
I know about the guessing thing but it just seems how can
he be dead on every time? Im sure there is a method to his
madness as there is to everything and everyone. But its
just amazing to see what i see with my own 2 eyes and not
be amazed and not have some sort of faith that he might
really be the real deal. Its hard because if you see it for
yourself or better yet have it done on you then its like WTF?
I mean he even knew which side of my nose was starting
to get congested from allergies, also which ear was feeling a
bit plugged. I know i cant seem to stress it enough and i know
its not going to be so easy to convince you guys on here
who have not seen it for yourself.
Maybe he should be tested? Im not sure how you would do
it personally, what would you suggest i do next time i go in?
Im looking for other ideas outside of my own.
Use a hidden camera and tape recorder.
weing
I think your a prick!
Since you seem to be of the narrow minded variety
and are so sure alternative medicine is “quackary” then
i will from this point forward refer to you as a “meat magician”.
I do not need your opinion nor do i wish to have any dialog
with you so for lack of better terms for someone like you,
Please insert a retractable baton up your a**.
That alternative medicine is quackery is my working hypothesis. I am looking for evidence to overthrow this hypothesis but haven’t found any so far. Your anecdotes are worthless and provide as much information as your sinking to personal attacks to make your point. Good luck to you.
pmoran
Almost forgot to make a point…
“guessing that a young otherwise healthy looking woman is consulting about female problems will be right in excess of fifty per cent of the time”.
Thats the thing pmoran, she did not inquire about the issue
he simply told her without ever meeting her and did so without
any prior knowledge.
Lucky guess every time?
weing
hypothesis
consists either of a suggested explanation for an observable phenomenon or of a reasoned proposal predicting a possible causal correlation among multiple phenomena. Yet not standing
on its own 100%. Its your “theory” and nothing more. Still not
able to prove your case just as i still cannot prove mine. Unlike
many on here i know what i saw and that is enough for me to
roll with.
“I am looking for evidence to overthrow this hypothesis but haven’t found any so far”.
If it is “quackery” in your book then why do you need to
have a “working hypothesis? but haven’t found any so far…
If you’re so sure then why do you need hypothesis?
Why are you not pushing this as a fact?
The personal attack was not meant to make my point, it was
intended to tell you that you’re a prick. Did my personal attack
prove my point to anyone else on here? Unlike you weing
i can admit to the possibility that i might be wrong. I can also
admit that there is a chance that it could all be a pile of bullcrap.
But i do not need a “hypothesis” to make my point. That is just
as unreliable as my supposed belief in what you claim to be “quackery”.
weing
I think i might have misunderstood your post about the
“hypthoesis. I now understand what you meant was
trying to find evidence to overthrow “your hypothesis”
on alternative medicine being “quackery”.
Sorry for jumping the gun.
pmoran said
To sum up: The plural of anecdote is not data.
I am a mechanical engineer, vargkill, I do not need to resort to tautology since you have more than adequately revealed your true nature.
vargkill posts:
“You are 100% correct and i should have been a bit more
professional on the board. ”
and then follows it up with:
“Chris i wanted to ask, How many of these doctors dicks did
you have in your mouth when you posted that?”
“You are a moronic tool”
“You’re the kinda
person i would slap if i met you in person.”
“I think your a prick!”
Here’s a false dichotomy for you: Were you insincere in the first statement, or are you just incapable of impulse control?
I suggest we all self moderate and stop replying to vargkill. I am done with him.
Chris
Im glad you are a “mechanical engineer” Chris, i still think you
are arrogant. Im an IT Pro and i think you have not really
been paying attention to what i have been saying on here.
You see Chris after my last reply to you all you have to say
is i reveled my true nature, well since you take such pride
in being a “mechanical engineer” along with making that
sound like your a perfect human being, why then did you
have nothing else to say after my long reply to you?
That shows that you are not truly listening and just did
nothing more then come into a conversation just wanting
to make your points and not try to hear anyone elses.
Looks like the “mechanical engineer” tough guy revealed your true nature! Nice way to push your point and then make someone else seem lesser simply because you dont want
to reply in any fashion that lets you be on top.
Here i thought “mechanical engineers” knew better?
Good solution Karl, If you don’t like what i have to say then
just dont reply to it. You see i personally think its funny that
for such prideful and educated people some of you people
sure are sensitive.
I dont know how many times i have explained the points
i was making, even acknowledging the fact that i am not 100%
right in my claims yet you still find a need to push the fact that
my evidence is not 100% factual. When did i ever say that
it was? If you clearly read what i have been posting i was
simply stating that for myself i cannot understand with all
thing considered how Mr Wu does it. There was never any
need to get so damn personal about it. Yes my personal
experience can be looked at with many different view points
and still having been through it yourself is much much different
then anything else i have read in a book.
I still stand in my opinion that we still cannot fully disprove
alternative medicine. I still stand in my opinion that i cannot
fully prove alternative medicine and can only go on my own
personal experience.
“Good solution Karl, If you don’t like what i have to say then
just dont reply to it. You see i personally think its funny that
for such prideful and educated people some of you people
sure are sensitive.”
I’ll make one last reply, in spite of my last statement, just to clarify.
I’m not being sensitive. In certain/most social contexts, I drop the F-Bomb more often than most people do. I’m not especially offended by your crude remarks. I’m just more interested in intellectual discourse than I am in listening to people resort to asking people, “How many of these doctors dicks did you have in your mouth…” in lieu of actual thoughtful or witty discussion.
By the way, why bother posting,
“You are 100% correct and i should have been a bit more professional on the board. ”
if you’re going to continue the way you did? Why not just be honest and say something like, “I’m sorry if you don’t like it, but that’s they way I talk/ write when I’m passionate about a subject, if you don’t like it too bad. I’ll keep talking that way until/unless the moderators warn/ban me.”?
That’s probably all form me in this thread. The dead horse is a bloody pulp anyway.
Well i will tell you Karl that sometimes that is just how i do things.
Unlike most on here i can admit where i am and can be wrong.
Yes Karl i can be an a**hole at times. That is just how i roll.
Anyways i have had a good conversation with a lot of you
on here.
One last thing Karl
We where having a pretty good conversation there for a minute.
Hey don’t let me stop this interesting conversation from evolving. You all had a lot of interting things to say on here
and i mostly enjoyed debating with some of you.
I will say that i am sorry for my crude nature. That is just
how i get sometimes. I can be an a**hole.
But if anyone wishes to continue this conversation in any manner then by all means.
Ill be nicer!
Sorry again for anyone who felt disrespected.
“Fool me once, shame on you. Fool me twice, shame on ME!” Or put another way, at this point why should anyone trust your claim that *this* time you’ll actually be civil – given what you posted immediately after the last such statement?
Scott
I am a human being and last time i checked no one is perfect.
We all make mistakes and do things that could have been
handled better right?
Ok then.
Vargkill-
I have three statements to make in regards to this entire conversation.
1) I have experienced “alternative medicine” and yes, this person diagnosed me without having heard one piece of information out of my mouth. Now, as an osteopathic medical student I can explain that away without resorting to non scientific principles.
a: I was in the office for some type of medical complaint
and I did not appear acutely ill- therefor she assumed
my complaint was chronic.
b: Many common medical conditions manifest somewhere
on the surface of the body in some way and it is
possible to make an initial diagnosis based upon that.
Without doing any sort of testing on me to confirm this she treated me with a form of energy healing and told me to come back regularly to keep up the treatment because my problem was not something that she could permanently fix- it needed surgery.
2)The above experience is something that I now remember in my studies to become a DO. There is a lot to be said about diagnosing the correct problem, the next step is being able to do something about it. Many pathologic processes are self limiting and I am sure these are the things that your practitioner treats. The problem with seeing a practitioner who only treats self limiting processes is that they may not recognize when it is not self limiting and may not get you the treatment you actually need.
3) Saying that a practitioner has a 100% correct diagnosis rate is absolutely ludicrous. No practitioner on this planet has a 100% anything. There will always be mistakes and denying them is only going to make you sound like a fool.
Ok now let’er rip. I know that you will have a snappy come back for all of this, but I am hoping that you take this as it is intended. To show you that people can be open to alt med but also hold many qualms about it due to the lack of testable efficacy and the limited usefulness it may have. I don’t dismiss things outright, only after many (many, many, many) factors weigh in.
Dr. Skeptizmo
No dude i enjoyed your explination very much and i thought
you said what you had to say in a very interesting way. So i respect your view point because you seem open minded about it. My issue comes when people are narrow minded and wish
to not look beyond anything other then what they have learned.
So snappy? No reason to be. I personally believe that there
are those who can do what they do and do it well. At the same
time i openly admit to anything being possible.
The only thing i can say to anything you wrote is, my claim
to the mans success rate is by what i have seen with my own
2 eyes. There are many other stories i could tell about my
expirences with Mr Wu. One noteable thing about the man
is he admits when he sees a problem and says he can only
fix for a short amount of time, or in his words… “I can fix but
very easy to come back”. Other simple things he fixes using
a very very different method. He only does acupressure but
seems to do it in his own way. I think he practices a very
old school chinese method that involves some kinda energy
reading with the general principles of classic energy points
in the body.
Whatever he does seems to work thats all im saying.
Now if i cracked my head open where would i go to get treated?
Not to him! I know and im sure he knows when someone needs
to have a good does of SBM. I believe both can co exsist without
the back and forth! I think SBM is good for some things and
alternative medicine is good for others.
I for one believe in alternative things for issues such as minor
injuries and hypertension which is the most misdiagnosed
things these days. I know for me i suffer from something we
all know as “white coat syndrome”. Im sure all doctors are
aware of the phenomenon. For some people something higher
then 120/80 could just be normal for that person. bp can
also change in the course of the day. My point is is that
i have seen far to many times meds being shelled out for
“hypertension” when for some people its normal to have
a higher reading then what we consider normal. Its when
the bp starts shooting up from a persons normal reading that
we need to consider medication. I just see to often people
are getting beta blockers thrown at them without extra monitering. Not saying all doctors do this but it happens a lot.
Im sure some of you are gonna attack me and say how you
never do or did this and anything over 120/80 is hypertension.
Well i will argue this point until im blue in the f**king face.
Point is, doing the “DASH” wont work for most people whos
normal bp is higher then the standerd. No one body is the same.
My grandmothers bp has been 140/80 her whole life and shes
80 years old and healthy!
Sorry for the long post just had a few glasses of wine and just
in the mood to talk!
Are these “primary care” naturopaths going to be paying the same kind of horendous malpractice insurance that I am paying?
They should.
I’m sure the trial lawyers will have a field day with this.
The Blind Watchmaker
Im not sure who that was directed at, but if you have been
reading most of the conversation you will see that i have never
once said that alternative medicine folk should be PCP’s.
Should they be allowed to practice? I think so!
If they are allowed to practice anything they should also be required to pay malpractice insurance.
Why? Most places make you sign a form that states what they
are doing. Making the person fully aware that they are being
treated by a form of theorpy that differs from SBM.
I know its hard to ween the good from the bad but not
every person who practices alternative medicine is a rip off
artist.
Plain and simple, If someone does not wish to be treated
by these people no one is making them right?
It is one thing if you do not believe in this form of practice
but you have to remember this is a different education and
its not your place to judge if it works or not. If someone goes
in and feels better then has it not served its purpose?
If its so bad then let people go get treated at their own risk.
Any normal person knows they are walking into a place that
practices alternative medicine.
Now i will agree that if they are able to become PCP’s then
maybe they should have to pay the malpractice insurance.
But what about the ones who are not trying to become PCP’s?
vargkill said “I know its hard to ween the good from the bad but not every person who practices alternative medicine is a rip off
artist. ”
Then they should be happy to pay malpractice insurance for those rare times when something goes wrong.
Why should only those who are primary care providers pay malpractice insurance? Why not those who claim to be specialists, like the chiropractic neurologists (who often do things like brain mapping and cranialsacral therapy)? What about those who claim to cure allergies with NAET? They are specialists, shouldn’t they have to pay malpractice insurance just in case their therapy does not prevent an asthma attack?
Wait you said “f its so bad then let people go get treated at their own risk. Any normal person knows they are walking into a place that practices alternative medicine. ”
Wouldn’t it be better if there was some real information that explained the real effectiveness of the alternative medicine? What evidence is there that chiropractic neurology is related to real neurology? What does cranial sacral therapy really do? Does NAET actually help allergies?
How does a “normal” person know these things work if the information presented is usually just marketing materials and without all that pesky science?
HCN
“Then they should be happy to pay malpractice insurance for those rare times when something goes wrong”.
So if i go in to get some acupressure done for a knee that
is bothering me and he/she does their thing, and i end up poping my knee out of place should i go and sue the person
who told did the acupressure work? Knowing full well that
i was not promised any drugs or any kinda shorts or surgery?
If you are like me and want an alternative other then filling your
body up with medications then your willing to try something else. I know full well the extent of my allergies and i hate taking
medication for it cause it makes me feel like s**t. So whats
my alternative? Do i just suffer? Or do i try something that might
help that does not involve taking meds?
My point is, if these people want to treat other people with
alternative medicine then let them. If people want to get treated
by these people then let them. They know full well it might not
work so in the end whos to blame? Are you just upset because
your not getting that persons insurence? Or do you really
hate folks who practice alternative medicine? Or is this just
against the ones who want to become PCP’s?
Again HCN im not in support of them being able to become
PCP’s. But i am in support of them having the right to practice
and treat those willing to come to them and try something different, placebo effect or not, its helps some people.
Thats my point.
PS
I honesly have not heard of all the methods you mentioned
but i will look some of them up so i have a better point of refrence.
Suppose he gives you some accupressure and your leg feels better and you keep coming back for maintenance and after a few months it pops and you can’t walk and end up losing the leg because the tumor growing there has gotten too big or worse, it has now metastasized. Would you want to sue him then?
weing
Would that be his fault? No it would be my fault for choosing to
go to someone who practices this form of medicine.
Have you guys like recently lost patients to these alternative
practitioners or something? I understand your concern but
who is it hurting?
1. There is no law against alternative medicine.
2. Its a persons choice to choose the treatment they want.
3. When is the last time anyone practicing alternative medicine
in the US was able to write a prescription? Unless of course they are already an MD and choose to embrace alternative medicine.
4. No one is holding a gun to your or anyone elses head and making you personally believe in it or anyone else for that matter.
I don’t understand this attitude. This is eastern medicine and it
must work or someone would have been able to fully debunk
its years ago. You ever been to China? Any of you personally?
Its a pretty common practice.
You have nothing to worry about because as soon as your
enemies prove to do their own undoing then you’ll get your
patients back.
Vargkill, if you view Not Being Chinese as a problem among the critics of medical practices traditionally used in China, go to skepticblog.org and read all posts by Yau-Man Chan. (Spoiler: he wants science-based medicine.)
Perky Sleptic
Ok that is just another opinion from a guy i have never heard of
until you had me go read his stuff. I know nothing about this man other then the fact that he is from East Malaysia.
Im sure i can find blogs of people who are for or against many
things in life. So i think to use him as a point of refrence to
prove a point is basically, pointless.
Try again!
vargkill,
Let there be CAM. Just please, don’t “integrate” it with science-based medicine.
Integrative medicine corrupts the rules of evidence. Once our evidential standards are corrupted, hello 1984.
Dr Benway
I guess the chips will land where they may right?
Look man i dont really believe in everything “CAM”
I just believe some people can practice alternatvie medicine
and provide real results. Do you guys finally get where im
coming from?
This is a no win argument for anyone. So why do we keep
going in circles?
“Would that be his fault? No it would be my fault for choosing to
go to someone who practices this form of medicine.”
What form of medicine? How would you be at fault unless you knew it wasn’t the real thing? Call it entertainment, distraction, anything. But it is not medicine. It would be your fault for choosing to go to someone who entertains you instead of a real doctor.
Maybe he should have a disclaimer saying that any benefits are illusory and not intended to treat any real illness.
weing
But when we choose to go to someone who is not a “real doctor” then they must know exactly what they are going into
right?
Iv never seen any alternative practitioner claim to be a real doctor.
It seems as if your grievances are with the people who want
to be PCP’s So for the last time im not in support of this.
Do you understand now? I have only said this probably
20 times on here now.
Maybe everyone should have a disclaimer saying that no
treatment of any kinda including SMB is 100% guaranteed
to work.
Sound fair?
That’s exactly the problem, vargkill. Most of the people seeing an alternative medical practitioner do not realize that they are not seeing a “real” doctor, or that the alt-med proponent lacks the training and expertise to recognize serious conditions that require the attention of a specialist. And many alt-med proponents do in fact try to sell themselves as equivalent to a PCP.
I think you are actually more on our side than you realize. You just don’t realize how pervasive the problem is.
I’m all for “traditional” treatments if they work. What I’m opposed to is the promotion of unproven therapies as if they *have* been proven, and that, in essence, is what alternative medicine is. If a traditional therapy is proven and practical and adequately safe, the mainstream will adopt it and it will no longer be “alternative”. So why have an alternative category at all? It actually impedes the study of this stuff, because if you can sell it without proving it, why bother proving it?
Calli Arcale
I am on your side in a lot of ways.
Im sure you have been reading a lot of my posts and still
i stand by what i went through with my acupressure guy.
Whatever he does or did or does for people works.
Placebo effect or not it worked.
Do i think everyone who practice is as good as him?
f**k no. There are some who are the real deal and others
who should not be able to practice.
vargkillon 23 Apr 2009 at 11:59 am wrote “But when we choose to go to someone who is not a “real doctor” then they must know exactly what they are going into
right?”
Iv [sic] never seen any alternative practitioner claim to be a real doctor.”
You are playing with words- chiros and naturos call themselves “doctor” with no distinction from real, medical professionals. Others may follow suit. Chiro- and naturo-quacks want to position themselves as “primary care physicians.” Your suggestion is just wrong. Many people mistake a “doctor” for a Doctor.”
vargkillon 23 Apr 2009 at 11:59 am suggests “Maybe everyone should have a disclaimer saying that no treatment of any kinda [sic] including SMB is 100% guaranteed to work.”
I suggest a disclaimer that says “No CAM method has ever been proven safe and effective” would be better.
There is no doubt that results from medical interventions vary, humans are complex beings. I think your warning is subsumed in the health professional saying “I cannot promise; but there is evidence for this therapy.” Quacks are seldom so modest, even when the supposed ‘evidence’ does not exist or, more likely, is as flimsy as toilet paper- they make their positive claims.
Hi, I just discovered this site the other day, having been directed here off of a comment on the HuffPo. This site is likely the best thing I’ve been exposed to as a result of visiting HuffPo from time to time.
I’m a soon-to-be MD, graduating in less than a month. I think I’ll spend some time in the run-up to residency indulging myself at SBM.
I’ve read much of this thread. I had to stop reading SD’s posts, as his behavior is too stereotypical to draw me into some kind of “challenge the tenets of the world” debate.
vargkill, I’ll give you my response to your queries. First, I think you’d have a hard time finding a physician who would tell you that their interventions are 100% guaranteed to work. If you have, I’m sorry. All interventions carry risk and there is no guarantee.
As for this statement: “Look man i dont really believe in everything ‘CAM’ I just believe some people can practice alternatvie medicine and provide real results.” …
While it’s certainly possible that some CAM treatments are safe and effective, the burden of proof is on the CAM practitioners to verify those claims. Why is the burden of proof on CAM? Why is it not up to modern medicine to disprove CAM? Because much of modern medicine has been built up through that kind of experimentation and it has been proven to work. Modern medicine is verifiable through the scientific method, the same method that has brought us most of modern life. Western medicine had its own shamanistic/holistic traditions in the lead-up to the scientific revolution; I’m sure you’ve heard of the “four humors”. The scientific method soundly defeated shamanistic tradition in the lab and in the world outside. In order for any treatments in CAM to be accepted as truly valid, they will have to pass the same tests that modern medicine has passed (and shamanistic tradition has failed).
I’ll be very happy when CAM produces a verifiably safe and effective treatment, as it will surely advance our understanding of life. Until that time, I’ll stay with what has been shown to work. Thanks for your time.
Ok let me address this again since you seemingly educated
folks cant seem to grasp what im truly saying…
First off, your making it sound like i believe in everything
that these folks practice. No i am not saying that.
Second, i chalked up my expirence as a good one and thus
i believe that some people have the ability to be fruitful in
their practice of alternative.
Im not sitting here trying to say that every single person
who practices alternative medicine is good at it or that
everything works. I am just saying that the person i know
seems to have a method that works.
Like i have said time and time again, let the patient decide
for himself what is safe or what works for them. Why is sudden
MD crusade on on everything not SBM? Just because you dont
believe it works dose not mean you can tell me it did not work
for me.
If we can give people choices in life like responsibilities and other grown up things then why not let the man decide if he
wants to put his trust in a CAM practitioner. I had a choice
and i went to one and it helped me. So its kinda like you’re
telling me that i should not have that choice? If im being fooled
then fine let me deal with it and if i die then so be it.
Joe
Whats the difference? My life was never in danger when i seen
my “CAM” person. I will say it again, you still cannot disprove
the effectivness of some of these practices so again aside from
the idiots out there who do practice “CAM” I dont see who it
hurts. If someone wants to find natural pain relief and finds it
with acupressure then f**k it let them. Did i ever say that
SBM does not work? No i never did. Did i ever say “CAM” works
for everything? No i never did.
vargkill,
If I said your lover were cheating on you, would you believe me? I assume you’d want proof first, something you could double check yourself.
If you were accused of raping a girl, should we believe the accuser without proof? Of course not.
If you have a dangerous heart condition and I tell you I can fix it but it will cost you $40,000, will you take me at my word? Wouldn’t you rather have some evidence you can check for yourself? Maybe some published papers describing the procedure, and describing how things went for several other similar patients?
Now, your story about the shaman-healer is nothing we can check. We just have to take your word for it. I don’t think you should blame us for feeling skeptical.
I don’t have a problem with people going to faith healers. I simply want to keep the faith healers separate from the healers who claim to be science-based. Science-based means people can double-check the facts. Faith means, “take my word for it,” which is convenient for liars.
I dont want the government involved with faith or religion, because that’s totalitarianism. So no Medicaid or Medicare for faith healers.
Dr Benway
How many times do i need to say the same things over and
over again? Im not against you as you might think. I just think
you people are on a crusade here and not for all the right reasons.
I clearly get your point and have gotten everyones point
thus far. Are you getting mine?
Tell you what, why not go lobby congress and make alternative
medicine not legal? Then you would have more of a solid ground
to complain about the things that you all have an issue with
instead of getting together on a forum and bashing alternative
medicine. Unless you’re personally willing to be proactive in
stopping what you think is unjust medical practice then you
are just as much a part of the problem and not the solution.
I also think you are comparing apples to watermelons here.
Do you somehow think i am advocating for alternative medicine
folks to treat real crappy conditions? I never said im in support
of this kinda practice. But what i am say and my whole point
is that “I THINK IN SOME CASES ALTERNATVIE MEDICINE CAN
AND DOES WORK TO PROVIDE SOME RELIFE FROM CERTAIN
CONDITIONS”. I even put it in caps so you can better understand my point.
Better yet, why dont you head up some research to finally once
and for all debunk alternative medicine. Im sure a lot of people
would be happy. Since there seems to be studies for everything
else would this not be a great idea? Then you can shut people
like me up and your enemies would just prove to do their
own undoing. And none of this its already been doen crap, i want to see a new study and im sure a lot of other people
would love to see it as well.
Let me know when the research is under way!
vargkill yelled ““I THINK IN SOME CASES ALTERNATVIE MEDICINE CAN AND DOES WORK TO PROVIDE SOME RELIFE FROM CERTAIN
CONDITIONS”. ”
Then prove it. Post the actual medical literature that shows that your favorite mode of alternative medicine provided relief from certain conditions.
Make it simple, list the the condition, then the alt med that helped it followed with a cite to the literature that proves it. The site http://www.pubmed.gov provides an easy way to find it.
Look at the title of this blog posting, it contains the word “hypertension.” What is still considered alternative medicine that relieves hypertension?
My step-mother’s family had a genetic form of hypertension. Members of her family typically died in their mid-40s after a long drawn out painful period. She had pictures of one of her brothers who died that way, they are painful even to look at. But shortly after he died the first set of medication for hypertension was developed: simple diuretics. The rest of the siblings lived into their 80s, and even 90s due to those diuretics (plus doing without salt, maintaining their weight, exercise and healthy eating… after my dad married my step-mother we learned to cook without salt! I still make my own chicken and beef stock with lots of marjoram and other herbs… a way to boost flavor without salt).
So what alternative medicine works for hypertension better than the diuretics introduced in the 1950s and the more modern beta-blockers? Be sure to give cites to actual medical literature.
HCN
Not my job, you guys are the big bad doctors so you do
the debunking.
Try harder HCN
HCN
Just wanted to add…
Your making it sound like i dont believe in SBM at all.
Never said i didnt, so enough with the crusade, i issues
a challange so whos gonna take it?
That’s not the way it works. You made the (ridiculous) claim. The burden of proof is on you.
vargkill,
Any right you claim for yourself you must extend to everyone else.
So if you’re entitled to make claims about the world that we must accept at face value without proof then so is everyone else. And that includes the district attorney at your trial for a crime you did not commit.
That includes those in power over us.
Thanks, but no thanks.
“Extraordinary claims require extraordinary evidence.”
From Carl Sagan Superstar, the Broadway musical. Everybody sing!!!
Perky Skeptic
You seem to have trouble coming up with original things to say.
Dr Benway
How am i supposed to prove to you beyond words that my
acupressure guy helped me? Last time i checked i was not
a doctor and did not have as much ability to do such things
as say maybe a doctor. So prove to me it did not work!
As a matter of fact you cannot prove to me it did not work
and i cannot prove to you it did. Can we leave it at that?
There is no way to win this argument.
weing
Same thing. How am i supposed to prove it? If you say
research online then i can say the internet is full of all kinds
of things that are true and false. You guys are the big bad
medicine doctors so show us the light of the path we should
be walking!
I at least admit that not all things CAM or all those who practice
it work or should be practicing. I at least admit CAMS should not
be PCPS. I at least admit and know that SBM works.
Can you admit that you might be living inside of a well with
not enough vision to admit that greater forces could be at
play in the world? Or do you believe we all just evolved from
mirco orgs?
The burden of proof is on the person making the claim. If you only have a claim that you cannot support, then there is no real argument.
weing
Well the same goes for you.
I believe i asked you to prove yourself first, so you too would
be guilty of the same thing you are accusing me of.
Way to stick it to me weing!!
vargkill,
I don’t think anyone is saying you didn’t feel better after whatever treatment you received. Our point is that we need further evidence before accepting that acupressure can reliably help people. Failing that, it is much more prudent to think that you basically got a placebo (and/or got very lucky). Since acupressure has been looked at and found to be ineffective, this conclusion is even more justified.
cheglabratjoe
Its been proven to be effective in a lot of way.
Some doctors are using it to calm children before surgery
i a recent experiment.
Now i read that online so how reliable is it? Not 100% sure
but there are many documented cases that it helps with calming
and other things. So why not do more research?
I guess that was my point to the other buffoons on here.
vargkill,
Well, if you think that there is lots of evidence that it is effective, I don’t think it’s unreasonable (or buffoonish) to ask that you provide a little bit of that evidence. I haven’t read all 200 comments; have you been providing links and references to that evidence and documentation? If you’ve only been offering personal anecdotes and talking about unspecified better evidence, I can understand why people are getting frustrated with you.
cheglabratjoe
I have not seen anyone else providing any refrences either!
Show me the research that my claims are full of crap!
heres an interesting link. Im pressed for time so youll have to
do the old fashioned copy and paste.
http://www.scienceblog.com/cms/acupressure_beats_physical_therapy_for_lower_back_pain_10049.html
vargkill,
You are the one making the positive claims, so you are the one expected to provide evidence. As an extreme example, I believe that fairies cured your ailments when you went to the acupressure clinic. Prove me wrong!!!
At a quick glance, your link is not very impressive. The information is pretty sparse, with hardly any details about the experiment. What do they mean by “physical therapy,” was it truly randomized, what does “reduction of disability” mean, what statistics were used, was this a peer-reviewed study (is BMJ the British Medical Journal), what previous studies do the results support, etc etc etc.
You mentioned being worried about things you read online. Reading peer-reviewed journal articles would help. Even the abstracts (which should always be available for free) of such an article would probably (but not definitely) be better than a random un-sourced blog entry. PubMed is a good resource for searching medical articles.
cheglabratjoe
Why is no one else providing links to any studies claiming
that alternative medicine is indeed “quackery”?
vargkill,
I’ve already told you: the onus is on your to prove your ideas, not on us to disprove your ideas. If we’re going to play that game, I would like you to disprove the notion that fairies cured you.
To make you happy, here is a study I found on Pubmed. It’s a review, but that should be acceptable. Here is the citation: J Perioper Pract. 2008 Dec;18(12):543-51. Here is the abstract:
“This literature review sets out to investigate the effectiveness of acupressure and acupuncture in preventing and managing postoperative nausea and vomiting (PONV) in adult patients. PONV is problematic, affecting patient satisfaction, delayed discharge and even patient re-admission. Current treatment of PONV constitutes a variety of drug therapies, which are only partially effective. With the integration of complementary and alternative medicines in healthcare, this review examined 10 research studies investigating the use of acupressure and acupuncture in treating PONV. Three studies found acupressure to be effective in preventing PONV. However, population samples were small and the research designs had numerous anomalies. Overall the article suggests that acupuncture and acupressure are ineffective in preventing and managing PONV in adult patients. Further investigation of the effectiveness of acupressure and acupuncture, combined with current drug therapies, using well designed and adequately powered studies is needed. Published studies predominantly examined the use of P6 as the pressure point. Further studies should examine other ‘acupoint’ sites, to ascertain whether these are effective dependent upon the operative site.”
Only three out of ten studies demonstrated any positive effect from acupuncture/pressure, and those weren’t very good studies (small sample size, and experimental “anomalies”). This study indicates that acupuncture/pressure doesn’t work to prevent nausea, which I believe is something is it proposed to especially work for.
cheglabratjoe
“I’ve already told you: the onus is on your to prove your ideas, not on us to disprove your ideas. If we’re going to play that game, I would like you to disprove the notion that fairies cured you”.
You’re subscribing to the notion that it is in fact ok for you
to ask me to prove my claims, yet me asking you to prove yours
is completly absurd? What how would you expect any normal
person to respond to that kinda thinking?
Now one thing i need to point out is that the study in which
you refrenced is no more large scale then the study i posted
that link to about back pain. Small scare and not enough research. So then how is that anymore convincing then my
argument? You seem to be comparing apples and apples here.
Also i might add, since you guys seem to be on such a large
scale crusade here against CAM, why noy conduct a large scale
research project to once and for all silence all of the CAM folks?
That was my original challange! You guys are the doctors!
You are the ones on a personal crusade here, not me. I never
once bashed your medical practice on here. I only stated that
CAM seemed to have worked for me and that the person i go
to seems to be very very good at what he does. I never once
said that SBM is evil and does not work.
So for a bunch of doctors whom are most likely to be presumed
intelligent, i cannot understand why it should be up to me to
have to prove that CAM works. If i could prove beyond a shadow
of a doubt then trust me i would. The difference between me
and most people on here is that since you are a doctor/scientist, that would make you smarter then me in this field
hence making me easily silenced.
I assume the general concenses is that you didn’t personally
like that challenge so therefor its all the sudden up to me to
prove anything beyond my own personal expirence. Which is
utterly impossible considering there are studies to suggest
that acupressure works and studies to suggest it does not.
So who truly wins here? Even if you can fully debunk acupressure which i can guarentee you cannot, it still does
not change what i witnessed with my own 2 eyes.
Let me ask you, if GOD himself came to you right now and told
you something, yet a bunch of people told you it was some kinda mind trick or some bullcrap, would that change the fact
that you seen what you seen? Would a book on evolution be
able to help you realize you did not see what you seen because
it suggests we are all just a matter of chance?
Get my point? Some things in life cannot be measured by science
or better yet, might be just a bit more difficult to measure.
Sorry for my type-o in that last post… Typed that way to fast.
What kind of studies would we have to do to prove that fairies did not cure your ailments? You and the rest of your CAM crowd are the ones making claims. You want us to accept your claims without any proof, just your say so? Sorry. Do you expect me to believe a pharmaceutical company’s claim that its medication normalizes blood pressure and peripheral vascular resistance because it says so? If I say I don’t believe it, they come back saying I have to prove my claim that it doesn’t, and since I can’t or won’t, then I have to accept it. Yeah, that would really work on me. Not!
Anyway, who are you going to believe? Me or your lying eyes?
weing
Again, you are the doctors not me. Im not the pharmaceutical
company. If they tell you a pill comes out they have more credit
then i do right? So as a doctor you should easily be able to debunk what im trying to say.
And in case you forgot, i believe this blog is all about trying to
debunk CAM folks. So then why are you not doing something or
posting links for me to read to try and convince me that CAM
is crap? All your doing is making stupid statements as if im some
scientist or some pharmaceutical employee trying to prove something to the MD community. Im a nobody who decided
medicine was not his calling in life. How hard can it be for you
to prove me and other people who practice or believe in CAM
that it is, in the terms of some folks on here “quackery”?
You seem like a well rounded educated man. So what i am asking is not hard. You have more of an ability then me to prove
yourself. I dont have access to labs, or other people in the MD
or science community like you folks do. So use your tools to your
advanted and finally silence the CAM folks!
“Anyway, who are you going to believe? Me or your lying eyes”?
What else do i have? Want me to go and video tape a session
with Mr Wu? What else can i do? Hold him at gun point and make him teach the world how he does it? I never said you personally or anyone has to believe me for that matter. But you
are asking me to spend the time to look up some kinda websites on studies over my claims.
Again lets get a study together to finally once and for all
see if its bullcrap or now. Im willing to be proactive here are
any of you?
Vargkill,
Humans make statements about the world. Some are true; some are mostly true; some are partly true; some are false.
The set of true claims is small compared to the other sets added together. In fact, the number of false claims about the world might be infinite, as anyone can make up a crazy idea.
So you see, if humans must disprove false claims, they will never have time for any fun. For this reason, the burden of proof always rests on the shoulders of the person asserting the claim.
There’s one exception: stating that a claim is unproven requires no proof. All claims are initially “unproven” until someone provides supporting evidence.
Dr Benway
Again, and it really pains me to have to keep saying this
over and over again… There really seems to be a lack of
reader comprehension going on here, which i find sad
coming from a room full of educated people…
the prestige of the all mighty doctor is slowly starting to expire
like a candle in a soft breeze… no longer illuminated by the
fact that your ability to understand what i have writen over and
over again is simply lost in the simplest of laymen’s terms…
As a matter of fact, your lack of reader comprehension is so
gross that it most of you have proven to be the coup de grâce
of this conversation.
Kinda sad since im speaking in
such a simple manner, hence not using big words and not
writing on a college education level. This is purly done so nothing gets lost in translation, but i see that has done me
no good thus far.
The only thing you guys on here keep doing is firing back with
cheap, defensive rehtoric in an attempt to be the all mighty
winner of the conversation. Im not asking any of you to discuss the theory of relativity. Im asking you to again, prove what i
expirenced was bullcrap, or better in your terms, “quackery”.
Again, when did i say i believed that every form of alternative
medicine worked? When did i say that i knew for a fact that
it did. I for one can admit that there is a possibility that i am
wrong, but since i personally went through it myself, it made
me ask myself a lot of questions.
“So you see, if humans must disprove false claims, they will never have time for any fun. For this reason, the burden of proof always rests on the shoulders of the person asserting the claim”.
The claim was made long before i started posting on this blog.
The claim was made that alternative medicine practioners
are bunk. I seen no evidence that offers any proof or any that
in fact i can personally count on. So yes Dr Benway, i guess
the burden of proof rests on your shoulders and every other
doctor on here who claims that my expirence was bogus and
everyone else who so dear believe in this “quackery” form
of medicine. So please continue to bloviate, and contridict yourself in the process of trying to get me the “quackery” believer to bare the burden of proof. Considering this jamboree
was happening long before i came along. You’re all asserting
the claim so i think its time to man up!
“There’s one exception: stating that a claim is unproven requires no proof. All claims are initially “unproven” until someone provides supporting evidence”.
Im waiting Dr…
As stated previously, lets get some kinda research going here.
Lets get all the tests going, and once and for all lay this demon
to rest. Anyone in? Im sure it would be a simple yet complex
study, then you could silence people like me!
“The claim was made that alternative medicine practioners are bunk.”
CAM is a set of unproven therapies.
“Bunko” is “A swindle in which you cheat at gambling or persuade a person to buy worthless property.”
Insofar as a practitioner misrepresents some unproven therapy as proven, that practitioner may be deemed a bunko artist.
“So yes Dr Benway, i guess the burden of proof rests on your shoulders and every other doctor on here who claims that my expirence was bogus and everyone else who so dear believe in this “quackery” form of medicine.”
No, the onus remains upon your shoulders to provide evidence in support of your claim that a particular faith healer can diagnose physical problems without taking a history of doing an exam.
Until you provide evidence, your claim remains unproven.
Dr. Benway:
What is so difficult with the concept that if you make a claim that you must provide the evidence?
Some suggested reading with reference to the evidence:
Snake Oil Science
and
Trick or Treatment
They are both available at most American libraries (unlike Ben Goldacre’s “Bad Science”, which I am going to have to pay more for to order from Europe!).
Once you grock the onus concept, vargkill, you will advance a degree in logic-fu. You will enjoy mental, social, and political power you did not have before.
Good lord!!
How am i supposed to do this? Are you going to come to WI
and challange the guy?
As i said before, you claim, wait… you all claim on this blog
that CAM is fake, so where is the research? Why am i being
asked to provide so much but you refuse to provide anything
to me?
Chris
We can read book all day man, Im asking these doctors
to go and prove this with a study.
Again and for the last damn time.
What can do to get this research going? Lets show the world
throught this research that its a waste of time.
Ok i almost forgot to add…
There are so many books that support acupressure and so many
that do not. That is why i will not read your book suggestions Chris, but i will keep them in mind.
Im asking the doctors to do something that im sure will
benefit all of mankind. Come on lets do this thing and we
can watch your enemies prove their own undoing.
@Chris on 26 Apr 2009 at 1:02 am Concerning Goldacre’s “Bad Science.”
I bought an inexpensive copy through Amazon under “new and used”. The vendor said “ships from Delaware” but it came by Royal post directly from the UK. As I write, there are two inexpensive copies listed, as well as some unbearably expensive ones.
Note: There is a new edition of the book containing a chapter that was held-back because it described ongoing (at the time) litigation. So, you could wait until Amazon lists the new edition, or, buy the old ed. and download the added chapter (free) from http://www.badscience.net/2009/04/matthias-rath-steal-this-chapter/
@vargkill on 26 Apr 2009 at 1:36 am wrote “There are so many books that support acupressure and so many
that do not. That is why i will not read your book suggestions Chris …”
“A man’s gotta know his limitations.” So, why do you argue with people who have the wherewithal to understand the subject and form proper conclusions (and have done so)?
“There are so many books that support acupressure and so many
that do not. That is why i will not read your book suggestions Chris, but i will keep them in mind.
Im asking the doctors to do something that im sure will
benefit all of mankind. Come on lets do this thing and we
can watch your enemies prove their own undoing.”
I’ll get on that topic as soon as I convince my kids that Santa, the Tooth Fairy, and the Easter Bunny are not real.
A question for you. If you won’t read the book suggestions that Chris gave you because of the above reason, why would you read and accept what we would write? What’s the difference?
Also, the books I suggested actually go into how to read a study and how to determine if it is biased, or has much weight. They would both help determine who one should actually get valid information from.
The kicker is that Snake Oil Science includes a section on how to find an alternative medicine practitioner. I thought you might find useful.
Well here, ill start playing along…
Ok assume i have never read any book or did any kinda
looking into the matter.
You all caught me red handed!!
I have no clue what im doing on this blog!
One day i woke up high on crack and decided to start
arguing with a bunch of doctors!!
Shame on me…
Need we need to remind you again that not every one here is a doctor? Plus the author of Snake Oil Science is not a medical doctor (he is a biostatistician), and one of the authors of Trick or Treatment is a physicist.
Anyway, all that anyone has asked you to do is to provide some real evidence for what you claim. The Snake Oil Science can be a guide on how to evaluate that evidence.
Well, no one would ever accuse you have having an open mind:
http://www.sciencebasedmedicine.org/?p=442
Chris
I know everyone on here is not a doctor. Including yourself.
Once again i am asking the doctors on here to conduct a new
study to find out once and for all if alternative is bunk or not.
What is so hard about that request?
I stress again, i have read books just like that but what i am
trying to tell you is this was a different expirence for me. Was not like most patterns that certain folks in the field of alternative
medicine follow. Do you understand what i am saying.
Now back to the point, doctors need more concrete evidence
to debunk alternative medicine other then links to studies
that still do not bare enough conclusive evidence on this
matter.
Other then that if i told you jesus came to me in real life
and told me to argue with you people on here, what evidence
could i find to make you believe me?
See how hard and not possible that would be? I feel as if
i witnessed something on a deep spiritual level. Nothing nor
any amount of science can measure that. No book can possibly
explain what i expirenced. This is on a whole new level or else
i would easily be able to see the logic and the explination
in what i witnessed.
You dont have to believe me but im issuing the challange
to get opinions or see what others have to say and it is very
hard to find people with an open mind.
Heres a bold question and really has nothing to do with the
topic at hand, but might help explain a lot…
Does anyone on here believe in god? a god? or better put…
the possibility of something spiritual?
“Other then that if i told you jesus came to me in real life
and told me to argue with you people on here, what evidence
could i find to make you believe me?”
Jesus Hernandez? You know him too? So what? Just relay his message.
“Does anyone on here believe in god? a god? or better put…
the possibility of something spiritual?”
Speaking only for myself, who grew up a Roman Catholic and is now an agnostic. Belief in God and an afterlife is very comforting, especially if you lose a loved one. But the comfort is not enough to make the belief true. I think we are programmed to believe in a God. Again, that is not enough to make the belief true. I am not an atheist, as I have no way of knowing one way or the other. I think those people who do, are probably much smarter than me.
Spirituality is another word that for most of my life has been in search of a meaning. I think of it now as what animates you, or has you take an interest in whatever interests you. In my case, I find spirituality in science, medicine, learning new things about the world around us and finding ways of applying that knowledge.
weing
I was a little suprised by you reply. Here i thought maybe
you where just plain and simply narrow minded.
“Jesus Hernandez? You know him too? So what? Just relay his message”.
Oddly enough my last name happens to be Hernandez…
See i was just relaying the message that i have seen the
effects of acupressure and have expirenced them for myself.
Now pretty much the basis for alternative medicine or should
i say more or less acupressure in laymen’s terms, is working
with the spiritual energy of the body, or chi if you wanna call it.
Since some people believe in this energy or the soul then
its no wonder why it might work.
I have seen it produce results. I have seen it manage pain
for others who go to this person i know. So i can only assume
more so with my own exprience that it indeed works for many
things. which is why i think more research needs to be done
to find out the whole truth once and for all.
PS
This is for all the haters on here…
Yes i believe in SBM, but i also believe in some and i stress
some forms of alternative medicine.
vargkill,
I have seen money the Tooth Fairy brought. Leaving the tooth under the pillow really works – I’ve experienced it myself many times.
Perhaps you will say I am mistaken. Perhaps it was the parents, not the Tooth Fairy, who put the money under the pillow. Yes, and perhaps it was not qi or the spiritual energy of the body that produced the results you experienced.
We can’t “prove” that there is no Tooth Fairy, and we can’t “prove” that qi is not real. The burden of proof is on believers in Tooth Fairies and qi to show that they are real.
Edzard Ernst “believed” in alternative medicine and was the world’s first professor of complementary and alternative medicine. He evaluated all the available evidence and found very little of substance. See http://www.sciencebasedmedicine.org/?p=195, where I quote a paragraph of his conclusions.
When medieval doctors used bloodletting to balance the humours, the experience of thousands of doctors and patients showed that it worked for many illnesses. Only it didn’t. If the experiences of all those thousands could mislead them so badly, your experience might just possibly have misled you too. Until claims like yours are tested scientifically, we can’t trust them.
Ah grasshopper vargkill, you do not yet grasp “onus.”
I do not say “CAM is bunk.” If I did, you would be correct in your demand for proof of that claim.
I say, “CAM is unproven.” That claim requires no proof. The onus is on the party claiming CAM does something more than placebo.
I say, “Your claim about the faith healer’s mysterious powers is unproven.” That statement does not require proof.
vargkill, your story is important to you. I understand. I could tell you of experiences from my own life that might curl your hair –prayers answered, unbelievable coincidences, transcendent feelings, etc.
These kinds of stories are precious to the people who tell them. But, like dreams, they’re not so interesting to everyone else. They’re a dime a dozen. Just part of the human condition.
Weird shit happens all the time. If you study statistics, you’ll understand why.
Such stories are
Now pretty much the basis for alternative medicine or should
i say more or less acupressure in laymen’s terms, is working
with the spiritual energy of the body, or chi if you wanna call it.
“Accupressure” is more specific than “alternative medicine.” I think you’re on the right track when you’re as specific as possible.
Traditional Chinese Medicine includes using ground up rhinoceros horn as a treatment for male impotence. That’s just old-fashioned sympathetic magic –something humans have done for thousands of years. The horn looks kinda like a hard-on, ergo…
Sympathetic magic lives on even though it doesn’t work. Sadly, TCM is driving the rhinoceroses to extinction. Primitive thinking can sometimes be pretty evil.
When you defend, “alternative medicine,” I’m guessing you’re not defending the rhinoceros horn remedy or all the other insane things that get included in the alt med set. You’re focused on the accupressure.
Harriet Hall
I am fully aware and can at least admit to the
possibilty that there might be a logical explination for my
expirence. Yet there still is plently to ride on the fact that
maybe something truly awesome that cannot be explained happened.
On top of it there are many many people who have been
helped by Mr Wu.
Dr Benway
As i have stated many times, i think some forms of alternative
medicine is crap and ill say it again, i think others works and if
a acupressure person knows their s**t i think it can be
truly effective.
I agree more research needs to be done.
[...] Modern Shamanism – Naturopathy for Hypertenstion – by Peter Lipson. Excellent article describing how a primary care physician would evaluate a patient with hypertension, contrasted with naturopaths, who claim to be able to deliver primary care. You should also check out the responses to Dr. Lipson’s Naturopathic Challenge where he invited naturopaths to describe their approach to a typical patient. He sums up the challenge here. [...]
[...] Modern Shamanism – Naturopathy for Hypertenstion – by Peter Lipson. Excellent article describing how a primary care physician would evaluate a patient with hypertension, contrasted with naturopaths, who claim to be able to deliver primary care. You should also check out the responses to Dr. Lipson’s Naturopathic Challenge where he invited naturopaths to describe their approach to a typical patient. He sums up the challenge here. [...]