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Aussie Barb
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| Joined: | Thu Jul 22nd, 2004 |
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Posted: Fri May 20th, 2005 01:55 |
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Why won't my doctor consider the Marshall Protocol?
Dr Marshall wrote:
"At the Chicago conference I used the above image for my final slide. I did this to remind us how short our memories can be, and how medicine, even the New England Journal of Medicine, can frequently be totally incorrect with its analysis of disease.
Unfortunately it takes brains and scientific training to be able to comprehend how these bacteria can attack the immune system in the same way, yet give rise to such a wide variety of syndromes.
There are two types of physicians - leaders and followers. The latter type wait until they read something somewhere and say "it must be true, I read it in the New England Journal of Medicine".
The leaders are those who can think "out of the box" and who recognized the signs that cigarette smoking, something which had been in vogue for centuries, was actually harming health.
It is a terrible mistake to assume that if you go to Mayo Clinic or to Johns Hopkins that the physicians there will be leaders. These days a huge majority (maybe 99.9%) have succumbed to the need to make money from their professions. And you can't make money by asking questions all the time. You can't make money by thinking too much.
As I look through the abstracts for the upcoming American Thoracic Society meeting I am struck by the helplessness of them all. Regurgitating slight variations on last years studies, they just keep on moving in fruitless directions in order to secure more grant monies for their institutions.
There was only one paper out of the thousands at ATS which even addressed the needs of patients, and this is a paper describing a survey that Cleveland Clinic used taxpayer money to perform, and which came to the conclusion that 85% of sarcoidosis patients at Cleveland Clinic are very happy with the treatment they are getting.
In order to comprehend the discoveries springing from the cracking of the genome, today's physicians need to have a good understanding of modern science. It is tough for us to expect this, as many have not been even taught the basics of molecular biology. The alternative is for them to listen to those who are accepted as well grounded in science. Many physicians find that just as hard to swallow, as the profession trains them to present medicine, and its practitioners, to the public as infallible.
These people live in their own little world, oblivious of reality. That is why you are still sick, and why so many diseases (even cancer and AIDS, each of which has had hundreds of billions spent on them) remain unsolved."
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Mark Nathan Cohen states in Health and the Rise of Civilization, "A colleague once defined an academic discipline as a group of scholars who had agreed not to ask certain embarrassing questions about key assumptions."
Last edited on Wed Feb 20th, 2008 18:58 by
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Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| Depression| 24+ years not Dx| MP Aug04| ABC of MP| MP Search|
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Aussie Barb
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| Joined: | Thu Jul 22nd, 2004 |
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Posted: Tue Sep 13th, 2005 23:45 |
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(filelink)
Medicine is a business
Medicine is a business. Big business. The most successful practitioners are often succesful because they have a better 'bedside manner,' because they are better 'salesmen,' than they are scientists.
A salesman cannot be a scientist, and vice-versa. There are a number of character traits which do not match, the most obvious being the need for a salesman to tell 'white lies' to reassure the customer.
Your Dr probably feels that his business, his livelihood, is currently under threat. The same goes for all the Sarcoid Pumlonologists.
It is under threat from outside forces - the acceptance that Sarcoidosis is a systemic disease (rather than a lung disease) is de-emphasizing the pulmonologists' role. Secondly, it is under threat from us, as a cure is not compatible with continuing a steady flow of income from perennially sick patients.
A recent newspaper article quoted one Dr as saying he gets 90% of his income from treating Sarcoidosis patients. Do you think that this disease concentration is conducive to change? No - it mitigates against change.
Your Dr is under extreme pressure right now, both from within his organization and from outside it. In many ways, it might be best for him if the MP was to fail. Every time he is reading your charts he will have this in the back of his mind.
I hope this helps
..Trevor..
You might also point out to your doctor that the (commonly credited) inventor of the microscope, Anton van Leeuwenhoek, was actually a cloth merchant whose hobby was optics.
One cannot dispute the fact that the discovery of the existence of bacteria revolutionised the application of medicine. The discovery of bacteria led, inevitably to the work of Pasteur, (who was a chemist) who is often regarded as the father of germ theory and bacteriology...which is a bit spooky as the bacterial pathogenesis of our aliments is not widely accepted today. Makes him a "poster boy" for our cause really!
Indeed, the discovery of penicillin by Flemming, and the development of its use in medicine by Florey required the knowledge made possible by the hobby of a simple cloth merchant.
Hubris about the lofty status of the practice of medicine ignores the undisputable fact that many paradigm shifting discoveries were made by people who were "too uneducated" to know what wasn't possible. ~Rayman
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Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| Depression| 24+ years not Dx| MP Aug04| ABC of MP| MP Search|
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Posted: Tue Dec 5th, 2006 01:00 |
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Consensus science
(filelink)
*Author Michael Crichton, (Harvard MD degree), said:
"I regard consensus science as an extremely pernicious development that ought to be stopped cold in its tracks. Historically, the claim of consensus has been the first refuge of scoundrels; it is a way to avoid debate by claiming that the matter is already settled. Whenever you hear the consensus of scientists agrees on something or other, reach for your wallet, because you're being had. Let's be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics...In addition, let me remind you that the track record of the consensus is nothing to be proud of."
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Posted: Thu Apr 12th, 2007 06:07 |
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(filelink)
Why Doesn't My Doctor Know This?
by Kent Holtorf, MD
Printed online in ImmuneSupport.com on 04-09-2007
Dr. Kent Holtorf, MD, is Medical Director of the Holtorf Medical Group Center for Hormone Imbalance, Hypothyroidism, and Fatigue in Torrance, California.* He specializes in treating CFS and FM patients.
A question that is often raised by patients is “Why doesn’t my doctor know all of this?” The reason is that the overwhelming majority (all but a few percent) of physicians (endocrinologists, internists, family practitioners, rheumatologists, etc.) do not read medical journals. When asked, most doctors will claim that they routinely read medical journals, but this has been shown not to be the case.
The reason is multi-factorial, but it comes down to the fact that the doctors do not have the time. They are too busy running their practices. The overwhelming majority of physicians rely on what they learned in medical school and on pharmaceutical sales representatives to keep them “up-to-date” on new drug information. Obviously, the studies brought to physicians for “educational purposes” are highly filtered to support their product.
There has been significant concern by health care organizations and experts that physicians are failing to learn of new information presented in medical journals and lack the ability to translate that information into treatments for their patients. The concern is essentially that doctors erroneously rely on what they have previously been taught and don’t change treatment philosophies as new information becomes available. This is especially true for endocrinological conditions, where physicians are very resistant to changing old concepts of diagnosis and treatment despite overwhelming evidence to the contrary, because it is not what they were taught in medical school and residency.
This concern is particularly clear in an article published in the New England Journal of Medicine entitled "Clinical Research to Clinical Practice - Lost in Translation."1 The article was written by Claude Lenfant, MD, Director of the National Heart, Lung and Blood Institute, and is well supported. He states there is great concern that doctors continue to rely on what they learned 20 years before and are uninformed about scientific findings. The article states that medical researchers, public officials, and political leaders are increasingly concerned about physicians’ inability to translate research findings in their medical practice to benefit their patients, and states that very few physicians learn about new discoveries [via] scientific conferences and medical journals and translate this knowledge into enhanced treatments for their patients.
He states that a review of past medical discoveries reveals how excruciatingly slow the medical establishment is to adopt novel concepts. Even simple methods to improve medical quality are often met with fierce resistance. The article states, “Given the ever-growing sophistication of our scientific knowledge and the additional new discoveries that are likely in the future, many of us harbor an uneasy, but quite realistic, suspicion that this gap between what we know about diseases and what we do to prevent and treat them will become even wider. And it is not just recent research results that are not finding their way into clinical practice; there is plenty of evidence that ‘old’ research outcomes have been lost in translation as well."
Dr. Lenfant discusses the fact that the proper practice of medicine involves “the combination of medical knowledge, intuition and judgment” and that physicians’ knowledge is lacking because they don’t keep up with the medical literature. He states that there is often a difference of opinion among physicians and reviewing entities, but that judgment and knowledge of the research pertaining to the patient’s condition is central to the responsible practice of medicine. He states, “Enormous amounts of new knowledge are barreling down the information highway, but they are not arriving at the doorsteps of our patients.”
These thoughts are echoed by physicians who have researched this issue as well, such as William Shankle, MD, Professor, University of California, Irvine. He states, “Most doctors are practicing 10 to 20 years behind the available medical literature and continue to practice what they learned in medical school…There is a breakdown in the transfer of information from the research to the overwhelming majority of practicing physicians. Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not."2
The Dean of Stanford University School of Medicine understands that there is a problem of doctors not seeking out and translating new information to benefit their patients. He states that in the absence of translational medicine, “the delivery of medical care would remain stagnant and uninformed by the tremendous progress taking place in biomedical science."3
This concern has also received significant publicity in the mainstream media. In an article published in a 2003 Wall Street Journal article entitled "Too Many Patients Never Reap the Benefits of Great Research," Sidney Smith, MD, former President of the American Heart Association, is very critical of physicians for not seeking out available information and applying that information to their patients. He states that doctors feel the best medicine is what they’ve been doing and thinking for years - because that is what they’ve been doing. They discount new research because it is not what they have been taught or what they practice, and refuse to admit that what they have been doing or thinking for many years is not the best medicine. He writes, “A large part of the problem is the real resistance of physicians…many of these independent-minded souls don’t like being told that science knows best, and the way they’ve always done things is second-rate."4
The National Center for Policy Analysis also reiterates concern for the lack of ability of physicians to translate medical therapies into practice.5
A review published in The Annals of Internal Medicine found that there is clearly a problem of physicians not seeking to advance their knowledge by reviewing the current literature, believing proper care is what they learned in medical school or residency and not basing their treatments on the most current research. They found the longer a physician is in practice, the more inappropriate and substandard the care.6
A study published in the Journal of the American Medical Informatics Association reviewed by The National Institute of Medicine reports that there is an unacceptable lag between the discovery of new treatment modalities and their acceptance into routine care. They state, “The lag between the discovery of more effective forms of treatment and their incorporation into routine patient care averages 17 years.”7,8
In response to this unacceptable lag, an amendment to the Business and Professions Code, relating to healing arts, was passed. This amendment, CA Assembly Bill 592; An act to amend Section 2234.1 of the Business and Professions Code, relating to healing arts, states, “Since the National Institute of Medicine has reported that it can take up to 17 years for a new best practice to reach the average physician and surgeon, it is prudent to give attention to new developments not only in general medical care but in the actual treatment of specific diseases, particularly those that are not yet broadly recognized [such as the concept of tissue hypothyroidism, Chronic Fatigue Syndrome, and Fibromyalgia]...”9
The Principals of Medical Ethics adopted by the American Medical Association in 1980 states, “A physician shall continue to study, apply, and advance scientific knowledge, make relevant information available to patients, colleagues, and the public.”10
This has unfortunately been replaced with an apathetical goal to merely provide so-called adequate care. The current reimbursement system in America fosters this thinking, as the worst physicians are financially rewarded by insurance companies. The best physicians are continually fighting to provide cutting edge treatments and superior care that the insurance companies deem not medically necessary. Even the best physicians eventually get worn down and are forced to capitulate to the current substandard care.
This was clearly demonstrated in a study published in the March 2006 edition of The New England Journal of Medicine, entitled "Who is at Greater Risk for Receiving Poor-Quality Health Care?" This study found that the majority of individuals received substandard, poor-quality care. There was no significant difference between different income levels, or between individuals who have insurance and those who do not. It used to be the case that only those in low socioeconomic classes without insurance received poor-quality care. Insurance company restrictions of treatments and diagnostic procedures have caused the same poor care afforded to those of low socioeconomic status without insurance to become the new standard-of-care.11
Most physicians will satisfy their required amount of continuing medical education (CME) by going to a conference a year, usually at a highly desirable location that has skiing, golf, boating, etc. A physician is rarely monitored as to whether he or she actually showed up for the lectures. One must also understand that the majority of conferences [organized] by medical societies are sponsored by pharmaceutical companies. These payments are called 'unrestricted grants', in that the society has free rein to do what it wants with the money and can thus claim there is no influence on lecture content by the pharmaceutical company. The problem is that if the society wants to continue getting these unrestricted grants from the particular company, they had better provide content that is of benefit to the pharmaceutical company that paid for the grant.
Consequently, ground breaking research that goes against the status quo and does not support the drug industry receives little attention. The doctor must actively search for these studies, which only a few percent are willing to do on a consistent basis.
There is clear evidence and concern that published research is clearly tainted by whomever is the financial sponsor of the study.
A study published in the Journal of Psychiatry (and later discussed in the May 2006 edition of Forbes magazine) states that the most important determinant of the outcome of the study is who paid for it.
An analysis in the Archives of Internal Medicine reviewed 56 studies of painkillers - and not once was the sponsor’s drug deemed inferior. In addition to reading the conclusion of the study, a physician must read the entire study and review the data with a critical eye, which is rarely done.
References
1. Lenfant C, New England Journal of Medicine. "Clinical Research to Clinical Practice - Lost in Translation" 2003;349:868-874.
2. William Shankle, MD. Key Note Presentation. International Conference on the Integrative Medical approach to the Prevention of Alzheimer’s Disease. Oct 11, 2003.
3. Phillip Pizzo, MD. Stanford Medical Magazine. Stanford University School of Medicine.
4. Begley S. "Too Many Patients Never Reap the Benefits of Great Research." Wall Street Journal. September 26, 2003.
5. "Science Knows Best." Daily Policy Digest. National Center for Policy Analysis. Sept 26, 2003.
6. Niteesh. C, et al. "Systematic Review: The relationship between clinical experience and quality of health care." Annals of Internal Medicine. February 15, 2005.
7. Balas, E.A. "Information Systems Can Prevent Errors and Improve Quality. Journal of the American Medical Informatics Association. 2001; 8(4):398-9.
8. National Institute of Medicine Report, 2003b
9. California Assembly Bill Number: AB 592 Amended Bill Text; Amended in Assemby April 4, 2005, Introduced by Assembly Member Yee February 17 2005. An act to amend Section 2234.1 of the Business and Professions Code, relating to healing arts.
10. The Principals of Medical Ethics adopted by the American Medical Association in 1980.
11. Asch SM, et al. "Who is at Greater Risk for Receiving Poor-Quality Health Care?" New England Journal of Medicine. 2006;354:1147-1155.
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* Reproduced with the generous permission of the author, Dr. Kent Holtorf, MD. All rights reserved. For more information about the Torrance, California-based Holtorf Medical Group Center for Hormone Imbalance, Hypothyroidism, and Fatigue, visit their website at http://www.HoltorfMed.com or phone 310-375-2705. See also "Kent Holtorf, MD, on Treating Chronic Fatigue Syndrome & Fibromyalgia - An Update" at http://www.immunesupport.com/library/showarticle.cfm?id=4532
Note: This information has not been evaluated by the FDA. It is not intended to prevent, diagnose, treat, or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or regimen without researching and discussing it in collaboration with your professional healthcare team.
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