White Coat Underground

Archives for November, 2009

Science-based medicine: we are not automatons

Opponents of science-based medicine like to accuse the rest of us of failing to be “holisitc”, of failing to see the whole individual who comes to us for health care. I’ve argued many times that this is not only wrong, but that so-called alternative docs, by recommending unproven treatments and giving false hope are actually…

Why I won’t be prescribing medical marijuana

In November, the citizens of my home state approved a medical marijuana law. The very next day, I started getting calls from patients (often not may own) asking how they could get it. I’m not fan of draconian laws that imprison people for getting stoned, but when it comes to medical interventions (rather than legal…

Basing medical practice on science helps us avoid the pitfalls of relying on our own reasoning and experience. If I want to start a patient on a new medicine, the individual characteristics of the patient are important (Is the drug meant for their condition? Will it interact with other drugs they are on? Are they…

There are a couple of quotes circulating widely claiming that major players in flu vaccine development are “denouncing” the vaccine. From (shudder!) mercola.com: “Dr. Anthony Morris, a distinguished virologist and former Chief Vaccine Office at the U.S. Federal Drug Administration (FDA), states that “There is no evidence that any influenza vaccine thus far developed is…

In a piece written for health reporters, journalist Jane Allen gives some useful advice about covering alternative medicine, but there are some gaps that are are hard for a non-medical professional to recognize (and frankly, for many medical professionals as well). She quite rightly urges skepticism, but when looking into ideologic and muddled topic of alternative medicine,…

Another way to find swine flu shots

Hat tip to the incomparable, contentious, pain-in-the-ass-who-we-are-all-better-for-having-around scienceblogs regular becca for pointing out this site (from google of course) that helps locate flu shots in your area (in my area, everyone is “temporarily out of stock”). While you’re visiting, check out google’s flu trends as well.

An easy way to kill a debate on health care policy is to use the “R” word. We saw this early in the HCR debate with overheated talk of “death panels” and other nonsense. But we ignore the real issue of rationing at our own peril. Those of us who favor real HCR must embrace…

Mumps redux

The resurgence of vaccine-preventable diseases is a fascinating, if unwanted, phenomenon. Pertussis, measles, and now mumps are cropping up after long periods of quiescence. Mumps has been generally very well-controlled since the adoption of wide-spread vaccination, with no nation-wide outbreaks, but there have been a number of regional outbreaks, most notably in 2006 and now…

Doctors are just like military dictators

There’s a number of dangers in carrying an analogy too far. One situation may be analogous to another without being identical, or they may not in fact be analogous at all. Forgetting this principle can get you into a wee bit of trouble. To formalize it a bit, just because you think “A” resembles “B”,…

"I am the great and powerful Oz PAL!"

In medicine, theater can go a long way. The seemingly simple acts of laying hands on a patient, leaning in to listen to them, and giving them instructions to follow can be therapeutic. Sometimes this is labelled as part of the so-called placebo effect, but whatever we call it, physicians (and priests) have been doing…