World, Writing, Wealth discussion
World & Current Events
>
Do docs know the score?
date
newest »
newest »
I use both. A holistic approach will not treat every physical ailment but there is absolutely no way medical science can address every human illness either. Medical science is often too arrogant for its own good and holistic medicine is often too arrogant for its own good, as well. I am college educated and practical so I trust science but I am also African and Native American so I trust nature and common sense as well.
Good subject. Good medicine around the world is the same. It depends on if you can afford it. All doctors, regardless of where they are, study the same books. Here in Germany, where I live, doctors with specialties, most of them, have studied in the US. I know a doctor that practices and teaches at a Germany university, and at a prominent medical university in the States. The reason he's in the states, is because the medical school is the tops in his medical specialty. He told me he doesn't understand the medical system in the US--it's destructive. I get this from a lot of German doctors who have studied in the US. But, as far as good doctors, it depends on the doctor--they're human, they make mistakes.
Case in point: My wife, before retirement, was a medical microbiologist. She told me an event that happened at the hospital where she work at the time in the States. The hospital was one of the best in the State. The doctor was one of the leading surgeons in the State. He had a practice of operating early in the morning--earlier the better. It was his best time for alertness. He had been at a party drinking the night before. He was so hyped up because the patient he was going to operate on was a very famous scientist, and up for the Noble Prize. The patient had a dead kidney and had to come out. The doctor read the X-ray wrong, and took out the wrong kidney. It happens all the time. Doctors are human. The problem is, they think they're gods.
The other thing, according to a doctor I knew back in 1970s, said all doctors are obsolete 5 five years after med school. Most doctors don't keep up their continuation education.
GR wrote: "The problem is, they think they're gods. ..."Yeah, registered such a bearing among some too. God or unlike god, many grow indifferent and when overwhelmed (and that happens pretty often) - act on autopilot, as a result - lots of omissions
This is what happened when my wife and I started to live outside the doctor's advice. My wife and I practice, a somewhat, Ayurveda Sattvic diet. A diet of nuts, vegetables, and whole grains. We're not strict at it, we don't eat that much meat, but occasionally chicken and fish. We do splurge once in a while and eat game meats and lean beef. We also drink red wine.
This is what happened to me over the last 5 years. My skin cleared up, and became fresh looking. Liver spots decreased. My thinking became acute. The pain in my joints stopped. I stopped having back problems--I now can walk without back pain. My BO turned sweet. Memory increased. I use to have all white hair. Since the diet, my hair is turning back to it brown color. That is the most disappointing thing about the diet. I like white hair.
GR wrote: "I use to have all white hair. Since the diet, my hair is turning back to it brown color. That is the most disappointing thing about the diet. I like white hair...."The advantages far outweigh. Dyeing would be odd though-:)
GR wrote: "This is what happened when my wife and I started to live outside the doctor's advice. My wife and I practice, a somewhat, Ayurveda Sattvic diet. A diet of nuts, vegetables, and whole grains. We'r..."
I'm not surprised and have heard similar stories. Nearly all health issues can be traced to what we put into our mouths. Congrats!
I will disagree with GR on a couple of points. Doctors do not become obsolete, but some do. My daughter is a consultant at Wellington hospital, and she goes regularly to international conferences and reads up the medical journals. Similarly, I just had a hip related by an excellent surgeon. On the other hand, there are some fairly ordinary surgeons, and some that border on the outright dangerous, as my daughter will testify. But this happens with all professions; some are good, some are not. The kidney story is bad. When I had my hip done, there were three occasions where I had to confirm which hip, and everybody was aware. There is no excuse for taking the wrong kidney.And yes, a certain amount depends on what we eat, and also on what we do not. There is no doubt in my mind that smoking is bad. BUT there are certain things that diet cannot affect.
I don't smoke. But, I've read that it is rare for people who smoke to get Alzheimer's. It has something to do with the nicotine. But, I suspect, it's more like, they die from lung cancer first.
Or from a cardiac infarction. Or from a number of other nasty ways to go. And maybe because Alzheimer's is rare anyway??? I remember in my younger days I saw an analysis of cigarette smoke. One of the 350 bad components is 3,4-benzopyrene. If you take a pure drop of that and put it on a lab rat (admittedly these are a little sensitive) you get almost 100% probability of developing a cancer at that point. No statistics required!
There was a statistic I read that said 1 out of 10 will get cancer from smoking. That 1% is a lot of people, but so is the 9%. I gave up smoking 50 years ago because it made me feel bad. I'm glad I did. The only thing that kept persisting was the urge to smoke every time I smelled cigarette smoke--it smelled good. That went away after 15 years. Now it stinks and turns my stomach.
I remember reading some interview with the eldest woman in UK or something like that, who was 106 years old, and they asked her what the secret of her longevity was. She attributed it to quitting smoking 4 year prior to the interview
I used to work with a gal (back in the 1970s) who was from Ecuador. She said, up in the Andes there is a tribe of Indians that smoke tobacco instead of chewing coca leaves. They live on the average of 100 or so years. They grow their own and process it without putting additives in it. I think what is harmful of tobacco, are the additives that keep it fresh and tasting good: lead, arsenic, are some of the ingredients, which cause cancer. I've noticed on the market here in Germany, Lucky Strikes has brought out an all tobacco cigarette--no additives--all bio. Do they have that where you are? And if you smoke, how good is it--health wise?
Haven't heard of 'organic' cigs yet, but that's maybe because I quit 4-5 years ago. But if I make it to 60+ years old, I'd like to start smoking again, because I like it -:)Those parallel markets is an unbelievable thing: I was buying Marlboro Light in Ukraine for maybe 1/7 of the price it cost in the West. Can't be sure they weren't fake though....
Not smoking was easy for me. First, I had seen my father give up, and why go through that? Second, I wanted to do research in organic chemistry, and it is painfully obvious that shaking up volatile flammable solvents with an ignition source right in front of your face is extremely dangerous. I don't know where the 1 in ten comes from, but I recall an ex tanker from my then annual fishing expedition who I had to pass to get to my spot. He smoked like a train, but it seemed to do little damage, until eventually in his mid eighties he got emphysema. So maybe smoking did not kill him in the ordinary way, but his ending was unpleasant. But then again, we all end, and maybe all the pleasure prior to the collapse is worth it. On the other side of the coin, I don't regret in the slightest not smoking. I certainly don't regret not paying the swingeing taxes.
The way I stopped was somewhat easy. My wife and children pestered me every time I lit up. I didn't just stop. I tapered off gradually. I started smoking a pipe. After 2 years I stopped completely. Try it.
GR wrote: "Good subject. Good medicine around the world is the same. It depends on if you can afford it. All doctors, regardless of where they are, study the same books. Here in Germany, where I live, doctors..."How terrible! taking out the wrong kidney, I mean.
For that reason, when I had a right hip replacement, I wrote on the left side:
OPEN OTHER SIDE
:)
Bob
Primitive is it may sound, because everything is written in the papers, but since surgeons just diagonally read them at best, the staff often marks the limb to be operated with marker before the surgeon condescends into the theater. But I say - don't count on them - verify on your own before conking out under anesthesia
Regarding safe surgery, there is an international recognised format of operating, in any part of the world, known as the World Health Organisation Safer Surgery Checklist. It is designed to minimise errors although it's not infallible. Not every hospital in the world uses it but it is a growing trend and movement to make it mandatory.Regarding western vs traditional medicine, there is room for both, but as a surgeon myself, it is clear that some conditions may require surgical intervention, in appropriate circumstances.
As with all of life's people, surgeons and treatments vary, but I have travelled all around the world and seen patients who have not had access to surgery or western treatment, and the outcomes are incredibly sad.
I describe in my recent book travelling through Africa and Asia seeing those patients without access to typical western healthcare, only traditional medicine - and I can assure you it's very heartbreaking.
Surgery on the Shoulders of Giants: Letters from a doctor abroad
Can't believe I hadn't noticed this thread before. I'm a physiotherapist in my (better) paying job.
*waves to Saqib the orthopaedic surgeon*
What should be kept in mind, is that despite all the best practice in the world, we are all human beings, and human beings all make mistakes at some point. Sadly, in healthcare, there is potential for great harm if that happens.
Having said that, certainly here in Australia, if you're having surgery, you'll have to answer which limb/side etc multiple times before the anaesthetic, and indelible marker is used to draw a large arrow on the correct side.
In terms of ongoing education - to keep my registration, I'm required to do mandatory continuing professional development, as are all registered health professionals in Australia.
Since I am recovering from surgery, I suppose I cannot help but add my two cents worth. Here, in NZ, the patient has a discussion with the senior nurse, the anaesthetist and the surgeon before anything is done. You fill out interminable forms and have various checks prior to the operation, then somewhat boringly, I had to identify myself I don't know how many times, and importantly, mention exactly what had to be done where (e.g. a right hand side hernia).My daughter is a consultant at Wellington Hospital, and as part of her job, she has to go to various conferences, etc, and maintain knowledge of what is going on where. As far as I know, all the medical staff take this responsibility very seriously.
As far as the choice between traditional and Western medicine, I know there comes a time when surgery is necessary. Last year I had a hip replacement. Before that I could barely walk (it got bad very quickly). Now I can. That to me is a step up. When I get over the hernia surgery, I should be able to have a reasonable life style, and that is important to me. Neither of these were going to fix themselves.
Doctors here in the USA nowadays face two pressures that interfere with quality.First, malpractice insurance. It is massively expensive. And, the fear of litigation guarantees they will indulge a plethora of tests to protect themselves.
Second, insurance payouts. When you see the doctor, your insurance company pays them for the treatment they provide to you. Over the years, that payment has shrunk significantly. Thus, just to break even, doctors must then see 50+ patients a day. That means they cannot afford to spend any time with the patient to really figure out what ails them. You thus get a quickie diagnosis and either a prescription or a date at the chop shop.
Shrinking payouts and sky-high malpractice will end up pushing many doctors to retire or move into different fields, like driving cabs/ubers or real estate.
Typically with state-control comes another demon: long queues. With so few doctors left practicing, and with an onerous application, you end up with a tiny population of doctors. If you doubt me, just try to find a doctor that accepts Medicaid. Most doctors dropped that because of the infinitesimal payouts (it pays LESS than Medicare!).
Sad. But your next doctor visit might require you to travel to a foreign land.
First of all, I hope you're doing well, Ian. Get well soon.Secondly, I never trust docs to know the score. I question my internist until I'm convinced that his opinion and treatment may make sense. Then I do my research. I think docs started this nonsense belief that the Internet isn't worth crap when it comes to medical conditions. If you're intelligent, you can find lots of pertinent info on your condition and its treatments.
Finally, I seek a second opinion. What one doc doesn't know, another one might.
Thanks Scout. Every day is getting just a little better :-)Interestingly enough, they were surprised I did not ask questions. As I told the anaesthetist, either you can put me out for the operation then wake me up, or you cannot. If you cannot, I am in deep trouble. I cannot do anything about anything else you want to tell me, so why waste time? Of course I did make sure everyone new who I was and exactly what had to be done, AND I knew the diagnosis was correct. No just thought - knew. So again, with the surgeon I had found the best in the field I could find who was accessible, and here my daughter, a consultant at Wellington Hospital could do some checking. That, of course, gets back, and hence when I was being put on the table the anaesthetist told me to move over further - "If you fell off," he joked, "Helen would never let me hear the end of it." He knew her name, and I had not told him.
I would caution use of the internet, Scout. As someone who sees patients three days a week, I can absolutely tell you that I spend a significant chunk of my time explaining that "that thing you just read on the internet has no relation to actual anatomy, or physiology."And a lot of that comes from very intelligent people. There are multiple sites out there that have very plausible sounding information on them, that is completely wrong.
Clearly, there are some excellent sites as well. Sadly, high traffic doesn't make a site right.
I often remind my patients that although I'm well educated, and reasonably intelligent, I employ a professional to fix my car, not mechanic Google.
What do you think about WebMD? Have you looked at it?
Ian wrote: "Thanks Scout. Every day is getting just a little better :-)Interestingly enough, they were surprised I did not ask questions. As I told the anaesthetist, either you can put me out for the operati..."
I don't have a daughter, but I am one. Great that you have her in your corner.
Scout wrote: "What do you think about WebMD? Have you looked at it?"I haven't really used it, so I just popped over and had a quick flyby look.
From a cursory glance at the info on ACL injuries, it's probably not too bad - or at least for ACL injuries it isn't too bad!
I noticed it has a symptom checker, which may or may not be helpful, dependent on the person popping the information into it, and their interpretation of the outcomes. (Nearly everyone assumes they're about to die of cancer, or some kind of awful neurological disorder.)
Don't know how well medical institutions are staffed elsewhere and what working conditions they practice, but here - fatigue and indifference are a big factor. Hospitals are understaffed and that influences everything. One needs to make sure to extract a relevant medical professional from his/her autopilot behavior. And all that - at the backdrop of having a reputation of a very high level medicine here.At this aspect - similar to what J.N. describes.
Another problem - is booming medical tourism. Wealthy foreigners (mostly from former USSR) having no adequate medical facilities at home, come here and pay a high dollar to get med assistance privately. Hospitals, earning much more from tourists, than from coverage of free local healthcare give tourists priority, thus queues become way longer than reasonable and people feel 'pushed' to use their private policies to get a faster treatment than wait for free healthcare .. Not acute at this point, but the tendency is alarming.
From my personal experience - reminding a surgeon, that didn't remember that an operation was not only about a replacement of internal fixation, but also a bone graft was kinda relevant -:)
So, do doc-s know what they are doing: always/sometimes/more luck than brains/rarely?
Nik wrote: "So, do doc-s know what they are doing: always/sometimes/more luck than brains/rarely?"Interesting enough Nik, I wonder sometimes how doctors even earned their degree and was able to pass the board! :-)
There are so many doctors here in the U.S. that it amazes me how some seem to know what they are doing and some do not. One doctor might give a patient one diagnosis which sends the patient looking for a second opinion getting a whole different diagnosis.
Also a few years ago we had a rash of events where doctors were cutting off wrong limbs or performing surgery on wrong body parts - how does that even happen in a world where we have more technology now than we ever did? No wonder we have so many lawsuits out there against doctors.
So your statement "more luck than brains" - yep, that sounds about right at least here in the U.S.
Atul Gawande's "The Checklist Manifesto" discusses the history of something that seems so simple, the checklist, and how it began in aviation as a result of a crash that killed two pilots. Gawande discusses how this notion was adopted by the medical/surgical community (and in nearly every modern environment) to prevent "preventable" mistakes in increasingly complex processes.
For many years, docs around here have given out prescriptions for antibiotics when people had a cold or the flu. A nurse friend offered them to me when I had a cold, and I refused. So, no, docs and nurses don't always know the score. Hence the problem now with antibiotic-resistant bacteria.
We seem to be getting conflicting advice and information from docs on the news here in the U.S. Masks necessary or not? Treatments safe or not? The virus is aerosolized or not? I heard a doc say today that you must spend 20 minutes around a sick person in order to catch the virus through the air. Are you getting conflicting information also?
Here is Australia, we have been encouraged not to wear masks if we are not unwell, except obviously, those in health care working with infectious people.Several issues: If you aren't trained with mask technique, you may well increase your risk by using them inappropriately. Secondly, type of mask. Thirdly, feeling reassured by the mask, and reducing other, potentially more important hygiene measures, eg. social distancing and hand washing.
Is the virus aerosolized, hanging around as a mist in the air, so that you can be exposed even if not in proximity to someone who has it?
The information provided to us here is that we require droplet protection, rather than aerosol protection. Having said that, droplets are often small, but then they settle onto surfaces. These surfaces are technically called 'fomites.'
Watch out for the fomites! :-) We were advised on the national news that we shouldn't go out even to the grocery store this week, but everyone I talk to on the phone has been out and about. Me, I'm staying home. I have some masks, and we've been told to use them by most experts, so when I go out I guess I will. Are they pretty effective if used correctly? Mine are just the kind one would wear in surgery I think, nothing special.
If you use a mask, putting it on and taking it off correctly is essential. You see, if you touch the mask with your hand and then touch your face, or anything else in fact, you've just negated the whole point of wearing one. One of my nursing colleagues recommends leaning forward, loosening the bottom tie to let the mask swing forward, then loosening the top tie.
And here's WHOs how to info. https://www.who.int/emergencies/disea...
They're better at protecting someone who is unwell from spreading droplets, generally. Which is why they're used in surgery.
They will be a rather weak protection against getting it, as opposed t giving it Unless the mask is tightly fitting at the edge, the air just goes around the path of least resistance and takes the aerosol with it. We don't know whether it is restricted to droplets, but I guess avoiding droplets is at least a defence that helps.
Agree that there is a lot of conflicting info on the subject.Here too they were with Australian approach, as described by Leonie, but changed it recently. Moreover, from Sunday on they made it obligatory to wear a mask when outside. The idea is less that it protects the healthy, but more preventing the infected, who doesn't know he or she is, from infecting others. If everyone needs to wear, then those unknowingly contagious would have less chances on spreading their droplets or aerosols or whatever :)
I said before that a doc said you had to be exposed for 20 minutes to someone infected in order to become infected. She also said that there was a certain number of infected germs you had to inhale before you were infected. Does this make sense?
I would disagree. In Queenstown there was a wedding and someone came with the virus and infected something like 87 people (including bride and groom - a wedding to remember) Nobody would spend 20 minutes with all of them close up.The outcome depends on whether the virus can replicate, so the lower the number of viruses, the greater the probability that you will get away with it. The more viruses, the more likely they will take.
I agree with Ian. It would depend on a number of things, one of which is how much virus the infected person is shedding. Others might be what the other person was doing - coughing, sneezing, touching stuff, how small the room was, what direction the wind is blowing etc.
I babysat my 4-month-old breast feeding grandson today, and he sneezed. Could he be a carrier?
Could be pollen, could be anything. If he hasn't got a fever, I wouldn't worry unless someone close to him, like a parent, has the virus. Actually, sneezing is not CVD-19's main symptom and victims only occasionally do that. Unless something gets worse, I would not worry.
I'm fine so far. I was a little surprised to be asked to babysit by my daughter-in-law, who's a nurse. But how can you turn down family? I can't, and we had a great time swinging on the porch swing and listening to country music. Worth the risk.
Interesting discussion. Doctors know more medicine that any of us that are not doctors, but they are human and can and do make mistakes. Medicine changes all of the time and they need to keep up. Yet, with a disaster like this one right now, they actually may be no more in the know than we are right now until more is known about COVID. So until this happens, they will fall back to what they know about similar types of viruses. Yet, they could be wrong. Still, I am willing to bet they are closer to the truth than not.
Actually, a molecular biologist may be able to guess closer to the truth, because they better understand what the features of a corona virus are and what they do. I think the problem here is that beyond basics, we are all guessing, but we do have some information from the Chinese - they had to guess first, and we have some results of their guesses. Shortly, New York should be a rich source of guesses and outcomes.
There are medical disciplines that docs became pretty good at, yet the fundamentals are missing. As far as I know the basics, like sleep, aging, cognition are still much of an unknown for modern medicine. Add to this - malpractice. Some researches claim that medical errors is the third leading cause of death in the US: https://www.washingtonpost.com/news/t...
For a pretty expensive service the treatment is not necessarily adequate, but shamans and healers is hardly an alternative. Or maybe they are? -:)
What do you think: how good is trad medicine and whether alternative one is a viable alternative?