This was going to be my next post of substance: a bit of irritation aimed at the American Medical Student Association for buying into the Complementary and Alternative Medicine (CAM) crap....
But then I found this. *shakes fist angrily* Damn you Orac for stealing my thunder. ;)
He pretty much covers everything that I wanted to talk about, as well as links to previous articles that he has written.
My problem with this whole snafu is that students that don't know a whole lot about quackery might well get sucked into this stuff because of the verbiage involved. "Holistic, huh? That sounds good..." "Everyone knows you have to take your vitamins!"
They don't realize that such things are essentially scams, and that they are being suckered into a modality that has no scientific basis whatsoever. Even more disturbing is the idea that these people graduate from medical school thinking they are helping their patients when they are simply peddling woo.
I was disgusted to find that California Pacific Medical Center, right around the corner from where I live in San Francisco, has an "Integrative Health Center".
Codename for bullshit.
Showing posts with label Orac. Show all posts
Showing posts with label Orac. Show all posts
Wednesday, January 5, 2011
Sunday, January 2, 2011
Residencies
I promised you content... and here is the first of many, I hope.
Recently there was a kerfuffle over allowing medical residents to work shorter hours. In the end, the law remained the same such that residents are only permitted to work 80 hours a week; the major change was that the shifts went from 30+ hours to about 16, though senior residents can do 28 hour shifts with "strategic napping".
This would seem to be painfully obvious to anyone halfway paying attention: tired doctors don't necessarily make the best calls for a patient that needs and deserves excellent care. Especially if the tired doctor in question is, in fact, in training.
With good reason, there has been public outrage about the number of hospital-associated mistakes. Unfortunately, the bandwagon has been made available to sensationalist media coverage of the number of times that people at hospitals screw up. It seems as if the culture that loves to find fault with an educated elite absolutely adored punching holes in the godlike facade of doctors. People like Faux news seemed to take childlike glee in exposing the idea that yes, doctors are people too. Yes, doctors are not infallible. Mistakes are made, and it is a shame, but the best that humans can do is to try an minimize the potential for such mistakes.
Now mind you, there are all kinds of systems in place to minimize mistakes. Nurses ask for I.D. and papers before drawing blood or doing any kind of procedure, due to a mishap at Mt. Sinai in New York with a woman going in for the wrong surgery. It is awful and deeply regrettable, and so we learn from these mistakes. We ask for I.D., discuss the patient's understanding of the upcoming procedure, answer questions, and try to have redundancy programs where if one nurse or doctor misses something, then someone else might be able to catch it. Much of the wait and drag of a hospital can involve running these types of checks. Yes it can get bogged down in bureaucracy, but I would rather have accuracy than speed when it comes to my health.
Which is why I simply did not understand the hue and cry raised about lowering the number of hours that residents can work. Exhausted students that work 30+ hour shifts, go home to study more, and then must return to the hospital for more work simply makes no sense to me whatsoever if a patient's life is on the line.
Put simply, safety is put into jeopardy. I don't really see that as being an option, really.
Arguments against cutting back hours and shifts are kind of ridiculous, in my opinion. The one good argument against cutting hours was made by Orac a few weeks back, and it is somewhat compelling. We'll visit it by and by.
A residency is a paid apprenticeship. A resident gets paid very low wages for a lot of work, but it is expected because the resident is learning their profession and their craft. An attending doctor oversees their work and makes sure that they are learning what they need to learn, but in a lot of ways they are basically practicing medicine.
Because the resident is working for very low pay, certainly less than she can command as a full doctor, she pumps a lot of free work into the hospital. More patients can be seen quicker because there is a larger staff of doctors that can cover the demand, and thus the hospital brings in more revenue. The hospital benefits from this, much like when you volunteer somewhere. You are performing a service for free because it helps the organization you are working for, and you personally are possibly learning or devoted to a cause. The teaching hospitals objected to the proposed changes because it would cost them revenue.
My question to them is this: if it meant fewer mistakes, fewer lawsuits, and lower malpractice insurance, wouldn't you do it? I'd love to see numbers where the cost/benefit analysis was done, with an estimation of how much the hospital can save in lawsuits and/or eating the costs associated with mistakes, vs. how much revenue is lost from either requiring more residents to cover the lost shifts or not having that many residents.
The next objection was safety. I worked veterinary emergency for years, and I know what happens when shifts change. You hand patients off to the next oncoming shift. In many cases, to promote safety and make sure that things go well, you have the shifts overlap significantly (by perhaps 2 hours) to make sure that nothing comes up. The oncoming shift reads the chart thoroughly to make sure that they understand the case and ask questions to make sure that they get it.
The process takes perhaps 20 minutes TOPS. WHY is this so difficult for human doctors to do? What, precisely, is wrong with handing patients off to another doctor?
There was all of this noise made about "continuity of care" nonsense that really irked me. I've sen it done. It isn't that hard. Why is this kind of continuity so flippin' important that it was raised as a major safety objection? If there is something here that I've missed, please let me know, because I frankly don't get it.
Dr. Wachter's article above made some good points, which kind of coincide with Orac's argument. One is the idea that even though a shift is technically over and the resident is free to go, that the resident might need to stay for whatever reason. I do get this. I've done it myself, because I had a project or issue in the back of my mind that I had to handle before I left, and explaining it might be too complicated or take too long. This I do understand.
The other is the "swinging door" mentality, that the resident might be too eager to leave or know that the shift is over and that things might get dropped just because the resident knows they have to go. Appropriate care to detail and discussions with the attending or oncoming attending physician, in conjunction with staying to make certain that cases are being handled adequately or to handle the case yourself, can probably settle this issue. Knowing the kind of sacrifice, hard work, and discipline involved in getting into and graduating from medical school, I think that this concern really doesn't give residents enough credit for being mature adults. Communication is the key when it comes to patient care, and not being communicative enough with your team will raise all kinds of problems, not just this one.
And we come, finally, to Orac's objection, the one that I think carries the most water. There is a massive amount of information necessary to becoming a doctor, and a good one at that. Book learning can only take you so far, which is why there are residencies and internships. Residencies can be anywhere from 2-5 years long, because there is so much to learn. Orac's problem with decreasing shifts is that there is less actual time to learn what you must in order to pass the boards and be a fully accredited and independent doctor.
I understand and agree with this point of view: there is a huge amount of material to learn, and less and less time in which to learn it. There will be a critical point, with short shifts and a very long residency, past which students will be unwilling to devote their education to a particular discipline simply because of the time involved. I also think, however, that there are ways to increase the efficiency of a program so that you can indeed learn more effectively. Due to the shift restrictions, this conversation about restructuring the residency programs offered at teaching hospitals is already happening. I think that that is a great idea, because learning medicine is like trying to hit a moving target: it is constantly changing and updating itself.
There are good objections to changing the shift requirements and allowances for residents, but I honestly think that the most important ones are being lost in the shuffle. In addition, creative solutions to solving the aforementioned objections are also being lost because of a seemingly stubborn adherence to a fixed curriculum.
Recently there was a kerfuffle over allowing medical residents to work shorter hours. In the end, the law remained the same such that residents are only permitted to work 80 hours a week; the major change was that the shifts went from 30+ hours to about 16, though senior residents can do 28 hour shifts with "strategic napping".
This would seem to be painfully obvious to anyone halfway paying attention: tired doctors don't necessarily make the best calls for a patient that needs and deserves excellent care. Especially if the tired doctor in question is, in fact, in training.
With good reason, there has been public outrage about the number of hospital-associated mistakes. Unfortunately, the bandwagon has been made available to sensationalist media coverage of the number of times that people at hospitals screw up. It seems as if the culture that loves to find fault with an educated elite absolutely adored punching holes in the godlike facade of doctors. People like Faux news seemed to take childlike glee in exposing the idea that yes, doctors are people too. Yes, doctors are not infallible. Mistakes are made, and it is a shame, but the best that humans can do is to try an minimize the potential for such mistakes.
Now mind you, there are all kinds of systems in place to minimize mistakes. Nurses ask for I.D. and papers before drawing blood or doing any kind of procedure, due to a mishap at Mt. Sinai in New York with a woman going in for the wrong surgery. It is awful and deeply regrettable, and so we learn from these mistakes. We ask for I.D., discuss the patient's understanding of the upcoming procedure, answer questions, and try to have redundancy programs where if one nurse or doctor misses something, then someone else might be able to catch it. Much of the wait and drag of a hospital can involve running these types of checks. Yes it can get bogged down in bureaucracy, but I would rather have accuracy than speed when it comes to my health.
Which is why I simply did not understand the hue and cry raised about lowering the number of hours that residents can work. Exhausted students that work 30+ hour shifts, go home to study more, and then must return to the hospital for more work simply makes no sense to me whatsoever if a patient's life is on the line.
Put simply, safety is put into jeopardy. I don't really see that as being an option, really.
Arguments against cutting back hours and shifts are kind of ridiculous, in my opinion. The one good argument against cutting hours was made by Orac a few weeks back, and it is somewhat compelling. We'll visit it by and by.
A residency is a paid apprenticeship. A resident gets paid very low wages for a lot of work, but it is expected because the resident is learning their profession and their craft. An attending doctor oversees their work and makes sure that they are learning what they need to learn, but in a lot of ways they are basically practicing medicine.
Because the resident is working for very low pay, certainly less than she can command as a full doctor, she pumps a lot of free work into the hospital. More patients can be seen quicker because there is a larger staff of doctors that can cover the demand, and thus the hospital brings in more revenue. The hospital benefits from this, much like when you volunteer somewhere. You are performing a service for free because it helps the organization you are working for, and you personally are possibly learning or devoted to a cause. The teaching hospitals objected to the proposed changes because it would cost them revenue.
My question to them is this: if it meant fewer mistakes, fewer lawsuits, and lower malpractice insurance, wouldn't you do it? I'd love to see numbers where the cost/benefit analysis was done, with an estimation of how much the hospital can save in lawsuits and/or eating the costs associated with mistakes, vs. how much revenue is lost from either requiring more residents to cover the lost shifts or not having that many residents.
The next objection was safety. I worked veterinary emergency for years, and I know what happens when shifts change. You hand patients off to the next oncoming shift. In many cases, to promote safety and make sure that things go well, you have the shifts overlap significantly (by perhaps 2 hours) to make sure that nothing comes up. The oncoming shift reads the chart thoroughly to make sure that they understand the case and ask questions to make sure that they get it.
The process takes perhaps 20 minutes TOPS. WHY is this so difficult for human doctors to do? What, precisely, is wrong with handing patients off to another doctor?
There was all of this noise made about "continuity of care" nonsense that really irked me. I've sen it done. It isn't that hard. Why is this kind of continuity so flippin' important that it was raised as a major safety objection? If there is something here that I've missed, please let me know, because I frankly don't get it.
Dr. Wachter's article above made some good points, which kind of coincide with Orac's argument. One is the idea that even though a shift is technically over and the resident is free to go, that the resident might need to stay for whatever reason. I do get this. I've done it myself, because I had a project or issue in the back of my mind that I had to handle before I left, and explaining it might be too complicated or take too long. This I do understand.
The other is the "swinging door" mentality, that the resident might be too eager to leave or know that the shift is over and that things might get dropped just because the resident knows they have to go. Appropriate care to detail and discussions with the attending or oncoming attending physician, in conjunction with staying to make certain that cases are being handled adequately or to handle the case yourself, can probably settle this issue. Knowing the kind of sacrifice, hard work, and discipline involved in getting into and graduating from medical school, I think that this concern really doesn't give residents enough credit for being mature adults. Communication is the key when it comes to patient care, and not being communicative enough with your team will raise all kinds of problems, not just this one.
And we come, finally, to Orac's objection, the one that I think carries the most water. There is a massive amount of information necessary to becoming a doctor, and a good one at that. Book learning can only take you so far, which is why there are residencies and internships. Residencies can be anywhere from 2-5 years long, because there is so much to learn. Orac's problem with decreasing shifts is that there is less actual time to learn what you must in order to pass the boards and be a fully accredited and independent doctor.
I understand and agree with this point of view: there is a huge amount of material to learn, and less and less time in which to learn it. There will be a critical point, with short shifts and a very long residency, past which students will be unwilling to devote their education to a particular discipline simply because of the time involved. I also think, however, that there are ways to increase the efficiency of a program so that you can indeed learn more effectively. Due to the shift restrictions, this conversation about restructuring the residency programs offered at teaching hospitals is already happening. I think that that is a great idea, because learning medicine is like trying to hit a moving target: it is constantly changing and updating itself.
There are good objections to changing the shift requirements and allowances for residents, but I honestly think that the most important ones are being lost in the shuffle. In addition, creative solutions to solving the aforementioned objections are also being lost because of a seemingly stubborn adherence to a fixed curriculum.
Tuesday, November 30, 2010
Medical Skepticism and Dr. Oz
I think that it is fair to say that a lot of the New-Agey, hippie, touchy-feely woo-tastic type beliefs in terms of medicine and nutrition either originated in or were propagated by the San Francisco Bay Area. I know a LOT of hippies that live here (my parents are hippies. I'll get to them by and by) that swear by things like healers and parasite cleanses and various other bits of woo.
My parents are hippies. (see? Told ya!) I grew up taking vitamins for everything from colds to cramps. I went to my first chiropractor's appointment by the age of 12. I still feel weird taking analgesics.
I was introduced to the nature of the vitamin industry at a nutritional seminar at Fresno State. The researchers had done nutritional studies on geriatric model mice in order to determine why geriatric animals have a difficult time keeping weight on. After tweaking the genes of the mice to promote obesity, they had supplemented the mice with a particular fatty acid in order to see if it helped improve appetite and weight retention. Unfortunately their results were inconclusive, but it opened the doors for further study.
In the Q&A session, the topic of the vitamin industry came up. Now mind you, this is a group of professional research scientists that basically dumbed down their research in order to make it accessible for the average biology undergrad to understand. I had a brief conversation with the presenter where he basically concluded that vitamins are pretty much a scam if you have a varied diet and that they should not be trusted because manufacturers can and do put anything in there and the FDA has no power to regulate.
Fast forward 7-8 years. I ran into an old friend of mine on Facebook who claimed that her 3 year old son got autism from his vaccines. I didn't know very much about the topic, but I did what any scientist does when presented with a question for which she has no answers: I did some research. I asked the lady how she knew the vaccines caused the condition and she sent me links from Age of Autism, Safe Minds, and some odd independent researchers. I hunted through the data there and concluded that it was mediocre at best and lies at worst (in fact it's all lies, really.) I did my own digging and I came up with the delightfully quirky Respectful Insolence.
Orac was my first glimpse into a world that I hadn't dipped a toe into for quite some time: the world of science based medicine. I jumped in and read everything that I could get my hands on. My brain seemed to like being dusted off and the cobwebs removed. I worked at an incredibly dull job that really required me to turn my brain off to be happy, and I guess it got to be habit. Thanks to him and a few others, I was inspired to go back to school and get my medical degree.
But I digress. There are scads of websites out there that have all the information on vaccines and whatnot that you need to know. Quackwatch is a great one. Respectful Insolence is another. I also like What's The Harm?, Autism News Beat, Code For Life, and The Truth About The Evils of Vaccination.
What is the difference between these people and the idiots I mean folks at Age of Autism and Safe Minds? These people are scientists and practicing medical professionals that base their practices on sound science-based medicine. AoA and SM do not.
What does this mean? It means that they base their conclusions about treatments and medications on sound scientific well-developed research that has been published by reputable scientists with no glaring conflicts of interest in reputable top-tier journals that has passed the vetting process by the scientific community. Science is a process, a long slow arduous one, and conclusions come gradually. Even an excellently developed and well-laid out paper will be met with cautious enthusiasm if there is only one set of data to back it up. One paper does not mean this is true always. Two? Closer. Ten? Much closer. A hundred? It becomes accepted fact. Science is slow for just this reason: it prevents us from jumping to conclusions about how things work until they have been rigorously tested.
Bottom line: Are vaccines safe? Yup. Are they thoroughly tested? Yep. Do they cause neurological conditions such as autism? Nope.
But much like the biological refutation of creationism, it gets discredited, cherry picked, and sneered at by the fundamentalists that have something to profit by propagating these outright lies.
Often what these people do is sell things like autism 'treatments' and 'cures' to credulous and terrified parents. Autistic children can be very difficult to handle, and require a lot of time and money in order to help them gain something close to normal function. What people like Joe Mercola and Mike Adams and other scumbags do is peddle expensive treatments to parents who will try just about anything to 'fix' their 'broken' child. This can include things like putting an industrial chelator into a supplement form (chelators draw out heavy metals and can be used for heavy metal toxicity clinically, but it can be incredibly damaging for a growing child because some heavy metals are necessary for development: magnesium and calcium come to mind) or using a drug that is used to chemically castrate sex offenders and those suffering from prostate cancer. (I hope I don't have to explain why messing with the hormones in a growing body is a very very bad idea)
And now we move on to the vitamin industry. In 1993 a piece of legislation was passed that prevented the FDA from regulating vitamins, minerals, supplements, and basically allowed the vitamin industry to self-regulate. But because the vitamin industry stands to profit egregiously, and indeed has: (Americans spent $26.9 billion on supplements in 2009 (from the Nutrition Business Journal)) the chances of that happening are slim to none. It is a repeated tale in America: give companies that can become megarich from shady business practices the chance to self-regulate and all kinds of abuses crop up.
What kind of abuses? Well, since the labels are not regulated by the FDA, they can put anything in their vitamins and herbal supplements. They often do. Hormones have been found in vitamins. The potency of vitamins is also dicey. The gram weight on the label can mean anything, but the part that your body can actually use (called bioavailability) varies wildly. In other words, the label may or may not have anything to do with reality. And frankly, the jury is still out on whether you really need supplementation anyway.
A fantastic overview of what might be in supplements can be found here.
The problem is that the FDA can't do anything about these abuses because of this bit of legislation. It took nearly 10 years to get Ephedrine off the market because the burden of proof of harm is on the FDA, not on the supplement company.
Pretty much the only thing the FDA can regulate are the claims made on the label. Even this, though, they seem powerless to do much about, because some of the claims you seen on supplement packages are absurd to say the least. But so long as they have the Quack Miranda Label on the package somewhere, the FDA seems hamstrung.
And so we return to my wonderful family. I love them dearly. But I get slightly concerned about where they are throwing their money if they have a subscription to Joe Mercola's blog and I see them get supplement shipments regularly. I have gently tried to explain why they should be a bit more careful about where they buy their supplements (or if they need them at all) and they pooh-pooh my concerns.
Somehow I doubt that they will pay any more attention to me if I have MD after my name.
I have given up trying to argue the point with them. But in an oddly defensive manner they brought up Dr. Oz as being a real genuine medical professional that they actually agree with. I didn't have an opinion on Dr. Oz because I didn't know much about him. But they were talking about how common sense he was about things like diet and exercise (A little side rant: I hate how alties claim that normal doctors don't care about the whole person. Of course we do! Of course there is nothing wrong with a sensible diet, lots of exercise, and proper hydration. Of course this is advice that normal doctors should be giving their patients. But by claiming that we want to 'medicate away' every ill the alties make themselves sound more caring and speshul. Grrr.) I told them that it sounds reasonable. But I was still skeptical.
But being the scientist I am, you know where that led. Yay for research!
The wonderful thing about Respectful Insolence is that if the person in question is a woomeister, quack, or otherwise has a reality problem, Orac will have written about them. And Dr. Oz has his own category. This doesn't bode well for Dr. Oz. In fact, he has merited multiple helpings of Insolence since the beginning of this year. I like this one in particular since Orac seemed to wrap up everything he has said about Dr. Oz in one nice tidy package of Insolence.
Now the next time my family brings up Dr. Oz, I know what to say: He's a quack.
My parents are hippies. (see? Told ya!) I grew up taking vitamins for everything from colds to cramps. I went to my first chiropractor's appointment by the age of 12. I still feel weird taking analgesics.
I was introduced to the nature of the vitamin industry at a nutritional seminar at Fresno State. The researchers had done nutritional studies on geriatric model mice in order to determine why geriatric animals have a difficult time keeping weight on. After tweaking the genes of the mice to promote obesity, they had supplemented the mice with a particular fatty acid in order to see if it helped improve appetite and weight retention. Unfortunately their results were inconclusive, but it opened the doors for further study.
In the Q&A session, the topic of the vitamin industry came up. Now mind you, this is a group of professional research scientists that basically dumbed down their research in order to make it accessible for the average biology undergrad to understand. I had a brief conversation with the presenter where he basically concluded that vitamins are pretty much a scam if you have a varied diet and that they should not be trusted because manufacturers can and do put anything in there and the FDA has no power to regulate.
Fast forward 7-8 years. I ran into an old friend of mine on Facebook who claimed that her 3 year old son got autism from his vaccines. I didn't know very much about the topic, but I did what any scientist does when presented with a question for which she has no answers: I did some research. I asked the lady how she knew the vaccines caused the condition and she sent me links from Age of Autism, Safe Minds, and some odd independent researchers. I hunted through the data there and concluded that it was mediocre at best and lies at worst (in fact it's all lies, really.) I did my own digging and I came up with the delightfully quirky Respectful Insolence.
Orac was my first glimpse into a world that I hadn't dipped a toe into for quite some time: the world of science based medicine. I jumped in and read everything that I could get my hands on. My brain seemed to like being dusted off and the cobwebs removed. I worked at an incredibly dull job that really required me to turn my brain off to be happy, and I guess it got to be habit. Thanks to him and a few others, I was inspired to go back to school and get my medical degree.
But I digress. There are scads of websites out there that have all the information on vaccines and whatnot that you need to know. Quackwatch is a great one. Respectful Insolence is another. I also like What's The Harm?, Autism News Beat, Code For Life, and The Truth About The Evils of Vaccination.
What is the difference between these people and the
What does this mean? It means that they base their conclusions about treatments and medications on sound scientific well-developed research that has been published by reputable scientists with no glaring conflicts of interest in reputable top-tier journals that has passed the vetting process by the scientific community. Science is a process, a long slow arduous one, and conclusions come gradually. Even an excellently developed and well-laid out paper will be met with cautious enthusiasm if there is only one set of data to back it up. One paper does not mean this is true always. Two? Closer. Ten? Much closer. A hundred? It becomes accepted fact. Science is slow for just this reason: it prevents us from jumping to conclusions about how things work until they have been rigorously tested.
Bottom line: Are vaccines safe? Yup. Are they thoroughly tested? Yep. Do they cause neurological conditions such as autism? Nope.
But much like the biological refutation of creationism, it gets discredited, cherry picked, and sneered at by the fundamentalists that have something to profit by propagating these outright lies.
Often what these people do is sell things like autism 'treatments' and 'cures' to credulous and terrified parents. Autistic children can be very difficult to handle, and require a lot of time and money in order to help them gain something close to normal function. What people like Joe Mercola and Mike Adams and other scumbags do is peddle expensive treatments to parents who will try just about anything to 'fix' their 'broken' child. This can include things like putting an industrial chelator into a supplement form (chelators draw out heavy metals and can be used for heavy metal toxicity clinically, but it can be incredibly damaging for a growing child because some heavy metals are necessary for development: magnesium and calcium come to mind) or using a drug that is used to chemically castrate sex offenders and those suffering from prostate cancer. (I hope I don't have to explain why messing with the hormones in a growing body is a very very bad idea)
And now we move on to the vitamin industry. In 1993 a piece of legislation was passed that prevented the FDA from regulating vitamins, minerals, supplements, and basically allowed the vitamin industry to self-regulate. But because the vitamin industry stands to profit egregiously, and indeed has: (Americans spent $26.9 billion on supplements in 2009 (from the Nutrition Business Journal)) the chances of that happening are slim to none. It is a repeated tale in America: give companies that can become megarich from shady business practices the chance to self-regulate and all kinds of abuses crop up.
What kind of abuses? Well, since the labels are not regulated by the FDA, they can put anything in their vitamins and herbal supplements. They often do. Hormones have been found in vitamins. The potency of vitamins is also dicey. The gram weight on the label can mean anything, but the part that your body can actually use (called bioavailability) varies wildly. In other words, the label may or may not have anything to do with reality. And frankly, the jury is still out on whether you really need supplementation anyway.
A fantastic overview of what might be in supplements can be found here.
The problem is that the FDA can't do anything about these abuses because of this bit of legislation. It took nearly 10 years to get Ephedrine off the market because the burden of proof of harm is on the FDA, not on the supplement company.
Pretty much the only thing the FDA can regulate are the claims made on the label. Even this, though, they seem powerless to do much about, because some of the claims you seen on supplement packages are absurd to say the least. But so long as they have the Quack Miranda Label on the package somewhere, the FDA seems hamstrung.
And so we return to my wonderful family. I love them dearly. But I get slightly concerned about where they are throwing their money if they have a subscription to Joe Mercola's blog and I see them get supplement shipments regularly. I have gently tried to explain why they should be a bit more careful about where they buy their supplements (or if they need them at all) and they pooh-pooh my concerns.
Somehow I doubt that they will pay any more attention to me if I have MD after my name.
I have given up trying to argue the point with them. But in an oddly defensive manner they brought up Dr. Oz as being a real genuine medical professional that they actually agree with. I didn't have an opinion on Dr. Oz because I didn't know much about him. But they were talking about how common sense he was about things like diet and exercise (A little side rant: I hate how alties claim that normal doctors don't care about the whole person. Of course we do! Of course there is nothing wrong with a sensible diet, lots of exercise, and proper hydration. Of course this is advice that normal doctors should be giving their patients. But by claiming that we want to 'medicate away' every ill the alties make themselves sound more caring and speshul. Grrr.) I told them that it sounds reasonable. But I was still skeptical.
But being the scientist I am, you know where that led. Yay for research!
The wonderful thing about Respectful Insolence is that if the person in question is a woomeister, quack, or otherwise has a reality problem, Orac will have written about them. And Dr. Oz has his own category. This doesn't bode well for Dr. Oz. In fact, he has merited multiple helpings of Insolence since the beginning of this year. I like this one in particular since Orac seemed to wrap up everything he has said about Dr. Oz in one nice tidy package of Insolence.
Now the next time my family brings up Dr. Oz, I know what to say: He's a quack.
Thursday, November 18, 2010
Paleontology, Anyone?
I love Jerry Coyne's blog Why Evolution is True. I have noticed, after watching and reading things about Pharyngula, Orac, and Coyne, that scientists tend to be completely and utterly sentimental saps. I know I am. And I think it is very sweet.
Anyway, enjoy this exploration of the life of a giant shrimp from nearly 450 million years ago.
-RF
Anyway, enjoy this exploration of the life of a giant shrimp from nearly 450 million years ago.
-RF
Wednesday, November 3, 2010
Vaccine Awareness Week
It's Vaccine Awareness Week over at Respectful Insolence. I am enjoying Orac's series very much, and I thought I'd share his posts from Saturday, Sunday, Monday, and today.
I got started on all of this (and actually it woke up an interest in real science that I think had been sleeping for years) when an old friend found me on Facebook and started talking about all of this 'vaccines cause autsim' nonsense. I instinctively knew that her position was BS, but frankly I didn't know very much about it. So I did what anyone would do under the circumstances: I Googled it.
Lo and behold. Enter Orac.
This caused a flood of new scientific data for me, and I spent a HUGE amount of time reading everything I could get my hands on. It's like working in veterinary clinics had starved my brain of nutrition for so long, and I was desperately hungry to feed my intellect. Once I had literally read the entire Respectful Insolence archive (5 years or so) I hungrily devoured the content at Pharyngula and all of the other blogs that I now happily and proudly link to on the left of this post.
It inspired and fed my skeptical sensibilities. The facets of scientific argument and scientific inquiry came out from where they'd been stored for years, and by dint of new knowledge and a new awareness got a spit shine and polish.
This experience actually helped me sort out and come to grips with my lack of religious belief. I had the time to consider (here a word that means mull, chew over voraciously, discuss at length with a very patient husband, and settle on a conclusion) how I felt about religion and being an atheist. And I must say that it makes me very happy indeed.
Funny story: I made a comment on an old friend's Facebook on how the Huffington Post (what Orac calls a villainous hive of scum and quackery; guaranteed to make me smile) bears at least some of the responsibility for the pertussis outbreak in Southern California for propagating misinformation and scare tactics on vaccines. Someone else who saw that post vigorously denied what I said, and went on (after multiple arguments) to quote Joe Mercola at me to say that vaccinations aren't really down, that outbreaks follow cycles, and that it is because of the urban poor. (We'll leave the racism and class stereotypes for another post, shall we?)
Let's be crystal clear here. Someone quoted Joe Mercola at me. To defend Huffpo.
It burns.
I got started on all of this (and actually it woke up an interest in real science that I think had been sleeping for years) when an old friend found me on Facebook and started talking about all of this 'vaccines cause autsim' nonsense. I instinctively knew that her position was BS, but frankly I didn't know very much about it. So I did what anyone would do under the circumstances: I Googled it.
Lo and behold. Enter Orac.
This caused a flood of new scientific data for me, and I spent a HUGE amount of time reading everything I could get my hands on. It's like working in veterinary clinics had starved my brain of nutrition for so long, and I was desperately hungry to feed my intellect. Once I had literally read the entire Respectful Insolence archive (5 years or so) I hungrily devoured the content at Pharyngula and all of the other blogs that I now happily and proudly link to on the left of this post.
It inspired and fed my skeptical sensibilities. The facets of scientific argument and scientific inquiry came out from where they'd been stored for years, and by dint of new knowledge and a new awareness got a spit shine and polish.
This experience actually helped me sort out and come to grips with my lack of religious belief. I had the time to consider (here a word that means mull, chew over voraciously, discuss at length with a very patient husband, and settle on a conclusion) how I felt about religion and being an atheist. And I must say that it makes me very happy indeed.
Funny story: I made a comment on an old friend's Facebook on how the Huffington Post (what Orac calls a villainous hive of scum and quackery; guaranteed to make me smile) bears at least some of the responsibility for the pertussis outbreak in Southern California for propagating misinformation and scare tactics on vaccines. Someone else who saw that post vigorously denied what I said, and went on (after multiple arguments) to quote Joe Mercola at me to say that vaccinations aren't really down, that outbreaks follow cycles, and that it is because of the urban poor. (We'll leave the racism and class stereotypes for another post, shall we?)
Let's be crystal clear here. Someone quoted Joe Mercola at me. To defend Huffpo.
It burns.
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