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Science, Medicine and Babble

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ennir
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Joined: Feb 8 2009

"well meaning, but naive" is offensive to me.

As I recall the banning  that was requested was by someone who shares Sineed's values.

Insult?  How is pointing out that Sineed profits from her views an insult, clearly she believes I and others who oppose her views are naive, in fact it is interesting that she would use that word, one that is frequently  used by those who seek to establish themselves as authorities, as far as I am concerned it was an insult.

I know that my biases are obvious and clearly they allow Sineed to dismiss what I am saying, well let's just be clear that if your livelihood is dependent on delivering these drugs to the public then you have a bias and I dismiss what is being said because of that.

 


G. Muffin
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Joined: Sep 28 2008

M. Spector wrote:
G. Pie wrote:
That's like saying "Citrus fruit is not a cure.  Vitamin C is."

What's wrong with that?

Nothing's wrong with that but you wanted to know what a natural cure was.  Polly B gave you eating mouldy bread as a cure for infection.  You rejected that on the basis that it is penicillin not mould that cures.  I see that (and you disagree) as similar to rejecting citrus fruit as a natural cure because it's actually the Vitamin C within the fruit that cures. 

Quote:
Are you saying scurvy can't be cured by taking Vitamin C tablets, but only by sucking on limes?

Of course not.  But Vitamin C tablets don't exist in nature.


Caissa
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Joined: Jun 14 2006

thread drift/Pogge, you have mail at BnR./end thread drift.


Sineed
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Joined: Dec 4 2005

ennir wrote:

 

I know that my biases are obvious and clearly they allow Sineed to dismiss what I am saying, well let's just be clear that if your livelihood is dependent on delivering these drugs to the public then you have a bias and I dismiss what is being said because of that.

 

Just to clarify, I work for the government and don't generally dispense.


Trevormkidd
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Joined: Jun 8 2006

ennir wrote:
I know that my biases are obvious and clearly they allow Sineed to dismiss what I am saying,

It is not the bias, it is the complete lack of evidence. We all expect and demand evidence from the pharmaceutical companies. Yet at the same time many think that they should be able to promote, unchallenged, every bit of unsubstantiated, untested (or testd and failed), unproven, "medicine" because it agrees with their worldview.

 

As Tim Minchin says in his song "Storm"

Science adjusts it's beliefs based on what's observed
Faith is the denial of observation so that Belief can be preserved.
If you show me
That, say, homeopathy works,
Then I will change my mind
I'll spin on a fucking dime
I'll be embarrassed as hell,
But I will run through the streets yelling
It's a miracle! Take physics and bin it!
Water has memory!
And while it's memory of a long lost drop of onion juice is Infinite
It somehow forgets all the poo it's had in it!

You show me that it works and how it works
And when I've recovered from the shock
I will take a compass and carve Fancy That on the side of my cock."


Snert
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Joined: Nov 4 2008

Laughing


oldgoat
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Joined: Jul 27 2001

I'm going to quote myself from where I closed the H1N1 thread a moment ago, before I saw this.

 

Quote:

 

Well here's another thread I should have closed ages ago. It's too bad we can't discuss something like the flu going around without descending into such acrimony and rancor.

For future reference, people are entitled to their own opinions about their own medical care.  No one should post expecting others to agree with their own opinion.  Such opinions may be very personal and strongly held, but as long as one holds them just insofar as they impact on themselves, it is at least bad manners to attack them. 

I'm for the most part western medical model when it comes to my physical health.  For the most part. For mental health not so much. I have family members who would use Reiki as a first response.  A respected colleague of mine is a practitioner of Pranic healing.  We all get along well and respect each others positions. As a mental health worker, I daily shake my head at the practices of big pharma, while sometimes being grateful for their products.

Bottom line is, there were disrespectful comments made here from both sides of the isle, and the same discussion could have been made without them. 

I'm still glad I got my flu shot, and I'm feeling much better today thankyou.

 

 

.

 

Honest to God, some days I just want to stick to moderating babble banter. This is a VERY active board and the mods have lives outside of babble.

 

Actually, I was going to start a new thread on this subject before I saw this, except I was going to do it right. Framing the subject and setting groundrules can be everything.

 

First, the OP was condescending and set a confrontative tone. It did not do a good job of framing a positive and productive discussion.

 

Toward the end, I see where Sineeds professional ethics where called into question in the post about her profiting from her veiws. Don't try to weasle out of it, it was an insult, and I would have been a lot madder. Sineed has put a lot of years into a particular area of scientific enquiry, which you might suggest makes her personally invested, but that's obvious and she's up front about it. It also gives her technical expertise which I've occassionally drawn on on this board. I pick this as an example not because I'm really on anyones side, because I'm not, but because it's an example and it's recent. I really don't want to have to go through 64 posts of he said-she said to see who started getting accusatory first.

 

 

 

 

 

 


saganisking
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Joined: Oct 26 2009

oldgoat

i think sometimes a line needs to be drawn and some ridiculous theories must to be refuted politely but without mercy,  I appreciate posters like Trevormkidd for being able to do with ease and wit what I struggle to do with my knowledge on the subject


ennir
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Joined: Feb 8 2009

Trevormkidd wrote:

ennir wrote:
I know that my biases are obvious and clearly they allow Sineed to dismiss what I am saying,

It is not the bias, it is the complete lack of evidence. We all expect and demand evidence from the pharmaceutical companies. Yet at the same time many think that they should be able to promote, unchallenged, every bit of unsubstantiated, untested (or testd and failed), unproven, "medicine" because it agrees with their worldview.

.......

LOL  Evidence.  LOL

"As for "we all expect and demand evidence from the pharmaceutical companies" that implies that the evidence provided by them is true, perhaps you might look up Pfizer and see how good their evidence is, or maybe look and find that a previous employee of Pfizer was awarded monies for blowing the whistle on them, as he said, profit before the health of their patients was their priority.

For the record I have little respect for most alternative health care providers, in  my experience they are happy to treat you as long as you can pay them.  Further, the frightening thing about most of them is they have adopted some simplistic modality and apply it to everyone equally, the only good thing about this is they don't have access to the same toxic medications and testing procedures doctors do.

 



oldgoat
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Joined: Jul 27 2001

Refuting theories is a part of debate.  Refuting them politely can be a pleasant pastime and good sport among friends, and it's what we encourage here.  Calling them ridiculous is getting off to a really bad start.

Draw lines if you will, but keep them dotted.  Things stay more congenial, and you just may surprise yourself by learning something. 


Tigana
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Joined: Oct 23 2008

Oldgoat, are you are referring here to my comment about bread and butter? 


Trevormkidd
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Joined: Jun 8 2006

ennir wrote:
LOL  Evidence.  LOL

"As for "we all expect and demand evidence from the pharmaceutical companies" that implies that the evidence provided by them is true, perhaps you might look up Pfizer and see how good their evidence is, or maybe look and find that a previous employee of Pfizer was awarded monies for blowing the whistle on them, as he said, profit before the health of their patients was their priority.

As I said we all expect and demand evidence from the pharmaceutical companies.  No one here lets those companies off the hook when they behave unethically.  We ask how did things go wrong and how can similar situations be prevented in the future and that is how we progress.  Is it perfect?  No.  But it is far better then tossing conventional medicine out the window and filling it with whatever fairy tale most appeals to you.

Quote:
For the record I have little respect for most alternative health care providers

That may be so, but, for me anyways, such a claim would be more believable if you showed any criticism for even the most egregious claims of medical pseudoscience that have been promoted here.


ElizaQ
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Joined: May 27 2005

siamdave wrote:

 More seriously, I think nobody is getting deep enough here - these days, in PR-land, it's not really about science or medicine at all, it's about politics. It's true that with the internet there are a lot of somewhat challenged people trying to sell weird stuff, and other people trying to make a buck by lying about stuff - but krist, the gov is doing the same thing since big business took over - how are we average people supposed to tell the snake oil guys from the real scientists anymore? Science (and medicine, as a part of science) are compromised all to hell these days, with 'scientific opinions' etc, like politicians, being to a large extent for sale to the highest bidder. It is a very, very bad situation for 'we the average people', when we can't trust these people anymore. And the only way we are going to do anything about it is to take back our country from the capitalists who have appropriated our government.

 I think that part of the problem is that this sort of debate seems to easily descend into binary type aruging. Either for or against, all in or all out,  with some people falling on particular sides and trying to make their respective cases and in doing so labeling anyone that divulges from a side as some sort of total believer in the other.  It makes any sort of more nuanced disscussion very difficult. At least that's how I personally feel and one of the reasons I've avoided the discussion so far.

I'm someone who understand the problems with 'big Pharma', has concerns about certain aspects of mainstream medicine as a whole, yet I'm not against all that 'big pharma' offers or am against mainstream medicine.  I have used and will continue to use both 'mainstream' and 'alternative' as generalized categories in my own personal healthcare.   It is difficult though and I think the reasons that you pointed out is why.  I actually do have a background in one aspect of alternative medicine and under current legal standards could practice it if I wanted, so my experience with 'alternative' comes from an actual place of some study.  However I find in conversation like this elsewhere I get just as maligned by some, be and and end all, alternative proponents because I have no problem whatsoever in calling out alot of the BS that comes from that side.  I see the exact same sort of pattern with systemic problems, likely due to things like the profit motive eg. capitalism over the past 10 years during overall mainstreaming of the industry. They mirror the very same patterns that form the much of the foundation of the main arguments made against the common mainstream medicine field, especially when it comes to arguements made around 'big pharma'.   The fact is that very many of the the cures, supplements etc etc as well as some of the science is now either made or supported by big pharma itself or huge and growing corporate interests.   There is big money to be made no matter what side of the fence one might sit on. 

I do think that at one time the argument that is played all the time about 'corporate interests' protecting themselves and thus maligning, ostracizing etc etc did hold a lot of truth.  However with the growth and interest in the area coupled with the 'oh look huge' market aspect has made that particular argument less weighty.  Science and in many cases good scientist have started studying the area and I personally find that a lot of people do have a problem when results come in that do show that 'some' things or theories aren't all they cracked up to be.  I personnally don't see this as a problem. I think overall it's a good thing and for the most part exactly what some proponants have been asking for all along.  The problem comes with the acceptance of some of the results.

As an example when the issues around vaccines and connections to medical issues like autism first started to see the light of day I fell into the 'uh oh' there could be some truth to this crowd, though I in no way took an activist role against vaccines.  However I did follow the debate and did follow some of the studies that were done around the issue and now feel comfortable with the findings that any connection is specious at best.  However for some it doesn't seem to matter what 'science' is actually done around it because although the demand for the science was made, and in many instances it did happen, and since it came out debunking that particular theory the result were automatically distrusted.  So now you have people claiming that the 'science' is bunk.  It's like a viscious self-confirming circle.   Science is bias, but please do some science on this anyways, oh look at the results they prove science is bias, carry on as before. 

On the other hand I do have some problems with the way that the science part is done on certain things, like with methodology or in what in my particular opinion is misunderstanding or misperceptions about the particular modality is studied.  Start talking about that and then the science be all and end all crowd chimes in with it's all just woo, woo and you're woo woo.   It's sad really because I do think that there are many good things that are offered by looking at health from different perspectives and from different modalities.

The problem as I see it now is that due to the $$$$ aspect there is a whole lot of BS from all corners to wade through.


oldgoat
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Joined: Jul 27 2001

Tigana wrote:

Oldgoat, are you are referring here to my comment about bread and butter? 

 

I'm unaware of your comment on bread and butter.  I'm all about bread and butter though, should I look for it?


ennir
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Joined: Feb 8 2009

I look at it this way, I may not wish to use the methods but that does not mean that I know whether or not they may work for someone else, as  was already established in another thread placebos may do more good than medication, so who to to say how some of these methods work?

 


Tigana
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Joined: Oct 23 2008

Well written, ElizaQ. You must be on the mend! Laughing

To take responsibility for out own health is the key, and to do that we need information. 


Bubbles
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Joined: Feb 21 2003

You see the same thing in agriculture. Science comes up with all sorts of products and practices. If one product fails to deliver the science gets adjusted in the next product. Resulting in a never ending line of man made products trying to improve on what nature already knows how to do. We are introducing tens of thousands of technical chemicals in our environment, is that sustainable applied science?


ElizaQ
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Joined: May 27 2005

Tigana wrote:

Well written, ElizaQ. You must be on the mend! Laughing

To take responsibility for out own health is the key, and to do that we need information. 

Yes I do feel better today.  I agree about responsibility for ones health and also agree about information. However my point is that I see just as much BS now coming from the 'alternative' side of things as I do from 'big pharma corporate side' of things.   In some cases they are pretty close to each other with how they are marketed. It wouldn't surprise me in the least to find out that the same marketing people are involved. In many magazines I don't see a whole lot of difference in the claims being made about certain pills, supplements etc etc coming from the 'natural' side as the the pills and cures from the big pharma side about the latest wonder drug that the chemists have cooked up.


ennir
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Joined: Feb 8 2009

ElizaQ wrote:

..........

Yes I do feel better today.  I agree about responsibility for ones health and also agree about information. However my point is that I see just as much BS now coming from the 'alternative' side of things as I do from 'big pharma corporate side' of things.   In some cases they are pretty close to each other with how they are marketed. It wouldn't surprise me in the least to find out that the same marketing people are involved. In many magazines I don't see a whole lot of difference in the claims being made about certain pills, supplements etc etc coming from the 'natural' side as the the pills and cures from the big pharma side about the latest wonder drug that the chemists have cooked up.

Thank you for your posts and I am glad to hear that you are feeling better.

I think that once you are very ill then radical changes are needed and no pills, vitamins, cleanses or mangosteen juice are going to fix you up in a jiffy, for some those radical changes are made in consultation with doctors and that is appropriate BUT for many the cause of their illness would be most effectively addressed by lifestyle changes not doctors.  Doctors are illiterate when it comes to proper nutrition and the medications they prescribe to those patients inevitably result in further illness, it only makes sense if you want an industry supported by sickness and by the way that is a three hundred billion dollar industry in Canada.

Did you know, thread drift, that the average time it takes to be diagnosed with celiac is 11 years and that by the time most people are diagnosed with it they have a host of other serious health problems?   What is funny to me is they call celiac a disease, it is not disease, it is damage done by what the body finds toxic and if you follow the SCD (Specific Carbohydrate Di et) you will recover from not only celiac but arthritis and second stage diabetes which are also referred to as diseases.  Strangely, in some European countries they routinely test children for celiac and if they test positive they are kept off gluten and never have problems unlike the milllions of North Americans taking a variety of pills for our guts.  Actually, I don't think it is strange at all, I think it is further evidence of the ineptitude of our system and the greed of pharmaceutical companies.  If anyone is looking to make money I suggest you get in line for the pills they are coming up with for celiac.  LOL

 


ElizaQ
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Joined: May 27 2005

ennir wrote:

 

Thank you for your posts and I am glad to hear that you are feeling better.

I think that once you are very ill then radical changes are needed and no pills, vitamins, cleanses or mangosteen juice are going to fix you up in a jiffy, for some those radical changes are made in consultation with doctors and that is appropriate BUT for many the cause of their illness would be most effectively addressed by lifestyle changes not doctors.  Doctors are illiterate when it comes to proper nutrition and the medications they prescribe to those patients inevitably result in further illness, it only makes sense if you want an industry supported by sickness and by the way that is a three hundred billion dollar industry in Canada.

Did you know, thread drift, that the average time it takes to be diagnosed with celiac is 11 years and that by the time most people are diagnosed with it they have a host of other serious health problems?   What is funny to me is they call celiac a disease, it is not disease, it is damage done by what the body finds toxic and if you follow the SCD (Specific Carbohydrate Di et) you will recover from not only celiac but arthritis and second stage diabetes which are also referred to as diseases.  Strangely, in some European countries they routinely test children for celiac and if they test positive they are kept off gluten and never have problems unlike the milllions of North Americans taking a variety of pills for our guts.  Actually, I don't think it is strange at all, I think it is further evidence of the ineptitude of our system and the greed of pharmaceutical companies.  If anyone is looking to make money I suggest you get in line for the pills they are coming up with for celiac.  LOL

 

Hey ennir.  I'm going to have to agree and disagree at the same time.  One of my quibbles with doctors and general healthcare is around the issues of diet and lifestyle. I do think that is a factor that is missing from some forms of care.  I can't agree that all doctors are illiterate about nutrition because in my experience some are and some aren't. For instance one of my relatives developed a heart issue and upon seeing a specialist his course of care was primarly diet related and his GP bugged him for years about eating more healthly and working on his issue with weight.  He didn't though and now is in more of a mess.  Ailments like diabetes also have a lot of dietary focus when it comes to treatment.  Nutrition is there in many cases but I do agree that more focus on these sorts of issues in many other cases would make general care and general health better.     I also can't agree that the only reason that some doctors don't do the nutrition thing is just because they're are supporting the medication industry.  While I do think that there are doctors that are more 'pill' focused I do think a lot of it comes down to a systemic problem related to time and resources.  I know a couple of doctors and one of the most frustrating things they say they have to deal with is the time with a patient pressure.  There isn't generally the time needed to actually sit down and discuss it all so you end up with coles notes versions of reccomendations.  Eat better, exercise more but no I don't have time to sit here and discuss it in detail.   I'd also argue that if the proof given that the dollar factor of the medication industry is a driving factor in the lack of nutritional counselling from doctors that one only has to look at the nutrition and health food industry which right now worth a whole lot of money as well.  I do however think that one of the reasons that many 'alternative' ways of looking at health have taken hold is because they to some extent fill in a lack of basic nutritional and lifestyle focus that isn't happening in the generalized care that people get for non-acute disease.

As someone who has a bit of experience approaching some things from the alternative side, issues around diet and nutrition are one of the reasons I don't bother to actually do any practicing outside of the personal.  I found that overall people just don't want a 'treatment'  based just on eating well and exercising. While saying they do when it comes down to it putting the reccomendations into practice is another thing.  It's a hard thing for many to do and it takes a lot of effort to get around some of the perceptions about what is 'medicine'.  Like medicine is something you take, not what you just do.  I found that very many people were looking for a herb pusher and honestly I don't find that to be very different then a pharma pill pusher.  Chemicals, are chemicals whether they come in a plant or come in a pill.    

The thing is, that there is nothing 'alternative' about nutrition.  Sometimes it's so basic it's obvious.  Like the woman who came to me complaining about generally being tired, caught a lot of things like colds and wanting to know what 'natural' remedys she could take to help because her doctor couldn't find anything wrong with her and she was sure something was wrong. Granted this is a more extreme example but by the end of it I felt I had a lot in common with her doctor.    After determining that there was not some underlying illness I asked questions about her diet  and the potential problem was so blatent that no expertise was needed to figure it out.  Poor, poor diet, practically no veggies, poor quality carbs, lots of sugary junk and lots and lots of stimulents like coffee, very little exercise and an average of 5-6 hours of sleep a night.  On further talking I found out that indeed her doctor suggested that not sleeping and not eating right might be a factor but it was discounted.  Well I ended up giving pretty much the exact same advice and suggested that no herb and no amount of supplementary vitamins was going to do that much to help if the lifestyle issues weren't looked after.  Start at the foundation, work from there is the general philosophy I follow.   No that wouldn't do. There has to something right? What about ginseng? I've read some stuff about it she said.  What about echinacia? Blah, blah.  What it came down to was she just wanted something to take and doing anything that could really change how she felt in general was just too foreign a concept.   Anyways she left talking to me, annoyed and said she was just going to go to a health food store and get some of these things she read about.  Who knows how much money she ended up spending, on energy formulations and supplements.    The only hope that is maybe some of the literature there about nutrition may have sunk in by osmosis or hopefully if she talked to the employees got some of the same advice.  It's a crap shoot though when it comes to health food stores. Some are quite good when it comes to that sort of thing and some aren't in my experience.

No I didn't know that about celiac disease. My sister has it and she was diagnosed in a matter of months, by her regular GP and since being on a gluten free diet has improved immensely.  I'm not surprised though at the number.   In the case of things like celiac which is a diet based disorder I do think that is one area where dietary based theory from the alternative side of the fence has done some good in getting it recognized more readily in the mainstream of NA.   I'd actually use that as an example of a positive that has come out of the alternative field.   It's not that it wasn't a known disorder in the mainstream it's just that it hasn't been recognized as a ailment that appears to be more common then generally thought.


Tigana
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Joined: Oct 23 2008

Beautifully written posts, ennir and EilzaQ. Thank you. 


ennir
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Joined: Feb 8 2009

Thanks Eliza, I definitely fall into the more paranoid community when it comes to health care issues and you do make good points, especially about people wanting pills, conventional or alternative to take away the problem and that there are doctors out there who do make recommend dietary changes to people who ignore them.

As I said before there is money to be made now that celiac is being diagnosed and there are many celiacs that would be happy to take a pill and not have to deal with the dietary changes.  When human beings first consumed wheat the gluten content was around five percent, but since about 400 A.D. we have been manipulating it to increase the gluten content, that wonderful stretchy bread thing, and hard red spring wheat is now fifty five percent gluten.  There are some, and I am one of them, who think gluten is not a great thing for anyone to eat and that there may be problems associated with it that do not manifest through the digestion including the form of celiac which is a rash.


Le T
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Joined: Oct 17 2004

Quote:
I know a couple of doctors and one of the most frustrating things they say they have to deal with is the time with a patient pressure.  There isn't generally the time needed to actually sit down and discuss it all so you end up with coles notes versions of reccomendations.  Eat better, exercise more but no I don't have time to sit here and discuss it in detail.

 

This might be a bit of drift but, I hate this excuse that doctors just don't have the time to spend with patients. They are choosing not to spend time so they can make more money. My partner and I had midwives when we had our child. We saw the midwife once a month and each appointment would be between 1 - 1.5 hours long. Lots of time for questions, for teaching us about things baby, for getting to know us on the level that someone should before they deliver a baby and give pelvic exams. Believe it or not, their office was nice (they run it as a cooporative) and non of them were living in poverty (for the most part far from it). Yet doctors keep telling us that they can only spend 10mins per patient despite the fact that they get $35 for a basic visit.


Unionist
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Joined: Dec 11 2005
How much did the midwives charge for 1.5 hours?

oldgoat
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Joined: Jul 27 2001

I'll second that.  My Dr., who the family has been seeing for over 22 years now, strictly limits his practice and the number of patients he sees.  He's personable and chatty, and gets to know his patients as fully developed people rather than a set of hurridly explained presenting symptoms.  His living circumstances are comfortable, and he will never be and does not wish to be rich.

He talks about lifestyle, and I'd say is open minded about peoples self care opinions, though he has had a falling out with the idea of chiropractic.  Given that, were he to suddenlyget very directive about something, and say "holy crap oldgoat, ya gotta take this treatment!" i'd be inclined to listen to him.


Fidel
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Joined: Apr 29 2004

Unionist wrote:
How much did the midwives charge for 1.5 hours?

Prolly less than Pete the pediatrician at large would charge taxpayers for a c-section.


Fidel
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Joined: Apr 29 2004

Ghislaine wrote:

I should add that the complete denial/refusal of those with power and so-called "scientists" to address the causes of cancer is just as anti-science as claiming that people should take Vitamin C instead of chemo or other cancer drugs.

US feds knew about common carcinogens in the 1940's and apparently kept it to themselves, And incidence of various cancers have risen here in the western most countries, although people are living longer with cancer on average now. A newer field of study researches environmental effects on our genetic makeup, epigenetics.  Mum's the word on industrial pollution still though. Like they say, an ounce of prevention is worth a pound of cure.

I think it's possible that humans may have produced our own vitamin C at one time, like many animals do. Goats produce somwhere around 13000 mg of vitamin C every day when healthy, and a lot more when theyre under stress. And I think it's more lucrative for big pharma to provide the treatments instead of focussing on blockbuster drug discoveries to actually cure disease. I really think prevention is where it's at, but that runs counter to the big business model for capitalism. And for all their multibillion dollar profiteering and extended patent protections handed to them in Reagan and Mulroney's time in the sun, big pharma has not produced anything as life-saving as the polio vaccines, or insulin - two miracle drugs discovered and developed on shoestring budgets a long time ago.


M. Spector
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Joined: Feb 19 2005

Le T wrote:

Yet doctors keep telling us that they can only spend 10mins per patient despite the fact that they get $35 for a basic visit.

If you do the math, and consider that doctors have to split that $35 with many other people to cover overhead expenses, it's not unreasonable to try to limit patient visits to 10 minutes.

Most lawyers will charge you more than that just to talk on the phone with you for 10 minutes.


Fidel
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Joined: Apr 29 2004

We're short of doctors in Canada. The ones we do have are in a hurry all the time.


Boom Boom
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Joined: Dec 29 2004

One of the physicians I saw here this summer was very helpful during a time I was having bad throat spasms, and he patiently explained each of the medications I was prescribed, and then wrote them out in longhand and with the explanations. I don't think I've had that level of attention anywhere else, although I had a great physician in Hearst who also invited me out to eat with his family a few times (we shared an interest in fine art),


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