Uranium, Polonium, what’s the difference?

Pardon my asking, but I know nothing about the subject: how do you know that this diagnosis is sound? Do you know that it’s a standard test from a reputable lab? There’s no end of charlatans out there, so I’m just wondering what your confidence is based on.

Wow, you woke the CIA up with this one. Nice work.

What are your symptoms?

Yes, I’m wondering about the symptoms too.

I would go to one of your regular doctors, and get them to double check this test.
Do you have any idea what cause this exposure?

There’s no telling, sometimes, where medical expertise really lies.

My sister is a business and personal partner to an optometrist, who runs a franchised practice in central Wisconsin. He takes great pains to explain that as an optometrist he is a “medical professional”, but he is not licensed to diagnose disease, perform surgery or prescribe drugs. But he does understand medicine and the body, and keeps informed on symptoms of disease, especially as they present via the eyes.

He has on many occasions during the course of an eye exam asked people pointed questions about other aspects of their health, just based on what he can see in their eye exam results. Again, he is very clear with his patients that he is not a doctor or a physician of any kind, and is not diagnosing them, but he very frequently tells them to see their physician and “suggest this kind of test for such-and-such a condition” and has nearly always (at least in the instances that we’ve heard about) had a follow-up call or visit from a satisfied eye exam patient, “Thanks for that lead; the doctor had been stumped until you suggested that test, and now we know what the problem is.”

Yes, I do. First, my board certified MD is also an expert and certified in diagnosing heavy metal poisoning. I have checked it out. It’s legit.

I filled out a questionnaire about possible exposure. (multiple huge amalgam fillings, and lots of exposure to mercury as a child- a neighbor used to give me mercury to play with). I ran a cleaning business for 30 years, where I absorbed every chemical you can think of, everything from solvents, and paints to petrochemicals, perfumes, and everything in between.

I have short term memory loss and nerve damage (another symptom).

In a normal person the circadian rhythm fluctuates throughout the day. My circadian rhythm is almost flat, with very little fluctuation through the day. This is also indicative of heavy metal poisoning.

Then I did a 24 hour urine collection which acted as a baseline, showing what my body naturally secretes. Next there was one session of chelation therapy which draws out the heavy metals from the cells, bonds to them, and allows them to be safely eliminated through the urine. This was followed by a second 24 hour urine collection, and it is this one that showed the extent of my poisoning.

Well I’m guessing it’s because your average conventional doctor doesn’t know jack about the subject. If anyone has any other ideas, I’m willing to listen.

Just please don’t do the ‘replacing amalgam fillings’ thing….

Children here are tested for lead poisoning. I don’t know why adults aren’t.
@trailsillustrated What is “replacing amalgam filings” thing?

@trailsillustrated Amalgam fillings do degrade over time, I had mine in for 25 or more years, depending, and that did indeed contribute to my problem.

Edit: Amalgam fillings contain mercury.

But that’s not the issue here, because I was massively exposed before I ever had a filling.

“certified in diagnosing heavy metal poisoning”

Certified by who?

@snowberry, in your first two posts above, it looks like you’re responding to specific comments, but we don’t know which ones.

@Jeruba Sorry, I’ll try to pay closer attention.

As for my comment on why doctors don’t address these issues, I was giving my own answer to the question.

Because doctors are ignorant fools who don’t know anything about the body.

@China it is more important that toddlers get tested for lead because it could lead to permanent brain damage at that age. With adults if you survive the effects are mostly reversible.
I personally probably miss more metal toxic then I catch. The problem with rare toxicities like that is the symptoms come on over months and the symptoms are common to “stress” (weakness, appetite loss, sleep changes, weird tinglys without paralysis, headaches). And stress is WAY more common than metal tox, so it kinda gets lost and forgotten about. My cop out as an emergency doc is 1) I can’t really order metal tests because the get sent to butt fuck, Colorado, and I won’t have results for 2 weeks and 2) I always tell patients to follow up with their primary for more testing when they come in with symptoms like that.

@Rarebear When it comes to metal toxicity, you might be right. I’m thinking that @drhat77 hit the nail on the head though.

What I find frustrating, amazing, irritating, etc. is that although alternative medicine is always presented by many (most?) conventional doctors as quackery, why do I have to go to an alternative guy to be diagnosed and treated? Why aren’t conventional doctors doing this? This is a question for which there apparently is no answer, or at least no clear answer.

One reason might be that treatment won’t be honored by most insurance policies. I am paying out of pocket.

I would agree with @trailsillustrated – amalgam is an intermetallic compound. The mercury is very tightly bound to the silver. It does not vaporize like liquid mercury. In fact, studies have shown that people with amalgam fillings do not have higher levels of mercury in their bodies, than people with similar backgrounds but having fewer amalgam fillings.

Amalgam fillings don’t fall out because they degrade. They fall out because the surrounding tooth material degrades. Teeth are much more susceptible to acid and cavities than amalgam.

If you have mercury in your body, it is due to playing with liquid mercury. No, you are not a freak to do that – I played with mercury, myself, when I was young. Then I went on to study intermetallic compounds in grad school. It is amazing stuff.

Try listening to some country music.

How did you get heavy metal poisoning anyways? What kind of work?

@XOIIO Funny you should mention that. I do listen to country music, but hasn’t helped my problem a bit. Thanks for the suggestion though.

I ran a cleaning business for 30 years, where I absorbed, breathed in, or somehow ingested every chemical you can think of, everything from solvents, and paints to petrochemicals, perfumes, and everything in between. Even a touch of formaldehyde. I didn’t get all this exposure on the job. Some of it I got working in a factory, and some I got elsewhere.

Because alternative doctors get paid by patients (and not insurance companies) they are much more driven by true market forces, like customer satisfaction. Also since patients must pay out of pocket for alternative doctors, the patients are much more likely to be actually ill with something (as opposed to “stress”), so alternative doctors keep an open mind about such things. Finally, alternative doctors don’t need to triple book, so they can spend a lot of time listening to you and uncovering clues like that.

@drhat77 Ah ha. Now that makes sense. So the next question is, if these people are actually providing a needed service to the public, why are they so maligned?

When tested under carefully controlled conditions, they don’t work very well.

Because alternative doctors love nothing more than finding “toxins” in a customer’s body. Even more so if that customer has a full pocket-book.

Dur. They’re hurting our bottom line. Not to mention telling us we’re bad at what we do. Time to bust out the personal attacks.

The idea that heavy metal toxicity is overlooked is false, and is abused by individuals trying to milk as much money as possible from gullible customers. For one thing, having toxic levels of mercury and uranium would be very serious (i.e. causing death), and therefor that seems highly unlikely. Furthermore, the use of chelators to “provoke” the release of heavy metals is clearly not a scientifically valid approach. If you have toxicity, then you should be secreting large amounts AT BASELINE, not after a provocation. Also, these labs use very low ranges that are not accepted by the scientific community. http://www.quackwatch.com/01QuackeryRelatedTopics/Tests/urine_toxic.html

Yes quacks exist, but some of them have mds as well. As long as they don’t hurt people and make them feel better, meh. I can’t argue with results. I’m not going to be categorically opposed to alternative medicine because a few crooks see a prime opportunity to score. Especially when the medical community I feel shields mds who commit ify medicine and turn a profit.

@drhat77 Did you read the link? Notice how it makes scientific sense and is consistent with everything you learned in chemistry, physiology, pharmacology and medical school? Yet, somehow these practitioners of fake medicine know better? Really? It’s like the whole movement to do bowel cleanses because of the “toxins” there, where we are now learning how important the gut microbiota are to human health. Why would we want to wash our bacteria away with high colonics? These people are simply modern snake oil salesmen, plain and simple.

Medicine exists to make people feel better. We are failing at that. People are stepping in to fill the gap. As long as they don’t hurt people I cannot slight them for doing my job and take my money.

@Seek_Kolinahr One of my problems is that I am highly estrogenic (due to these toxins) which cause severe hormone problems. You’re thinking I should not bother to deal with the cause, and instead do what one doctor told me to do: get a hysterectomy, and go on prescription hormone replacement therapy. Does not sound appealing at all to me.

@Quakwatch Hmmm, interesting. So what are you suggesting I do instead? I’m certainly not satisfied with the current level of care by my past conventional doctors.

@drhat77 I disagree that the aim of medicine is to “make people feel better” (weeeee, dilaudid for everyone). The aim of medicine is to cure people of disease, with the hopeful byproduct that in the long term they will indeed be healthy and well. The people stepping in to “fill the gap” are charlatans, and should be revealed as such. If someone tried to tell you that evil humors caused pneumonia, and that a little blood letting would cure it, would you buy that? What if the patient said “but I felt better”? BS is BS, no matter what people say.

@snowberry I suggest you consider reevaluating whether a lifetime of “heavy metal toxicity” can really explain how you feel. If at first you don’t succeed, find another doctor with whom you can establish a positive relationship.

@Quakwatch That’s easier said than done. I’ve been hugely disappointed by every single conventional medical doctor I’ve seen, and I have seen many. I see no point in continuing to do the same thing over and over expecting a different result (Einstein’s definition of insanity, remember). I like my current doctor. He takes the time to address my problems. He actually listens to me, and he doesn’t take insurance because he doesn’t want them to dictate how he runs his practice. I have the money, and I cheerfully pay the guy. We both win.

We don’t just eradicate disease to check a box. We do it to ease suffering. That is medicine’s goal. Dilaudid for everyone is not a good idea because it would be fatal (medicinal marijuana now causing death and toxicity in toddlers, whoops).
Long term alternative practioners are still in business because they are not harming anyone (otherwise they would have been brought up on charges and shut down). And they are thriving because conventional medicine has forgotten its prime mission.

@drhat77 citation needed

Bed time for snowberry. Thanks for all the comments. I appreciate it. Carry on folks! ;D

@Seek_Kohlinar for which part. I can find the medicinal marijuana bit with minimal digging, but the quack bit is just my gut feeling.

medical marijuana causing deaths in toddlers.

@chyna there was a movement in the 90’s for people to remove their amalgam fillings and have them replaced with plastic. Because what @RocketGuy said, the mercury in them is INERT. Also as I have written here before, the tooth is a living creature, much like an oyster. When manipulated ( such as drilled on to remove said amalgam) this can cause the tooth to die, requiring expensive root canal therapy and crown, rct is never guaranteed, it’s a bad move.

@snowberry Sometimes people need to take a long look in the mirror and assess that if multiple experiences were bad, is it really possible that each and every one of the multiple doctors is a jerk, or an idiot, or misinformed, or is the common denominator a patient with unrealistic or misguided expectations (i.e. apply Occam’s Razor).

@drhat77 Again, we disagree. These quacks abound because people are, by their very nature, gullible and naive. Science education in this country is a disaster and some people have appropriated bizarre beliefs (see the recent measles outbreak in Texas). Most of these alternative practitioners “treat” very “soft” problems, like depression, headaches, joint aches, fatigue, etc. and as such the placebo affect alone can be curative. There are no alternative treatments for severe infections, cancers, kidney diseases etc. The fact that many people distrust medicine these days is the fault of the medical community and its outreach, not that medicine is necessarily failing (life expectancy is 80, for pete’s sake!)

@Quakwatch agree with you- ‘leaky gut syndrome’ anybody?

@Quakwatch -unrealistic or misguided is the key. In our dear @snowberry‘s case, the medical professionals gave their thoughts on what would amount to a viable permanent solution to her problem.

She obviously felt this was an undesirable course of action, and began grasping at straws to find someone who would tell her what she wanted to hear: that it was something completely different and easily treatable with regular office visits. money be damned.

@Seek_Kolinahr Yes, the list of quackery is long these days: chelation therapies, colonic “cleanses”, alkanization of blood, bizarre diets, unvetted stem cell therapies, vitamins for everything, etc. It really is a shame that we cannot regulate these activities more, or at least gain more oversight over certain practitioners.

@Seek_Kolihnar I did mispeak here is the article I read recently, no deaths.
IMHO the best way to prevent quacks is patch the holes in the medical system that cause patients to seek them out. To me that means treating the patients symptoms as important, not just looking for a cause, and giving up when “everything’s normal”

@Quakwatch – I just want permission to break the necks of anyone who performs chiropractic on a newborn.

@drhat77 But don’t you see, these quacks create the disease that they then “cure”. Heavy metal poisoning is not all that common. It should be seen in the urine in an unmanipulated specimen, yet these quacks have to provoke excess secretion by delivering a chelation therapy, and then have the audacity to use a falsely low “normal” range in an UNMANIPULATED specimen. Talk about skewing results in favor of a “diagnosis”. This isn’t simple quackery, like homeopathy. No, this is more nefarious because these doctors have to actually create the circumstances of disease in order to peddle their chelation therapy.

The quacks didn’t give the patient the symptoms. We are being disingenuous with patients when we skirt telling them “I think the symptoms are in your head”, instead shrug our shoulders. This sends them to alternative doctors who get results the patients can appreciate. You are focusing on numbers (disease oriented endpoint). I am focusing on patient oriented endpoints. Doctors have to strap their nuts on in the morning and honestly tell patients when all the rational testing comes back “stress is causing your symptoms”. Or depression. Or whatever. We can’t be afraid of a few patient who will get nasty because of continued stigma.

@Seek_Kohlinar I think we perform too many hysterectomies in this country. I think a patient wanting to seek nonsurgical options first is understandable.

and when the rational testing comes back “your body is wonky, here’s what we can do to fix it. There will be pain and downtime but the results should be permanent” and the patient says “WOAH… but Dr. HappyHerbs says I just need chelation and regular green tea colonics…”

how does one handle that?

@drhat77 – you and I both know there is a difference between nonsurgical and nonmedical.

You know that Kevin Trudell whack-o? he blames every body ailment on yeast. Whatever it is, it’s because you’re just chock-full of candida. and this guy sells millions of books. It’s scary.

This is occurring because doctors are failing their primary job: listening, educating, communicating, treating symptoms. We tend to think our job ends once the tests are negative.

@Quakwatch Welcome to Fluther! Are you an official representative of the site? or just a fan? Either way, it’s great to have you participating.

One aspect that I agree with @drhat77 is that the current system does seem to drive patients to alternatives. The triple booking necessary to compensate for rapidly shrinking reimbursements and the rapidly increasing overhead of running a medical practice are producing fertile grounds for charlatans who can provide plenty of “face time” with the patient. Health insurances companies are largely to blame in my opinion. And defensive medicine is a real problem as well.

My girlfriend’s father got cancer of the throat, and found a rich supply of sites eager to provide him with natural “cures” including raw foods diets and blends of flax and cottage cheese. As a reader of Science Based Medicine and the son of a general/vascular surgeon, I pushed really hard for him to pursue conventional treatment. He has been in remission for well over a year after chemo and radiation from Johns Hopkins. It was a rough ordeal, but it saved his life. Stories like this never make the news or show up on blogs, or in Google searches for natural cancer treatments.

@snowberry I would seek out a second opinion to confirm a heavy-metal diagnosis via conventional diagnostic process. If that comes back negative, I would get the hell away from this guy.

@drhat77: Is there also the issue of the average guy expecting his doctor to fix everything? We have somehow elevated everyone with an MD to the Houdini level.

I have a PCP who does listen, educate, communicate and treat symptoms. He also agrees with me that some of my symptoms cannot be fixed…unless I grow younger. So I don’t bug him. He and I both know about exercise, diet, stress reduction, laughter and tears and a nice house pet.

@gailcalled I do get a lot of fix me now, and there seems to be high overlap with “stress”. I think if doctors could spend more time with their patients a lot of that would be headed off at the pass.

@drhat77 So what about Dr. Dean Ornish? Steve Jobs would almost certainly still be alive if it weren’t for him. Apparently he’s a successful professor of medicine at UCSF and the author of many best-selling books. Shouldn’t he be in prison?

I didn’t know anything about that until your post @gorrilapaws. People are scared when they are ill, and they feel they need to do something to get back control. This may mean alternative doctors if conventional ones aren’t cutting the mustard, and it may mean starvation diets. Medicine needs to anticipate and treat that aspect, but we prefer to ignore it, focusing on tests, medicines, and surgeries.

@gorilla paws I just remembered about “emminence -based medicine”, where one’s academic clout serves in lieu of actual scientific evidence. It seems like that’s a factor in the Ornish situation. If doctors do not stand up to weirdos with tenure, this kind of thing will happen.

@drhat77 “If doctors do not stand up to weirdos with tenure, this kind of thing will happen.”

I completely agree. I would like to see all medicine return to the days when all treatments needed to be demonstrated as safe and better than placebo in well-designed, well-controlled, peer-reviewed studies to be legal. With all of the fuzziness around complementary and alternative medicine, companies can legally make claims like “supports immune health” without any evidence whatsoever. Hell, water “supports immune health.” It’s a meaningless claim, but dangerously misleading to the average person. Patients are the ones who suffer while they profit. Lying, misleading and taking advantage of people who are sick, scared and desperate is morally repugnant.

@gorrillapaws return to those days? I’m waiting for those days to get here.

@drhat77 Fair point, but the Dietary Supplement Health and Education Act of 1994 marked the beginning of the floodgates of quackery opening up resulting in the cesspool we have today. Also Wilk v. American Medical Association really neutered the AMA’s will to publicly criticize unscientific practices. Without a well-respected entity keeping quacks in check, they have flourished.

This is demand-side ecomomics, which you cannot fix by making the supply illegal. You need to address the demand, otherwise supply will always manifest, by both scrupulous practitioners and otherwise.
But the AMA could have “regulated” Cornish, but we chose not to.

@drhat77 That’s fair, but because of the changes to how supplements and the like have been regulated, there has been a huge marketing push to promote these treatments which has played a massive role in generating the demand. It’s similar to how pharmaceutical companies can now advertise drugs with happy people dancing on the beach, and patients showing up at their primary care telling their MDs that they want a script for X. It’s back-assward.

Wait, there’s a drug that can make me a happy person dancing on the beach? Finally! I need that!

I want the tampon that will make me remember to go to kick boxing class.

It the only tool in your toolbox is a hammer, every problem looks like a nail.

For prostate cancer, radiation oncologists will recommend radiation, surgeons will recommend surgery and oncologists will recommend chemo or hormones.

Is that alternate doc selling you the chelation or other chemical to draw out the toxins? Where is the independent source for verifying the results?
I wish you well.

@Seek_Kolinahr and others: I see just a touch of hypocrisy here. You say that a person should be able to do what she wants with her body concerning abortion, yet you would shut down all my alternative medical doctors, denying me access to the only medical care that has offered me hope. Instead you’d have them pluck out my uterus and fill me full of all sorts of medications with nasty side effects. Why shouldn’t I have the same right over my body that you insist you have over yours?

Pro-choice people even want the tax payers to pay for it, but I’m not asking tax payers to pay for my alternative medical care. Don’t you see the glaring double standard here?

I’ve lived the failings of our medical system first hand. It’s a horrible way to live and die, and the damages are collateral rather than individual. For insight on how the system fails people, follow the discussion @drhat77 and I had.

http://www.fluther.com/162847/what-do-you-think-about-new-jersey-usa-governor-chris-christie/#quip2782435

@snowberry FWIW If this treatment is helping you and you are willing to pay for it, I say mroe power to you.

incorrect.

I don’t wish to take away your choice to ignore sound medical advice in lieu of snake oil. I want the snake oil salesmen prosecuted for making false claims and calling it healthcare.

If there were alternative abortion providers telling women to drink pennyroyal, they would absolutely be convicted.

@Seek_Kolinahr Have you even looked at the link I provided? Please take the time to read it all (especially what life was like at our house when I was growing up).

I was involved in that thread.

For what it’s worth, I had a fling with naturopathic medicine. it just happened to be while I was pregnant with my son. if I had seen a real doctor, maybe – just maybe – someone would have realized I was carrying a toddler and I might have had an alternative to a life threatening post-dates birth that I’m pretty sure I have PTSD from.

That said, personal experience does not fact make. Again, if it’s making you feel good and you’re unconcerned about long term changes, more power to you.

but it is kind of silly to complain about the reported side effects of scientific medicine when the naturopathic medicine hasn’t even been studied to sufficiently report side effects OR efficacy.

@Seek_Kolinahr That sounds like a nightmare every bit as horrid as life was for me watching my mother die. Yours didn’t last as long, but the effects were as damaging. I don’t blame you one bit for saying that all alternative doctors are quacks, but you can bet I carry tremendous emotional scars too, and you should understand why I’m reluctant to turn to a system that failed my mother for 40+ years.

I have PTSD type symptoms from horrid experiences in the dental chair, all of which could have been avoided. I think I am a dentist’s worst nightmare.

As for myself, I’m unconcerned about not having a hysterectomy BECAUSE I DON’T NEED ONE! Yaaaaay! I DON’T NEED prescription hormone medication! Instead I have hormone cream from a compounding pharmacy designed to fit my particular needs. The dosage is exact, and the only side effects are positive.

You bet I’m unconcerned.

I’ll also mention that it was not only growing up watching my mom die that brought me to this conclusion. I have also have nightmare stories of my own to tell of a medical system that fails.

@snowberry I am glad you have found treatment to suit you. I grew up in such a rural area that we were medically treated by the local vet. I was so traumatised by the dental experiences that I had I grew up to be a dentist. I have had good experiences with non-mainstream choices for certain things, but I was careful, careful in my research. Best of luck to you.

@trailsillustrated Oh, you bet. It’s buyer beware, regardless of whether you’re going to a highly recommended board certified MD, a top of the line endodontist that your dentist sends you to, a chiropractor, or my alternative doctors. You have to do your homework, and sometimes you still end up with another nightmare story.

One thing I’ve figured out is if I go to a doctor whose offers surgery as a possible cure for my problem, sooner or later it will be an option. If instead I choose to go to a chiropractor, he’ll be highly motivated to keep me pain free and only send me away when he can’t help me anymore. I’ve noticed it works.

My chiropractor knows when he can’t help someone and he tells them to find a surgeon/orthopedist, etc. I’ve seen him do it.

I am so glad to hear it is working for you. I personally don’t subscribe to chiropractics et al, but I have done other unconventional things that worked. I’m glad you have the money to find your cure. I don’t but have been very happy with some of the results I’ve had, especially in the realm of therapy and natural medications. I am very happy for you.

@Seek_Kolinahr “incorrect.I don’t wish to take away your choice to ignore sound medical advice in lieu of snake oil. I want the snake oil salesmen prosecuted for making false claims and calling it healthcare.”

Well said. I echo that sentiment. Patients have a sacred right to INFORMED consent. This includes the right to decline treatment if they choose. MISINFORMED consent is criminal and is not unlike rape in many respects. Quacks don’t have the right to trick people into treatments they don’t need, or have no way of helping.

@Seek_Kolinahr That’s funny, I’ve never had anyone offer me snake oil, anywhere. I’ll have to check around. Did they mention the species of snake?

http://whatstheharm.net/metaltoxicityfear.html
http://skeptoid.com/episodes/4055
http://skeptoid.com/episodes/4083
http://www.sciencebasedmedicine.org/chelation-compounding-pharmacys-problems/

And I can go on.

@snowberry I don’t think there is anyone here who is so warped, hateful and misguided that they would want you to have unnecessary surgery or take drugs that fail to help a condition, or worsen it, and absolutely no one is so vile as to have wished years of pain on your mother. And even the physicians in the room will admit that there are bad doctors around. It seems that you’ve experienced more than your share of them.

However, the reason that people are living lifespans of over 75 years more or less routinely in most industrial societies these days is not because of “alternative medicine”, though it may have its successes and a fair number of proponents. Western medicine, as imperfect as it still is, gets most of the credit, along with general health and dietary knowledge that has improved as health care itself has improved.

The fact that you’ve had bad doctors give bad advice is not a condemnation of the whole system of modern medical study and practice. It says more about your acceptance of continued bad advice and apparent refusal to seek second opinions, perhaps. Not that I’m blaming the victim here, but if you take bad advice and follow it, and then go back to the same practitioner, then it’s not “all their fault”, either.

you keep saying that conventional medicine’s profit motivated…

why do you think your naturopath is in it? Just as a matter of fairness. I mean, it’s not like you aren’t paying the other guys, and probably quite
handsomely.

Yep, all medicine in this country is profit motivated. But my alternative docs plan for the extra time they are going to spend with me. They actually know me as a person, which is something a conventional doc never has the privilege to do due to time constraints. It’s also why my alternative doc doesn’t do health insurance. Neither he- nor I- want an insurance company dictating what is and is not allowed.

I’m off to bed. Nighters!

your naturopath doesn’t take insurance because insurance companies do not cover alternative medicine. He’s not a hero turning down money.

I’m back for a bit. @Seek_Kolinahr I happen to go to an alternative board certified medical doctor. Sorry, I mentioned this before, several times.

And it’s not about hero anything….

@snowberry “I wonder how much of the information in your websites is fueled by gossip, because let’s face it. It’s about money- who’s stealing your cheese. If you can discredit them, you’ll have less competition, and you’ll look better. ”

This part of your argument is complete bullshit. Doctors aren’t standing around with nothing to do, desperate for patients because they’ve all been abandoned for alternative practitioners. There isn’t a huge gap in demand for their services (in fact it’s quite the opposite). With too few MD’s and a rapidly growing (and aging) population they are as busy as ever. This isn’t motivated by money, sorry.

There are doctors who are practicing Concierge medicine for people who want to spend extra time and don’t mind paying for it. It’s sad that the system has reached this point, but the business model requires large volume of patients because reimbursements from insurance are often so low and the costs of running a practice are so high.

A huge part of the overhead cost of running a practice is the administrative costs of dealing with insurance companies, you need several well-paid and employees with degrees in medical billing to file paperwork, process claims, handle billing, file for approvals, fight the rejections (which they constantly do just to slow things down and save themselves money), schedule peer-to-peer reviews, handle referral requests etc. It’s not cheap. Then there’s malpractice insurance, huge IT expenses as things go to Electronic Heathcare Records, HIPPA/OSHA compliancy courses for your staff. There’s the cost of well-paid nursing staff, receptionists, practice administrators, schedulers, marketing, facility overhead costs, medical supplies, laundry services (We have patients wear clinical shorts for varicose vein visits), medical waste disposal, shredding costs (HIPAA-compliant disposal of patient records), specialized phone/data services to allow for access to physicians 24/7, legal costs, accounting costs, payroll costs, taxes, fees, professional licenses, fees and dues. I could go on forever, but I hope you get the idea that the overhead expenses of running a medical office is enormous. And you’re totally at the mercy of the health insurance companies who dictate what your reimbursements will be (and they’re under NDA so you can’t talk to your colleagues at other practice to see if you’re getting screwed on your rates). Just to give you an idea, we had 10 staff members supporting 2 providers in our office-based outpatient surgical practice: my dad the MD and his PA. That’s a LOT of overhead.

To sustain this behemoth, primary care practices need to handle a high volume of patients. Doctors hate it, and they’d like nothing more than to have nice long visits with their patients, which is why so many have moved towards these other business models.

@gorillapaws Naw, Not complete bullshit. And drhat77 brought it up first, in this very question. Rather than force you to backtrack, I’m reposting it here.

@drhat77 Because alternative doctors get paid by patients (and not insurance companies) they are much more driven by true market forces, like customer satisfaction. Also since patients must pay out of pocket for alternative doctors, the patients are much more likely to be actually ill with something (as opposed to “stress”), so alternative doctors keep an open mind about such things. Finally, alternative doctors don’t need to triple book, so they can spend a lot of time listening to you and uncovering clues like that.

@drhat77 Ah ha. Now that makes sense. So the next question is, if these people are actually providing a needed service to the public, why are they so maligned?

@drhat77 Dur. They’re hurting our bottom line. Not to mention telling us we’re bad at what we do. Time to bust out the personal attacks.
.

@gorillapaws You’re calling bullshit on the wrong one!

I’ve heard of quite a few MD’s that plan to stop accepting insurance of any kind. I guess they’d be your concierge docs. They’ll charge an annual fee, and you can go in as often as you need to. It ends up costing waaay less overall. Sounds like a step in the right direction!

@snowberry I’ll let @drhat77 point out any inaccuracies in the statements I’ve made. I’m not a doctor, but I do have expertise in running a medical practice.

Everyone in medicine hates insurance companies, it would be great if we could get rid of them. Concierge services are great for the people who can afford them, but if the whole system switched to this model, there would be a lot people without much money who would be left without care. Access to quality medical care shouldn’t just be a privilege for the rich…

@gorillapaws You’re right about that. The thing is, cradle to grave medical care for everyone is a relatively new concept in history. Until rather recently, it wasn’t even an option to discuss. And as sad as that may be, I don’t think it’s very realistic even now. Either there are going to be people like me who with some exceptions, shun the medical system, or people who simply slip through the cracks altogether, like the burgeoning and ever present homeless population
.

Really interesting Q. Especially with having so many medical people on it.

@Quakwatch One explanation for @snowberry running into so many bad doctors (this has happened to me as well) is maybe, and I can’t speak for her, she has had some chronic conditions that medical science has not figured out yet. Has not figured out the underlying cause. Maybe the havy medals is not the answer, I don’t know, but what we do know is many of us have things wrong with us that science has not figured out, and I completely disagree with dismissing it as stress (although I do agree stress can be a huge abtagonist on our bodies) if the patient has had the problem for years. I think maybe it was @drhat77 who recommended that, I don’t want to mix everyone up, but the thread was long. I am fine with asking about stress, especially an accute event, that has produced much increased anxiety forthe individual.

Case in point: ulcer sufferers were told stress was there problem for years. Maybe stress did aggravate the conditions at times, but there was an underlying infection that ciuld be addressed. Doctors treat symptoms usually, and most don’t give a shit about possible underlying causes if the cause has not been identified yet. That is one of the big differences between researchers and doctors.

I once had an argument with a doctor on here about PCOS. I was annoyed so many teenage girls especially are given birth control pills when they are extremely irregular missing periods, or not cycling at all. I said they should be referred to RE’s if the GYN’s are not learning to do the testing for the sugar problems to look for that is believed to be a possible underlying cause for PCOS. She said the pills treat the symptoms. We went round and round, and then after bunches of posts she said she actually recently made an appointment with an RE (seems she has PCOS since forever, which I did not know initially) and her symptoms are really starting to bother her after many years. That she didn’t even know about the specialty of RE untill she was an intern (or might have been her residency). That was my fucking point with the entire conversation. We layman don’t know all the specialties out there, and we rely on doctors to get us to someone who can cure us. If not them, then a specialist, and we don’t want a bandaid, or pain meds, we want to be cured. Now she is a doctor and she basically told me she will continue to treat girls who don’t cycle with BC pills, even though there might be an underlying cause that is treatable.

Part of the culprit is standard of care. As much as I understand why there is a standard of care, and that it is there to protect patients; it also protects doctors from lawsuit and allows a doctor to stop, or not think. Doctors are great at memorizing what needs to be done in what situation. When it isn’t working they often really suck in thinking about what else might help or what else might cause the problem. They have all this medical knowledge, but only seek what is in the books they read, rather than go one step further and think about what else might make sense. The legal system stops them from trying unproven treatment, so doctors are in a tough spot.

One last think about snowberry having bad doctor experiences and myself. I am only speaking for myself here. When you are sick for a long time and doctors can’t help, and they basically tell you nothing is wrong or diagnose you with something that really doesn’t help, after years of that I am quite defensive in a doctor’s office. When I get treated like what I say is true, even if it is completely unrelated to the chronic problem I have, I am almost surprised. I think doctors need to get a better understanding of what it is like for patients who constantly feel the medical system is taking advantage of them and maybe be better at treating us like partners in our medical care, be willing to explain “why” they want to do a treatment if we ask why, and not mind explaining it to us. Doctor don’t want to be asked questions, because they know best right? You don’t get treated like that if you are doctor or in the field; you would be treated like you have a basic understanding and your knowledge would be respected.

@drhat77 I really liked your answers. I disagree with you about chalking everything up to stress whem medicine does not have the answer for long standing chronic problems, but I like your empathy for patients who are not finding answers with tradition medicine. It does allow for some charatans, but some remedies I think are just not proven yet scientifically, but eventually are.

@gorillapaws I generally agree with you about the market for vitamins and herbs. However, if someone is actually difficient, I think we would agree that most of the time the individual needs supplements. For isntance all doctors would agree low iron and low B12 needs addressing. I’m low in vitamin D (I realize the D parameter was changed fairl recently) and when I first started taking big doses I was reluctant and doubted it would help me. Without telling the whole story, D has greatly improved my muscle problem. Many doctors don’t test for it, because they think the American diet gives us all we need. They don’t even know so many of their patients are dificient. Also, there are some conflicting studies about vitamin D, and some doctors choose to believe the studies that say vitamin D doesn’t really help.

As far as Stever Jobs, from what I understand (I couldn’t open the link) he had operable pancreatic cancer when it was diagnosed. He was a total idiot if that was the case not to do the surgery, because removing it is so effective, and finding pancreatic cancer when operable is a gift from the universe that rarely happens. But, someone who is terminal, with no real hope of cure, if they choose to try some alternative stuff and better eating and possibly die faster, but not be abused by chemo, I can totally get behind that.

Suzanne Sommers, who is well known fro promoting vitamins and hormones and other similar things, says she herself would take or recommend using radiation and chemo drugs if the outcomes are proven to be successful. A classic example is childhood leukemia, which has an incredible cure rate with modern medicine. A girlfriend of mine had a small cancer in her breast, and she had it removed and chose to go with the doctors reccomendation of radiation and chemo following it. I told my husband I wouldn’t do the chemo and radiation if it were me possibly. Low and behold, now the standard of care has changed since her lumpectomy and the chemo and radiation is not always recommended, because they ascertained it doesn’t help, could cause harm. Not much unlike the HRT that was recommended for postmenopausal women. Sometimes HRT is still a good solution for some women, but it is not magical with no possible side effects as many doctors wanted to believe, they went as far to think it was good for us, not just treating symptoms, and women should teke it even if they were not symptomatic. Many doctors seem just as happy to prescribe as the herbal pushers.

In conclusion: You cannot have one way of thinking in medicine for all situations. Sometimes medical science has not discovered what is really wrong yet with a set of symptims, nor discovered a cure. When science has, then great, we should consult modern medicine for the wonderful answers it has. When it doesn’t have an answer, we need to think out of the box and do more research. Think rheumatic heart disease before we knew it was strep, lymes disease when we still believed it was just unfortunnte all those kids had arthritis, and the ulcer example I gave above. Even chlamydia when it was considered normal flora, but leaving women infertile. Science does not have the answer until it does, but the underlying pathogen is still there whether science detected it yet or not. Generally, I am very negative about rheumatic diagnosis. I think very often there is some sort of underlying cause we have not discovered yet and the body is not just going haywire.

Alternative practioners can no longer leave in their covered wagon in the morning, so the snake oil sales man analogy is not valid. Instead, they must plan for the long run, which involves enough repeat and referral business to keep in business. Additionally, if they incur significant harm on a patient, it seems to me the potential legal risk for practicing alternative medicine may put them out of business permanently.
This is to contrast traditional medicine practioners, where maximizing billable can keep them afloat (but patient satisfaction is a nice touch, if you can swing it). Also if you incur significant harm on a patient, the lawsuit will be a significant burden but almost never puts the doctor out of business. In fact doctors can continue to practice after multiple lawsuits.
Because of this, alternative practioners must operate a little more safely, and have to prioritize patient results and satisfaction. Even if they are for “soft” diseases, if the patient is not harmed and is happier, that’s the goal of medicine.

I suppose I’ve created part of the problem here by calling any doctor a “quack” who would insist conventional standard of care is always responsible medicine. From my point of view, it’s irresponsible to tell someone she MUST have a cesarean or a hysterectomy when she doesn’t, and my history is chock full of this sort of nonsense.

For one example, I refer you to the alarming rise of C-section rates in the US. When I was having kids, it was awfully high (25%). Now the national rate is just under 33%.

Quack, quack, quack.

“I suppose I’ve created part of the problem here by calling any doctor a “quack” who would insist conventional standard of care is always responsible medicine.”

So you think any doctor is a quack who actually uses science, reason, and evidence to guide his or her decisions?

@snowberry The c-section rate is especially tricky I think. The baby only gets born once, and if something goes wrong it is devastating. I completely agree that the word MUST needs to be used with more caution. Also, many people are truly clueless about medicine, anatomy and physiology, and so doctors tend to assume that about most patients I think. They of course to do have more education and more medical experience, except that people with chronic problems often know more than their dctor sometimes in terms of what the patient’s experienced has been, and the patient might be very very read up on the ideas out there regarding the illness compared to the doctor.

I know too many stiories where a c-section should have been done and the result was disasterous either for the mother or the baby. The doctor basically wants to choose the route they think will cause the least harm, least chance of harm. Although, I do think doctors tend to play down the risks of the surgery, and I do think a lot of people don’t want surgery for many different reasons. My husband is very quick to be willing to do a surgery and I avoid it like the plague. If I was pregnant though I would want to have a c-section because of my specific circumstance and I would need to find a doctor who would be willing to do it, not all would.

I have known women who say they refuse to go into labor. I know doctors who cheerfully choose to accommodate such women. The thing is, C-sections are still major surgery, and carry significant risks over vaginal birth, for mother and baby alike.

http://www.kon.org/urc/v9/holt.html My opinion of a doctor who would perform an elective surgery on both mother and child is below contempt.

@JLeslie You’re absolutely correct that modern science-based medicine doesn’t have an answer for every problem. This of course doesn’t legitimize alternative practices that haven’t been proven to be safe and effective however. I’m for any treatment that can objectively demonstrate being safe and effective. The problem is that alternative therapies don’t do this, and the ones that do become part of real medicine.

With regards to supplements, my criticism isn’t that supplements are universally bad or quackery (I take Vitamin D too). It’s that they’ve been deregulated so there’s no oversight to them and the claims being made for various things are very misleading and often dangerous. We prescribe horse-chestnut extract to some of our patients because it has the active ingredient Aescin which has proven safe and effective in clinical testing for treating Venous Stasis Ulcers. This leads me to my other criticism of the supplement industry: many of these supplements have powerful active ingredients that can cause serious problems in people who diagnose and treat themselves from what they can find on Google. They can have dangerous drug interactions with other prescription meds and they should be regulated like other medicine instead of being classified as “food.”

@gorillapaws We agree on many points. I also hate that the supplement industry is not regulated in any way. I worry that the vitamins I take are not the dose they advertise on the bottle.

I actually disagree that standard of care is always something proven through double blind scientific methods. Many drugs are given off label is just one example of many.

Studies are not always repeated right away, and so conclusions are made from one study and then later we find out through additional studies we were wrong, or we see long term effects develop that we did not anticipate. Just observing how many drugs and medical devices that wind up recalled or pulled off the market is an example of that. Sometimes intuition is right. Intuition a patient has about their body and what just doesn’t sound right.

I agree with whoever said that the OP’s test should probably come up high for the metals without inducing them to be excreted, that sounds right to me, but I really don’t know much about that sort of testing. Maybe when it is in the tissues it doesn’t show in a regular blood or urine test? Same as blood calcium does not really tell us what it actually happening the bone. Again, I don’t know the science behind testing for heavy metals. I had my mercury blood level checked, because I was curious since I eat tuna.

@JLeslie Some alternative doctors test for heavy metals by testing hair cuttings. That works if they’re already being excreted in the bloodstream (so it can get into the hair). But with some people it doesn’t excrete. The cells “hold onto it”, and it’s only by a provoking method such as chelation therapy that it comes out.

What @snowberry is so full of flaws as to be worthless. Yes, some metals and other drugs/toxins accumulate in hair (that is the basis for very sophisticated drug testing), but most are excreted in the urine. Cells don’t “hold onto” excess heavy metals. If there is excess, which is toxic to cells, then the body tries to rid itself of the excess through urine and stool. To save yourself some time @JLeslie , here you go. http://www.quackwatch.com/01QuackeryRelatedTopics/Tests/urine_toxic.html

Some compounds, like DDT, accumulate in fat.

Some compounds, like THC, get stuck in hair as the hair grows. A person’s marijuana usage history can be seen through measurement of THC along the hair’s length.

Article from jama pointing out alternative medicine practices can help people with chronic pain

@drhat77 Course, that article was written by two people from the National Center for Complementary and Alternative Medicine. They clearly don’t have a vested interest in promoting alternative medicine, right?

@drhat77 the article you pointed to is an opinion piece and not scientific research. If you’re an ER physician you should know better.

@Quakwatch interestingly, I don’t have a problem with people having a vested interest in their paper. All I care about is the science. If the methodology of the study is sound I will pay attention.

@Rarebear In this era of tight budgets and cuts at the NIH, everyone is fighting for scraps, and making your work seem relevant and timely certainly doesn’t hurt. I just assume significant bias and move on.

I agree. Bias is an issue. But again if the science is good Ill read.

You guys are right it is opinion but it references several studies in the body that show yoga, acupuncture, and something else I forgot beneficial for chronic pain. Yes you guys are right probably biased b it my experience reading research is most is biased one way or another. I thinki poste to show it merits august attentions of jama.

The placebo affect gets such a bum rap. If it helps and does not hurt why bicker.

Pain has been shown to respond well to placebo affect, while for other illnesses it doesn’t work well at all. Also, there is some evidence that placebo works well for things like mild depression. There have been scientific studies on this. One that comes to mind that you all might remember was in the last few years it has been concluded that the antidepressant medications for mild depression may not really be beneficial. They concluded some of the effect seems to be placebo.

So, telling a patient something might help that has no scientific proof it helps, but they report it helps could be considered a valid medical treatment so to speak. I just think it depends on the ailment whether the recommendation is worth a valid try and will not cause harm. There can be enough science so we cam extrapolate what might help, think a little out of the box, and with no risk why not try?

@gorillapaws I have to agree if something has been proven to not work it is bad medicine to say it does work. However, if a very small percentage of the population finds it does work, maybe it still was worth the try? Because they have their own placebo affect. What I mean is, some people are much more susceptible to suggestion. Maybe their brains are better at producing the chemicals they need if they just have a belief about something? I don’t have that at all in me from what I can tell.

so if sticking eiher toothpicks or accupunture needles or doing ANYTHING makes someone feel better, and does not hurt them, we shouldn’t leap down their throat. Rigorous science is great when it can be done, but it always turns soft when applied to humans and “human subject protection” and whutnot. Sometimes we will have to accept that the best science is just not available, but releif of symptoms may be.

You either understand critical thinking, proper methodology and science based medicine or you don’t. There is no grey area wiggle room in between.

The best, most rigorous science is frequently unethical, and we have to settle for compromises between patient autonomy and proper controls, etc.
Medicine, unlike other many other scientific disciplines, have a massive industry (pharma) which abuses science to promote its own agenda. Plus, it’s a frequent hot button issue that govenerment cannot afford to not fund, but how much and where the funding goes is a perpetual debate. And of course to that end vested “scientists” have polluted the research literature with their biased findings.
This unfortunately has created a gray area that you cannot ignore when making recomendations to individual patients.

Bullshit.

@Quakwatch that was elegant in its simplicity but you may have lost me. May I trouble you to break down the logical steps you used to reach that conclusion?

Not total bullshit. Meds get through the FDA that shouldn’t sometimes, some of it has to do with who knows who.

Also, studies are accepted and then later on another study is done and we change our minds. Obviously, even when we try to control things errors are made. Making a valid study isn’t easy.

@drhat77 Why should I? For someone who claims to be an ER physician, you clearly have never picked up a pipette or read a scientific journal. The most rigorous science leads to Nobel prizes and changes in the way we understand science and medicine.

@Quakwatch You wrote The most rigorous science leads to Nobel prizes and changes in the way we understand science and medicine.

So, where did the original understanding and opinions come from? The ones you now changed your mind about after the new rigorous science?

@JLeslie Perhaps you might consider clarifying your comments. As it stands, you’ve written pseudoscientific jibberish.

@drhat77 Clinical studies are “dirty” by definition. Humans aren’t mice that can be genetically controlled. Thus, large studies are needed, and sometimes small changes are all you can observe. Pharmaceutical companies have invested billions into drug development, and as such indeed do have a vested interest in seeing new drugs come to market. For every drug that eventually fails in very large post-hoc analysis, there were a) many that failed before that and also b) a few that really have massive benefits.

I’m not against the FDA or research science. Clearly it is needed to advance medicine. But science and agendas make very uneasy bedfellows, and it pays to be skeptical about medical science. There is too much money and too much politics behind it to just trust it blindly.

@Quakwatch My mother worked for the FDA, my father approved grants for the fed gov’t for psych research. I know it can be difficult to create valid studies, if you don’t know that I really can’t understand. How can you explain conflicting studies? One of the studies had a bad set up if three others disprove it. Think vitamin C cured colds. That idea wound up to be garbage. Or, fiber prevents colon cancer. That one seems to be untrue also.

People thought Rely tampons would be ok. Not the case. Medical devices that get recalled. All these went through all 4 phases of testing.

I am not saying we throw the scientific method in the garbage, I am saying humans construct the experiments and humans conduct them, and humans participate in them, and there is room for error in every step. The majority of the time the science works. Some of the time we don’t catch the bad outcomes that can happen, or we know about bad side effects, but didn’t think it would happen in such a high percentage of people. Drug companies set aside funds for when some law suits come, but when more people than predicted are harmed the drug is pulled. It doesn’t happen often, but it happens.

@drhat77 And once again, AT LEAST basic and clinical research undergo vetting processes, either by other scientists in the form of repeated experiments, and clinical research by larger studies and post-hoc analysis. These are things that are NEVER done on so-called alternative medicine, and in the rare occasion that they are done (i.e. antioxidants to prevent cancer, etc.), they tend to fail, miserably. How many clinical studies have you seen about chiropractic (another bullshit “medicine”), homeopathy, naturopathy, etc.? They won’t do them because the purveyors of these dark arts intrinsically know that they are built of false premises.

@JLeslie You know, having a couple of relatives in “science” doesn’t mean as much as you think. Anecdotes are just that, anecdotes. Studies are disproved all the time because often they are built on flimsy statistical methods, or because the initial study was done on a very narrowly chosen population of patients and the results can’t be extrapolated to the general population. And yet, we now have an armory of effective drugs: antibiotics, anti-inflammatories, chemotherapies, anti-hypertensives, anti-cholesterol medicines, etc. People are living to 80 not from voodoo magic, or wishful thinking.

What my premise about alternative medcine was not that is or isn’t scientifically valid. without those studies of course I cannot say that it is. My point is that the patient needs to be the final arbiter about whether or not symptom releif was achieved. Patients frequently find releif with alternative medicine. Placebo effect? Maybe. There is psychological evidence that paying more for something will translate into enjoying it more.
If the patient is suffering, the why is meaningless to them.

@Quakwatch Wait, I think we are arguing about two different things. I agree with you that I want supplements and herbs and all that stuff to go through testing by scientific method. I feel they should not be able to to advertise something cures something without prof from scientific testing, or at minimum it should state on the bottle it has not been tested.

@drhat77 Should we allow carmakers to make all sorts of outlandish claims about their cars? Should a car seat be tested for safety? How about foods?
Why do homeopaths and naturopaths and chiropractors get a free pass?

I agree. A lot of the time the initial studies were not really very scientific. But, the medical community goes ahead and accepts them. The very people who should be more critical. The colon cancer example is a good one. Doctors still tell patients fiber will help prevent colon cancer I bet. I bet most doctors believe it. HRT was another example. Doctors doling out those drigs telling women how it will help their bones and protect their hearts.

the difference between cars and carseats is we can test them before we install people in them. Diseases hit the patient, and only then can we test them. Meanwhile, the patients continue to suffer. Yes it irks me that many alternative practioners choose to fleece the suffering. But regular doctors do that to. Sometimes they get charged with fraud. frequently, they operate just within the law. So being tradiotional is not a guaranteed protection.
If a patient achieves results with something I cannot scientifically explain, as long as it doesn’t endager them, I am not in a position to criticize.

@drhat77 And cars don’t get recalled? What about foods? Your argument is flimsy. Regarding doctors, yes there are a few bad apples, but I’m saying the entire alternative “medicine” field is fraudulent. There’s a big difference.

@Quakwatch I don’t need a link, I know there are conflicting studies. Hence, you prove my point. But, doctors didn’t believe there was any down side, and now they know they need to weigh the risks and benefits. I don’t know your specialty, but I can tell you a lot of GYN’s really had no reluctance prescribing those drugs. I find most doctors to “trust” a drug is safe, and don’t look up contraindications. Thank God computers now do some cross checking with drugs that should not be prescribed together, that sort of thing. Both my mom and my dad have been prescribed drugs together that were contraindicated. One was a black box warning. I knew a pharmacist who used to specialize in evaluating medications that had been prescribed and making sure there was not overlap or dangerous combinations. Now the computers do some of this, which I think is a good thing.

As far as the supplements, some of them probably do actually work. Just because something isn’t proven yet, does not mean the hypothesis or antidoctal results won’t be proven to be true. I think a lot of supplements probably are a farce, but a few might work. Imagine if someone said to take tree bark to lower your fever. Thing is aspirin is developed from tree bark originally. That one works. Many of our pharmaceutical drugs come from nature.

The mission of medicine has always been to help the suffering. Science was added on as a tool in our armementarium to reach that goal relatively recently, in the late 19th century. For medical doctors, science exists to help people. I trust the biologists, etc, to pursue science as an end in itself, which is very important. But I cannot lose sight of the patient because of science, because then I’m not a medical doctor.

Without the scientists, you wouldn’t be a medical doctor at all. Prior to the introduction of the scientific method, doctors were glorified barbers. Now you can give experimentally verified treatments that we understand at the molecular level. Pretending otherwise is a fallacy.

I’m not saying science isn’t the biggest thing in medicine since medicine itself. Science is THE game changer for medicine. But it is still not the goal for medicine. It is a tool.
The practice of modern medicine is separating the patient form the physician and we are forgetting that the patient is the only end result that matters.

@drhat77 No, many of us are not. In fact, we (the critical thinkers, the scientists, the evidence-based medicine doctors) care so much about patient care that we will stick our necks out and proclaim whole swaths of treatments as bogus, even though it is more expedient to just “go with the flow”, as you seem all-too-willing to do, all while suggesting you “care about patients.”

Stopping bogus practitioners, especially who are just interested in milking patients, is important. But we cannot forget physicians are doing that to. So unless we want even more regulation and denials from third party payors we probably need to stick our necks out and denounce unethical conventional practioners as well, and shut them down.
While I would not refer patients to unproven therapies, if a single instance of a patient is experiencing releif from something I cannot medically recommend, I would not stop them.

They are not everywhere. But they are there. Orhtopedic surgeons doing joint injections when the evidence is so-so becase they pay out. Hysterectomy-mania. PCTA for low risk chest pain. Abdominal CTs in the ED for EVERYTHING. Look at the CMS fee schedule, and probably the most common/highest price items have a good amount of utilization in soft/no indications. The reason these are done is not necessarily fraud. But they are risky with limited benefit. The reason it’s done is to do SOMETHING for patients that feel the need to have something done. So maybe placebo water is better for a patient than a joint injection when the evidence isn’t convincing that joint injections help. At least the placebo water doesn’t harm anybody.

to clarify hysterectomies are probably aren’t in the same category preceisely with the others, because they help myriad of conditions. But the amount they are done feels insane. Probably there are some that are done for softer indications than others.

Good science is good science no matter the source. When I open a medical paper I read the methods section first. If the methodology is sound then I read the paper.

I will prescribe things off label if the science supports it.

Off-label =/= unscientific. It is just the FDA approved use.

I never stated I am a doctor. I might have stated above I’m not a doctor, I don’t remember, I usually do when I am giving my opinion on medical Q’s, but this Q is not really giving the OP medical advice, she is just asking a question of why. I said my mom worked for the FDA and my dad approved grant money; I didn’t say I was a doctor.

There are several off label uses of medication that are standard of care in intensive care medicine. In fact, if you are NOT using them in the indicated situations then patients have increased risk of harm.

[mod says] This discussion is fascinating, but it’s drifting pretty far from the original question and we’re in the general section. Hint, hint.

@augustlan Sorry for the detour.

I do want to correct one thing I said. Rely tampons did not go through strict FDA required testing. I thought of it when I saw this Q again. It was grandfathered in, if I remember correctly, and that was part of the problem. After Rely the government decided to put tampons under the heading of medical devices and regulations were changed for medical devices.

This all ties back into the main question, Rely is another example of why testing is important. Alternative methods become standard of care either through testing, or through medical professionals taking risks deviating from the standard of care and documenting results eventually sometimes leading to a good study being done to prove the treatment is a good or better option than current standard of care.

I think when doctors take the risk themselves, patients don’t really understand they are test subject so to speak, and I think that has a lot of problems, because the patient is not really informed. Taking supplements is close to the same, people don’t understand they are basically test subjects, because what they are taken has not been through rigorous testing.

@drhat77 Thank you for your many posts supporting and helping to explain why I do and think the way I do. I appreciate it more than you know. Your comments have helped to restore my faith that some doctors, at least, have a heart.

“If a patient achieves results with something I cannot scientifically explain, as long as it doesn’t endager them, I am not in a position to criticize.”

I will add that when I find an MD, conventional or not, who actually LISTENS TO me and obviously cares about what I want, my concerns, and my past experiences, I am far, far more likely to go with his recommendations.

On the other hand, I always fire a doctor who only spouts statistics and case studies at me and never shows any inkling that they understand what I am talking about, or that they actually care about me as a person.

@drhat77 sounds like he might be one I’d listen to.

I was reading these comments over. @Quakwatch was right in that the common denominator in my many negative experiences with people in the medical sytem is myself. To re-cap, I believe I tend to hold doctors to a higher standard than the average person does (such as refusing to allow a doctor to cut me up and drug me up like they do the majority of the US population). But in addition, I’ve truly seen and experienced quite a lot of horror stories, which makes me even less trusting of medical people.

I’ve educated myself far more than the average consumer, and therefore and therefore I often know when doctors lie to me about my medical care (so frequently, I’m used to it). I refuse to accept the “business-as-usual, run ‘em through the mill” sort of care that is typical of conventional medicine, which really makes me sound like a bitch to a medically oriented person.

The victim-blaming attitude throughout that entire post is just so offensive. I don’t understand the sense of superiority because you’re healthy and other people are not. You can cite anecdotes that support your case all you want (and I’m not convinced that those people are necessarily ill in a way that could be solved by diet and exercise like you seem to think), but the vast majority of us are doing what we can to be healthy and might still be struggling anyway, but that doesn’t mean that we’re uneducated or irresponsible. A lot of it is just shitty genes and shitty luck, and it is so offensive to be treated like it’s our fault just because you’re lucky enough to be healthy, and you think that that is proof that your point of view is correct.

Traditional medicine is supported by studies. Much of alternative medicine is not. Is it really so illogical to follow the science?

Just to clarify, I am very wary of most alternative medicine as I have stated before. My comment only had to do with doctors who sometimes do unnecessary procedures and make mistakes that are unexcusible in my opinion. My aunt has smoked forever and has fibromyalgia and other problems and many people in my family talk about how she does nothing to help herself, and it just is not true. The poor women has been dealt a pretty shitty hand and has suffered quite a bit, and she visits doctors to try and improve her life. She pretty much feels about doctors the way I do. They have scanned her so many times I am surprised she doesn’t glow. Sometimes two weeks apart when really nothing has changed. Medicare just pays. She went along with them saying she likely had mouth cancer, endured a surgery, which is not simple go to the dentist surgery, she had to be hospitalized. She and I both did not believe it was cancer. It wasn’t. I do understand where you are coming from @Mariah. I hated peiple who suggested alternative things to me for my chronic health problems and especially those who impied it was psychosomatic or that pain is in my mind.

My husband just went to a new dentist that told him he needed a deep cleaning (expensive) and they insisted on a full mouth of xrays and a panoramic xray. I was so pissed off. I wrote our jelly dentis trailsillustrated and she agreed the deep cleaning with antibiotics is likely a scam to make money. Of course she doesn’t have the benefit of seeing my husband’s mouth, so I don’t hold her to her opinion. She said there is no scientific evidence the treatment actually prevents or improves anything. And, yet the other dentist is doing the procedure. Trails also said the insurance companies will cover the treatment, or part of it, without proof, it basically is a judgement of the dentist.

My mom used to work for the FDA and their were lawsuits about a stent for heart disease that was coated with some sort of something. That stent had more complications than the other stent on the market at the time, but insurance companies would pay a lot lot more to doctors for the pricedure with the medically coated stent, so the doctors did that one. The doctors may not have known the stats well, and they may have though it was good medicine, but still they definitely chose to do the more expensive one. That has been taken care of now, this was a while ago.

Doctors are not always up to date on the info that is out there, and things take time, protocols take time to change. Sometimes you have to go with your gut. It depends, it depends on all the risks and benefits. When my girlfriend had breast cancer she did the lumpectomy, chemo and radiation. I would not have done the radiation, not sure about the chemo I would have to have researched it. Her doctor told hernif she did all of it she had less chance of reoccurance. Now, years later, depending on the type of breast cancer the chemo and radiation is not recommended because of side effects to thos treatments and not very significant benefits. I would have removed the cancer, I would not have tried to eat Spinach and drink herbal tea to rid my body of the cancer, but I also would not blindly follow what my doctor recommended.

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There is an old German saying about doctors, and it goes like this (first the original German version, then its translation into English):

“Was bringt den Doktor um sein Brot? A) die Gesundheit, B) der Tod. Drum hält der Arzt, auf dass er lebe, uns zwischen beiden in der Schwebe.”

“What makes a doctor poor? A) health, B) death. That’s why the doctor makes us float between the two, so the doctor can live.”

That saying was first composed by Eugen Roth (1895–1976).