Saturday, July 18, 2015

get ready for the push-back

I just read an interesting article, and even Dr. Ioannidis -- Mr. Medical-Industry-Is-Flawed -- is unhappy!  It's here:

For over 100 years, the medical establishment in America has ruthlessly attacked anyone outside their club who has threatened to cut into their profits.  Midwives, herbalists, alternative healers ... the list is probably longer than I suspect, and when looked at world-wide it's bound to be huge.  Hell, even INSIDE their club, if a doctor tries to reform a bad practice he gets stomped -- just google Semmelweis.  And HEAVEN HELP any dentist who finds an promising treatment for cancer!

Get ready for all their heads to explode at once!  An entrepreneur has developed some testing procedures OUTSIDE THE PEER-REVIEW SYSTEM!  That electric fence that protects their monopoly has been breached with the complicity of the FDA -- heads are gonna roll for this.

Although very exciting indeed, for those of us who think we have a right to know what's going on inside our own bodies, i'm not going to get my hopes up TOO far yet.  There WILL be a backlash, and I can imagine that access to this technology will be delayed as long as possible.

Of course, the chorus from the AMA has been, all along, that they're just protecting us from our simple-minded credulity.  They're protecting us from faith-healers (not acknowledging that they do that, too).  They're protecting us from snake-oil salesmen (whose products were probably not much worse than today's pet pharmaceuticals ... just higher in alcohol).  They're protecting us from our misguided attempts to HEAL OURSELVES.

Some of the "protection" has been beneficial, but some of it has not.  If they honestly CARED about our well-being, they'd be open to us being proactive in safeguarding our health.  If they had our best interests at heart, they'd want us to change our habits before they get out-of-hand, while they're easier to manage. 

It would waste less of their time -- fewer check-ups where nothing really gets accomplished.  Doctors, complaining that they don't have enough hours in the day to see all the people they need to deal with, SHOULD be delighted to find their work-load reduced, but I doubt that will happen.  The proportion of "intractables" would go up -- hypochondriacs, "munchauseners," and people who are worried about the results they got from their self-tests would increase, and I imagine such patients ARE their least favorites.

Of course, their time would be taken up more by people who NEED their services.  But what a bad precedent -- for patients to come to the office KNOWING what is wrong with them....  Next thing you know, they'll refuse to take their statins, or go on a low-fat diet!  ;-)

Jokes aside, I didn't begin writing this to pick on the medical profession as a whole.  My mockery is for the INDUSTRY which does its very damnedest to disempower its clients for its own aggrandizement.

I certainly acknowledge that poorly-informed people must drive their doctors crazy with the notions they pick up on goofy television shows, advertisements, and facebook postings from nutcases and profiteers.  But I also believe that brushing aside legitimate notions about averting illness through nutrition and supplementation is actively damaging to their patients' health.

IF (that big "if"...) on-demand testing for various parameters does reach people in a meaningful way, a health-care revolution will have begun in this country ... and it's long, LONG overdue.


  1. As a licensed and boarded Med Tech- I can see both sides. I'm all for me finding a second career and/or performing or overseeing quality on the 20% of esoteric tests that lab on a chip won't cover (or anytime soon).

    As long as the quality aspects are there ( false negatives, false positives, interferences, specificity, accuracy, precision, etc), I'm all for it. Bring the lab on a chip concept. Cheaper prices, faster, all for a finger stick. Sure. Accessing JAK2 (cancer geneotype) status from a blood draw rather than a bone marrow biopsy- yes, indeed!

    I'm not all for having a lab in someones garage, equipment from the bone pile at labs that are out of business, and having unskilled workers running the tests and not participating in proficiency testing, with some oversite. This would happen and does happen without regulation.

    Even now I can point to my 23nMe results and say "Not likely" or "Yes, lets rule out XYZ" when talking to my doctor. That saves us both time and money. I've heard that many kids under the age of 4 who are very ill get 23nMe genotype tests run so that they can rule things out very quickly and concentrate confirmatory testing. Makes sense for older kids and adults, too- IMO.

    Interesting article,Tess. Already thinking about my second career. :) And yes, the doctor OZ effects and risk factors do bring people to their doctors.

    I would love to monitor my own TSH, hs-CRP, and HA1c more often. I have relatives in Phoenix, AZ. Walgreens on every street corner!! The next 10-20 years will be very interesting.

    1. [nodding] ...every point, highly reasonable! I have no way to judge how reliable this kind of testing is, compared to the industry standard, but it would have to measure up. On the other hand, i hear there is some very shoddy lab-work going on out there, too (the last "real" job i had was as a laboratory technician, and i've seen it)....

      I'm delighted that 23andMe-type testing has become a starting-point in helping to diagnose sick children! What awful lives those poor little things must lead. :-( I always wonder how hard they could have been to conceive, and what kind of pre-natal environments they had?

  2. I'm in agreement with Karen, I'd like to run my own diagnostics, since I'm healthy all I need is a surveillance now and then. You can already oder some test without a Dx/Rx from your doc...this may free up time. If someone wants to spend their own money on tests go for it. Some are quite pricey. I did 23andme and it is helpful to rule out certain things I wasn't sure I was at risk for.

    1. Even just to confirm a surprising "official" lab test, i think this stuff has value.... To self-assure that a diet/lifestyle-change is progressing in the right direction -- so many applications could be useful! Sure, it could be mis-used too -- but isn't that the case in a lot of circumstances already?

      :-) Why oh why are all health-professionals not like you two? It has been reassuring to become acquainted even in the slightest way, with the quality thinkers (and doers) such as are on my blog-list. I've had doctors at both ends of the spectrum, when it comes to denseness and sharpness, compassion and self-centeredness, all the things that can go wrong in a business relationship.... The fact that there are Kendricks out there willing to go out on a professional limb to call BS on the Sir Rory Statins of this world is highly reassuring! Thanks to all of you put on the good fight!

  3. Anyone here ever heard of a man called Ignacio Ponseti ? thought not. Let me tell you about this genius. He devised a method of correcting club foot in children. His idea was to use manipulation and plaster casts to correct club foot. All around him were naysayers from the medical establishment, surgery was the only way they said and Ponseti was wrong. Well Ponesti was right, very right ! Let's move forward a bit.

    From Wiki.

    Clubfoot (talipes equinovarus) affects almost 150,000 children annually. Almost 80% of these children live in developing nations. Dr Ponseti's technique is painless, fast, cost-effective and successful in almost 100% of all congenital clubfoot cases. The Ponseti method is endorsed and supported by World Health Organization[3][4] National Institutes of Health,[5] American Academy of Orthopedic Surgeons,[6] Pediatric Orthopedic Society of North America,[7] European Pediatric Orthopedic Society,[8] CURE,[9] STEPS Charity UK,[10] STEPS Charity South Africa,[11] A Leg to Stand On (India)[12] and others.

    At the 2007 International Clubfoot Symposium attended by 200 doctors from 44 countries, papers were presented for an estimated 10,000 children successfully treated with the technique around the world in the past few years.

    The Ponseti International Association for the Advancement of Clubfoot Treatment was founded in 2006 at the University of Iowa. The Ponseti International Association aims to improve the treatment of children born with clubfoot through education, research and improved access to care.

    Now here is the $64,000 question, when did the great man come up with this idea ?

    Again from Wiki.

    The Ponseti method is a manipulative technique that corrects congenital clubfoot without invasive surgery. It was developed by Dr. Ignacio V. Ponseti of the University of Iowa Hospitals and Clinics, USA in the 1950s, and was repopularized in 2000 by Dr. John Herzenberg in the USA and Europe and in Africa by NHS surgeon Steve Mannion. It is a standard[1] for the treatment of club foot.

    How many years will it take the medics to realise, treating type two diabetes with a high carb diet and a bag of drugs is not the way to go ? 20, 30, 40, 50 years.

    Just a thought.

    1. Same with stomach ulcers. The doctors who suspected that ulcers weren't caused by stress or spicy food, but bacteria, were shouted down. Finally, one of them drank a solution full of H. pylori bacteria to prove his point.

      Resisting change--especially a sea change like we're seeing now--isn't peculiar to doctors. Warren Buffett calls it the institutional imperative: do what everybody else in your industry is doing, even if it means running your business into the ground.

      Some bright person is going to come up with a new business model for treating patients. Maybe finding a reliable lab and getting a volume discount there, using modern protocols like LC, reduced carb and occasional fasting and taking only those patients who at least try to comply, having support groups available for the kind of people who need a companion to go to the bathroom, open weekends and evenings, communicates by text and email, and so on. The person who does this and franchises it will do to traditional will do to traditional clinics what Sam Walton did to Sears.

    2. YES, indeed, to all those points! :-) Inertia IS obviously the biggest deterrent to progress in this world....

  4. Well, what it takes is time to listen and read and a lot of docs won't make time for that. You also, have to be able to admit that your training was mistaken or outdated in some way...that scares people.

    1. I can only imagine the horror of a conventionally-practicing physician, when s/he learns how much harm the "company policy" has done through them telling their patients the wrong things in trustingly good conscience....

  5. Hi Tess - this is completely off topic ... I'm just stopping by to wish you a Happy Weekend. Where these weeks go I just don't know!

    All the best Jan

    1. thank you! and a happy weekend to you two, as well! :-) the time really IS flying, isn't it?