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Why Doctors Hate Science
theodp writes "A 2004 study found some 10 million women lacking a cervix were still getting Pap tests. Only problem is, a Pap test screens for cervical cancer — no cervix, no cancer. With this tale, Newsweek's Sharon Begley makes her case for comparative-effectiveness research (CER), which is receiving $1 billion under the stimulus bill for studies to determine which treatments, including drugs, are more medically sound and cost-effective than others for a given ailment. Physicians, Begley says, must stop treatments that are rooted more in local medical culture than in medical science, embrace practices that have been shown scientifically to be superior to others, and ignore critics who paint CER as government control of doctors' decision-making."
Also, Linux is for fags.
Correction: Linux is for fags that can't afford a Mac.
The thing is, you can't completely absolve doctors of legal responsibility, what would stop them from killing and maiming people at will o.O?
What you want done, you give that evidence to who you choose to be your doctor. There truly aren't many doctors anymore because they are all bought and payed-for by Abbot Laboratories, Pfizer, and Merck. It was just the other day that I heard on the radio about all the "black needle" incidents where licensed "doctors" would kill a patient if the insurance company exposed litigation or the treatment cost the doctor from his liability. I'm aware of people getting rid of cancer homeopathically and therapeutically, yet are killed in good health by the court-ordered radiation therapy they were coerced into continuing.
It's absolutely nuts, like Slashdot moderation as to why I wouldn't login just for this to be modded-down.
"I'm aware of people getting rid of cancer homeopathically and therapeutically, yet are killed in good health by the court-ordered radiation therapy they were coerced into continuing."
Because we are talking about EVIDENCE-based medicine, not eye-of-newt, toe of frog nonsense and tinfoil hat paranoia. Let me guess, this is all orchestrated by the Jewish Illuminati Freemasons?
I bet that radio show was something like Alex Jones', which is why you didn't care to mention what radio show you heard it on. Some people will believe any form of bullshit--you are one of them.
1. It's white.
2. It works.
3. They're too proud to pick the cotton out of the bottle.
All I can say is that the stock market is down 7,000 points since Obama first overtook McCain in the polls. You can talk about how great he is, but as it is, everyone with half a brain knows that Obama just spend a trillion dollars on welfare, won't accomplish anything, and all this talk about the Bush budget deficits is just utterly dwarfed by Obama's spending spree.
And you just wait, until we make you Democrats defend free trade. WE'll take the blue collar vote away from you, and then what will you have left?
This is my sig.
Let bureaucrats decide your treatment not doctors!
Wow, this is great!
Instead of my doctor making medical decisions, we'll have a government panel of "experts" making decisions about my medical treatments.
What could go wrong?
I thought it was bad when healthcare companies (HMOs) used accountants to make medical decisions, but I guess letting government bureaucrats make medical decisions is A-OK.
That's change for you.
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U.S. Senator Tom Coburn, M.D. (OK), a practicing physician, released the following statement today regarding ongoing negotiations between House and Senate over controversial and complex health care provisions in the stimulus bill.
"The health care provisions in the House stimulus bill represent ideological and partisan overreach of epic proportions. It is ludicrous to ask a body that can't track its own spending to determine which medical treatments are best for individual patients suffering from complex diseases. The only reason to fund this project now is to lay the groundwork for establishing a government board that will be empowered to make life and death medical decisions about health care treatments and cost," Dr. Coburn said.
Dr. Coburn explained that both the House and Senate version of the stimulus bill include $1.1 billion for comparative effectiveness research. Unfortunately, the House language overreaches by permitting the use of that money to make coverage decisions based on cost to the federal government.
"The practice of medicine is about 40 percent art and 60 percent science. A so-called 'comparative effectiveness' formula will replace the professional judgment of doctors and nurses, which is developed over many years, with the political judgments of politicians and bureaucrats. A comparative effectiveness formula will only save money by rationing care and ending lives. Congress is on the verge of enacting the same policy that Great Britain has used to decide, for example, that extending a patient's life for a year isn't worth more than $45,000," Dr. Coburn said.
"Trusting the government to ration care will take away choices and life-saving treatments from sick patients and deny families more time with their loved ones. Doctors and patients should be making decisions based on individual patient conditions and needs. Allowing government to make these decisions would set us on a dangerous path. The unelected staff and career politicians who are negotiating these details have almost zero real world experience in the health care sector. Congress should confess its limited capabilities in this area and debate this issue in the open, not rush through massive policy changes in secret," Dr. Coburn said.
Will this help hospitals stop cutting the penis of babies? I know a few folks that want there foreskin back.
No, because the evidence for the medical benefits of circumcision is very clear:
- the elimination of penile cancer
- dramatic lowering of the rate of aids infections
Now, you might point out the incidence of penile cancer is already low, and the incidence of aids can be reduced even more by the use of condoms, clean needles and abstinence, but the medical evidence is very clear.
The harm of circumcision is negligible, and benefits are real. And if you really want your foreskin back, it's gone, deal with it.
"Real world patients do not step out of a cookie-cutter, and cookie-cutter medicine (which is what EBM zealots really are promoting) does not always equal best practices."
This is where you are wrong. Patients are rarely unique in any meaningful way, most get better on their own.
For instance, if you come in with back pain after twisting and lifting an object, the doctor should rule out any obvious problems then send you home (maybe with a scrip for a painkiller). They shouldn't send you for an Xray because there might be something.
If your pain does not resolve after a period of time, THEN you order an Xray.
If that doesn't show anything, THEN they refer to a specialist.
And even if it does show a significant finding, it might be irrelevant (most people over 40 have abnormal backs).
I practice evidence based medicine as much as possible. The trouble is that patients have a very hard time understanding it, let alone appreciating it.
You sound completely like most doctors I know. Educated, but with their head shoved so far up their own arse they don't realize it. To get a feel of jut how FUCKING STUPID what you're saying is, consider replacing medicine with auto care in the sentence above:
I practice evidence based auto maintenanceas much as possible. The trouble is that car ownershave a very hard time understanding it, let alone appreciating it.
I wonder how many mechanics would be able to use that line if they were sued because someone was killed due to bad brake maintenance? Why then do doctors get to utter such UTTER FUCKING BULLSHIT and get taken seriously.
I don't give antibiotics for colds, but those patients often go see other doctors to get their antibiotics. When they get their inappropriate prescription, ironically I come across as a bad doctor for not prescribing it in the first place.
Boo fucking hoo. Extending the mechanic analogy, you're saying that you should fix problems that aren't their or offer solutions that don't fix the problem just because people are stupid about it? NO. The buck stops with you. Educate them about why antibiotics don't work. Speak to them in simple language. Tell them to try 3 or 4 times with and without antibiotics for themselves. Explain why prescribing antibiotics eventually renders them impotent. Your job is as much to educate a patient about their own well being as to prescribe medicine.
When people bring their kids in to get some gravol for their viral gastroenteritis, I tell them that it has been shown to be no better than placebo, so I don't offer it. Parents hate that.
Have you explained to them that it can actually make their child sick to be given medicine they don't need? Have you offered them any suggestions on how to comfort their child instead of just shoving them out the door feeling no better? If you're complaining that they've come to you for help and you've offered them nothing and denied them what they thought would help and are wondering why your actions don't go down well you need to get a grip.
I could go on but honestly you demonstrate the same buck passing arrogance most doctors do. Being a good doctor is a difficult job and the years of study are just one of the easier pieces. You need to have a better bedside manner and learn to educate your patients instead of railing about their stupidity. YOU are the expert here. YOU are the one with years of learning. Depending on where you work, some of these people probably haven't finished highschool. What the fuck do you expect? Grow up and quit complaining. Fuck.
These posts express my own personal views, not those of my employer
Most of your post makes good sense (although simplistic, I'd guess) until
Try to check if you actually know something before opening mouth. Or did you think that the Slashdot crowd wouldn't understand the word "inflammation" and went for the car analogy: "lubrication"?
You are correct that corticosteroids do not directly aid the healing of the damage, but they are not helping because of their lubricating effect. They modulate the immune response, which is how they relieve the pain and inflammation. The "truth" here is probably more complicated than what we know about it. (Yes, I realize the linked research deals with muscles and not bone or connective tissue, it's just illustrative.)
Paul Krugman is an idiot.
There is ALWAYS something that can be done that has value. Rushing to spend money on doing nothing is pure unadulterated stupid.
Do not look at laser with remaining good eye.
Because he's a bad doctor and a fucking moron. He'd rather save his own ass than help someone, and he'd rather someone else make all his difficult medical decisions for him rather than having to think for himself. He wants evidence based medicine so that he never has to be culpable for his own decisions, because he can simply cite a government study which backs up his cowardly decision.
That's why he won't prescribe a placebo. That's why he makes faulty claims of "ethics" while doing it. He's a bad doctor and a fucking coward.
There are plenty of females here, you troll
You must be new here... I find your response to my irrefutable scientific claim to be weak and without substance. No wonder you posted anonymous.
Your post was not worth the time it took to read it.
Yet you read it and responded. Are you in the habit of wasting your time?
You are not only arrogant in trying to teach someone else their profession and deride them for acting in a way that harms no one and is clearly motivated by morality, but you are incredibly abrasive and foul in doing so.
You tend to get abrasive when your life and your family's life is in the hands of a profession that doesn't take any responsibility for itself. Me and mine have personally been put at risk by quackery and corruption under the guise of medicine.
I have frequently noted your contributions to discussions here on slashdot, and generally found them to be lucid and insightful. This sort of bile is shameful, and reflects poorly on both yourself and this community as a whole.
This sort of bile is not at all shameful. What's shameful is a professional insisting that he can't engage in his profession honourably because his clients force him to act corruptly. It's unfortunate you don't like what I've said this time around but I don't contribute to discussions based on how popular those contributions will be. That's called karma whoring. I've personally witnessed incredibly and life endangering negligence, incompetence, arrogance and seen my relatives reduced to tears by doctors who'd rather be dismissive of their patients because they don't fall into some profitable subset of obvious cases they'd like to work on rather than provide the treatment they are suppose to be there to provide.
These posts express my own personal views, not those of my employer
Absolutely not. When it comes to your own health, the buck stops with YOU, the patient.
That's a load of rubbish. Doctors rant and rail against self diagnosis then when they misdiagnose or mistreat want to pawn off the responsibility. You can't have it both ways. The law recognises professional responsibility, so the fact that you don't really doesn't matter.
Inappropriately prescribing antibiotics for education is no better than inappropriately prescribing for treatment. The bacteria certainly don't care why the prescription was made. Adverse side-effects are still a risk either way.
Fucking straw man from hell there. I never suggested he misprescribe antibiotics. I suggested that he tells the patient who is going elsewhere to actually think about what they are doing and since they insist on getting the meds against his advice to try going without and compare the result. I suggested he educate them as to why antibiotics won't help.
If a doctor doesn't protect his Professional Integrity, he becomes no better than a glorified snakeoil salesman. Telling patients only what they want to hear or prescribing inappropriate tests or prescriptions may make patients (temporarily) happier but it doesn't help them, and it certainly isn't ethical.
Hey dipshit I never said he should misprescribe. Get the wax out of your eyes and re-read what I said. Idiot.
P.S. You have a lot of anger. Can you show us on the doll where the bad doctor touched you?
Yes right here in the brain where a doctor nearly killed my wife by failing to hede contraindications on a medicine that had her seizing more and more frequently while 2 other doctors upped the dosage without doing the same basic checking. Then when I finally do get a fucking appointment with the piece of shit that perscribed the med in the first place he suggests okay maybe she should stop COLD TURKEY. Pity that's been known to lead to suicide. Fortunately _I_ with my total lack of medical training brought it to this fuckwit's attention that it might not be a good idea. "Oh okay come off gradually". Yeah that's worth $300 for 15 minutes of your time you incompetent piece of turd.
So you know what: FUCK YOU.
These posts express my own personal views, not those of my employer