Here is a comment from a naturopathic US doctor which explains the modern day pressures they are under which, he believes, leads his (non-complementary minded) colleagues to prescribe in ways that, under other circumstances, they mightn't do. I think commonsense tells us laymen that he is speaking the truth. But what a damning indictment it is on the top hierarchy of the medical profession that they don't do anything to change this. Whatever happened to that fundamental precept of medical ethics "First, do No Harm" ? [The follow-up comments appended below came from the same website]
"As a naturopathic physician, I am always looking to new scientific findings to help explain why the treatments I provide work so well, despite often not having been subjected to "gold standard double-blind, placebo-controlled cross-over studies." We vastly undervalue empiricism in medicine, yet many experienced conventional docs use unproven empirical treatments all the time. They figure out what works, despite what the "gold standard" research says.
Some of the treatments I provide have been around for thousands of years and I continue to be surprised how well my patients respond to acupuncture, nutrients, herbs, homeopathy, hydrotherapy and other approaches. I use several therapies simultaneously with my patients, an approach that is difficult to study using "gold standard" methodology. Additionally, you have to consider that "gold standard" methodology makes a massive and impossible assumption right out of the gate, that the population being studied is socially, phenotypically and genetically homogenous.
Perhaps my medicine's focus on the individual's overall health and function does work best -not labelling him with a diagnosis for the purpose of justifying a FDA/ industry accepted, standard-of-care treatment. The treatment X for condition Y approach sounds scientific and rational; but the catch is in determining the "condition," the whole health picture of the patient, not just that they have an affected part.
Yes, I use the available science to best direct my treatments, whether the approach is "conventional" or "alternative." I just like to practice good medicine; what I know works based upon my experience and what has worked for doctors who've come before me.
It's ironic that the word, physician, means 'one who knows nature.'
It seems that THE ONLY THING CONVENTIONAL PHYSICIANS KNOW THESE DAYS IS WHAT IS TAUGHT TO THEM IN MEDICAL SCHOOL FROM DRUG REPS AND PRACTICE GUIDELINES THAT ARE DICTATED BY THEIR INDUSTRY, DRUG COMPANIES AND INSURANCE FIRMS(my emphasis added).
I actually feel sorry for MDs these days. Even if they wanted to do things differently, the various industry influences would prevent it.
In addition, with ever-dwindling reimbursement from insurance, they have to provide even less individualized care than ever before; having to squeeze in more patients in a day just to pay their bills.
MANY MDS THESE DAYS ARE VIRTUALLY SLAVES WITH NO CHOICE BUT TO PRACTICE MEDICINE IN A WAY THAT IS BOTH ACCEPTABLE TO THEIR PEERS AND PROFITABLE FOR DRUG COMPANIES.
No, everyday MDs aren't evil. They are (most of them) very decent, well-intentioned individuals who are, unfortunately, caught up in a meat grinder of an industry. MOST of them aren't the ones churning the meat-grinder handle, so don't lump them all together. I say this even though MOST OF THEM HAVE BOUGHT INTO THE ANTI-COMPLEMENTARY AND ALTERNATIVE MEDICINE BIAS THAT IS FED TO THEM."
The constructive vision is there, in the article!
1. Take more time caring for your patients - listen to them, think about what is going on, what are the real causes/triggers of their individual condition?
2. Don't give too much emphasis to routine test results.
3. Avoid prescribing cocktails of drugs routinely and thoughtlessly. Take your patients off drugs whenever possible.
4. Resist the pressure from colleagues, manufacturers and journals to accept research at face value.
5. Don't get attached to trendy theories (e.g. dietary cholesterol causes heart disease - disproved decades ago, but still trotted out by many medics)
I get really flabbergasted by the opaqueness of many physicians vision when the answer is staring them in the face: YOU HAVE BECOME TOO DEPENDENT ON DRUGS TO SOLVE YOUR PROBLEMS FOR YOU!
[TNM COMMENT: One could well add the advice to conventionally trained doctors .... Have the humility to understand that in any given case you may well not be the person in the best position to help the patient back to full health if all you can think of dosing them with is an antibiotic, statin, steroid, antidepressant etc which will just mask the symptoms and not cure but potentially damage the patient's immune system. It may well be that unless it is a case for acute emergency treatment the patient's best interests would be better served by you attempting a diagnosis and then handing the casenotes on to a qualified complementary healthcare practitioner eg homeopath, naturopath, nutritionist, accupuncturist, chiropracter, osteopath etc]
- For many physicians it is very difficult to keep up with every single new guideline because publishing increases at an exponential rate every year (despite 90% of research being rejected by publishers).
- Only 54% of people seen in hospitals get what is considered the standard of care.
- The standard of care is usually based on gold & platinum standard large randomized control trials, of which around 10-25% may be wrong.
- Pharmaceutical companies fund about 90% of Randomized Control Trials performed globally. (WHY? Because these are REALLY EXPENSIVE).
- These RCTs rarely produce results that are unfavourable to the [pharmaceutical] companies' products. AND, overall, studies funded by a [pharmaceutical] company were four times more likely to have results favourable to the company than studies funded from other sources.
[TNM COMMENT: RCTS have been and doubtless still are being "fudged". Take a look at http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269.
For testing homeopathic remedies conventional medicine's RCT test is totally unsuitable and inappropriate because homeopathy, as properly practised, treats each patient individually and most often with a succession of different remedies depending upon the aetiology in the case, that patient's vital state and the totality of their symptoms, to nudge the patient's system back to full health. This would be the case even where, say, each individual had been diagnosed as having eg arthitis. There is no way an RCT could begin to accurately test this process, but that has never stopped homeopathy's detractors from clamouring for the homeopathic profession to use RCTs!]