The license to prescribe drugs is largely useless as an indicator of pharmacological expertise. We let chiropractors prescribe drugs in this country (Edit: I was mistaken; we don't). The government has no idea what it's doing in its process for deciding who gets that power. I have encountered plenty of doctors who clearly had no idea what they were doing when it came to pharmacology, to the point of prescribing drugs together with dangerous interactions and not informing the patient of the risk.
As for his neurosurgery practice... what? Why would you think that would make him an expert on pharmacology? Because they both fall under the wide umbrella of "medicine"?
Not that I disagree with him on this issue, but your reasoning seems incredibly shaky here.
We let chiropractors prescribe drugs in this country.
What country is that, mistercow? Here in the United States, they cannot prescribe drugs with one notable exception in New Mexico for chiropractors that have received "advance practice" training.
In fact, prescribing drugs actually goes against the chiropractic philosophy that involves physical manipulation of the body and your body's ability to heal itself.
>You seem to be equating osteopathy (a completely accepted medical science)
No, osteopathy is not completely accepted by medical science. Osteopathy is absolute pseudoscience. Please do your research.
Yes, I realize that DOs undergo actual medical training in addition to the quackery that gives their field its name, but they are still taught the pseudoscience on which the practice was originally based. That they believe these techniques are legitimate medicine is indicative that their entire understanding of science and medicine is compromised. This hypothesis has been borne out by literally every experience I have had with a DO.
If you are outside the U.S. then I understand your belief that osteopathy is quackery because outside the U.S., it is. Inside the U.S. though a D.O. is equivalent to an M.D.
You would know this if you bothered to read either of the citations I provided. You and the person downvoting me apparently disagree with the American Medical Association that says a D.O. is equivalent to an M.D.
For failing to read my citations before you replied to them and for providing no citations of your own other than "every experience I have had with a DO." you are currently in the category of Ignorant Fool. If you would like to provide a citation or two for what you say and perhaps if you actually respond to my citations instead of around them I might be able to upgrade you to Misguided Goof.
EDIT: Never mind, I see in another comment below you are saying that you are just as suspicious of medical doctors. I have no further desire to discuss this with you.
> Never mind, I see in another comment below you are saying that you are just as suspicious of medical doctors.
You accuse me of not reading your citations (I did), did not actually read my response to your comment, and then somehow you got that out of my comment below?
I said that MDs don't have immunity. If I find out that my doctor believes in pseudo-medicine, I will find a new doctor. If you think that's unreasonable, then I guess this "no further desire to discuss" feeling you mentioned is mutual.
It's not about what their predecessors believed. It's about what is still taught in their standard training.
Also, by no means should you take this to mean that I am giving MDs any special immunity. The only leg up they have is that I can't tell just by looking at the letters at the end of their name that their model of science in medicine has been poisoned by bullshit.
Because their training also includes the scientifically bankrupt "osteopathic manipulative medicine", presented as if it were real medicine.
If you found out that your doctor had, in addition to her ordinary training, received training in psychic healing, and believed that this was a valid approach to medicine, how comfortable would you feel with that doctor being allowed to prescribe potentially dangerous medications to patients?
In an article published in the New England Journal of Medicine in November 1999, researchers concluded that osteopathic manipulative medicine and traditional drug therapy resulted in equivalent resolution of lower back pain in a nearly identical time frame. The difference was that participants receiving osteopathic manipulative medicine required less pharmaceutical intervention. The advantage of osteopathic manipulative medicine was a diminution of adverse drug reactions while the disadvantage was the greater amount of physician time required for each patient.[22]
A 2005 meta-analysis and systematic review of six randomized controlled trials of osteopathic manipulative treatment (OMT) that involved blinded assessments of lower back pain in ambulatory settings concluded that OMT significantly reduces low back pain, and that the level of pain reduction is greater than expected from placebo effects alone and persists for at least three months.[23]
The National Institutes of Health's National Center for Complementary and Alternative Medicine states[24] that overall, studies have shown that spinal manipulation can provide mild to moderate relief from low-back pain and appears to be as effective as conventional medical treatments.
You are the worst kind of debater. You say something wrong, are called out on it, then you change the entire topic. Only you're wrong about that new topic too, so you cling to it to death. So now you're in the position of arguing against the American Medical Association, the National Institute of Health, the New England Journal of Medicine and frankly thousands of studies.
See my other responses. In summary, DOs are fully trained doctors who also believe that a completely pseudoscientific methodology (OMM) is valid medicine. I have very little confidence in such a person's ability to critically weigh evidence, and it seems crazy to me to let them give people drugs.
DOs are fully trained doctors that happen to have gone to medical schools affiliated with osteopathy. A previous commenter related osteopathy to Catholicism via Georgetown; that sounds about right. People choose medical schools for a variety of reasons (cost, admissions, locations). One of the practitioners at my primary care doctor's office is a DO, and does not believe in pseudoscience.
I think what happened here is that you overreached; you claimed that chiropractors could prescribe drugs, were corrected, and then scrambled to recover your argument instead of just admitting you were wrong. Now we're in a totally pointless and, from what I can tell, one-sided discussion about the legitimacy of DOs, despite the total irrelevance of osteopathy to the thread we're on.
>I think what happened here is that you overreached; you claimed that chiropractors could prescribe drugs, were corrected, and then scrambled to recover your argument instead of just admitting you were wrong.
It's a good hypothesis, but for the purposes of updating your model, I should inform you that your guess is wrong. This is a position I've given a lot of thought to. I know that a lot of people disagree with it, so I chose chiropractic for my argument, as it would have been a less controversial and more clear cut example - had I not been mistaken about their ability to write prescriptions. That was sloppy of me.
The difference between OMM and Catholicism is that Catholicism does not purport to be medicine and is not part of the medical curriculum. If it were a Pentecostal school and they taught all of real medicine, but also taught faith healing, then I would feel very similarly about that to how I feel about DOs.
Here's a test: ask the DO at your primary care office if he thinks that OMM is a valid medical practice.
You should submit a story to HN about the problems of osteopathy; that would make this an interesting discussion.
But here, it's just a sideshow. Your point was that being able to prescribe medicine is not a big deal. Whatever you may think of the philosophy of osteopathy, being a DO is a big deal; DO's are doctors, licensed by the state to practice medicine. It is approximately as hard to become a licensed DO as it is to be an MD. DO's are not like chiropractors. Chiropractors don't go to med school.
You were wrong, obviously wrong, and it is clear that no matter what your underlying feelings about osteopathy are, this subthread is irrelevant. In fact, you're doing your opinions about osteopathy a disservice by hitching them to to this particular argument!
To be fair, the one DO I know is a DO rather than an MD because he couldn't get into a normal medical school (schools of osteopathy are not as selective in general).
Though I suppose that also may not be something you'd want to know about your doctor. But as far as I know the academic rigor of his medical program was no less than that of any MD school, minus the inclusion of osteopathy itself. I wouldn't have any issues going to him as a primary care doctor.
This isn't a debate I think is worth having. I'm just saying that there's practically no reason to believe Gupta was an appropriate choice for CNN as an expert in radiological hazards, but there is some reason to believe he should know what he's talking about re medicine.
That's fine. I just feel like there's a dangerous overtrust of doctors among intelligent and educated people, and I hate to see comments that encourage that.
If you're scientifically illiterate and generally uneducated, trusting doctors is a very good idea. If you have the cognitive tools to check their work, though, it is very smart to do so.
Fair, but a little knowledge really can be a dangerous thing. I'm not a practicing physician, but several members of my family are (whose characters I tend to trust).
The annoyance you may feel when a non-engineer pontificates on a technical topic they clearly only have a surface level understanding of is similar to the aggravation they (M.D's) feel when patients who have perused pubmed and webmd decide they're better informed than they actually are.
I'm of the opinion that "trust, but verify" is a reasonable way to approach subject matter experts in other fields.
Sure, but unfortunately, most doctors don't seem to be able to distinguish the patient who's been reading alt med forums and maybe skimming some cherry-picked articles (perusing would actually be the correct thing to do with a study), from the patient who is scientifically literate and has a reasonable knowledge of pharmacology and the evidence regarding their own condition.
When your doctor is giving you opiates and not even trying to find a sustainable alternative, and you do a ton of research, find an alternative drug (with few side effects and no recognized potential for abuse) that has been shown to help people with similar conditions, and send that study to the doctor, only to have him say "Well, I've never heard of that drug being used for this, so no", it is... frustrating.
They're supposed to ignore their patients, dismiss scientific evidence without reading it, and keep their patients on dangerous, addictive, and tolerance building drugs indefinitely?
There is also the article, wherein he describes four pages worth of research he did, and in medical school they teach you a good bit about how to read scientific papers, because doctors have to do that sort of thing (eg. GSK releases lamotrigine, do you give it to your patients?).
So, unless he's intentionally and maliciously lying (unlikely), he presents plenty of good and valuable information, and as a media correspondent is probably better than most at conveying that to people.
>because doctors have to do that sort of thing (eg. GSK releases lamotrigine, do you give it to your patients?).
Ideally, that's how it would work. In practice, it appears that in many cases, doctors do little research beyond what pharmaceutical reps tell them[1].
This seems to have a lot to do with time constraints. Doctors report spending an average of 4.4 hours per week reading medical journals, and they only read the full text of about a third of the articles they read[2]. On average, the FDA approves about three new drugs each month. If new drugs were all a doctor needed to read about, 6 hours for each one might be enough to get a decent idea of safety and efficacy. But of course, that's not all a doctor needs to read up on.
But of course that has no bearing on whether doctors know how to read scientific papers.
