Rambling Around the Medical Blogosphere

(A roundup of some of the non-seismic events that have been troubling medical bloggers -PB)

Whaddya’ Mean it Doesn’t Work?

I rise in support of the makers of Airborne, an all-natural cold remedy, who are the unfair victims of a class action lawsuit that alleges, among other things, that the product neither works as advertised nor has any legitimate research behind it to back its claims. Developed by a couple of school teachers in the late nineties, this nostrum was promised to do nothing less than cure the common cold and in the process fulfilling the second part of the impossibility trifecta; the first of which was putting a man on the moon and the third, the remote possibility that Whoopi Goldberg will ever make a funny movie. Having been involved in a couple of business ventures myself, I understand the difficulty of marketing a new product in an economy packed to the gills with hundreds of variations of every product you can think of. The spatula section alone at a typical Target, for example, offers a bewildering array of spatulas (spatulae?) each with some carefully researched but ultimately ineffectual angle to attract the consumer. It’s not easy marketing some crap in bottle as the market is currently saturated with the stuff.

Claiming to cure the common cold was a good start because that takes some chutzpah even if it did require a careful strategy to keep the FDA at bay. The teacher angle was pretty good, too. I mean they’re school teachers fer’ Muhammed’s sake. School teachers! Everybody knows they’re smart and that they can do no wrong. They’re, like, untouchable, man! Accusing them of chicanery would be like bludgeoning the Pope with a baby seal. It should have been enough except that the makers of Airborne forgot one important lesson: In this day and age, lawyers are everywhere and if you’re going to sell useless crap to a gullible public, at the bare minimum you’ve got to have some big academic medical center providing cover. They know this in Durham, North Carolina where Duke Integrative Medicine flogs the usual candy-ass Complementary and Alternative Medicine with complete impunity, secure in the knowledge that every brand of snake oil they peddle, from Reiki to Guided Imagery and every breed of utter stupidity in between, bears the august imprimatur of Duke University.

You’re Doing it Wrong

I also rise in support of the New Scotland International School of Medicine, which, as its home page breathlessly informs us, is the Number One Leader in US Medical education. Not bad for a school that just opened its alleged doors a little more than a year ago. Ostensibly a churlish little enterprise taking advantage of some little-known (and perhaps imaginary) World Health Organization loophole conceived by French bureaucrats to legitimaze medical schools in countries ruled by oleaginous fat guys in military uniforms, Stewart University (as it is also known) promises to provide affordable and easily accessible medical training to people who, by virtue of bad grades, poor test scores, lack of a high school education, and other injustices are incapable of gaining admission to more traditional American medical schools.

Is it a scam? What do you think? At the risk of sounding shallow, one look at the nepotic rogues gallery comprising its administration, including the Provost Emeritus whose photograph lools like the last known picture of a Nazi war criminal before he fled to Argentina and the Chief Operations Officer who is a dead ringer for the Girl in the Back of the Bus who smoked cigarettes and let the boys look at her hooters, should be all anybody needs to know. The provost himself is a 32nd Degree Mason and a Member of the Ancient Arabic Order of the Nobles of the Mystic Shrine so, you know, he’s gotta’ be qualified as is the Facilities Director who couldn’t get a date for the prom and decided to get a job with Stewart instead.

Clinical rotations, you ask? Hah! “Clinical rotations,” the eponymous Chancellor informs us, “Are the least concern of a new applicant to medical school.” So apparently yer’ not going to do any. MCAT? College degree? Not required, allegedly, in Burundi or Southern California. A GED will do. That troublesome extra fourth year? Not necessary. The United Nations has decreed it, we believe it, and nothing more need be said. All you gotta’ do is get one of their cut-rate degrees, pass the USMLE Step tests, and finagle your way into the American residency training system with a generic international medical degree and no clinical experience whatsoever.

Oh the seductive allure to those whose dreams of a medical career are otherwise impossible to attain. This school has it all. No admission requirements to speak of. Easy courses taught by a lackluster faculty. Three-year curriculum. Southern California location. One last chance to redeem frustrated dreams, an in-your-face to those who said that your child pornography conviction would forever keep the prize out of your reach. With this in mind I must ask Graham to stop busting down on this little enterprise, this last best hope for those who could be great physicians if they could only get a handle on that, what do you call it, heart-thingy. The fact that this beacon of mediocrity might have to close its alleged doors (if it already hasn’t) would be a great blow to American health care and could be avoided if the school just tried a different marketing approach.

First of all, if you’re going to make a virtue of a weak curriculum, broken-down faculty, and shoddy instruction, you have to protect yourself from your potential critics. The military angle had got to go. The academic left will forgive a lot and tolerate all sorts of assaults on their academic standards but as every single member of Stewart’s executive body is a uniformed, blood-thirsty, baby-killing, My Lai torching, brainwashed, current or former military officer, they are nothing if not a big old fat target. Might as well put a big sign on the alleged doors begging to be shut down. If they’re going to do it right the Chancellor et al need to grow beards, learn how to tell jokes, and give their medical school some whimsical name like the Gesundheit Institute or the Center for Caring. Can’t shut you down if you’re wearing clown suits, home boy, or don’t you watch movies?

Not to mention the school needs to drop the legitimate medical education angle. Nobody’s buying it and it is too hard to fake. Instead, they need to invent some useless crapola and market it to the leftover hippies. I suggest they go au natural and offer degrees in Naturopathic medicine or similar horseshit. It’s not as if there are any standards. You can pretty much make it up as you go along, gleaning whatever you need from head shop catalogues, Wiccan literature, and whatever you can rustle up in the Alternative lifestyles section of your local Barnes and Nobles. Then they need to move to Seattle where they’re into that sort of thing. Give Bastyr University a run for their money.

39 thoughts on “Rambling Around the Medical Blogosphere

  1. Three years for medical school? I knew I had gone to the wrong university. The military angle looks a little scary though. I’m also not sure what a bunch of non-doctors are doing running a medical program.

  2. Naturopathic Medicine is not real. They prescribe ginko biloba. I can go to the store and buy ginko biloba whenever I feel like it. I can take it for any reason. And more likely than not it will not have any effect on me.

    Case in point. Pt comes to my office, he’s been treated for hypothyroidism by a naturopath for the last 2 years because he doesn’t want to take medicine that might be bad for him. The natural way is the right way. He wants me to take over his care, however, because he’s getting older and has recently been diagnosed with diabetes, and he thinks it’s too complicated for his naturopath. Check the TSH…….wait for it……19. So the treatment he was getting was worthless. 1 yr later, his TSH is in the normal range on levothyroxine, plus he has more energy and he’s lost weight.

  3. Dear Panda,

    Seeing a mention of the illustrious Stewart University on your blog has made my cold, shriveled heart skip a beat with what must be joy.

    If we’re really lucky, the provost will do his usual vanity search engine check and come defend himself here. Since you’re the first bona fide veteran publicly ridiculing him, I’m almost tempted to email him the link.

  4. Very funny post. “At the risk of sounding shallow, one look at the nepotic rogues gallery comprising its administration, including the Provost Emeritus whose photograph lools like the last known picture of a Nazi war criminal before he fled to Argentina and the Chief Operations Officer who is a dead ringer for the Girl in the Back of the Bus who smoked cigarettes and let the boys look at her hooters, should be all anybody needs to know. ” – had me laughing out loud.

  5. Oh crap. Thanks for the laugh. That rogues gallery….oh man.

    I had to take some slow deep breaths for a minute to regain my composure after that one.

    By the way, wasn’t one of those guys knocked off a horse with a golf ball in the movie Animal House?

    Oh, and who says Airborne doesn’t cure the common cold?

    I’ve taken it myself and it absolutely works.

    Usually only takes me about 2 weeks of Airborne to get over the worst of most colds!

    (Okay, I stole that one from Granny on the Beverly Hillbilly’s)

  6. Panda you might have missed the extensive SDN thread on the subject of Stewart but for awhile it was the most entertaining reading on the web.

    Given some of the information posted there and in other places by persons claiming to be “the chancellor,” I actually suspect that the guy is less of a scam artist than he is mentally ill will delusions of grandeur. Having had some run-ins with an individual like this who targeted a member of my family (a physician who was a friend to his parents and attempted to get him help) I feel more sorry for the guy than anything. But I really feel sorry for anyone who falls for the idea that his school is a legitimate enterprise that will let them practice clinical medicine.

    Unfortunately, California is a great place to run unaccredited schools and diploma mills. A lot of the major ones are run out of California which seems unable to shut them down, for whatever reason.

  7. More of those schools will pop up to compete with the lucrative offshore schools that already produce 20-25% of licensed physicians practicing in the U.S.

  8. “including the Provost Emeritus whose photograph looks like the last known picture of a Nazi war criminal before he fled to Argentina and the Chief Operations Officer who is a dead ringer for the Girl in the Back of the Bus who smoked cigarettes and let the boys look at her hooters, should be all anybody needs to know.”

    Best laugh this month!

  9. This whole Stewart thing IS a joke, right? I mean, the staff page (http://www.stewartmed.org/staff.html) only consists of 3 people, one of which is a 3rd party web designer (the logo is in the bottom right- http://godmomasforge.com/about.html). Their staff page in turn only has three other employees, one of which is a goldfish of indeterminate sex….

    “We operate outside the jurisdiction of the State of California. The State of California has no authority over New Scotland International School of Medicine. If you call the State of California, they will not say that they recognize New Scotland International School of Medicine because New Scotland International School of Medicine is a corporation outside the authority of the California state government.”

  10. What am I doing wasting my time in a “traditional” 4 year allopathic program when I could be done in just under 3 years? I see they have some job openings. I wonder if I could make more money recruiting students or trying to get people to buy stock in their school. I think I’ll apply for both positions.

  11. Panda Bear posts: “I rise in support of the makers of Airborne, an all-natural cold remedy, who are the unfair victims of a class action lawsuit that alleges, among other things, that the product neither works as advertised nor has any legitimate research behind it to back its claims.”

    Of course you do b/c only 4% of medical treatments, tests and procedures are evidence based.

    That means you are comfortable ordering untested, over hyped remedies, tests and procedures.

    After all you do it everyday in the ER.

    Source for the 4% figure: “Overtreated” by Shannon Brownlee, copyright 2007.

    (If I recall correctly it is mentioned in the last 2 or 3 pages of the last chapter)

  12. ????? “behind Bosnia and Jordan” ?????

    Panda Bear, the following is significantly more important than your ditty on the latest minor health scam:

    “Many Doctors, Many Tests, No Rhyme or Reason”

    By SANDEEP JAUHAR, M.D.
    Published: March 11, 2008

    Here are some ugly yet key facts about American health care delivery today lifted from the article:

    “…of the more than $2 trillion that Americans spent on health.

    “Are we getting our money’s worth? Not according to the usual measures of public health. The United States ranks 45th in life expectancy, behind Bosnia and Jordan; near last, compared with other developed countries, in infant mortality; and in last place, according to the Commonwealth Fund, a health-care research group, among major industrialized countries in health-care quality, access and efficiency.”

    “And in the United States, regions that spend the most on health care appear to have higher mortality rates than regions that spend the least, perhaps because of increased hospitalization rates that result in more life-threatening errors and infections.”

    You have made the following point may times yourself:

    “Overconsultation and overtesting have now become facts of the medical profession.”

    I urge everyone here to find time to read the article AND THE COMMENTS. Please treat both as one artcle to get into the flow of the issue.

    I know you will react to what you read there.

    LINK: Go to the NYtimes dot com site and do a search for the article title.

     

    (Yeah, not to mention all of the money spent on chiropracty, one-hundred percent of which is totally useless. -PB)

  13. im1dc – I believe Panda argues the same thing. We order too many tests because thats the only way to prevent getting sued. Maybe you should actually read the blog?

  14. So the Stewart Provost listed AOPA in his credentials. Is that the Aircraft Owners and Pilots Association? What a tool.

  15. BlackSails is spot on correct.

    Too bad our back-cracker friend doesn’t realize how completely stupid and meaningless those comparison statistics on life expectancy and infant mortality actually are.

    Maybe if we could just get more chiropracters into the nations NICUs and make back adjustments on all those severely early preemies (kids that in other countries wouldn’t even be counted as live births when reporting their infant mortality rates), maybe then we could undo all the obvious damage being done by our overpaid neonatologists, and get our ridiculous infant mortality rates down.

    And perhaps if Panda would just wise up and start handing out the Airborne to his GOMERS in the ER we could get a better life expectancy than Bosnia.

    Sorry im1dc, you make yourself look foolish with your posts.

  16. BlackSails, it’s been well-established that im1dc rarely bothers to read anything he posts. Why should he trouble himself to read the blog?

  17. Did anyone see that movie “Accepted”? Pour yourself another cup of coffee, put away the biochemistry notes, and take a long hard gander at their website. It is reminiscent of something put together by an idiot-accomplice (perhaps played again by Jonah Hall). The scenes in the movie involving the “recreational activities” showing the skate board ramp are only beaten by the scenes of the beach highlighted in the photos section of NSISM being advertised as a substantial part of a medical education (sans rotations, of course). They haven’t even been able to get a .EDU webaddress…of course if Lewis Black was an actual instructor, I might swing for the $10k/session tuition just for the laughs; he might have more credibility than some of these other jokers.

  18. Panda Bear burps out another unproven unsupported anti-professional slur: “(Yeah, not to mention all of the money spent on chiropracty, one-hundred percent of which is totally useless. -PB)”

    Really?

    Then tell me why M.D.’s are practice manipulation in a highly unsuccessful attempt at imitating precision chiropractic adjustments?

    Your beliefs and words don’t jive with reality.

    Seek help.

     

    (Precision chiropractic adjustments…har har…stop…yer’ killing me!  Har! -PB)

  19. “BlackSails” posts “im1dc – I believe Panda argues the same thing.”

    Yes, I’ve acknowledged that several times in prior posts.

    Try to keep up.

  20. “drsam” posts “Too bad our back-cracker friend doesn’t realize how completely stupid and meaningless those comparison statistics on life expectancy and infant mortality actually are.”

    And you obviously don’t realize how completely stupid and meaningless your comment is since the data is what is collected and the statistics derived from the data is all we have to do comparisons.

    If you want different data become an Epidemiologist and gather it.

    Deniers like you are the problem, imo. Wake up and smell the coffee, ‘drsam’.

    Your NICU comment demonstrates your ignorance of the facts, issues and debate.

    Let’s turn the issue around and ask why Chiropractors are not now routinely in NICUs?

    How do you frame the issue?

    I frame it like this: Its b/c of anti-competitive monopolisitic medical practice that bars patients in hospitals from other practitioners who may help them and has nothing whatsoever to do with patient care or safety.

    (Dude…you cannot possibly be for real.  Do you even know what a NICU is and if you do, what, for the love of Allah, do you propose chiropractors do there? -PB) 

    IOW, its all about money for medicine.

    The medical shrines you guys practice in (HOSPITALS) ought to busted up any Federal Anti-Trust Trust Busters and forced to open up to competiton, real competition, i.e., best outcomes.

    Moving on, this by you has a shred of truth in it: “And perhaps if Panda would just wise up and start handing out the Airborne to his GOMERS in the ER we could get a better life expectancy than Bosnia.”

    Statistics indiciate that if he meet ALL the patients at the ER door and told those who could respond to go home he would extend the lifespans of ALL the patients, those admitted and those not. That’s established fact. Medical intervention kills. That’s basic medical science 101. Why aren’t you aware of it and why aren’t you using it in every patient encounter when you may do more harm than good?

    Here’s more unsupported and unproven ego blather: “Sorry im1dc, you make yourself look foolish with your posts.”

    Why don’t you guys ever cite proof for anything you say?

    You think your opinion cuts mustard with me?

    The M.D. letters after your name have given you a pass with others far too long. You don’t get one with me.

    With me you either have something or you don’t and you guys come to the debate empty handed and headed far too often.

    FYI, the smears, slurs and ad hominem attacks I endure here only go to show medical practitioners desperation in the face of reasoned, factual, supported argument.

  21. Panda Bear, its good to see you are online right now b/c came here today to share this video with you and the others.

    It’s truly a powerful, moving and informative presentation.

    But, it is also 18:30 long, so if you watch it make sure you have the time to see it through to the end.

    “When a Brain Scientist Suffers a Stroke”

    “As a Harvard-trained neuroanatomist, Jill Bolte Taylor has always known more about brains than most people. But when a brain hemorrhage triggered her own stroke, she suddenly had a front-row seat on the deterioration of the brain.”

    “Dr. Taylor recounts the details of her stroke and the amazing insights she gained from it in a riveting 18-minute video of her speech at the Technology, Entertainment, Design Conference in Monterey, Calif., last month. Her fascinating lecture includes a detailed explanation of the differences between the left and right sides of the brain, complete with an incredibly cool prop — a real human brain.”

    Reconstruct link:

    htt

    p:/

    /ww

    w.te

    d.co

    m/ta

    lks

    /vie

    w/id

    /229

  22. Sigh. This again?

    ad hominem = about a person. Calling a profession useless is not ad hominem. You may find it personally insulting, but it isn’t ad hominem. Besides, wasn’t it you that told me to change careers and/or seek psychiatric help for clinical depression, and called me a crybaby who responded emotionally rather than rationally when I last disagreed with you without personally insulting you?

    Stones. Glass houses.

  23. Since im1dc seems unable to figure out how to code a simple HTML link, I’ll save interested parties the trouble of cutting and pasting his fractured link. You can view the video he’s flogging here.

    As the father of a child who spent his first three and a half months outside the womb — which properly should have been inside the womb — let me say that im1dc can keep his clammy, snake-oil greased fingers to himself. Parents of children in a NICU have enough problems without his ilk skulking about the warmer beds and isolettes.

    DC, you don’t endure ad hominem attacks here. You don’t understand what the phrase means any more than you do the genuine needs of premature infants. Here’s a clue, cracker. You don’t deal with conditions that have serious negative outcomes. Since your treatment does essentially nothing, there’s no way you can possibly fail. Sure, that makes you look real good if you’re looking at mortality rates.

    Big, fat, hairy, deal. I can claim the same success rate with the candy pills from my toy doctor satchel when I was 5.

  24. Re: Chiropractors and NICU’s

    You people are so CONFUSED.

    I am forced to repeat my post b/c those here cannot read with comprehension:

    This is what I posted:

    “Let’s turn the issue around and ask why Chiropractors are not now routinely in NICUs?”

    “How do you frame the issue?”

    “I frame it like this: Its b/c of anti-competitive monopolisitic medical practice that bars patients in hospitals from other practitioners who may help them and has nothing whatsoever to do with patient care or safety.”

    Note that I asked “drsam” how he would frame the issue and then framed it from a chiropractic VS medical monopoly perspective.

    I framed the question squarely and clearly on the premise of Medical Monopoly Anti-Trust not chiropractors in NICU’s.

    NICU’s was merely the vehicle used to force you view the issue from the chiropractic perspective.

    Why aren’t chiropractors in hospitals routinely?

    I don’t know what a chiropractor would do in an NICU and neither does anyone else since there never have been chiropractors in NICU’s.

    The question has never been asked before, thus never answered.

    To you low functioning M.D.’s: What I’m saying is that there is no Evidence Based Medicine one way or the other.

    Only supposition, myth, bias, prejudice and anti-competitive behavior.

    So while you scoff and believe my question to be absurdly objectionable the fact is that you cannot legitimately or knowledgeably answer.

    Will you people ever wake up?

    BTW, I was around at the origin of NICU’s and watched their growth. Offhand I don’t know what a chiropractor could add to the care of patients of a NICU. I don’t know if it would be a good or bad thing. Obviously a chiropractor would not have benefited Chris C’s child.

    What he and PB don’t get is that just b/c a chiropractor may not benefit certain or even most patients in a NICU doesn’t mean they may not – potentially – benefit select others.

    (I repeat, you cannot possibly be for real.  Please, by some sign, show me that you know what a NICU is and what goes on there. -PB)

    Why do I feel as though I am speaking to infants?

  25. Chris C, I have asked you previously to teach me how to use html code to link and you ignored me.

    I ask you again, please post how to code a link as you did in your March 14, 2008 12:59 am post.

    Instead of using my html code deficiency to smear, slur and slime me how about sharing your html coding knowledge?

    Is that too much to ask?

  26. I returned here this early morning to share the following I found in Slate.

    I could have written it, indeed my posts here are the same indictment, however, this was written by one of your own.

    I am looking forward to seeing how you respond to one of your own saying exactly what I have been said on this blog.

    At some point I suspect even the whining slow learners that occupy this blog will have to acknowledge the evidence presented as overwhelmingly factual and then hopefully turn your focus to solutions, which will include Alternative Health Care, imho.

    We are on the same team and want the same goal -healthy happy paying patients – you just don’t seem to know it.

    Training Daze

    “Why do doctors fixate on diagnosis, not treatment?”

    By Darshak Sanghavi

    Darshak Sanghavi is a pediatric cardiologist and assistant professor of pediatrics at the University of Massachusetts Medical School. He is the author of A Map of the Child: A Pediatrician’s Tour of the Body.

    Posted Wednesday, March 12, 2008, at 1:06 PM

    “When doctors are freed from commercial pressure, how well do they perform? We’ve grown accustomed to scapegoating pharmaceutical companies for health-care ills—consider movies like The Constant Gardener and the recent New York Times Magazine exposé by a psychiatrist paid by drug makers. The implication is that if left alone by money-grubbing drug companies and health insurers, physicians make the right decisions on behalf of their patients.”

    “Not so fast. It turns out that improving the quality of health care has only a little to do with drug companies. Their influence is a symptom of a deeper underlying pathology. The real trouble is that doctors—somewhat paradoxically—are simply not focused on actually treating disease.”

    “A key indicator of this problem emerged last October, when a team of researchers led by Rita Mangione-Smith reviewed children’s medical records from 12 major American cities and found that fewer than half of children got the correct medical care during doctor visits. The researchers asked basic questions such as these: Did doctors properly inform mothers to continue feeding infants who had diarrhea? Was HIV testing offered to all adolescents diagnosed with a sexually transmitted disease? Was a follow-up visit scheduled after a child’s medication changed for chronic asthma? These were all simple things doctors should have been doing yet weren’t. (A similar study of adult quality of care was published in 2003 with similar results.)”

    Much more to read at Slate.

    And don’t forget to read “Overtreated” by Shannon Brownlee.

    BTW, I suspect Dr Sanghavi spends a lot of his time in NICU’s.

    Reconstruct link: htt

    p:/

    /www

    .sla

    om/i

    d/21

    864

    46/

    ?GT1

    =38

    001

  27. PB says “(I repeat, you cannot possibly be for real. Please, by some sign, show me that you know what a NICU is and what goes on there. -PB)”

    Your comment shows me that you have not taken the required 18:30 of time to view the video “Jill Bolte Taylor: My stroke of insight: at Ted ‘dot’ com.

    I am real.

    I carried my second child to her birth hospital’s NICU along with her Pediatrician.

    NICU’s did not exist when my first was born.

    I am not overwhelmed or over awed by high tech NICU’s. I know they have limitations.

    You would too if you read “OVERTREATED” by Shannon Brownlee.

    Right now your RIGHT BRAIN is LIMITING your ability to see beyond what you’ve been taught. That condition may make you a good ER doc but simultaneously it makes you a lousy BIG PICTURE THINKER.

    Just b/c NICU’s are one of the last inner sanctums of medicine does not mean they are off limits to Alternative Care anymore than the surgery suite.
    ++++++++++++++++++++++++++++++++++++++

    I once asked on this blog a few weeks ago why it is that it is such a bad thing that alternative care practitioners/chiropractors help patients do without drugs or surgery.

    No one dared answered that query.

    My surmise, you must believe drugs and surgery are good for you, better than not having drugs and surgery.

    While that is certainly true in some limited conditions it is also certainly not true in others, perhaps most human conditions.

    Have you gotten around to accepting the fact that the US Health care system ranks BEHIND BOSNIA according the WHO?

    Maybe the way you think, the way you are trained to think, is the problem.

    I certainly posit that as my premise.

    I don’t believe it is b/c you are incapable, incompetent and inept.

    I know you show up and try to do your best.

    So why all the failure?

    Hummmm?

  28. “Just b/c NICU’s are one of the last inner sanctums of medicine does not mean they are off limits to Alternative Care anymore than the surgery suite.”

    What “Alternative Care” do you propose surgeons use? Or neonatologists, for that matter.

    “I am not overwhelmed or over awed by high tech NICU’s. I know they have limitations.”

    No kidding. What is there that exisits that is without limitation? What would the alternative to NICU care be for a 27 week preemie?

    “Have you gotten around to accepting the fact that the US Health care system ranks BEHIND BOSNIA according the WHO?”

    Based on what, exactly?
    In which nation would you prefer to have an automobile accident/trauma? An MI? A CVA? Type 1 diabetes? Colon cancer? Breast cancer? Thyroid cancer? Hematalogic cancer?
    I know my answer.

    Alternatiev medicine may make some people feel better about minor complaints. Some “alternative” treatments may work on a biological level. But the majority of alternative treatments have nothing to offer in the treatment of the majority of real medical conditions.

    If you disagree, feel free to tell me how alternative therapy has proven to be effetive in acute cholecystitis, diabetic ketoacidosis, respiratory failure, acute appendicitis, diverticulitis, MI, thyroid storm, status epilepticus, pneumonia, cancer, sickle cell disease, splenic rupture, or subarachnoid hemorrhage. Pick any (or all) of them and enlighten us, or substitue your own (real) disease.

    “In the middle of my sophomore year at Lincoln, I began to have doubts about its teachings that adjusting the vertebrae would cure or prevent most ailments. My pivotal experience occurred in the classroom of James Firth, D.C., professor of chiropractic, president emeritus of the college, and author of the prominent textbook Chiropractic Diagnosis. One day a student suddenly fell to the floor with an epileptic seizure. Since Firth’s book specified which vertebrae to adjust for epilepsy, I was anxious to see the master at work. After some hesitation, he walked over to the student and popped his neck. Then left the room, leaving the student convulsing on the floor. As far as I could tell, this “treatment” had no effect whatsoever. ”

    from Chriopractic school experience

  29. Babies in NICUs need “vertebral subluxation” treating DCs almost as much as they need spatulas. Spatulas are great tools in the right environment but they are not only useless in the wrong one, they can get in the way and be dangerous when you are trying to reach for the tools to put in a central line. (Obviously this is where my opinions diverge from Panda’s, as he sees spatulas as infinitely more useful in all environments compared with a DC). Anyway, I give up. I’m going back to my policy of non-engagement with people who are more interested in being right than they are with addressing serious flaws in their own arguments.

  30. “Right now your RIGHT BRAIN is LIMITING your ability to see beyond what you’ve been taught. That condition may make you a good ER doc but simultaneously it makes you a lousy BIG PICTURE THINKER.”

    ——————————————-

    You know, when I was a kid, I once accused my dad of being a “linear thinker,” thinking he wouldn’t allow himself to think outside the box.

    As I’ve grown older, I realized that he is plenty creative, and is more than willing to listen, he just didn’t accept my enthusiasm as a substitute for proof. My name-calling was an immature cover for the statement “Why don’t you take my word for it?”

    You may now selectively quote my story to prove your point.

  31. Going through DO school I understand manipulation can at best be helpful for some back ailments, but how the hell will manipulation come into play in the NICU, or even for a DDx on a patient? All chiropractors do is manipulate, which in itself limited to some physical ailments (contrary to what you are taught). What makes you people so dangerous is the belief that what you do is helpful for all types of ailments, be it an infectious or chronic disease etc. the vast vast majority of healthcare ailments will be treated by evidence based medicine and you need to get used to that. The problems in the American healthcare system are real, but a chiro is sure as hell not the answer.

    As to why doctors do not like alternative care, its because many times alternative care providers sell it as the only care needed which is dangerous for the patient.

  32. im1dc, like every other question you claim has gone unanswered around here, you’ve already been told how to format a link but have either misunderstood or failed to read it. I showed you exactly how a while ago and you screwed it up. There are also ample online references that tell you how. You can also look at the source for most web pages and see how links are made. This isn’t rocket science. Nor it it brain surgery. It’s not even naturopathy.

    You use the “a” tag.

    <a href=”URL GOES BETWEEN THE QUOTES”>clickable text</a>

    This may not look right since I don’t know what WP does with HTML entities, but if it doesn’t there are all those other resources.

    See, WordPress will turn any bare URL you write in a post to a link. The trouble was that you were pasting them indiscriminately, regardless of how long they were. Since they contain no spaces there can be no line breaks, so one very long URL will screw up the format of the whole page by making the text boxes too wide.

    If this is still too complicated you can use tinyurl to make all your URLs short enough to behave well when pasted in.

    Others have given you good answers to the “issues” you raised, but as to the evidential basis that chiropractic would do no good in the NICU — as usual, you have it exactly backward. It’s the chiropractors who have to show evidence that they can do any good. There’s not often anything mysterious going on in a NICU. Most of those kids have extremely serious acute conditions for which good outcomes are unlikely at best. That doesn’t mean the conditions are so poorly understood that people are willing to try snake oil on the off-chance it’ll work. Most of the conditions are well-understood. It’s that they have to be managed with extreme delicacy and under very close attention.

    MDs staff NICUs because MDs created NICUs. DCs didn’t create NICUs because they’re not qualified to provide the kind of treatment needed. If you honestly think you are, you’re deluded.

    You bring up an excellent example of something that PB has talked about numerous times in this blog that, were you actually reading it, you could not have failed to notice. His most recent entry talks on the same subject. You quoted a Slate article as saying:

    A key indicator of this problem emerged last October, when a team of researchers led by Rita Mangione-Smith reviewed children’s medical records from 12 major American cities and found that fewer than half of children got the correct medical care during doctor visits. [emphasis mine]

    These people didn’t find that most of what they talked about wasn’t done. They found out that most of it wasn’t written down. Why the hell (for example) should a doctor record that he told the mother to keep feeding a kid with diarrhea? That’s absurd. There’s no medical reason to record every utterance of standard medical advice — assuming this is really standard, because I can’t see why any parent would consider not feeding a kid who has diarrhea. Are you going to insist on burdening the medical profession even further by requiring a stenographer in every examining room to make a transcript of everything said?

    My kids’ pediatricians have a reference pamphlet they give out to all new parents who start bringing their kids in, giving all kinds of standard advice like how to deal with diarrhea, constipation, low fevers, and most other routine childhood ailments. Do they chart that this pamphlet is given out? Why on earth should they? That would be idiotic.

    At least one of those issues isn’t the doctor’s responsibility at all, but the parents’. A doctor has no power to compel a parent to schedule a follow-up visit. They can say one is necessary, but the parent still has to go ahead and do it.

    But I bet that’s not what’s happening anyway. I bet the pediatricians are saying something like, “If your child shows this, this, or this symptom after x amount of time, then call us.” And then didn’t write it down, because charting the fact that you said something like that is stupid. I hear that kind of thing from ours fairly often. With asthma, it would be particularly unsurprising. My wife has asthma — which her DC has done nothing to manage, by the way — and an asthma sufferer knows perfectly well when the problem is getting better or worse. You really can’t miss it no matter how little medical training you have.

  33. im1dc is quite humorous >). I choose to believe it’s a female, because “she” reminds me of my grandmother who’s been steadily going insane over the past 10 years. Every year she sends us books on homeopathy that rival the snake oil salesmen of early morning paid programming on cable. The hippies of the 60’s didn’t reform to mainstream thought, they’ve been reborn into a society that accepts evidence-based, scientifically proven medicine. These people are today’s counter-culture, only this time we already have a largely immoral, a-religious society. Medicine is the new, perfect target in a world of pre-manufactured goods. “Naturally” manipulating the body, herbal “remedies,” ancient Chinese “secrets”….all these things have the same hippie appeal, and provide the only alternative, even if it’s only an illusion. They go blue in the face trying to convince us of their not-unlike LSD-induced clairvoyance. The only thing for us to do is sit and laugh- we certainly can’t argue with them.

    PS- before you accuse me of industry bias, I am not a physician; I don’t even work in healthcare.

  34. From what I understand from attorneys, putting too much detail into your notes can actually work against you in case of a malpractice suit. For instance, if you write, “Discussed side effects A, B and C” and patient suffers from side effect D, lawyer may successfully argue that your notes show that you did not discuss side effect D.

    Also important to note that “patient verbalized understanding.”

  35. For the love of God, Panda, ban it. Not worth talking to or dealing with. Trolls at that level aren’t productive, even to smash down.

    Back to the post, I’ve always thought “Airborne” was very likely a complete placebo – if only because the best reason they could give me to trust it was “made by schoolteachers!”.

    Schoolteachers might be generally well-meaning, but that’s about the highest commendation I can give them as a group, and that doesn’t make me confident in their ability to design medicines.

    Or, for that matter, test the efficacy of same.

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