Out of work due to woo

Based on my experience in the Civil Service of the United States, I should offer that this is somewhat less clear cut on the other side. I spent 32 years as an officer of the Yankee Government, the last 17 as a supervisor and manager. The rules we had were that for any health absence (claim of sick leave) of more than two working days, a signed certificate (official YG form required or invalid) from a physician was required, and acceptance was conditional on whether the supervisor felt like accepting the physician's certificate. In other words, there was a built-in Catch 22 that supervisors could ignore the certificate with no more cause than orneryness. I never observed such but it was clearly possible.
What I did see was a lot of: ignore the request; decline to provide a certificate; and ignore the legal requirement that the official form had to be used. Admittedly this was more common among surgeons than physicians, but there were several instances where I personally called both for employees that I could see were sick and begged for a verbal certification so I could legally (sort of) allow the employee to take sick leave (rather than leave without pay.) Too often the response was Typical Medicaal Rudeness.

Dear HR Catbert-Type,

This is to certify that Mr H O'Chondria is suffering from:

1) Misaligned financial chakra
2) Excess of credulity
3) Depleted reality
4) Shyness in relation to work

He will be off work until I have completed a full wallet irrigation.

Dear Sir:

I am writing in regards to the health of my patien, Orac. Mr. Orac came to my office yesterday. I could instantly recognize that he has been severely Deepaked as well as dangerously toxified by mercury. It will be necessary to realign his quanta in order for his body to return to a healthy state of mercury excretion through his hair.

While I will engage immediately in an emergency detoxification treatment here in the office, please be advised: Though Mr. Orac may appear in excellent health when he returns to the office, this is an illusion brought primarily by the healing fields to which he will have recently been exposed. In fact, the forces within his chi are unstable. Significant amounts of devisualization linked to negative quantum energy--in other words, too much stress and/or work--could reverse the polarity of the charge process and potentially threaten Mr. Orac's wellbeing. I ask for your assistance in avoiding any negative images of Mr. Orac while you are within 21 feet of his person, for at least the next 4 weeks and 2 days.

I'm very much in favour of such legislation. I'm desparately in need of a few days off but far too obviously healthy to qualify for a doctor's note from anyone qualified.

Based on the title, I was expecting a much more, erm, exciting post.

"Dear Sir or Madam,

Please excuse Dr. Orac from his duties for the next two days. He has thrown out his back in a singularly athletic session of woo."

Dear Boss,

Please excuse Orac from work today. I have predicted dire consequences for him if he goes outside.

Toodles,
Sylvia Browne

This posting was made for Bronze Dog with assistance from his nurse. BD is currently unable to post a witty response after a session of C&C, and is thus unable to post anything on the topic of Orac's absence. Thankfully, he induced vomiting before passing out, and will be up to posting more than shameless plugs for his blog entries in a few days.

Orac, you are very hurtful, and I have to wonder how you treat your patients. If your cancer patient is deriving benefit from Reiki (which is nothing more than a healing touch from another human being), do you laugh at him/her? Do you make jokes about your "ignorant" patients as they walk out of your office? Do you deflate the hope of your patients if they seek any kind of alternative care?
I have seen lots of doctors write medical excuses for patients and they could absolutely care less if their note was true or even accurate. And to even get a doctor to write a note for excuse probably costs a $100 because his time is too valuable to give a F...about anyone.

You left out engrams (that's "technology", it says so right on the label!), hexes, and unfavorable conjunctions of Uranus.

On the other hand, I don't see that much wrong with the original list with the exception of the acupuncturists. Unless physiotherapy Down Under is particularly plagued with quackery?

Nina, since I'm a semi-altie scientist reader of RI and the husband of a medical oncologist, I think that you may be overreacting a bit to Orac's tongue-in-cheek mocking of CAM practitioners. His jest is very different than thinking that he is hateful or in any way demeaning to his patients.

Instead, I would venture to say that the Orac is very respectful of his patients' autonomy and choices to pursue alternative therapies so long as they did not compromise the care he was providing (I do a lot of work on making sure that alt therapies do/don't interfere with chemotherapeutic efficacy.). His collective writings are suggestive that he is critical of approaches that are clearly not supported by the literature or outright fraudulent and this, I view, as an essential role of an oncologist. Moreover, I would think he'd be concerned about patients pursuing untested, harmful, or otherwise financially-wasteful practices while they could be doing some proactive things post-surgically like avoiding soy supplements if they have ER+ breast cancer or improving their dietary regimen to reduce risks of recurrence. This is very, very different than being hurtful or joking.

I think you'd be very pleasantly surprised that the modern oncologist at NCI Comprehensive Cancer Centers is capable of very reasoned conversations with patients about CAM approaches. The bottom line is to guide patients in making wise decisions to embrace scientifically-proven modalities that help them while also avoiding hucksters that prey upon the emotional fragility of many cancer patients.

The problem, Nina, is willful ignorance. Orac performs critical investigations, and arms people with the tools they need to do their own. Science isn't an ivory tower concept: It's accessible to everyone. Unfortunately, most people aren't willing to put forth the effort.

Maybe you should try applying some critical thinking to Reiki. Have you run into any properly controlled and blinded studies of Reiki? And, no, if you run into one, I won't blindly brush if off. I'm openminded enough to give verifiable results some thought. (For those with more experience at interpreting medical studies, please give the studies I linked to a once-over.)

Please note that anecdotes don't filter out the patients' biases, like proper studies do. That's why I don't try things myself: I don't trust in my own objectivity.

I think I've unleashed a monster.

Of course, here in Australia, the Sicky is a longstanding tradition: take a day off whenever neeeded and claim it as Sick Leave.

Most medical certificates I saw when processing staff absences simply said the person was "unfit for work". One memorable application (from the staff member, not the doctor) stated the illness as "decapitation". I duly entered it into the staff record computer system, and it's probably still there today.

Dear Sir,

Attempting to cleanse himself more efficiently than the traditional "course" of treatment, A. attempted a single super-jumbo enema, and was injured when he tripped on the cape...

To Whom It May Concern,

Orac is unable to attend work until further notice due to possession by a demon.

Dr M'Wembe,
Witchdoctor

Some of the more frightening hucksters not only make recommendations about CAM technciques (presenting them as "evidence based' after reading a few in-vivo and in-vitro studies) but they ALSO put themselves out there as experts on what chemotherapies should be used and when, what types of scans folks should or shouldnt be having, recommending folks also take things like low dose naltrexone and celebrex, etc, etc..... Most of the CAM stuff they recommend may be quite harmless, but its when they venture into other territories that real damage may be done..

Dear HR Catbert-Type,

In covering for Dr. Kev this weekend in the care of Mr H O'Chondria, I regret to inform you that his absence from work may be prologned.

Although the full wallet irrigation was successful, additional testing revealed further complication and a potential hereditary link that has lead us to place the entire O'Chondria family under special quarantine. All family members tested positive for distinctly green auras.

Until a complete family portfolio cleasing can be carefully administered, Mr. O'Chondria will be unable to return to work.

Wallet irrigation? I thought the proper term was cashectomy.

I'm only suffering from Credititis. I need to work MORE.

Dear Principal,
Juan is sick and will be out of school until the day after the NCAA finals.
Signed,
Epstein's Mother

Cashectomy is such an allopathic term. Personally, I prefer fiscal attunement.

Thanks BronzeDog, and Abel Pharmboy. Your explanations are very clear and respectful, and I really appreciate it! I still think Orac goes a little overboard. At what point does a joke become an insult? I think Orac crosses that line sometimes.
Believing in your personal healing is very powerful. Chemo can very much be aided by such things as Reiki, meditation, hypnotherapy, acupuncture, etc. When you say that Chemo works, how do you know that it was the chemo, and not the human spirit, that healed the person? There is no amount of science that can convince me that the human spirit is not a factor in healing, whether it's by traditional medical means or not.
I guess I'm going off topic at this point.

Well, Nina, that might just be covered by the placebo trials. Basically, you give one group the treatment, and another a fake. The only people who know who received what are typically removed from the patients and the ones handing out the treatments, so that they can't bias the results.

Control group: Psychology + Natural improvement.
Treatment group: Psychology + Natural improvemnt + treatment.

We determine the effectiveness of the treatment by seeing the difference between the two groups.

However, I do think a proper attitude does play a role in recovery, even if it's not physiological. A patient who thinks a treatment is working is more likely to stick with his regimen, for example.

As for all those things you list as aiding chemotherapy, I'd like to see some control studies.

As for humor, Orac's probably more like me: I adjust my humor level. You're much, much more civil than most people I encounter with similar opinions, so I give you credit for that much. If you were more like Fore Sam (who's very fond of putting words in my mouth for subconscious propaganda purposes) or Dr. MAS of the JREF Forums (whose beliefs about homeopathy change hourly), I wouldn't hesistate to ridicule you. But you aren't, so I won't.