From Voodoo Economics to Voodoo Medicine

[Jay]

Re: From Voodoo Economics to Voodoo Medicine

Jay, thanks for all you do and all the many many good doctors out there. I know my personal physician is one of them. To imply that the profession is as bad as the others are implying is simply wrong. I have been involved with far more good doctors than poor ones.

jim

Thank you, Jim. That is something I rarely hear.

[flintlock]

Re: From Voodoo Economics to Voodoo Medicine

Raja, my point isn't that these things don't happen, it is that you have painted the profession with a homogenous, broad, unfair brush. I wouldn't be so narrow minded to say that doctors never act unethically and didn't insinuate that at any point in my post.

I didn't read anyone's posts on here that painted the ENTIRE profession like that. It's becoming all too prevalent is all. And people are sick of it.

[Jay]

Re: From Voodoo Economics to Voodoo Medicine

"Whereas the prevalence of sore throat caused by bacterial infection among adults is between 5% and 17%, a study of physician practice in 1989 and 1999 found that antibiotics were prescribed during 73% of visits."

Seems broad to me . . . .

Raja, if you would likie to discuss the pro's and con's of treating pharyngitis with antibiotics or refraining, and in what patient population it is appropriate please PM me. We can also discuss relevant current practices and whether they are appropriate also.

[flintlock]

Re: From Voodoo Economics to Voodoo Medicine

I laud you on your efforts to maintain a healthy lifestyle, which is clearly the most important piece in staying healthy. You will mitigate the chances of hypertension, type two diabetes, or other conditions befalling you. That said, there are plenty of people who live very healthy lives and still end up with treatable chronic conditions that place them at risk for other diseases. Hopefully you are not one of these people and your solo act lands on the runway.

Agree 100%. This idea that lifestyle and diet can always fix these type problems is wrong.

[ax]

Re: From Voodoo Economics to Voodoo Medicine

Raja, my point isn't that these things don't happen, it is that you have painted the profession with a homogenous, broad, unfair brush. I wouldn't be so narrow minded to say that doctors never act unethically and didn't insinuate that at any point in my post.

Jay, I think it's about time someone came to your aid. At no point has Jay denied the existence of the practice of defensive/poor medicine (i.e. the overprescribing of antibiotics, unnecessary CT scans and x-rays). I would even add that the medical community has created disease states for alcoholism, gambling, sex addiction, and a host of other activities without much proof.

I think that everyone is glossing over one huge factor in medical decision making, and that is the constant threat of being sued. Most people don't operate in professions where every client is a potential threat to their livelihood. If EJ makes an incorrect market call, we'll forgive him based on his record and look forward to his next call. Even a twit like Mike Mayo can be wrong for years, switch companies, and take the completely opposite stance he had six months ago without repercussions.

But what if Jay and I see 10K patients in a year, and treat them all appropriately? Our next patient could be the one who fails to get antibiotics for what appears to be a simple/viral respiratory infection, goes home looking good, and returns the next day in respiratory failure with possible cardiac or cerebral impairment. For those who don't work in medicine, the ER is a surreal place. People can show up with the most complex, difficult to diagnose, and deteriorated states imaginable. The omnipresence of superinfections such as MRSA and the delay in time to treatment for the uninsured is making our jobs more difficult by the day.

There's a reason why medical malpractice suits rarely win; most of them are bogus. Combine that with the fact that most people have the misconception that medicine comes from a cookbook full of simple decision trees, and we have the makings for completely unrealistic patient expections.

So, I'll continue to avoid placing myself or my family on antibiotics for common colds (as I'm sure Jay does), and hope that the myth of the magic pill can be destroyed. But in our quick fix society where some states have 20% of their children on ADHD meds, I won't hold my breath.

[ThePythonicCow]

Re: From Voodoo Economics to Voodoo Medicine

I diagnose electrical problems for a living.

So that explains your avatar - of the boy testing the outlet .

[ThePythonicCow]

Re: From Voodoo Economics to Voodoo Medicine

Agree 100%. This idea that lifestyle and diet can always fix these type problems is wrong.

It is entirely true that some substantial proportion (likely most) of "lifestyle and diet" changes cannot and do not fix the targeted problem.

However I contend that most such chronic illnesses (most cardio-vascular and cancer in those under 80) can be avoided with proper diet changes.

There is much conflicting and confusing advice and expertise. This is a protean area. That's fine by me ... better than all being locked into a single decided doctrine. It's a bit like the world wide web itself, which is a wonderful source of conflicting information and opinion, as well as of misinformation and propaganda.

This does put it beyond the capacity of most people, I'm afraid, to find enough of what's useful and true for themselves to follow this path for their primary health maintenance.

[raja]

Re: From Voodoo Economics to Voodoo Medicine

Raja, if you would likie to discuss the pro's and con's of treating pharyngitis with antibiotics or refraining, and in what patient population it is appropriate please PM me. We can also discuss relevant current practices and whether they are appropriate also.

Don't take this as an insult, because that is not my intention . . . but I would rather rely on the opinions of medical researchers who specialize in this field than an emergency room physician.

[Jay]

Re: From Voodoo Economics to Voodoo Medicine

Don't take this as an insult, because that is not my intention . . . but I would rather rely on the opinions of medical researchers who specialize in this field than an emergency room physician.

The evidence, or lack of it, depending on what aspect you want to look at is clear. I'm not sure if you are looking for an ENT, pediatrician, PCP, epidemiologist, infectious disease specialist, or other. Good luck on your quest.

[petertribo]

Re: From Voodoo Economics to Voodoo Medicine

Dr. Nortin Hadler, professor of Medicine, University of North Carolina in his book, The Last Well Person, p. 202:

"The institution of medicine is ethically bankrupt."

So, maybe read the book for those who make judgements about posters here and their concerns. As a person who is forced to deal with this Medical Monopoly, I sit up and take notice when a noted Professor of Medicine says it is "ethically bankrupt". So many here profess Free Market ideas and principles but in Medicine we have none of that. So, if you support American Medicine you support Monopoly and Restraint of Trade.

Thank you Doctors Hadler and Newman for informing the Public about the true state of the Industry, you may save my life. I hope other Doctors will be joining you.

[raja]

Re: From Voodoo Economics to Voodoo Medicine

The evidence, or lack of it, depending on what aspect you want to look at is clear. I'm not sure if you are looking for an ENT, pediatrician, PCP, epidemiologist, infectious disease specialist, or other. Good luck on your quest.

You surprise me . . . .

I would assume that anyone who had been to medical school would know how to obtain the most up-to-date information on the subject we've been discussing -- do a search of the medical literature. This is how all the clinicians and others you recommended obtain their most current information (unless they are doing the actual research).

I don't know what "quest" you are referring to. Could you elaborate on that?

[vanvaley1]

Re: From Voodoo Economics to Voodoo Medicine

I have a number of complaints about the medical system. So far I have none against any individual doctors, nurses, etc. other than not warming up their instruments before they start practicing on me. This family has been lucky in getting good medical care from the folks on the ground.

However, I don't believe the system should be self-regulating as regards to ridding itself of bad apples. Somebody needs to get into the system and root out the minority of incompetents. Secondly, I'm disappointed that the system doesn't address the future very well. And when they do...see it clearly...nothing is done to mitigate the tsunami about to engulf the public. For example, I saw a CSPAN program put on by the medical profession. It included doctors, government officials, medical scholars, etc. that discussed this issue. A diverse, intelligent, and apparently well-meaning and forward looking group of folks they were. This occurred some years ago. They claimed that there was going to be a huge shortage of medical personnel in the coming years as baby-boomers were retiring.

Why weren't more American schools created to turn out competent medical personnel? I went to a university that had a medical school. There were more qualified applicants than the school could take. I'm sure that's not an isolated case. The AMA sat on its hands. Now we are getting an increase of foreign trained folks. Nothing wrong with that. But there's been complaints about misinformation and not understanding what's being clearly said from the care giver to the patient. This is anecdotal as it relates only to a couple of friends and one experience I had but I'm guessing it's more widespread than that.

And why isn't the profession supporting a national health care system? Hell, I don't care which type it is: French, British, Canadian, German, Swiss, Taiwanese, Japanese, etc. etc. etc. But it's obvious that the one in place is not sufficiently adequate from cleanliness to corruption (poor oversight of 'bad' care givers, $300 for an arm brace/sling?, aspirin I can pick up at considerably lower cost at a local drug store, insurance meddling, etc. etc. etc.) to meet the requirements of this nation's sick? Lord knows it's not the least expensive.

[ax]

Re: From Voodoo Economics to Voodoo Medicine

"They claimed that there was going to be a huge shortage of medical personnel in the coming years as baby-boomers were retiring."

Get ready for a huge shortage of family/primary care doctors. Racking up hundreds of thousands of dollars in med school loans isn't that high on people's lists anymore when reimbursement for patients can range as low as $12/month for multiple visits. Better get used to the idea of your PA or NP taking care of you because doctors are going to specialize going forward, that's where the money is.

"And why isn't the profession supporting a national health care system?"

I know we have a lot of readers who live with nationalized health care. Anecdotally, I can tell you that my European and Canadian patients hate it and think an urgent care/walk-in clinic is like an oasis for acute needs.

[Jay]

Re: From Voodoo Economics to Voodoo Medicine

You surprise me . . . .

I would assume that anyone who had been to medical school would know how to obtain the most up-to-date information on the subject we've been discussing -- do a search of the medical literature. This is how all the clinicians and others you recommended obtain their most current information (unless they are doing the actual research).

I don't know what "quest" you are referring to. Could you elaborate on that?

Of course it is. Where did I suggest otherwise? If you are able to wade through reams of medical literature on your own, and understand the limitations and strengths of each study, without the advice of someone who has made it their profession and who has spent a lifetime trying to incorporate it into their practice, good on you. Most have trouble sorting it all out, especially without having the real life benefit of interacting with thousands of patients and having years of specific course study and continued education.

Is it not at least part of your motive to get to the bottom of what is wrong with medicine? That is what I intended by quest.

[petertribo]

Re: From Voodoo Economics to Voodoo Medicine

I know we have a lot of readers who live with nationalized health care. Anecdotally, I can tell you that my European and Canadian patients hate it and think an urgent care/walk-in clinic is like an oasis for acute needs.

As usual, the disparagement of the medical profession in other countries is trotted out. Objections are made when the US profession if criticized here but it's OK to whack the doctors in other countries. At least, it was related as anecdote because, in FACT, it is untrue, false and misleading that European and Canadian healthcare is inferior. The US is 37th in Health Performance ranked by the WHO:

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America
38 Slovenia
39 Cuba
40 Brunei
41 New Zealand

Canada and most European countries are ahead contrary to what has been suggested.

In health life expectancy, the US is 24th.
Yet the US is 2nd in total health care expenditure. Lousy bang for the health buck.

http://www.photius.com/rankings/healthranks.html

So, the American Medical Monopoly, licensed by the State, looks more and more like Zombie Banks and Finance sucking on the lifeblood of the country. Dr. Newman in his article cites $23BILLION going down the Voodoo rathole alone. So, put an M on that FIRE acronym, for Medicine. FIREM.