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Why I voted in favour of alternative medicine
Posted: 24 May 2009 06:50 AM   [ Ignore ]   [ # 31 ]
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asanta - 24 May 2009 06:22 AM

Off label use is NOT usually a BAD thing.

I did not say it was bad: I said it is not science based.

As far as prescribing antibiotics for minor illnesses. The bigger problem is appropriate prescribing when patient INSIST on antibiotics for viral illnesses and the doctors give in to overly annoying patients to get rid of them, but also a bigger problem is the patient that doesn’t FINISH the prescribed course and exacerbates the creation of ‘superbugs’.

Fully agree. The only point I wanted to make was that pharmaceutical industry hasno interest in the correct use of antibiotics. Overuse is good for the profit…

The other problem is insurance. Would YOU be willing to risk YOUR license and lively hood by making the call that an illness that the prudent doctor would treat with antibiotics will get better without it.

I don’t know what you are referring to. Maybe because I don’t know the american situation?

Another problem with making the decision about where or not you treat, you are not always treating for mortality, you are sometimes treating to prevent disability and morbidity.

I said ‘dangerous’. That includes disability and morbidity of course.

Sometimes, it’s just because the patient needs to go back to work and earn a living and doesn’t have the luxury of time to allow nature to take its course.

I understand that. But I think on average antibiotics are prescribed too lightly. I once read about a statistic that in some countries (Netherlands come to my mind) have less antibiotics resistance, because dutch doctors are a bit more cautious in which situations they prescribe antibiotics.

Do you realize that people as a whole are LIVING LONGER AND HEALTHIER WITHOUT DISABILITY THAN THEY HAVE EVER DONE IN THE HISTORY OF OUR SPECIES. HOW EXACTLY DO YOU THINK THAT HAPPENED?????

Why are you yelling? Of course I know the answer: increase of hygiene. snake

GdB

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Posted: 24 May 2009 07:04 AM   [ Ignore ]   [ # 32 ]
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asanta - 23 May 2009 05:21 PM
VYAZMA - 23 May 2009 02:03 PM

What does it say in the dictionary under “Medicine”?

*sigh* I need to place this where I can paste it in instead of rewriting it into every thread where it comes up.
THE DICTIONARY DEFINES WORDS AS THEY ARE BEING USED IN COMMON USAGE. It is not the same as a math problem which says 1+1+2.
DEFINITION FOLLOWS USAGE IN THE DICTIONARY. THE DEFINITIONS ARE SUBJECT TO CHANGE AS USAGE CHANGES.
If idiots equate quackery with medicine in the dictionary through usage—-it doesn’t magically change it from being quackery (abracadabra)—it is STILL quackery masquerading as medicine.

-sigh- I didn’t make usage an issue Asanta. The previous 4 posts before my dictionary comment did. However “quackery” does have it’s own entry in the dictionary.

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Posted: 24 May 2009 07:05 AM   [ Ignore ]   [ # 33 ]
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dougsmith - 24 May 2009 06:21 AM

And your proposed solution is to ensure that at least one class of decisions is explicitly not made on the basis of truth, but on the basis of falsehoods?

No, no, not on falsehoods. But based on my ideas how to get quack believers on board. E.g.temporary agree that these alternatives are paid for, but open the research for e.g. homeopathy together with the homeopaths, more or less following the lines of Randi’s million dollar challenge.  When it then turns out that it does not work (no question for us), then we throw them out.

Some of the embrace of quackery comes from the apparently genetic tendency of humans to believe in woo—the power of prayer, etc. I don’t believe there is anything that modern medicine alone can do to combat that form of quackery.

That’s true. I think we will always have to live with a little quackery. We should try to avoid that people die because of such believes, especially children, who did not (yet) choose their beliefs. Examples of these are healers that are punished, because it was their responsibility that a patient of their’s did not go to a regular doctor, and died of a disease that could have been treated.

As for getting quack believers on board, one issue that has been discussed time and again is that much of modern medicine is too cold and impersonal. Many people do not feel that their doctors care about them as individuals, mostly because those doctors are overworked and—yes—underpaid. (The medical profession is nowhere near as remunerative now as it once was). That is particularly true of nurses, who are most likely the people one will spend the most time with. Some of this is simply unavoidable. Everyone is trying to cut medical costs, and that will not change.

This is very true. At some point I wanted to stop my listing, I fully agree with you.

GdB

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Posted: 24 May 2009 07:14 AM   [ Ignore ]   [ # 34 ]
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Okay, suppose the quack treatment placates the hypochondriac that didn’t really need to be seen anyway. What about all of the people who will use the quackery for serious illnesses and end up getting worse than they would have been had they pursued proved medicine in the first place and eat up medical dollars, or just plain die from something that would have been easily treated? To put quackery on the same level as proved science based medicine is to take away the ability of the lay person to discern what is real, and what is not real medicine. When I go to the doctor I want science treating me, NOT superstition!
If you haven’t noticed I am in total agreement with the docs!!!

Well Asanta, if you’ve read these posts thoroughly, you’ll see that 1. I’m not advocating CAM, or whatever else it’s called.
2. We’ve been discussing the introduction of Alt.Meds into the regime of the professional health system(like they already are to some degree). So nobody is going to be more or less falsely diagnosed than they already are.
These people we are assuming, have been using what ever alt. meds. their Doctor approved- you know,as part of the system.
Nobody is talking about roving bands of illegal “quack” dealers, steeling into the night to “heal” people in their basements.
Again, there are plenty of alt. meds. which have nothing to do with superstition!!

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Posted: 24 May 2009 07:22 AM   [ Ignore ]   [ # 35 ]
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GdB - 24 May 2009 06:50 AM

Why are you yelling? Of course I know the answer: increase of hygiene. snake GdB

Not JUST hygiene, antibiotics and vaccination played a LARGE part in that. I do a lot of genealogy research and people died from mundane things we don’t give a second thought to. President Calvin Coolidge’s son died at 18 from a blister he got while playing tennis. They were an affluent family who could afford the best care. The best care did not include antibiotics and he died of sepsis. My own children have each had several illnesses that would have killed or seriously incapacitated them 70 years ago. When my own mother had strep throat as a child, she was not expected to survive, and polio was still rampant the year I was born.

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Posted: 24 May 2009 07:24 AM   [ Ignore ]   [ # 36 ]
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GdB - 24 May 2009 06:50 AM
asanta - 24 May 2009 06:22 AM

Off label use is NOT usually a BAD thing.

I did not say it was bad: I said it is not science based.GdB

??????why do you think it is not science based????????

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Posted: 24 May 2009 07:28 AM   [ Ignore ]   [ # 37 ]
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VYAZMA - 24 May 2009 07:14 AM

Again, there are plenty of alt. meds. which have nothing to do with superstition!!

‘Alt meds’ are SUBSTANCES that have no proof of efficacy or dosage related safety.
Good night, I’m going to sleep!

[ Edited: 24 May 2009 07:30 AM by asanta ]
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Posted: 24 May 2009 07:31 AM   [ Ignore ]   [ # 38 ]
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asanta - 24 May 2009 07:28 AM
VYAZMA - 24 May 2009 07:14 AM

Again, there are plenty of alt. meds. which have nothing to do with superstition!!

‘Alt meds’ are SUBSTANCES that have no proof of efficacy or dosage related safety.
Good night, I’m going to sleep!

Sleep well. smile

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Posted: 24 May 2009 07:45 AM   [ Ignore ]   [ # 39 ]
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VYAZMA - 23 May 2009 11:21 AM
GdB - 23 May 2009 11:06 AM
Hawkfan - 23 May 2009 07:23 AM

As a physician, I dislike the term alternative medicine.  I would prefer it be labeled superstition based treatments. 

Well, this forum group is called ‘alternative medicine’. At least it seems to be a lable that works for us all.
From the content I agree that for the most part it is ‘superstition based treatment’. However, I think it is not wise to call it that.

GdB

I wouldn’t say for the most part it is superstitious. A small part-yes.
1. placebos aren’t superstition.
2. massage, or chiropractry isn’t superstition.
3. homemade remedies aren’t superstitious mostly.( a hot onion and mustard chest compress on a bronchial sufferer- zb.)
4. tonics, salves, foods, herbs, alcohols aren’t superstitious.
Praying is superstitious.
Wearing a gold earing because it protects against blindness is superstitious.
Dr Florians Mysterio Electron-Ether Cleansing Chamber is superstitious. That’s quackery.
Magnetic Bracelets-that’s quackery.
Toxic FootCleaning Pads-that’s quackery.

I have found multiple defintions for superstition, the simplest of which state an irrational belief.  I fail to see how any of what you listed is not irrational.  Except regarding #1 in which the placebo effect is noted when someone thinks or believes they are taking active medication and not if you tell them they are taking a placebo(which would be unethical to prescribe). 
I would also dispute in one of your previous posts in which you state that so called alternative medicines replace the availability of scientifically proven medicines.  I’d love to see your data to support that contention.  What I can tell you in practice is that a large number of patients take them because they are not satisfied with the limitations of science based medicine.  Yes, modern medicine does have limitations.  There are things we don’t know and have no easy answers for, and if we are honest with patients we discuss those.  But, I fail to see how spending money for something like acupuncture to fix the imbalance in your Qi is any less superstitious than praying to Zeus.

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Posted: 24 May 2009 07:57 AM   [ Ignore ]   [ # 40 ]
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asanta - 24 May 2009 07:22 AM

Not JUST hygiene, antibiotics and vaccination played a LARGE part in that.

I know, was just teasing. You are not talking with a quack believer. But that does not mean there is nothing wrong in the modern medical world…

GdB

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Posted: 24 May 2009 07:57 AM   [ Ignore ]   [ # 41 ]
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GdB - 24 May 2009 06:50 AM
asanta - 24 May 2009 06:22 AM

Off label use is NOT usually a BAD thing.

I did not say it was bad: I said it is not science based.

As far as prescribing antibiotics for minor illnesses. The bigger problem is appropriate prescribing when patient INSIST on antibiotics for viral illnesses and the doctors give in to overly annoying patients to get rid of them, but also a bigger problem is the patient that doesn’t FINISH the prescribed course and exacerbates the creation of ‘superbugs’.

Fully agree. The only point I wanted to make was that pharmaceutical industry hasno interest in the correct use of antibiotics. Overuse is good for the profit…

The other problem is insurance. Would YOU be willing to risk YOUR license and lively hood by making the call that an illness that the prudent doctor would treat with antibiotics will get better without it.

I don’t know what you are referring to. Maybe because I don’t know the american situation?

Another problem with making the decision about where or not you treat, you are not always treating for mortality, you are sometimes treating to prevent disability and morbidity.

I said ‘dangerous’. That includes disability and morbidity of course.

Sometimes, it’s just because the patient needs to go back to work and earn a living and doesn’t have the luxury of time to allow nature to take its course.

I understand that. But I think on average antibiotics are prescribed too lightly. I once read about a statistic that in some countries (Netherlands come to my mind) have less antibiotics resistance, because dutch doctors are a bit more cautious in which situations they prescribe antibiotics.

Do you realize that people as a whole are LIVING LONGER AND HEALTHIER WITHOUT DISABILITY THAN THEY HAVE EVER DONE IN THE HISTORY OF OUR SPECIES. HOW EXACTLY DO YOU THINK THAT HAPPENED?????

Why are you yelling? Of course I know the answer: increase of hygiene. snake

GdB

GdB, I believe you are clearly misinformed.  Upon what information do come to the conclusion that anti-biotics are “prescribed too lightly”?  If you perform a search here you will generate numerous articles in which researchers lay out their cases for the the judicious use of anti-biotics.

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Posted: 24 May 2009 08:00 AM   [ Ignore ]   [ # 42 ]
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asanta - 24 May 2009 07:24 AM
GdB - 24 May 2009 06:50 AM
asanta - 24 May 2009 06:22 AM

Off label use is NOT usually a BAD thing.

I did not say it was bad: I said it is not science based.GdB

??????why do you think it is not science based????????

It seems to me that off lable use is per definition not science based. If it was tested in double blind research, and proven to work, it would become ‘on lable use’. Another (good!) ground to sell it!

GdB

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Posted: 24 May 2009 08:04 AM   [ Ignore ]   [ # 43 ]
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Hawkfan-

I would also dispute in one of your previous posts in which you state that so called alternative medicines replace the availability of scientifically proven medicines.  I’d love to see your data to support that contention.  What I can tell you in practice is that a large number of patients take them because they are not satisfied with the limitations of science based medicine.  Yes, modern medicine does have limitations.  There are things we don’t know and have no easy answers for, and if we are honest with patients we discuss those.  But, I fail to see how spending money for something like acupuncture to fix the imbalance in your Qi is any less superstitious than praying to Zeus.

Hawk- I wasn’t clear enough. I was trying to get to the root of Alts. My statement “...replace the availabilty…” is the view of the evolution of medicine. Once there was a time when scientific data was non-existant or wrong.(leeches for example, or skull drilling), this is an example of Alternative medicines replacing the AVAILABILITY of scientifically proven meds.

Semantics here is just bogging down the discussion. I reserve the word “superstition” to imply otherworldly, or magical. That’s me.
Yes-there are plenty of Meds which are superstitious.
I don’t want to get into this, but I think a more specific categorization of the variuos forms of meds and alt meds would greatly help our discussion here. Obviously too, there are grey areas.
For example, there are plenty of alt meds that are based on some form of “comfort”, or “soothing”. Massage, or liniments.
You know, how about speed laced diet pills? Are these alt-meds? Surely they aren’t a form of superstition. They are bad. No doubt!!

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Posted: 24 May 2009 08:06 AM   [ Ignore ]   [ # 44 ]
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Hawkfan - 24 May 2009 07:57 AM

GdB, I believe you are clearly misinformed.  Upon what information do come to the conclusion that anti-biotics are “prescribed too lightly”?  If you perform a search here you will generate numerous articles in which researchers lay out their cases for the the judicious use of anti-biotics.

Of course! Researchers yes! Doctors: no. (Risking over generalisation…) How many patients ask, when they have fever for antibiotics, and the doctor gives them because he is not interested in discussion (because he hasn’t the time for it). How many illnesses, where the doctor can’t find the cause, and with the argument 50/50 virus/bacterium, prescribe an antibiotic? I once was in Indonesia: you don’t get away from the doctor without getting antibiotics! It seems to me you are not well informed. Welcome in the real world.

GdB

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Posted: 24 May 2009 08:06 AM   [ Ignore ]   [ # 45 ]
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No, no, not on falsehoods. But based on my ideas how to get quack believers on board. E.g.temporary agree that these alternatives are paid for, but open the research for e.g. homeopathy together with the homeopaths, more or less following the lines of Randi’s million dollar challenge.  When it then turns out that it does not work (no question for us), then we throw them out

In the first place, provisionally paying for something that there is no reason to think has efficacy base don scientific principles to begin with, and for which there is not favorable evidence makes no sense. And even if it did, the research and challenges you mention have been done, and homeopathy has failed repeatedly. As has acupuncture and chiropractic, ther “Big 3” of alt med. The U/S/ government has spent enormous sums of money of the NIH center for complementary and alternative methods, founded by a big believer in the senate, and the center has conducted many trials over many years and has failed to prove that any of these dsorts of methods work. So what do the believers say? Well, we need more research. Or we need research done by believers, because that usualy turns out the way we want.

More research will convince no one because it is not a lack of evidence that supports belief in these therapies, it is faith, and evidence cannot diminish faith for most people.

As you and Doug both agree, quackery will always be with us. But we minimize the harm it does and maximize the well-being of people by marginalizing it as best we can, and that clearly does NOT mean supporting it with public money. This is not a way tow ean believers off the nonsense; it’s just a way to feed the quack industry.

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