Nicotine

@salima,

salima;69760 wrote:

i find it hard to trust controlled studies even when i know who the controller is! whenever i run across them, i have to go further, i never take them at face value.

Hi,
It is one thing to question the methodology of studies. Many are funded and many are suppressed if they do not yield the results that the pharmas are looking for. All legal. Many stop short, just to hide potential harmful effects. Take a look at the report concerning Ritalin and its possible link sudden death in children that is in the papers today, and how the FDA is handling it.

But we can go beyond this ... we can explore the fundamental underpinnings of controlled studies. Exactly what are the studies attempting to find?

Basically they are looking for a substance that will suppress symptoms in a large population. There is nothing about cure. As a result, these studies produce a slew of extremely powerful drugs that can suppress symptoms in a large population of diverse people. This they may do, but they may also cause great harm in the process. Since most studies are rather short term, the longer term effects are pretty much unknown. Many drugs are used for purposes that they were never tested for. Other drugs have been used for a very long time even though the medical profession knew that they were not providing any benefits ... e.g children's cough medicine.

What I look for in a physician is individualized cure (not suppression of symptoms), that looks at root causes, usually lifestyle but possibly other things, and uses a process that subjects the body to the least amount of potential harm. Symptoms should go away, in order to pronounce cure. Symptoms are a warning from the body that something is wrong. When they are gone, the body is healthy again. Suppression merely hides the underlying problem.

[CENTER]"Above all, do no harm"
Hippocratic Oath

Rich

[/CENTER]

1 Reply

@richrf,

richrf;69811 wrote:

Many are funded and many are suppressed if they do not yield the results that the pharmas are looking for.

True, and the FDA has been less than competent. However, you fail to acknowledge that the vast majority of clinical research is NOT funded by drug companies -- it's mostly funded by the NIH and by other non-profit foundations.

richrf;69811 wrote:

Exactly what are the studies attempting to find?

Basically they are looking for a substance that will suppress symptoms in a large population.

I'm going to spare this a long response, because it's a load of bull. Pick up the latest copy of any major clinical journal, be it NEJM, JAMA, Lancet, BMJ, Annals of Internal Medicine, or some of my own subspecialty's journals like CID or AJTMH, and I can quickly disabuse you of this nonsense.

Furthermore, you have not yet responded to my post a couple pages ago that demonstrates that 1) we use symptoms to identify someone's underlying disease, 2) we have an inordinate amount of training in preventative medicine and this receives a lion's share of NIH funding because it's cost-effective, and 3) there has been only one disease EVER eradicated by a preventative intervention, and that was smallpox through vaccination -- so we MUST do studies that investigate treatments of disease, because however good our prevention we WILL have disease!

1 Reply

@Aedes,

Aedes;69882 wrote:

True, and the FDA has been less than competent. However, you fail to acknowledge that the vast majority of clinical research is NOT funded by drug companies -- it's mostly funded by the NIH and by other non-profit foundations.

Medical Community Takes Steps To Prevent Pharmaceutical Industry Influence Amid Recent Criticism

"Catherine DeAngelis, editor of the Journal of the American Medical Association, said, "The influence that the pharmaceutical companies, the for-profits, are having on every aspect of medicine ... is so blatant now you'd have to be deaf, blind and dumb not to see it," adding, "We have just allowed them to take over, and it's our fault, the whole medical community."

My observations are in agreement with the above comment.

Rich

0 Replies

@William,

1. Last week, Rich, I cured a woman of cellulitis, which was a life-threatening soft tissue infection she'd gotten after a cat bite. I cured two people of pneumonia. I cured a man of septic shock due to a bone infection. Tomorrow I have my pediatric HIV clinic, which is my subspecialty. HIV cannot be cured. It CAN be prevented, but these were unfortunate children who were born to HIV positive mothers who had not been detected in time. While I cannot cure them of HIV, I can prevent AIDS by treating these children with antiviral medications. I have a 22 year old patient who was born with HIV who just graduated from college and is going off to graduate school, and this is solely because of the medications. That's what I do. Where did I ever mention a "symptom" here?

2. Here are the three original scientific articles from the current issue of The Lancet, one of the most prestigious medical journals. Please illustrate to me how this exemplifies symptom management, and how these are tied to drug industry manipulation.

Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases 2005-20: a multicentre prospective registration study
Funding: European Community Concerted Action Program
Conclusions: If present trends continue, doubling of new cases of type 1 diabetes in European children younger than 5 years is predicted between 2005 and 2020, and prevalent cases younger than 15 years will rise by 70%. Adequate health-care resources to meet these children's needs should be made available.

Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis
Funding: Chief Scientist Office of the Scottish Government Health Directorate.
Conclusions: Progesterone, administered vaginally, does not prevent preterm birth in women with twin pregnancy.

Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001-05: an epidemiological survey
Funding: China Medical Board of New York, WHO, and Shandong Provincial Bureau of Health
Conclusions:: Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.

And by the way, I do NOT deny the excessive and deleterious effect of industry influence on medicine. However, I think it's overblown, naive, and harmful to reject all medical research as you do when it's plain for the eye to see that there is good research being done that focuses on cure, on prevention, on quality improvement, on epidemiology, on cost-effectiveness, and this is often without the vested interest of industry.

1 Reply

@Aedes,

Aedes;69899 wrote:

1. Last week, Rich, I cured a woman of cellulitis, which was a life-threatening soft tissue infection she'd gotten after a cat bite. I cured two people of pneumonia.

Deaths from pneumonia each year:

Deaths from Pneumonia - WrongDiagnosis.com

If you have a cure, I think you should publish it.

As for the state of the medical research, I think it is a major problem:
Pharmaceutical industry sponsorship and research outcome and quality: systematic review -- Lexchin et al. 326 (7400): 1167 -- BMJ

Conclusion Systematic bias favours products which are made by the company funding the research. Explanations include the selection of an inappropriate comparator to the product being investigated and publication bias.

Rich

1 Reply

@richrf,

richrf;69904 wrote:

If you have a cure, I think you should publish it.

Being a subspecialist in infectious diseases, I'm quite comfortable with my ability to diagnose and cure pneumonia. And if you ever are suffering from this malady and show up on my medical service, I would without hesitation offer you the same high quality, evidence-based diagnosis and therapy that I have seen save the lives of many many people in my career.

I can save the life of one person at a time. I can cure one person of one episode of pneumonia. Highlighting its huge public health importance only justifies how lucky we are to be able to cure it, because without antibiotics, without modern medical diagnostic techniques, without pneumococcal and influenza vaccines, without public health and sanitation, and without smoking cessation efforts, the death toll from pneumonia would be far higher.

So tell me a good alternative for when you show up in septic shock from pneumonia. What treatment would you prefer? And can you offer a solution rather than just complaining about everything?

Quote:

As for the state of the medical research, I think it is a major problem

Yes, I know you do, and the fact that NONE of the articles in this week's Lancet suffer from the problems of which you complain is surely just an aberration -- after all, every other journal should prove your point, right? Shall we look? Which journal would you like me to run down for you? Annals? JAMA? NEJM? BMJ? Archives? Pediatrics? Mayo Clinic Proceedings? PLoS Medicine? Take your pick.

1 Reply

@Aedes,

Aedes;69907 wrote:

Being a subspecialist in infectious diseases, I'm quite comfortable with my ability to diagnose and cure pneumonia.

People who have pneumonia die. People who have pneumonia live. Many who die are treated. Many who live are not treated or are treated in many different ways. However, it is always interesting to me when someone claims that they are confident that they can cure.

My body, and those of my family, has so far never been in a state of pneumonia or any other life threatening disease. I treat the underlying cause before it gets there. I reform my lifestyle in an appropriate way.

Rich

1 Reply

@richrf,

richrf;69909 wrote:

People who have pneumonia die. People who have pneumonia live. Many who die are treated. Many who live are not treated or are treated in many different ways. However, it is always interesting to me when someone claims that they are confident that they can cure.

I am confident that the likelihood of survival will be improved if someone with this condition receives treatment, and I would be happy to direct you to an abundance of evidence to support this claim. And while I'm relatively young in my career, in the 9 years since graduating from medical school and in the 4 years before that, I've witnessed a remarkably reliable improvement in the physiologic parameters perturbed by pneumonia when such patients are given antibiotics as well as (when necessary) appropriate hemodynamic and respiratory support. Let me ask you -- do you think it would be ethical to do a study comparing antibiotics to placebo for pneumonia, just because some may die and some may survive irrespective of treatment? Do you not recognize that before antibiotics the mortality from pneumonia was far higher, and the survivors were often left with permanent complications like bronchiectasis?

Quote:

My body, and those of my family, has so far never been in a state of pneumonia or any other life threatening disease. I treat the underlying cause before it gets there. I reform my lifestyle in an appropriate way.

You can't prevent everything, and you can't "treat" every "underlying cause". What is the underlying cause of pneumonia that you find so amenable to "treatment"? What about glioblastoma multiforme? What about Huntington's chorea? What about septic shock? What about primary biliary cirrhosis? How do you "treat" the "underlying cause" of these "life threatening diseases" and "states"? And if you regard your treatment as so efficacious, then can you demonstrate to me (who would LOVE to make an impact in my career by changing medicine for the better) how exactly this can be applied safely in practice?

Paul

1 Reply

@Aedes,

Aedes;69924 wrote:

You can't prevent everything, and you can't "treat" every "underlying cause". What is the underlying cause of pneumonia that you find so amenable to "treatment"? What about glioblastoma multiforme? What about Huntington's chorea? What about septic shock? What about primary biliary cirrhosis? How do you "treat" the "underlying cause" of these "life threatening diseases" and "states"? And if you regard your treatment as so efficacious, then can you demonstrate to me (who would LOVE to make an impact in my career by changing medicine for the better) how exactly this can be applied safely in practice?

Paul

For me, the human body and human consciousness provide the best defense against illness and the best mechanism for treating illness. I have formed my own theory about maintaining health and it has worked very well for me and my family.

I am not here to convince anyone of the efficacy of my approach. If someone comes to me and asks me how I have been able to maintain such a healthy state for so long, I provide them with some ideas. If someone is not interested, that is fine with me. My concern is with my own health and the health of my family. I don't pretend to have cures nor do I take credit when one of my students cures himself/herself via good health practices.

I am not involved in any way with the medical industry in this country so it is not of great concern to me what it does. Other than the fact that I may have to pay into some government insurance program (it may be cheaper for me to just pay the penalties for not joining), it has been pretty tangential to my life. However, I do read the papers and magazines and I believe that the medical industry needs to scrutinize itself using outside agencies and investigators, and get all of the information out in the public so that people can make transparent choices, just like the government is forcing the financial industry to clean up its practices. For example, from Consumer Reports:

Medical ripoffs, overspending on overtreatment

But if it doesn't, that is fine with me.

Rich

1 Reply

@richrf,

richrf;69946 wrote:

For me, the human body and human consciousness provide the best defense against illness and the best mechanism for treating illness. I have formed my own theory about maintaining health and it has worked very well for me and my family.

I am not here to convince anyone of the efficacy of my approach. If someone comes to me and asks me how I have been able to maintain such a healthy state for so long, I provide them with some ideas. If someone is not interested, that is fine with me. My concern is with my own health and the health of my family. I don't pretend to have cures nor do I take credit when one of my students cures himself/herself via good health practices.

I am not involved in any way with the medical industry in this country so it is not of great concern to me what it does. Other than the fact that I may have to pay into some government insurance program (it may be cheaper for me to just pay the penalties for not joining), it has been pretty tangential to my life. However, I do read the papers and magazines and I believe that the medical industry needs to scrutinize itself using outside agencies and investigators, and get all of the information out in the public so that people can make transparent choices, just like the government is forcing the financial industry to clean up its practices. For example, from Consumer Reports:

Medical ripoffs, overspending on overtreatment

But if it doesn't, that is fine with me.

Rich

rich-
it really does sound as if you are trying to convince people of something.

can you prevent accidents resulting in broken limbs or internal injuries? how does your philosophy of health care address these possibilities?

as far as health issues are concerned, the worst scenario in the world that i can conceive of us the conditions after floods and other natural disasters when there is no clean drinking water available, or the level of ignorance that leads to deaths of so many babies in india from something as simple as diarrhea. how do your methods relate to situations like this?

reading your quote i was a little unsure of what you meant by referring to insurance. do you have medical insurance? you dont have to tell me about the unethical results of medical insurance, i used to work in a health insurance company for 14 years and that would be a great subject for a new thread. we have really strayed off the subject here now!

0 Replies

@William,

Rich, you make two mistakes here that I need to point out:

1) You've pointed out many many REAL flaws in our health care system. But systemic flaws does not mean that the entire enterprise of medicine is a giant joke in which no one who sees a doctor gets better and everyone gets worse. And it does not address your patently erroneous contentions that prevention and cure are absent from medical practice -- they're what it's about. It wouldn't take you too long on rounds with me or my colleagues to realize that.

2) Your string of good fortune with health is not unique. I've met a lot of people who have led healthy lives without having theories about mind and body, without seeing a regular doctor, and even in some cases eating crappy food and smoking. I applaud your confidence in your ideas about your health, but you don't have a ticket to immortality and some day someone in your family will get sick -- because we ALL do.

1 Reply

@Aedes,

Aedes;69991 wrote:

Rich, you make two mistakes here that I need to point out: but you don't have a ticket to immortality and some day someone in your family will get sick -- because we ALL do.

I think that physicians should clean up their system and I think they should stop trying to drum up business by scaring people (Above all do no harm). My family is very healthy. We all die. And we don't go to physicians. A simple congratulations on a job well done would have sufficed.

Rich

0 Replies

@William,

I think that we are only going to clean up our system if we have patients who can help us recognize what works and what doesn't. They are our checks and balances. But people who do nothing but whine don't help anything.

It's ridiculous to say that we "drum up business by scaring people", considering that 1) people come to us when THEY feel sick -- we don't go out looking for people and convincing them that they are, and 2) we've lowered the death rate from countless diseases by prevention techniques, from screening colonoscopies to mammograms to lead screening in babies to vaccinations, so people have less to be scared about.

In 1900 the infant mortality and life expectancy in the United States was about the same as it currently is in Nigeria. We're doing something right. How about you congratulate us for a job well done too.

And if your technique is so unimpeachable, then go teach people and show us how much better it is.

1 Reply

@Aedes,

Doctors do not drum up business with psychological manipulation (scare tactics, ect) - big pharma does that.

2 Replies

@Didymos Thomas,

Didymos Thomas;70129 wrote:

Doctors do not drum up business with psychological manipulation (scare tactics, ect) - big pharma does that.

To me, one could not exist without the other so one feeds the other,

Rich

1 Reply

@Didymos Thomas,

Didymos Thomas;70129 wrote:

Doctors do not drum up business with psychological manipulation (scare tactics, ect) - big pharma does that.

Surely we cannot say all doctors drum up business with psychological manipulation, but to say none do, seems a bit naive. Not every doctor has the same ethical agenda.

1 Reply

@Zetherin,

Zetherin;70139 wrote:

Surely we cannot say all doctors drum up business with psychological manipulation, but to say none do, seems a bit naive. Not every doctor has the same ethical agenda.

exactly. these tactics are used by a certain percentage of unethical people in all trades or walks of life. a television repairman can use them-a politician-any time someone has more knowledge about a subject than the person they are trying to manipulate. so it makes sense to be as informed as possible in whatever area of life you are facing decisions, including health.

1 Reply

@salima,

salima;70189 wrote:

exactly. these tactics are used by a certain percentage of unethical people in all trades or walks of life. a television repairman can use them-a politician-any time someone has more knowledge about a subject than the person they are trying to manipulate. so it makes sense to be as informed as possible in whatever area of life you are facing decisions, including health.

Hi salima,

I am not sure it is a question of being or not being unethical. It seems that the words that are uttered have become more or less woven within the fabric of the medical profession.

Next time you visit a physician, if you do go, listen to the words they use to get you to come back. Listen to what they say when they prescribe drugs. Scare tactics may be very overt but they can also be much more subtle. I witness it all the time in my age group. I think doctors, among themselves, "practice" what to say in order to get patients to do as they tell them to do. It is very effective. The best one, of course being, "if you don't do ..... you will get sick or even die. It took me a very long time to develop a body of knowledge to the point that I was able to be amused by the way doctors make these subtle and not so subtle suggestions. Who is really able to look at a physician in the eye and tell him/her that you disagree? I have. Try it and look at the astonishment in their face. It is a wonder to behold.

Rich

0 Replies

@richrf,

richrf;70135 wrote:

To me, one could not exist without the other so one feeds the other,

Rich

Why is that supposed to be true? Medicine(what doctors study, and therefore what is co present with doctors) existed before pharmacology was even a word, much less the cash base for a huge industry.

So I think that your claim has no basis. Unless you think Hippocrates was taking some checks under the table from Viagra? Smile

0 Replies

@William,

Paul, regarding the commercialization of the healthcare industry, I need to ask you for your professional opinion. Why are so many pharmacuetical companys advertising "to patients" via the boob tube the value of a particular pharmacuetical product? It has been my experience, you don't tell doctor's what to prescribe. All the ads are saying "ask your doctor about "this drug or that drug. Who are they really talking to? The patient or the doctor? What doctor has the time to watch television? Don't these companies still have sales reps. who call on doctors and give them free samples along with a sales pitch. Who pays for those ads? And there are so very many. They claim to be talking to the patient when the patient does not now, nor ever has, had a say in such matters. Their only concern: "does it come in generic form"? I would love to hear you answer. There may be a valid reason. Please enlighten me. :perplexed:

William

1 Reply

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