Doctors are full of shit?

[nirvarq]

https://www.youtube.com/@DrEricBergDC

 

[porcaputtana]

Let's skip this med bed nonsense ok?

Don't you think sam has a point regarding common metabolic ailments as mentioned above?

It's relatively easy to fix with a change in lifestyle, but every doctor tries ramming you with meds the moment the numbers look slightly off? I know doctors who take statins as prophylactics.

Basically, I am questioning the huge urge for docs to prescribe drugs at the drop of a hat. Don't you think that pharma is the the master of docs?

By metabolic ailments I take it you refer to diabetes. Not thyroid disorders.

You are oversimplying things. Insulin resistance at a cellular level differs from patient to patient and hence the response to dietary and lifestyle modification. The human body is not a 1 or 0 toggle switch. If conservative treatment fails then of course pharmacotherapy is indicated.

Statins to mitigate cardiac risks is well established as evidence in the literatures. I myself am on statins. The benefits far far outweigh the risks.

Private medical practice like any other private enterprises is subject to economic pressure. This is especially true in group practices where there is a profit guarantee clause in the contract, or clinics subject to unfair manipulation by TPAs so have to jump through hoops in order to make a profit to sustain business. Pharmaceuticals is of course the easiest form of revenue. This is unfortunate and also next to impossible to regulate by the MOH. However the doctor who over prescribes runs the risk of getting attention from the SMC should there be a complaint. It's up to the doctor to decide how he wants to roll his dices.

Pharma is not the master of docs. It's the other way round. If the doctor decides not to use that drug or go to a competitor the Pharma company is dead. Nowadays with strict corporate compliance there is very very little Big Pharma can do to sway doctors if their product is rubbish and not backed by evidence.

At the end of the day every patient is empowered to seek another opinion. If you are not happy with one doctor you can always go to another. Or self medicate . Or seek alternative TCM or homeopathic therapy . Or better yet seek medical advice here on this forum. I am sure the various nut job conspiracy theorists here will be more than happy to lend you their expert medical opinions.

 

[nightsafari]

I actually asked my doctor why he was so quick to prescribe drugs. His answer was simple... most people want the pills. They are happy to confess that they don't have the discipline to modify their lifestyles and just want to pop a pill. The pharma industry and their foot soldiers ie the doctors, are only to happy to oblige.

yeah, and there are those that don't even ask. Just take it and begone.

This leads to the next question which is whether the drugs actually do make a difference to outcomes in the long term. Some doctors don't think so. It all depends how you interpret the statistics.

I guess it depends. sometimes it does, others it doesn't.

 

[Loofydralb]

Let's skip this med bed nonsense ok?

If medbeds want to have their sales take off, the should recruit a FOUR board certified Cuck as their ambassador.
Is there a FIVE board Cuck anywhere @porcaputtana ?

 

[nightsafari]

By metabolic ailments I take it you refer to diabetes. Not thyroid disorders.

You are oversimplying things. Insulin resistance at a cellular level differs from patient to patient and hence the response to dietary and lifestyle modification. The human body is not a 1 or 0 toggle switch. If conservative treatment fails then of course pharmacotherapy is indicated.

Yes I am oversimplifying things. Otherwise where do we start the discussion? You want me to create a specific case? What's the point? It's a general question.

Statins to mitigate cardiac risks is well established as evidence in the literatures. I myself am on statins. The benefits far far outweigh the risks.

Yes I've heard that line before.

Private medical practice like any other private enterprises is subject to economic pressure. This is especially true in group practices where there is a profit guarantee clause in the contract, or clinics subject to unfair manipulation by TPAs so have to jump through hoops in order to make a profit to sustain business. Pharmaceuticals is of course the easiest form of revenue. This is unfortunate and also next to impossible to regulate by the MOH. However the doctor who over prescribes runs the risk of getting attention from the SMC should there be a complaint. It's up to the doctor to decide how he wants to roll his dices.

this helps explain some of the unknown motivating factors. thank you.

As far as taking statins go, Sam's point about NNT (the following lifted from BMJ) : statins were estimated to prevent 19 heart attacks, nine strokes, and eight deaths from cardiovascular disease per 10,000 patients treated for a year.

https://www.bmj.com/company/newsroo...tins-for-healthy-adults-generally-favourable/

I don't know about you, but those are discouragingly poor results for the input given. These benefits are worth it to you?

Pharma is not the master of docs. It's the other way round. If the doctor decides not to use that drug or go to a competitor the Pharma company is dead. Nowadays with strict corporate compliance there is very very little Big Pharma can do to sway doctors if their product is rubbish and not backed by evidence.

At the end of the day every patient is empowered to seek another opinion. If you are not happy with one doctor you can always go to another. Or self medicate . Or seek alternative TCM or homeopathic therapy . Or better yet seek medical advice here on this forum. I am sure the various nut job conspiracy theorists here will be more than happy to lend you their expert medical opinions.

Homeopathy is hornswoggle as far as I know. TCM has uses in biomechanics and some herbal therapy has been co-opted and placed in capsules ephedrine for eg. Unfortunately, TCM is not as rigorously examined as western medicine is. But these is not the question I am asking.

No need to go off the deep end here and start pointing fingers at other alternatives. It doesn't answer the original question that I posed.

Let me put it more directly : Other people may think that doctors are full of shit. But I think doctors are full of themselves and don't really consider the patient's side of the story and the whole picture.

But some of us really don't understand the vigour which doctors using the benefits outweigh the risks line to prescribe at the slightest hint of a condition without giving the full facts as the example above.

Faced with those odds, the question is what's the point? 32 events per 10,000? I'm not seeing it.

 

[nightsafari]

If medbeds want to have their sales take off, the should recruit a FOUR board certified Cuck as their ambassador.
Is there a FIVE board Cuck anywhere @porcaputtana ?

I know nothing about medbeds. Please excuse me, but I'm staying out of topics I have zero experience with.

 

[nightsafari]

Consider the flip side.

The family doctor that sees and tells every one of his patients with high cholesterol, high blood pressure and diabetes to NOT take medicine. Exercise more. Eat less. Eat healthy. Take vitamins and antioxidants.

That's not a doctor anymore. And most patients would say its a waste of time seeing him cos he tells them what EVERYONE KNOWS already.

then that patient is a dumbfuck and that doctor is the best kind of doctor that is. And dumbfucks need to be told what to do. And being the dumbfucks that they are, they will likely diminish said doctor by saying they already know that.

Not your fault. You did your best. Too bad the patient is too dumb to see it. And yes that may be most patients, but the smarter ones will appreciate such advice and will be loyal to you.

 

[Loofydralb]

This is the new paradigm in patient doctor relationships.

Patient decides and chooses.

Full autonomy for the patient. Most of the responsibility however falls on the physician.

That's not what @porcaputtana wants.
He wants to force everything down our throat thinking he knows everything.

Anyway glad to know you're still alive.

 

[nightsafari]

This is the new paradigm in patient doctor relationships.

Patient decides and chooses.

Full autonomy for the patient. Most of the responsibility however falls on the physician.

That's absurd. How can 1 party have full autonomy and responsibility goes to the other party? Not legally possible.

Consult type practices are dying because of free flow of information and opinions these days. People choose what they want to hear and stick to it. Confirmation bias.

Have you watched "Painkiller"?. The Sacklers are the ones who created the blueprint for drug sales. It is exactly what convinces drs to prescribe drugs. FDA approved conditions tick. Clinical practice guidelines tick. Recommendation from esteemed colleague tick. Majority of physicians prescribe it tick. Safety in numbers. Crowd mentality. Conformism.

No I haven't watched painkiller. I should I guess. What you describe sounds about right. I find the mindless conformism to accepted practice quite off-putting. It really diminishes the respect patients have for doctors.

I always love it when they come back from a conference touting everything they heard from keynote speaker without thinking twice about it.

 

[nightsafari]

Unfortunately my friend. The numbers who are smart, hardworking, willing to make changes for themselves, and committed to doing so are so so small.
Plus the way fam drs are paid is by number of patients seen. VOLUME.

Smart as they are they are not going to pay the dr $165/hr for 3 hours of assessment discussion and review. More like $30 even if the dr spent 1hr. One day see 10 patients work 10 hours see smart patients do good "medicine" with no medicine. Earn $300 for working 10 hours a day. Sorry man. I might as well be a car mechanic.

Just the realities.

That just points to a problem with the system.

Thats why be surgeon. Be anaesthetist. Be proceduralist. Also can do assessment needed for legal purposes. Eg USA VBA assessments. Or certifications for sport. Clear fit for games. Clear fit for procedure.

Forget about giving "advice". Those smart patients know how to google and read themselves. No need doctor at all. Right @nightsafari ?

Again the problem is the system. Looks like I need to watch painkiller.

 

[nightsafari]

Oh yes.

Its the system. Medicine is the shittiest system.

you don't like the system you can get out.

A friend of mine also said. That only in medicine can you fine hundreds of thousands and sue for millions over a $30 consult payment.

Look at the property agent who got fined $4000 for doing a property (money laundering) deal worth how much in commission?

Mental health......the future is not pharmaceuticals anymore. Its talk therapy. And there are powerful catalysts to help with that as well.

the world is not an equitable place. go where you are happiest. just look at sg and my. Difference race in different country and your fortunes are reversed.

 

[nayr69sg]

That's absurd. How can 1 party have full autonomy and responsibility goes to the other party? Not legally possible.

No I haven't watched painkiller. I should I guess. What you describe sounds about right. I find the mindless conformism to accepted practice quite off-putting. It really diminishes the respect patients have for doctors.

I always love it when they come back from a conference touting everything they heard from keynote speaker without thinking twice about it.

Oh in medicine can boy.

Anyway it's good to chat with you again. Hope you are keeping well.

 

[dredd]

Oh in medicine can boy.

I have left the mainstream medical community already. I understand what you say. I also have heard this from many patients and clients.

Nothing new to me. Which is why I also left. I dont want to be caught in the crossfire.

You want some treatment to sell well? Get FDA on board. Get some respected professor on board. Is black bear see the Grizzly do will follow. Cos black bear is scared ownself do only ownself doing wait caught naked when the tide is out. But if following Grizzly is ok one.

Anyway it's good to chat with you again. Hope you are keeping well.

Good to hear from you buddy.

As what I've told you, the forum here is only for entertainment and as long as we see it that way, we don't get distressed unnecessarily.

 

[nayr69sg]

Good to hear from you buddy.

As what I've told you, the forum here is only for entertainment and as long as we see it that way, we don't get distressed unnecessarily.

Thanks. Good to hear fron you too.

 

[porcaputtana]

Yes I am oversimplifying things. Otherwise where do we start the discussion? You want me to create a specific case? What's the point? It's a general question.

Yes I've heard that line before.

this helps explain some of the unknown motivating factors. thank you.

As far as taking statins go, Sam's point about NNT (the following lifted from BMJ) : statins were estimated to prevent 19 heart attacks, nine strokes, and eight deaths from cardiovascular disease per 10,000 patients treated for a year.

https://www.bmj.com/company/newsroo...tins-for-healthy-adults-generally-favourable/

I don't know about you, but those are discouragingly poor results for the input given. These benefits are worth it to you?


Homeopathy is hornswoggle as far as I know. TCM has uses in biomechanics and some herbal therapy has been co-opted and placed in capsules ephedrine for eg. Unfortunately, TCM is not as rigorously examined as western medicine is. But these is not the question I am asking.

No need to go off the deep end here and start pointing fingers at other alternatives. It doesn't answer the original question that I posed.

Let me put it more directly : Other people may think that doctors are full of shit. But I think doctors are full of themselves and don't really consider the patient's side of the story and the whole picture.

But some of us really don't understand the vigour which doctors using the benefits outweigh the risks line to prescribe at the slightest hint of a condition without giving the full facts as the example above.

Faced with those odds, the question is what's the point? 32 events per 10,000? I'm not seeing it.

BMJ is rubbish journal. Low impact and will publish just about any non randomised garbage with poor controls. Only thing worse than BMJ is Singapore Medical Journal which is not even suitable for wrapping fish.

Assuming the data from BMJ is believable: 19 out of 10,000. To the 19, that is 100% prevention. If you think 19 out of 10,000 is not good enough for you then don't take statin. No one can force you.

I am sorry if you have only encountered doctors who are full of shit and full of themselves. There are about 10,000 of us in Sg. You can easily find another.

 

[porcaputtana]

That's not what @porcaputtana wants.
He wants to force everything down our throat thinking he knows everything.

Anyway glad to know you're still alive.

Compared to you even my golden retriever knows everything

 

[Loofydralb]

Compared to you even my golden retriever knows everything

Like master, like dog.
Dog retrieves, master regurgitates.

 

[zhihau]

So now Nobel Prize has turn into a shit prize too?

I’m more fascinated by the research done for the Ig Nobel Prize.