Medical Scientism Threatens Physicians

"N-H-P" <[email hidden]> wrote in message

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

This oversimplifies what is reality a very complex interaction of influences
between patients and doctors.

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a broad
spectrum, to diseases where treatments actually have to have an effect upon
underlying pathological processes.

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

There is another complicating factor, which only arises when a practitioner
is claiming to be applying mystical or novel healing forces when he is
actually only observing the natural progress of illness or placebo effects.
He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

An interesting demonstration of placebo influences here ---
http://www.eurekalert.org/pub_releases/2003-08/uorm-wbc082703.php

The difference between alternative medical practice and conventional medical
practice would not be the denial of any effect from the acupressure
bracelets. It would be the likely explanation for it. The former would be
claiiming the validation of acupuncture. The latter would be pointing out
that dummy treatments have produced equivalent or better outcomes in
thousands of clinical trials.

(We can then look at what placebo influences actually are, but we need to
get the rubbish cleared away first. Then we can get onto the same page,
science-wise. In practical medicine it often doesn't matter anyway, so
long as you don't try to use a placebo treatment for real diseases..)

Peter Moran

Peter Moran

--

"Peter Moran" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

This oversimplifies what is reality a very complex interaction of

influences

Quoted message said:

between patients and doctors.

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a

broad

Quoted message said:

spectrum, to diseases where treatments actually have to have an effect

upon

Quoted message said:

underlying pathological processes.

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

This is nowhere more true than in the emergency room setting. We do not have
the opportunity to follow up most of our patients and thus have no effective
way to guage the effectiveness of our interventions other than through the
research that has established the standard of care. And I resent John's
claim that patients have "only 2 minutes." Even in the chaos of the ER, our
doctors take the time to get a full history and do a throrough physical
exam. They then order the appropriate studies to make a proper diagnosis and
based on the results, the symptoms, and the history, prescribe treatment.
And yes, Mr. Gohde, it is ideividualized to the patient, not "everyone the
same" even though it is within the standard of care guidelines. --Rich

Quoted message said:

There is another complicating factor, which only arises when a

practitioner

Quoted message said:

is claiming to be applying mystical or novel healing forces when he is
actually only observing the natural progress of illness or placebo

effects.

Quoted message said:

He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

An interesting demonstration of placebo influences here ---
http://www.eurekalert.org/pub_releases/2003-08/uorm-wbc082703.php

The difference between alternative medical practice and conventional

medical

Quoted message said:

practice would not be the denial of any effect from the acupressure
bracelets. It would be the likely explanation for it. The former would

be

Quoted message said:

claiiming the validation of acupuncture. The latter would be pointing out
that dummy treatments have produced equivalent or better outcomes in
thousands of clinical trials.

(We can then look at what placebo influences actually are, but we need to
get the rubbish cleared away first. Then we can get onto the same page,
science-wise. In practical medicine it often doesn't matter anyway, so
long as you don't try to use a placebo treatment for real diseases..)

Peter Moran

Peter Moran

Quoted message said:

Professional
judgement according to EBM is categorized as the lowest form of
evidence, even superseded by methodologically flawed clinical research
evidence. The issues raised are whether the EBM evidence criteria are
solely capable of legitimizing clinical practice, or are other
perspectives on evidence necessary and equally valid? These issues
affect physicians just as much as they affect alternative medicine.

I will start out by illustrating just exactly how flawed the logic of
Medical Scientism / Evidence-Based Medicine actually is. 🙂

The value of professional judgement is lower than that of
methodologically flawed clinical research evidence, according
published papers critiquing EBM.

EBM equates professional judgement at the same level of the placebo
effect. According to the logic of EBM, one can not think for
themselves because of the placebo effect. Neither is one capable of
practicing sound professional judgement without referring to the
toss-of-the-coin offered by EBM population evidence according to EBM.

How does Medical Scientism population evidence answer a simple
question? Like for example, how does adding milk affect the plasma
antioxidant capacity effect of drinking tea?

My scan of Medline revealed six studies. The results were mixed.
Three studies said adding milk to tea had no effect. And, three
studies said the addition of milk had a dramatic reduction effect (pro
11264903, 10694777, 10202389 and con 11103296, 10945114, 8617188).
Moving beyond the simple, how does plasma levels of the flavonoids
affect the blood's antioxidant capacity? And, how does this
antioxidant capacity directly affect LDL oxidation rates? And,
ultimately how does adding milk to tea affect a persons health? Isn't
it wonderful how EBM population evidence answers this simple question?

Oh ... I see now what a foolish child I have been for questioning the
value of Medical Scientism.

Ha, ... Hah, Ha!

Sorry, but Medical Scientism is obviously flawed. Flawed Medical
Scientism affects the validity of clinical practice just as much as it
affects alternative medicine.

Who says so: Simple logic says so. 🙂
--
John Gohde,
Achieving good Health is an Art, NOT a Science!
http://NaturalHealthPerspective.com/
The ONLY Frauds in Health are those who couldn't care less about
prevention.

"Rich Shewmaker" <[email hidden]> wrote

Quoted message said:

This is nowhere more true than in the emergency room setting. We do not have
the opportunity to follow up most of our patients and thus have no effective
way to guage the effectiveness of our interventions other than through the
research that has established the standard of care.

Perhaps if you were to concentrate, and to reply to the subject matter
of the thread? For one thing, I recall Surgery separating from
Medicine between the Roman period of European history and the
Middle-Ages. Funny, how I don't recall discussing Evidence-Based
Surgery. Are you lost?

Quoted message said:

And I resent John's
claim that patients have "only 2 minutes."

Then obviously you have not been keeping up with the latest research
studies as EBM requires? EBM population evidence provides the 2
minute figure, not moi.

Quoted message said:

Even in the chaos of the ER, our
doctors take the time to get a full history and do a throrough physical
exam. They then order the appropriate studies to make a proper diagnosis and
based on the results, the symptoms, and the history, prescribe treatment.

Ha, ... Hah,Ha!

Some how I don't think those "appropriate studies" have anything at
all to do with EBM population evidence.

Again, perhaps if you were to concentrate? Yes, the problem with
Doctors attacking Alternative Medicine is that they have no idea what
they are talking about. 🙂

It is purely an emotional response to their feeling threaten. 🙁

How long do I have to hold hands?

Ha, ... Hah, Ha!

Quoted message said:

And yes, Mr. Gohde, it is ideividualized to the patient, not "everyone the
same" even though it is within the standard of care guidelines. --Rich

You are simply not believable, by your own words.
--
John Gohde,
Patient Empowerment Advocate
http://home.naturalhealthperspective.com/empowerment.html
Email: [email hidden]
www.NaturalHealthPerspective.com - Pioneering De-Medicalization by
handing back the power to the people, encouraging self care and
autonomy, and resisting the categorization of life's problems as
medical.

Peter Moran <[email hidden]> wrote in message news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

This oversimplifies what is reality a very complex interaction of influences
between patients and doctors.

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a broad
spectrum, to diseases where treatments actually have to have an effect upon
underlying pathological processes.

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

There is another complicating factor, which only arises when a practitioner
is claiming to be applying mystical or novel healing forces when he is
actually only observing the natural progress of illness or placebo effects.
He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

An interesting demonstration of placebo influences here ---
http://www.eurekalert.org/pub_releases/2003-08/uorm-wbc082703.php

The difference between alternative medical practice and conventional medical
practice would not be the denial of any effect from the acupressure
bracelets. It would be the likely explanation for it. The former would be
claiiming the validation of acupuncture. The latter would be pointing out
that dummy treatments have produced equivalent or better outcomes in
thousands of clinical trials.

(We can then look at what placebo influences actually are, but we need to
get the rubbish cleared away first. Then we can get onto the same page,
science-wise. In practical medicine it often doesn't matter anyway, so
long as you don't try to use a placebo treatment for real diseases..)

Peter Moran

Peter Moran

You were doing great until the last line. On the contrary, it is important
that every treatment include a modicum of placebo. From mommy's
"kiss to make it well" to physician's "bedside manner" and the "doctor-
patient relationship". And can mean the difference between success
and failure. Don't they teach this in med. school? Why not?

Al

"Peter Moran" <[email hidden]> wrote

Quoted message said:

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

Quoted message said:

This oversimplifies what is reality a very complex interaction of influences
between patients and doctors.

As stated in my post, the above quote is bascially a direct quote from
a published paper whining about EBM, to wit.

"It seems that in a clinical environment, given a single patient, no
control group, and the absence of the opportunity to apply single-case
study method, the clinician cannot validate the claim that a
particular treatment has resulted in patient's improvement. Does this,
however, completely invalidate the clinical process?"

Downing AM, Hunter DG.
Validating clinical reasoning: a question of perspective, but whose
perspective?
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN0-487KJXH-3&_coverDate=05%2F31%2F2003&_alid=110095405&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6948&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8da5eb9e5359691e31c6cee489724da8
Man Ther. 2003 May;8(2):117-9. Review.
PMID: 12890440

Quoted message said:

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a broad
spectrum, to diseases where treatments actually have to have an effect upon
underlying pathological processes.

Then I suggest that you complain to the authors of that paper. 🙂

Angela M. Downing, MSc, MCSP, DipTP, Cert. Ed.,
D. Glenn Hunter, MSc, MCSP, SRP, Cert. Ed.,
Senior Lecturers in Physiotherapy, School of Allied Health
Professions, Faculty of Health & Social Care, University of the West
of England, Bristol, UK.

Quoted message said:

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

Your comments do not speak to the point of my thread. 🙁

They are an emotional response to the feeling of being threatened by
Alternative Medicine. 🙂

Quoted message said:

There is another complicating factor, which only arises when a practitioner
is claiming to be applying mystical or novel healing forces

Ha, ... Hah, Ha!

Yes, we already known that you feel doctors are pure as the driven
snow and that Alternative Medicine uses "mystical or novel healing
forces." Now, how about some population evidence as required by EBM
to back up your hogwash?

Quoted message said:

actually only observing the natural progress of illness or placebo effects.
He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

Your bias is showing again.

What is the useful function that a practicing clinician serves when
treating a patient with Mono, the kissing disease. Does he inform the
patient that he is only a Quack holding their hands while nature takes
it course?

The dominant issue with physicians is their emotionality to rational
discourse about anything that threatens their income. 🙁

Quoted message said:

The difference between alternative medical practice and conventional medical
practice would not be the denial of any effect from the acupressure
bracelets.

Sorry, but acupressure bracelets does not equate to Alternative
Medicine.

Nor, do I recall mentioning acupressure bracelets once in my post.

Somehow, I expected more rational comments from a so-called person of
science.

But, again maybe therein lies the problem?
--
John Gohde,
Achieving good Nutrition is an Art, NOT a Science!

Get started on improving your personal health and fitness, today.
http://www.Tutorials.NaturalHealthPerspective.com/
Offering 14 easy to understand lessons that will change your life.

"Al Hephy" <[email hidden]> wrote in message
news:1062248589.405387@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

This oversimplifies what is reality a very complex interaction of

influences

Quoted message said:

between patients and doctors.

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a

broad

Quoted message said:

spectrum, to diseases where treatments actually have to have an effect

upon

Quoted message said:

underlying pathological processes.

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

There is another complicating factor, which only arises when a

practitioner

Quoted message said:

is claiming to be applying mystical or novel healing forces when he is
actually only observing the natural progress of illness or placebo

effects.

Quoted message said:

He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

An interesting demonstration of placebo influences here ---
http://www.eurekalert.org/pub_releases/2003-08/uorm-wbc082703.php

The difference between alternative medical practice and conventional

medical

Quoted message said:

practice would not be the denial of any effect from the acupressure
bracelets. It would be the likely explanation for it. The former would

be

Quoted message said:

claiiming the validation of acupuncture. The latter would be pointing out
that dummy treatments have produced equivalent or better outcomes in
thousands of clinical trials.

(We can then look at what placebo influences actually are, but we need to
get the rubbish cleared away first. Then we can get onto the same page,
science-wise. In practical medicine it often doesn't matter anyway, so
long as you don't try to use a placebo treatment for real diseases..)

Peter Moran

Peter Moran

You were doing great until the last line. On the contrary, it is important
that every treatment include a modicum of placebo. From mommy's
"kiss to make it well" to physician's "bedside manner" and the "doctor-
patient relationship". And can mean the difference between success
and failure. Don't they teach this in med. school? Why not?

Yep, placebo effects are ubiquitous and inescapable, whether practitioners
know it or not.

They can only make the "difference between success and failure" at the
"soft" end of the spectrum of illness I have referred to. Placebos work
mainly upon symptoms and have no effect upon most underlying disease
processes. They may well have some physiological effects such as release
of endogenous opiods.

Placebo influences may thus help relieve the symptoms of cancer and a host
of other serious illnesses, while having no effect upon the underlying
progress of the disease.

Peter

"N-H-P" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"Peter Moran" <[email hidden]> wrote

Quoted message said:

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

Quoted message said:

This oversimplifies what is reality a very complex interaction of

influences

Quoted message said:

Quoted message said:

between patients and doctors.

As stated in my post, the above quote is bascially a direct quote from
a published paper whining about EBM, to wit.

"It seems that in a clinical environment, given a single patient, no
control group, and the absence of the opportunity to apply single-case
study method, the clinician cannot validate the claim that a
particular treatment has resulted in patient's improvement. Does this,
however, completely invalidate the clinical process?"

Downing AM, Hunter DG.
Validating clinical reasoning: a question of perspective, but whose
perspective?

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN0-487KJXH-3&_coverDate=05%2F31%2F2003&_alid=110095405&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=6948&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8da5eb9e5359691e31c6cee489724da8

Quoted message said:

Man Ther. 2003 May;8(2):117-9. Review.
PMID: 12890440

Quoted message said:

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a

broad

Quoted message said:

Quoted message said:

spectrum, to diseases where treatments actually have to have an effect

upon

Quoted message said:

Quoted message said:

underlying pathological processes.

Then I suggest that you complain to the authors of that paper. 🙂

Angela M. Downing, MSc, MCSP, DipTP, Cert. Ed.,
D. Glenn Hunter, MSc, MCSP, SRP, Cert. Ed.,
Senior Lecturers in Physiotherapy, School of Allied Health
Professions, Faculty of Health & Social Care, University of the West
of England, Bristol, UK.

You cunningly snipped the last sentence of what this group says, which
explains what I was reacting to. It said ----

Quoted message said:

If not, then no more should alternative medicine be

Quoted message said:

held to be invalid for the applying the same reasoning process.

This shows the authors as fools. They have no understanding of the issues.
It is not asserted that clinical experience has no significance at all. Nor
are claims held to be invalid for simply through "applying the same
reasoning process". The problem is that alternative practitioners and
patients want to turn it all around and claim that "my clinical experiences
are absolute proof of the following scientific claims"- and moreover
numerous different scientific impossibilities and improbabilties (along with
some more plausible effects such as may apply with some herbs and
supplements).

Do you know that in some clinical trials fifty per cent of the subjects have
"responded" to placebo? This means that in that particular context the
opinion of the practitioner as to his treatment having a true effect in any
individual patient will be wrong fifty per cent of the time.

That's before you ever consider that patients of charisimatic practitioners
or dominant personalities often will not tell them the truth, and will
always try to find some way in which the treatments helped. Otherwise they
just go elsewhere, dropping off the practitioner's radar, but never
registering as a failure. There are many factors within medical practice
that serve to reinforce false hypotheses one they have taken hold. What do
you think sustains Hulda Clark? She will have patients fawning over her,
even though she is patently deluded. Every charlatan has their admirers,
even Jan Drew.

But this is another area of medicine where generalisation is unwise
(actually any generalisation in medicine is invariably wrong). Producing a
few patients whose cancers have disappeared has a totally different meaning
as evidence to that some one's headaches or anxiety improved with treatment.

Peter Moran

Peter Moran <[email hidden]> wrote in message news:[email hidden]...

Quoted message said:

"Al Hephy" <[email hidden]> wrote in message
news:1062248589.405387@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

Quoted message said:

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

This oversimplifies what is reality a very complex interaction of

influences

Quoted message said:

between patients and doctors.

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a

broad

Quoted message said:

spectrum, to diseases where treatments actually have to have an effect

upon

Quoted message said:

underlying pathological processes.

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

There is another complicating factor, which only arises when a

practitioner

Quoted message said:

is claiming to be applying mystical or novel healing forces when he is
actually only observing the natural progress of illness or placebo

effects.

Quoted message said:

He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

An interesting demonstration of placebo influences here ---
http://www.eurekalert.org/pub_releases/2003-08/uorm-wbc082703.php

The difference between alternative medical practice and conventional

medical

Quoted message said:

practice would not be the denial of any effect from the acupressure
bracelets. It would be the likely explanation for it. The former would

be

Quoted message said:

claiiming the validation of acupuncture. The latter would be pointing out
that dummy treatments have produced equivalent or better outcomes in
thousands of clinical trials.

(We can then look at what placebo influences actually are, but we need to
get the rubbish cleared away first. Then we can get onto the same page,
science-wise. In practical medicine it often doesn't matter anyway, so
long as you don't try to use a placebo treatment for real diseases..)

Peter Moran

Peter Moran

You were doing great until the last line. On the contrary, it is important
that every treatment include a modicum of placebo. From mommy's
"kiss to make it well" to physician's "bedside manner" and the "doctor-
patient relationship". And can mean the difference between success
and failure. Don't they teach this in med. school? Why not?

Yep, placebo effects are ubiquitous and inescapable, whether practitioners
know it or not.

They can only make the "difference between success and failure" at the
"soft" end of the spectrum of illness I have referred to. Placebos work
mainly upon symptoms and have no effect upon most underlying disease
processes. They may well have some physiological effects such as release
of endogenous opiods.

Placebo influences may thus help relieve the symptoms of cancer and a host
of other serious illnesses, while having no effect upon the underlying
progress of the disease.

Peter

There's some risk that we're having semantic differences, but I feel that
the human body is a marvel of self regulation and repair. People very
often recover from 'serious illness' without intervention by a physician.
Indeed, if you look at some standard treatments of the 18th & and 19th
centuries, they made matters worse and the patient had a better chance
on his own (without the blood letting, etc.) Point I keep trying to make
is that the placebo effect is REAL and can be demonstrated. There is
some kind of mind-body relationship we don't yet understand. Why
isn't someone studying it?

Al

"Al Hephy" <[email hidden]> wrote in message
news:1062330835.49660@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"Al Hephy" <[email hidden]> wrote in message
news:1062248589.405387@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

Quoted message said:

It seems to many physicians that in a clinical environment, given

a

Quoted message said:

Quoted message said:

Quoted message said:

single patient, no control group, and the absence of the

opportunity

Quoted message said:

Quoted message said:

Quoted message said:

to apply single-case study method, the clinician cannot validate

the

Quoted message said:

Quoted message said:

Quoted message said:

claim that a particular treatment has resulted in a particular

Placebo influences may thus help relieve the symptoms of cancer and

a host

Quoted message said:

of other serious illnesses, while having no effect upon the

underlying

Quoted message said:

progress of the disease.

Peter

******
There's some risk that we're having semantic differences, but I feel
that
the human body is a marvel of self regulation and repair. People very
often recover from 'serious illness' without intervention by a
physician.
Indeed, if you look at some standard treatments of the 18th & and 19th
centuries, they made matters worse and the patient had a better chance
on his own (without the blood letting, etc.) Point I keep trying to
make
is that the placebo effect is REAL and can be demonstrated. There is
some kind of mind-body relationship we don't yet understand. Why
isn't someone studying it?

Al
******

Peter reveals his apparent pre-judgement (=predjudice?) therefore
making further study unnecessary. :-)

And I quote:
1 "In practical medicine it often doesn't matter anyway, so

Quoted message said:

long as you don't try to use a placebo treatment for REAL

diseases..)
2 > "Placebos work mainly upon symptoms and have no effect upon most
underlying [Real?] disease processes". (my insert [ ])

By implication, diseases then are REAL chemo-electrical-mechanical
malfunctions needing a mechanistic correction employing the
physician's brain only, but not the patient's.
The Placebo effect [imaginary?] only serves to obscure the
'instrumentation', so to speak.
Al, I prefer your view that the brain, mind , and supporting
sub-systems are all parts of the same unimaginably complex interactive
system.

The interactions are only beginning to be understood.
Apparently P discounts any possibility that the mind/brain could have
had any involvement in producing the 'real' disease in the first
place? No possibility of the disease itself being a symptom?
Hypertension is a disease? Hypercholesterolemia is a disease?
They look more like symptoms to me. The/mind brain is of course
involved at many levels from feeding decisions, to satiety, to stress,
to addictions, to stress effects, to immune system effects.
While I use will drugs in emergencies, in my book, they are closer to
bludgeons comparable to using a knife and fork to perform brain
surgery.

Pharmaceutical companies apparently disagree with Peter's apparent
view also. They spend billions isolating the minds of the both
researcher and the patient from the perception of a product's success
or failure.

If this is the medical consensus, I can only infer that in practical
medicine, most doctors are forced into the position of having to treat
symptoms, rather than patients.

Mike V
Eminent non-expert.

Al: Take a look at the evidence:

http://www.healthwell.com/healthnotes/Therapy/Mind_Body_Medicine.cfm

"Mind/body medicine takes a holistic view of the healing process,
believing that because each person is unique, it follows that
treatment for an individual should also be unique. Placing emphasis on
the body's ability to regulate and *heal itself* as well as on the
importance of the practitioner/patient relationship, mind/body
medicine ensures the patient is an active partner rather than a
passive recipient in all stages of treatment. Given the individual
emphasis of mind/body medicine, treatments can encompass a wide range
of modalities, including imagery, biofeedback, yoga, and
hypnotherapy."

"Research in biofeedback, hypnosis, and meditative states has shown
that people have a powerful range of self-regulatory capacities.
Likewise, studies in the United States and England suggest that many
health problems presented to primary care clinics are emotional,
social, or familial in origin, though these problems are manifested in
pain or illness."

"Biofeedback training can improve health by teaching a person to
consciously regulate bodily functions that are normally unconscious,
such as heart rate, breathing, and blood pressure. Biofeedback
training is particularly useful in treating health conditions where
psychological factors are present".

Mike <[email hidden]> wrote in message news:[email hidden]...

Quoted message said:

"Al Hephy" <[email hidden]> wrote in message
news:1062330835.49660@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"Al Hephy" <[email hidden]> wrote in message
news:1062248589.405387@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

>It seems to many physicians that in a clinical environment, given

a

Quoted message said:

Quoted message said:

>single patient, no control group, and the absence of the

opportunity

Quoted message said:

Quoted message said:

>to apply single-case study method, the clinician cannot validate

the

Quoted message said:

Quoted message said:

>claim that a particular treatment has resulted in a particular

Placebo influences may thus help relieve the symptoms of cancer and

a host

Quoted message said:

of other serious illnesses, while having no effect upon the

underlying

Quoted message said:

progress of the disease.

Peter

******
There's some risk that we're having semantic differences, but I feel
that
the human body is a marvel of self regulation and repair. People very
often recover from 'serious illness' without intervention by a
physician.
Indeed, if you look at some standard treatments of the 18th & and 19th
centuries, they made matters worse and the patient had a better chance
on his own (without the blood letting, etc.) Point I keep trying to
make
is that the placebo effect is REAL and can be demonstrated. There is
some kind of mind-body relationship we don't yet understand. Why
isn't someone studying it?

Al
******

Peter reveals his apparent pre-judgement (=predjudice?) therefore
making further study unnecessary. :-)

And I quote:
1 "In practical medicine it often doesn't matter anyway, so

Quoted message said:

long as you don't try to use a placebo treatment for REAL

diseases..)
2 > "Placebos work mainly upon symptoms and have no effect upon most
underlying [Real?] disease processes". (my insert [ ])

By implication, diseases then are REAL chemo-electrical-mechanical
malfunctions needing a mechanistic correction employing the
physician's brain only, but not the patient's.
The Placebo effect [imaginary?] only serves to obscure the
'instrumentation', so to speak.
Al, I prefer your view that the brain, mind , and supporting
sub-systems are all parts of the same unimaginably complex interactive
system.

The interactions are only beginning to be understood.
Apparently P discounts any possibility that the mind/brain could have
had any involvement in producing the 'real' disease in the first
place? No possibility of the disease itself being a symptom?
Hypertension is a disease? Hypercholesterolemia is a disease?
They look more like symptoms to me. The/mind brain is of course
involved at many levels from feeding decisions, to satiety, to stress,
to addictions, to stress effects, to immune system effects.
While I use will drugs in emergencies, in my book, they are closer to
bludgeons comparable to using a knife and fork to perform brain
surgery.

Pharmaceutical companies apparently disagree with Peter's apparent
view also. They spend billions isolating the minds of the both
researcher and the patient from the perception of a product's success
or failure.

If this is the medical consensus, I can only infer that in practical
medicine, most doctors are forced into the position of having to treat
symptoms, rather than patients.

Mike V
Eminent non-expert.

Al: Take a look at the evidence:

http://www.healthwell.com/healthnotes/Therapy/Mind_Body_Medicine.cfm

"Mind/body medicine takes a holistic view of the healing process,
believing that because each person is unique, it follows that
treatment for an individual should also be unique. Placing emphasis on
the body's ability to regulate and *heal itself* as well as on the
importance of the practitioner/patient relationship, mind/body
medicine ensures the patient is an active partner rather than a
passive recipient in all stages of treatment. Given the individual
emphasis of mind/body medicine, treatments can encompass a wide range
of modalities, including imagery, biofeedback, yoga, and
hypnotherapy."

"Research in biofeedback, hypnosis, and meditative states has shown
that people have a powerful range of self-regulatory capacities.
Likewise, studies in the United States and England suggest that many
health problems presented to primary care clinics are emotional,
social, or familial in origin, though these problems are manifested in
pain or illness."

"Biofeedback training can improve health by teaching a person to
consciously regulate bodily functions that are normally unconscious,
such as heart rate, breathing, and blood pressure. Biofeedback
training is particularly useful in treating health conditions where
psychological factors are present".

Thanks, Mike.
Another curious thing is that the same people who go into denial
will also loudly delare that the mind can make you sick -- only
they want to call it 'stress'.

Al

[email hidden] (David Sprouse) wrote

Quoted message said:

The above studies illustrate the incredible complexity of the
pharmacokinetics, chemistry and metabolism of the various polyphenols
found in green tea as well as the fact that different dosages and/or
laboratory methods provide different results, rather than pointing out
any kind of flaw in the basic approach to answering such questions.
Just because each of those studies are published in a journal and the
abstracts are available on Medline, does *not* mean that they each
carry equal weight when it comes to the quality of the work and the
study design.

Quoted message said:

Is it simply a matter of, when things get too complicated for you to
understand, you become frustrated and conclude that therefore the
entire scientific approach is to blame?

Quackery can be practiced by both allopathic medicine and alternative medicine.

And, B/S is B/S.

And, what you wrote is pure B/S. 🙂

Just thought that you might want to know. 🙂
--
John Gohde,
Achieving good Health is an Art, NOT a Science!
http://NaturalHealthPerspective.com/
The ONLY Frauds in Health are those who couldn't care less about prevention.

[email hidden] (N-H-P) wrote in
news:[email hidden]:

Quoted message said:

Medical Scientism Threatens Physicians just as much it threatens
Alternative Medicine.

This post will refer to several Full Text published papers available
online in their entirety for free.
In another thread, I introduced the idea that:
Evidence-Base Medicine (EBM) = Medical Scientism.

Anybody who has studied the topic of Medical Scientism can clearly see
the connection to Evidence-Based Medicine.

Issues of clinical validity are being challenged by the burgeoning
evidence-based medicine (EBM) movement. A culture of medical scientism
is developing whereby clinicians seen not to be assessing the validity
of their assumptions and actions by EBM criteria are deemed to lack
credibility(ie, are practicing Quackery) by their peers. Professional
judgement according to EBM is categorized as the lowest form of
evidence, even superseded by methodologically flawed clinical research
evidence. The issues raised are whether the EBM evidence criteria are
solely capable of legitimizing clinical practice, or are other
perspectives on evidence necessary and equally valid? These issues
affect physicians just as much as they affect alternative medicine.

Attack EBM and you are in effect supporting the evidentiary basis of
alternative medicine. Support EBM and you are negating the value of
clinical autonomy. Support EBM and you are saying that non-physician
administrators of HMO's should have the power to dictate how medicine
should be practiced based upon population evidence.

The issues for both alternative medicine and physicians are: (1)EBM
relevance to individual patients, (2) the time-consuming nature of
EBM, (3) the quality of population evidence, and (4) EBM threats to
clinical autonomy.

It seems to many physicians that in a clinical environment, given a
single patient, no control group, and the absence of the opportunity
to apply single-case study method, the clinician cannot validate the
claim that a particular treatment has resulted in a particular
patient's improvement. Does this fact completely invalidate the
clinical process? If not, then no more should alternative medicine be
held to be invalid for the applying the same reasoning process.

Unfortunately this discussion has degenerated into a "Oh,yeah? Yeah!"
thing.

It seems to me that as medical costs continue to rise, as iatrogenic
injury and illness continue to escalate, as people seemingly become more
dependent on the health care business for their sense of wellness, we
need some objective information.

Health care (all modalities) has historically been rife with a history of
treatment trends and fashions - from blood letting to tonsillectomies,
gastrectomies, hemorrhoidectomies - to name a few that are in my field.
Some fall out of favor as newer, less invasive treatments become
available and understanding of the underlying condition evolves. Most are
well intended. The seem like "good ideas" based on simplistic thinking.
But many people have died or been seriously disabled by treatments that
have later been shown ineffective or unnecesary. Each new technology that
becomes available spawns new treatments. Ten yrs ago any woman with
pelvic pain got scoped because there were no other good readily available
diagnostic methods. Now, with an MRI on every corner, everyone with
shoulder pain gets scoped. People with back pain and bulges on MRI get
disk decompressions even though a matched population with similar
radiographic findings is asymptomatic.

My chief where I trained devised a particular operation for a particular
problem. He went around the world selling it. In the meantime, there were
just as convincing articles advocating other approaches as the gold
standard. There are too many variables to come to definitive conclusions.
Skill and experience of the physician, support for the care of people
undergoing a particular treatment, and of course patient selection.

What physician has not pondered the thought that what we are doing today
will be looked upon as misguided, archaic, or downright stupid by the
next generation of providers?

I have recently been reviewing what EBM is out there for my line of work.
The conclusions of most are simply "we don't know," there is insufficient
good research to come to a conclusion.

EBM is new and investigational in itself. I don't believe it has
significantly impacted practice patterns yet and it shouldn't. At this
point, the methodologies and conclusions are no more refined than the
research that is reviewed.
But it needs to be done.

[email hidden] (N-H-P) wrote in message

Quoted message said:

And, what you wrote is pure B/S. 🙂

That's the best you can do, Johnny? Well then, I rest my case.

[email hidden] (David Sprouse) wrote

Quoted message said:

Quoted message said:

And, what you wrote is pure B/S. 🙂

Quoted message said:

That's the best you can do, Johnny? Well then, I rest my case.

Thank you for publicly confirming that your Academic Snobbery,
otherwise known as B/S, is the best that you can do. 🙂

A detailed response was not provided, because you provided nothing
that warranted a response.

In my original post, I definitively stated that in the example
provided by me EBM did *not* provide the answer. As you did *not*
provide the answer, nor proved my assertion wrong, you sir are full of
[censored].

Just my opinion. But, I am *right* as usual!
--
John Gohde,
Patient Empowerment Advocate
http://home.naturalhealthperspective.com/empowerment.html
Email: [email hidden]
www.NaturalHealthPerspective.com - Pioneering De-Medicalization by
handing back the power to the people, encouraging self care and
autonomy, and resisting the categorization of life's problems as
medical.

"Peter Moran" <[email hidden]> wrote

Quoted message said:

Yep, placebo effects are ubiquitous and inescapable, whether practitioners
know it or not.

My how you babble on so about the 'placebo effect.'

Everything you wrote so far is quite irrelevant as 'placebo effects'
applies equally to both allopathic medicine and alternative medicine.

Just thought that you might want to know. 🙂

[email hidden] (N-H-P) wrote in message news:<[email hidden]>...

Quoted message said:

[email hidden] (David Sprouse) wrote

Quoted message said:

Quoted message said:

And, what you wrote is pure B/S. 🙂

Quoted message said:

That's the best you can do, Johnny? Well then, I rest my case.

Thank you for publicly confirming that your Academic Snobbery,
otherwise known as B/S, is the best that you can do. 🙂

A detailed response was not provided, because you provided nothing
that warranted a response.

In my original post, I definitively stated that in the example
provided by me EBM did *not* provide the answer. As you did *not*
provide the answer, nor proved my assertion wrong, you sir are full of
[censored].

Just my opinion. But, I am *right* as usual!

Oh come on, Johnny! Surely you can address the issue, at least.
Maybe even suggest an answer of your own, using your "alternative"
methods of obtaining knowledge about green tea extract. No? Don't
know what you're talking about? Oh well, at least that's more clear
than ever now.

Have a nice day!

[email hidden] (David Sprouse) wrote

Quoted message said:

Oh come on, Johnny! Surely you can address the issue, at least.
Maybe even suggest an answer of your own, using your "alternative"
methods of obtaining knowledge about green tea extract. No? Don't
know what you're talking about? Oh well, at least that's more clear
than ever now.

Oh, ... I get it now.

The topic of this thread is Evidence-Based Medicine and how it equally
impacts upon both physicians and alternative medicine.

You were obviously confused. And, your confusions, thus, accounts for
your moronic comments.

Just thought that you might want to know. 🙂

On Sun, 31 Aug 2003 07:54:06 -0400, "Al Hephy"
<[email hidden]> posted:

Quoted message said:

Peter Moran <[email hidden]> wrote in message news:[email hidden]...

Quoted message said:

"Al Hephy" <[email hidden]> wrote in message
news:1062248589.405387@savina...

Peter Moran <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

"N-H-P" <[email hidden]> wrote in message

>It seems to many physicians that in a clinical environment, given a
>single patient, no control group, and the absence of the opportunity
>to apply single-case study method, the clinician cannot validate the
>claim that a particular treatment has resulted in a particular
>patient's improvement. Does this fact completely invalidate the
>clinical process? If not, then no more should alternative medicine be
>held to be invalid for the applying the same reasoning process.

This oversimplifies what is reality a very complex interaction of

influences

Quoted message said:

between patients and doctors.

It also grossly oversimplifies illness, which can range from the
self-limiting and/or placebo responsive and/or psychosomatic end of a

broad

Quoted message said:

spectrum, to diseases where treatments actually have to have an effect

upon

Quoted message said:

underlying pathological processes.

The practitioner has no hope whatsoever of reliably sorting out true
treatment effects in the hurly -burly of normal clinical practice, and has
been shown to draw faulty conclusions on hundreds of occasions. :Let's
not repeat history..

There is another complicating factor, which only arises when a

practitioner

Quoted message said:

is claiming to be applying mystical or novel healing forces when he is
actually only observing the natural progress of illness or placebo

effects.

Quoted message said:

He may be serving a useful purpose for some people, but should not be
pretending to be advancing scientific knowledge on the basis of clinical
observation that have other explanations. This is usually the dominant
issue with alternative practitioners.

An interesting demonstration of placebo influences here ---
http://www.eurekalert.org/pub_releases/2003-08/uorm-wbc082703.php

The difference between alternative medical practice and conventional

medical

Quoted message said:

practice would not be the denial of any effect from the acupressure
bracelets. It would be the likely explanation for it. The former would

be

Quoted message said:

claiiming the validation of acupuncture. The latter would be pointing out
that dummy treatments have produced equivalent or better outcomes in
thousands of clinical trials.

(We can then look at what placebo influences actually are, but we need to
get the rubbish cleared away first. Then we can get onto the same page,
science-wise. In practical medicine it often doesn't matter anyway, so
long as you don't try to use a placebo treatment for real diseases..)

Peter Moran

Peter Moran

You were doing great until the last line. On the contrary, it is important
that every treatment include a modicum of placebo. From mommy's
"kiss to make it well" to physician's "bedside manner" and the "doctor-
patient relationship". And can mean the difference between success
and failure. Don't they teach this in med. school? Why not?

Yep, placebo effects are ubiquitous and inescapable, whether practitioners
know it or not.

They can only make the "difference between success and failure" at the
"soft" end of the spectrum of illness I have referred to. Placebos work
mainly upon symptoms and have no effect upon most underlying disease
processes. They may well have some physiological effects such as release
of endogenous opiods.

Placebo influences may thus help relieve the symptoms of cancer and a host
of other serious illnesses, while having no effect upon the underlying
progress of the disease.

Peter

There's some risk that we're having semantic differences, but I feel that
the human body is a marvel of self regulation and repair. People very
often recover from 'serious illness' without intervention by a physician.

Of course, and there's an idiot on this group who thinks this is
"vitalism", with its "spiritual principle".

Many diseases and diabilities are self-repairing, and a good medical
advisor can recommend aids to this self-repair, such as rest and diet
modification, perhaps, but the main value of this medico is to
diagnose whether the disease or disability compalined of is amenable
to more radical intervention, such as may save your life, or avoid
considerable inconveniece expence or discomfort.

Quoted message said:

Indeed, if you look at some standard treatments of the 18th & and 19th
centuries, they made matters worse and the patient had a better chance
on his own (without the blood letting, etc.)

Of course. There was much ignorance around then. There is still some
today, but things are hugely improved.

Quoted message said:

Point I keep trying to make
is that the placebo effect is REAL and can be demonstrated.

You bet. No-one is denying this. You should just realise what it is,
and what it can be harnessed into doing.

Quoted message said:

There is
some kind of mind-body relationship we don't yet understand.

I think we do.

Quoted message said:

Why
isn't someone studying it?

I think they have done and are continuing to do.