No, I don’t think that catching any disorder pales in comparison to another. Tay Sach’s disease is pretty rare, but I’m not going to stop screening my patients for it because cancer is more prevalent…

• Posted by: Jason Levine on Jun 8, 2000, 10:22 AM

maybe we should start screening the doctors first, to find out the prevalence of how many each have killed. at 200,000 deaths per year — half from drugs, half from “errors” — a lot of doctors probably even have multiple deaths on their hands. murders, really, as it is now known and even published in the doctors’ own JAMA that pharmaceutical drugs handed out by the doctors are killing the patients. http://www.washingtonpost.com/wp-srv/national/health/daily/april98/drugs041598.htm

so will the cameras also be used to catch the doctors who kill their patients, and bring them to justice, too, or will the societal brainwash that puts the doctors up on a priestly-caste pedestal override justice and grant continued impunity to a medical and pharmaceutical establishment that continues to kill hundreds of thousands of people every year? or is it somehow an exaggeration or mistake in logic to say that an industry that kills 200,000 people every year is harmful and extremely dangerous?

• Posted by: cardio crome on Jun 8, 2000, 3:01 PM

Listen, while I agree that there are less-than-scrupulous doctors out there, I think it’s funny that you cite unreferenced stats in your first post, and now cite them conclusively in your second post. In addition, that Washington Post article that you cite doesn’t exactly hold up your point (emphasis added by me):

Only one-quarter of the reactions were due to patients being allergic to the drug in question. In theory, those reactions could be avoided by more carefully asking people about known allergies. The rest of the side effects were classified as inevitable, bound to affect a certain percentage of the population for unknown reasons.

I’d love to know how you would recommend that we doctors approach this bolded part — how I’m supposed to be able to predict ideopathic side effects in my patients.

The article continues:

Alan Holmer, the group’s president, said in an interview that side effects were inevitable given the increased potency and effectiveness of modern drugs. “Drugs are powerful substances and affect different people differently,” he said. “They cannot be made completely safe for all patients in all circumstances.”

Second, yes, at baseline I agree that if there is a valid reason for suspicion that a doctor is a threat to his or her patients, that monitoring can be set up to determine if this is the case. This is how the Munchausen by proxy study was conducted; I quote from the methods section of the Pediatrics paper:

A multidisciplinary team was assembled to consider the pros and cons of monitoring in each case before beginning CVS. The team consisted of the attending physician, representatives from nursing, social work, risk management, and security. Consulting physicians were also involved when appropriate. The team considered monitoring only when they believed MSBP was more likely than other diagnoses as an explanation for the child’s presenting complaint. The primary goal was to protect the child. In some circumstances, surveillance was used when MSBP was believed to be unlikely, but no other explanation accounted for the patient’s symptoms. Thus, the patients included in this report came from a highly selected population.

Lastly, yes, it is a mistake in logic to make the blanket statement that “an industry that kills 200,000 people every year is harmful and extremely dangerous” — perhaps people within that industry are dangerous (e.g., a doctor who practices without proper training and kills patients), or perhaps the industry lends itself to dangerous outcomes (e.g., a brain cancer patient who gets an antiseizure medication alongside chemotherapy is much more likely to develop fatal Stevens Johnson syndrome, yet not giving that patient an antiseizure medication means that they are much more likely to suffer a fatal seizure), or perhaps any other number of reasons. The auto industry is responsible for tons of deaths, as is the alcohol industry, but I don’t think you can classify either as inherently dangerous.

• Posted by: Jason Levine on Jun 8, 2000, 3:32 PM

Look, whoever you are:

1)Docs don’t hand out meds. Nurses hand out meds, pharmacists hand out meds. Docs write prescriptions, and occasionally give the meds themselves.

2) The study you cited was an inferred number based on a meta-analysis of other studies, some not very well done/documented.

3) Even if the health care industry did kill that many people, consider how many people would die if we didn’t treat people? It may be a crappy game, but it’s the best bet in town.

Sometimes I think we that Niven and Pournelles “Lucifer’s Hammer” should be required reading so that people could get a real idea of what kinds of things you can die from without high tech interventions…

Bahhh. I don’t have time for this nonsense.

• Posted by: Alwin Hawkins on Jun 8, 2000, 5:40 PM

look, whomever *you* are: “to hand out” is a figure of speech related to what is known as “synedoche.” it is a type of metaphor that in this instance means “to prescribe.”

secondly, you are obviously either brainwashed or extremely cold-hearted to call 200,000 unnecessary deaths a year “nonsense.” 200,000 deaths per year sounds like a serious issue to me, hardly nonsense at all. if 200,000 people died every year from flying in commercial airplanes, would you dismiss that as “nonsense”? would you say, “many others reach their destination okay, so it’s nonsense to discuss the fact that 200,000 others die from flying?”

thirdly, apparently you do not understand the concept of meta-analysis, which is to *strengthen* the evidence, to strengthen previous analyses by throwing out variables and earlier methodological mistakes that can skew the results in a biased manner. the methodological problems of the earlier studies from which the meta-analysis was made not only were taken into consideration in the analysis in question, but were in fact thrown out to focus the study even more specifically — a study which in fact was regarded as “stronger than previous ones.” one reason it was stronger is because it looked “only at cases in which drugs were taken correctly.” so, furthermore, you apparently are attempting to argue for something that, taken correctly, kills, which to me sounds like a weird thing to be in support of, but you can if you want to. maybe you are in favor of people taking arsenic, too, or smoking, both of which, when taken correctly, kill.

Lastly, i suppose since as you say people can die from all sorts of things anyway, that therefore justifies anything else we can come up with to kill even more people? in fact, that people can die from other things has no bearing at all on the current discussion, which is specifically about people dying from standard mainstream medical practice, not from other causes. the two issues are unrelated, sorry.

• Posted by: cardio crome on Jun 8, 2000, 6:27 PM

> By: Jason Levine (q@queso.com)

===================================================================
> Listen, while I agree that there are less-than-scrupulous doctors out there, I think it’s funny that you cite unreferenced stats in your first post, and now cite them conclusively in your second post.
— — — — — —
what’s so funny? those are the numbers, a matter of public record,
whether or not i cite them.

===================================================================
In addition, <a
href=”http://www.washingtonpost.com/wp-srv/national/health/daily/april98
/drugs041598.htm”>that Washington Post article that you cite doesn’t exactly hold up your point (emphasis added by me):
>
>

Only one-quarter of the reactions were due to
patients being allergic to the drug in question. In theory, those
reactions could be avoided by more carefully asking people about known allergies. The rest of the side effects were classified as
inevitable, bound to affect a certain percentage of the population for unknown reasons.

— — — — — —
it actually makes the point quite clearly, in fact. a conclusion to be drawn from the study is that the drugs are inherently dangerous, not causing effects due to allergic reactions, but causing death even when taken as intended. “unknown reasons”?? unknown to whom? that’s a code phrase meaning: we don’t want to have to admit these chemical substances are dangerous, because then we would need to question the very foundation of the existing profit-drive system that exists to sell the drugs, not to make people well (though that is the propaganda sold to the public).

====================================================================
> I’d love to know how you would recommend that we doctors
approach this bolded part — how I’m supposed to be able to predict
ideopathic side effects in my patients.
— — — — — —
easy. don’t give the drugs. you don’t need to predict anything, as we already know that 3/4 at least of the seriously adverse outcomes are not from allergies or other reactions but b/c of the properties of the drugs themselves, and, as the study says, are therefore inevitable. so study and promote methods instead that actually do heal people, instead of believing in a myth that says adding chemical drugs to a person’s physiology is actually good for them.

====================================================================
> The article continues:
>
>

Alan Holmer, the group’s president, said in an
interview that side effects were inevitable given the increased potency and effectiveness of modern drugs. “Drugs are powerful substances and affect different people differently,” he said. “They cannot be made completely safe for all patients in all circumstances.”

— — — — — —
effects from giving other known poisons are inevitable too, and that would be murder. so what is the difference? when people die from non-pharmaceutical poisons, though, the cause is not said to be “unknown.” why not?

====================================================================
> Second, yes, at baseline I agree that if there is a valid reason for suspicion that a doctor is a threat to his or her patients, that
monitoring can be set up to determine if this is the case.
— — — — — —
the whole system is the problem, not one or two or even a hundred
thousand doctors — except, of course, to the extent that they buy into the pharmaceutical myth. the contemporary medical drug model itself is deeply flawed, and that’s why people are dying from it.

====================================================================
> Lastly, yes, it is a mistake in logic to make the blanket statement that “an industry that kills 200,000 people every year is harmful and extremely dangerous” — perhaps people within that industry are dangerous (e.g., a doctor who practices without proper training and kills patients),
— — — — — —
the ones who practice with the training are the ones who seem to be
doing most of the killing, however.

===================================================================
or perhaps the industry lends itself to dangerous outcomes (e.g., a
brain cancer patient who gets an antiseizure medication alongside
chemotherapy is much more likely to develop fatal Stevens Johnson
syndrome, yet not giving that patient an antiseizure medication means that they are much more likely to suffer a fatal seizure), or perhaps any other number of reasons.
— — — — — —
and if the existing economic structure were not designed to promote the widespread use of the poisons that cause the brain cancer to begin with — the benzenes, the toluenes, the dioxins, the organophosphates, the countless other industrial poisons — the person would not need any drugs at all. that approach would tend to cut into profits a little too much though, wouldn’t it?

====================================================================
The auto industry is responsible for tons of deaths, as is the alcohol industry, but I don’t think you can classify either as inherently dangerous.
— — — — — —
if you really believe that, then you should read _Unsafe at Any Speed,_ by Ralph Nader for starters (no pun intended). the products of the auto industry cause more pollution than almost any other source, spewing sulfur dioxide, CO2, and tons of other complete and incomplete products of hydrocarbon combustion into the atmosphere that are responsible for increased incidence of child onset asthma, increased fatalities from respiratory distress in major cities worldwide, most of the global warming and climate change, not to mention the 80,000 - 100,000 people that are killed in the US from auto accidents directly (still at least 1/2 less than the number killed by doctors, however). gas- and fossil-fueled autos are in fact inherently dangerous. alcohol may or may not be, but it sure is the way it is marketed and promoted in this society, for billion dollar profits while being a major cause of sickness, suffering, and death, as i am sure you are aware.

• Posted by: cardio crome on Jun 8, 2000, 6:39 PM

I can’t help that you want to live in a different economic world. If that’s the case, then do so — move to a third-world country, where first-world “poisons” don’t wreak their harm. Or don’t. I don’t care.

Oh, and computers (CRTs, keyboards, magnetic fields from the motors, what have you) have been “linked” to cancers and all kinds of other deleterious effects, too. Yet you use one, it seems; that just seems strange to me.

And as for the rest — it’s flame bait. Have fun stoking the fire, but I’m not game.

• Posted by: Jason Levine on Jun 8, 2000, 7:05 PM

Is cardio crome Harlan? He sounds to off the wall to be a real person.

Phil

• Posted by: phil jache on Jun 8, 2000, 11:31 PM

cardio crome is cardio crome. perhaps you are not aware that it’s not considered proper netiquette to question identity in the manner you do here.

i can see, however, that it arises from the impulse toward the usual, tired ad hominem attack seen so often instead of from an honest attempt to engage the comments in the dialog in any meaningful way.

“to [sic] off the wall to be a real person”? gee, that really adds a lot to the discussion, thanks for your contribution.

• Posted by: cardio crome on Jun 9, 2000, 12:51 PM

Waaaaah. Phil is a friend of mine, posting to my forum with my permission whatever he fucking wants to post. You, on the other hand, are an semi-unknown to me, clearly upset about the state of society, the state of medicine, whatever.

Be careful using your keyboard there, Cardio (or should I start calling you Jeffrey now?) — you may get RSI, and end up at a doctor’s office.

• Posted by: Jason Levine on Jun 9, 2000, 1:21 PM