That the Cleveland Clinic has become one of the leading institutions, if not the leading institution, in embracing quackademic medicine is now indisputable. Indeed, 2017 greeted me with a reminder of just how low the Clinic has gone when the director of its Wellness Institute published a blatantly antivaccine article for a local publication, which led to a firestorm of publicity in the medical blogosphere, social media, and conventional media to the point where the Cleveland Clinic's CEO Dr. Toby Cosgrove had to respond. Dr. Cosgrove was—shall we say?—not particularly convincing. Indeed, even as he voiced support for vaccines (good), he was clearly in denial that all the pseudoscience and quackery that the Cleveland Clinic has embraced under his leadership facilitated antivaccine views because so much of it included practitioners and belief systems that tend to be antivaccine. As I like to point out in response every time Cosgrove's becomes all righteously indignant about the criticism the Cleveland Clinic receives for its embrace of pseudoscience and his being shocked—shocked!—that there are antivaccine beliefs in a physician in a leadership position in his Wellness Institute, he hired Dr. Mark Hyman to set up a "functional medicine" (FM) clinic at the the Clinic, the same Dr. Hyman who co-authored with
vaccine safety activist antivaccine activist Robert F. Kennedy, Jr. an antivaccine propaganda book, Thimerosal: Let the Science Speak: Mercury Toxicity in Vaccines and the Political, Regulatory, and Media Failures That Continue to Threaten Public Health, a book full of antivaccine fear mongering of the mercury militia variety. I also note every time Dr. Cosgrove gets his knickers in a bunch over this that Hyman and Kennedy published that book the very same year that Cosgrove hired Hyman. Not only that, but RFK Jr. and Hyman appeared on The Dr. Oz Show to promote the book a mere week and a half before the Cleveland Clinic announced Hyman's hiring.
So it was with some interest that I came across an article praising the Cleveland Clinic's embrace of pseudoscience as "disruptive innovation." Yes, it was co-authored by an old "friend" of the blog, Glenn Sabin. We've met Sabin multiple times before, most recently earlier this year when I became aware of a book he published about integrative medicine's latest rebranding of itself. Years before that, he had bragged that integrative medicine is brand, not a specialty, and this was one of the few areas where I actually agreed with Sabin, just not in the way that he meant it. For instance, he liked how "complementary and alternative medicine" (CAM) had been "rebranded as "integrative medicine." He also thinks integrative medicine is a good thing, whereas I view it—and quite rightfully so, I might add—as "integrating" quackery with real medicine, at least where integrative medicine doesn't rebrand science-based health interventions like diet and exercise as somehow being "alternative" or "integrative." So enamored of integrative medicine is Sabin that he also recently wrote a short book on what he considers to be the 125 most important milestones along the path to the acceptance of "integrative medicine," or, as I refer to them, milestones on the way to normalizing quackery.
In their article, Disruptive Functional Medicine Innovation Drives Value-based Future at Cleveland Clinic, Walsh and Sabin start out quoting Clayton Christensen:
The instinct of every leader is to frame disruption as a threat—even if it constitutes an extraordinary opportunity for growth by reaching more people more affordably. If today’s hospitals set up focused-hospitals to disrupt themselves…the evolution can be profitable rather than painful.
So right from the beginning, you see that they view integrative medicine and FM at the Cleveland Clinic as "disruption" in the service of "innovation":
Christensen, one of the nation’s leading authorities on disruptive innovation in business, wrote those words at a time after the early forces of healthcare disruption had started coalescing, around 2000.
He would not have recognized them at that time because they were not dependent upon the technological advances he often cites as the basis for successful disruption. Rather they were, and remain, disruptive in how patients can be most beneficially treated. This evolution has often been painful, and it may yet produce profit, if, as we will see, that disruption establishes value based on quality outcomes, reduced costs and patient satisfaction. The Triple Aim by any name.
Those early disruptive forces in care first stirred in the U.S. in the 1980’s, initially in the form of formal recognition of complementary and alternative medicine (CAM) modalities by the U.S. healthcare system. The subsequent growth of clinical businesses and their patient populations (to shocking levels by 19912) was completely driven by patient preferences and out-of-pocket spending that was not reimbursable.
There are two interesting, perhaps unintentional, admissions in just this brief passage. First, a whole lot of "integrative medicine" is not reimbursable by insurance companies because they don't cover it. Why don't they cover it? The reason is simple: It's not science- and evidence-based. Once you get away from the interventions that integrative medicine has rebranded, such as diet, exercise, lifestyle, and a handful of others, such as a very few herbal medicines, you're left with acupuncture, reiki, homeopathy (and, yes, homeopathy is still used because naturopathy is popular in integrative medicine, and you can't have naturopathy without homeopathy), reflexology, chiropractic, and a large number of other pseudoscientific modalities. That's what's being integrated into medicine.
The second admission is that this integration has been driven by patient preferences. Now, I don't agree that it's been "completely" driven by patient preferences. There are plenty of physicians who have, for whatever reason, fallen into pseudoscience and offer these services to patients. Sure, many of them are responding to what they see as a marketing opportunity, but there are a lot of docs who have gone into "integrative medicine" because they've become true believers as well. Be that as it may, the National Center for Complementary and Integrative Health (NCCIH) doesn't exist because scientists and physicians clamored for it. The NCCIH exists because a woo-friendly politician aligned with quacks who sold laetrile and other nonsense foisted it on the NIH. Similarly it wasn't physicians who clamored for these programs Walsh and Sabin describe:
- In the establishment of many Centers of Integrative Medicine at U.S. medical schools, growing from eight at its 1999 inception to more than 70 today, and leading to the formation of The Academic Consortium for Integrative Medicine & Health, ACIMH.
- The growth of integrative health and medicine in the U.S. Military Health System and especially the VA that began in the wake of the wars in the Middle East, that now influences the approaches to care and healing in these and other major institutions.
- The investment in integrative medicine and health units at academic and non-academic regional and national hospital systems such as Mayo, Allina, Medstar, Sutter Health, Meridian Health and Beaumont Health (many, including the VA, are now members of ACIMH).
Yes, over the years I've discussed these developments, such as the infiltration of quackery into medical school education and academic medical centers and the VA, as well as the proliferation integrative medicine centers like the Cleveland Clinic's Wellness Institute:
If there is a model of disruptive innovation in healthcare that Christensen might recognize today it is probably located at the Cleveland Clinic, where its Center for Functional Medicine (CC-CFM) is as close to a ‘focused-hospital’ bent on deliberate self-disruption as we are likely to find.
Established in 2014 after CEO Delos (Toby) Cosgrove, MD and Mark Hyman, MD, current chairman of the Institute for Functional Medicine, agreed to bring to the Cleveland Clinic functional approaches to identifying root causes of illness and to treating conditions in collaborative fashion.
Behind this decision was the intention to create a sustainable business model based on value that would scale in such a way as to establish new relationships with insurers and make the functional approach a norm in healthcare.
In presentations at the Personalized Lifestyle Medicine Institute (PLMI) conference “Harnessing the Genomic Revolution: Breakthroughs in Personalized Precision Health Care” in October of 2016, Dr. Hyman, now Director of CC-CFM, and Patrick Hanaway, MD, its Medical Director, described the careful, intentional efforts being made to establish this business model grounded in the precepts of the Triple Aim: reduced costs, better outcomes and greater patient satisfaction.
Let's step back and remember what FM really is. Basically, FM represents itself at getting at the "root cause" of illness and attacking it directly. In reality, FM is more like "making it up as you go along" the same way that so many other alternative medicine practitioners do. Basically, FM involves the worst of both worlds, alternative medicine and conventional medicine. Like the worst aspects of conventional medicine, FM involves massive overtesting, with FM doctors sometimes testing dozens or scores of lab values. They claim they know what these values mean and how to treat them based on evidence, but seldom do. So, like alternative medicine practitioners, they make it up as they go along. Of course, when you test so many different lab values, inevitably by random chance alone one or more of them will be abnormal, because normal lab values are usually set so that their ranges encompass 95% of normal people. So you get things like hormone panels, thyroid panels, metabolic panels, micronutrient testing, and many, many more. You get bogus tests like provoked urine heavy metal testing, in which a patient is given a dose of a chelating agent and then a urine test for heavy metals is carried out. Inevitably the values are high, and FM docs use them to justify chelation therapy.
Now look at what they're doing at the Functional Medicine Center:
- Dr. Hanaway’s presentation described the programs and clinical systems, analytical tools, team-building and research programs being put in place to create this paradigm of value. These include:
- Conducting a select group of small RCTs.
- Working with the Institute for Functional Medicine to standardize clinical protocols.
- Collecting and integrating quality, outcome and cost data (often for the first time ever).
- Collecting patient case studies that illustrate the patient experience.
[Note: Dr. Hanaway’s full presentation (40 min.) is available here on the PLMI web site (requires free registration). Click on the “Day 2” tab.]
In reviewing these efforts in some detail, Hanaway noted, “We’re in a learning process of ‘How do we put these tools together?’ We look at quality, we look at cost, and work toward value.”
Let's see: Do a few small RCTs? That's a perfect recipe for either a bunch of negative results because the trials are underpowered or for spurious results. Collect case studies? That's the lowest form of clinical evidence, not even a case series! Then there's this:
Another measure, using the NIH’s PROMIS-10 tool to compare the results of “clinically significant improvement” from CC-CFM treatments to those of the Clinic’s family medicine unit (CC-FM) (already among the nation’s best for patient clinical improvement), demonstrates the following improvement scores:
- CC-CFM: + 38.7%
- CC-FM: + 27.4%
In part this nearly 40% difference reflects what Hanaway reports as the CC-CFM’s success in encouraging patients to actively embrace activities that support their health (through ‘patient activation measures’). Indicative of this were results from comparisons of patients being treated for fatigue, mood, and autoimmune conditions.
And here's where the rebranding comes in. Remember, the Center for Functional Medicine claims that its greater success is due to its ability to get patients to "embrace activities that support their health." Whenever I discuss FM, I'm forced to conceded that there is a grain of good there. There are some things that FM gets right. The problem is that these things tend to be no different than the sorts of things every good primary care doctor should be getting right anyway, such as emphasizing healthy lifestyles, good nutrition, enough exercise, adequate sleep, cessation of habits known to be deleterious to health (e.g., smoking). How do they do it? One advantage FM doctors have over primary care doctors practicing science-based medicine (SBM) is that, because insurance often won’t cover much of what they offer, FM doctors tend to spend more time with patients, which is something that primary care doctors have a harder time doing these days. They emphasize prevention, which is a good thing but again something that good primary care doctors do anyway. Unfortunately, the FM version of “prevention” isn’t always in line with the SBM version of prevention. Where FM doctors go so very wrong is in what Grant Ritchey described as a major unstated premise. That premise is that FM really does address the root causes of disease better than conventional medicine. FM also encompasses a lot of quackery, such as acupuncture, chiropractic adjustments, and especially “detoxification” programs. It’s little wonder that many naturopaths are very enthusiastic about FM.
So here's the problem. Whatever benefit there is from FM almost certainly derives from the things that primary care physicians do right, such as getting patients to improve their diet and exercise more, which FM docs could well be more successful at because they can spend more time with each patient. There's nothing magical about that. Also notice how the RCTs that are being done are not testing individual FM interventions, but rather the whole package. If the improvements seen are driven primarily by lifestyle interventions, they'll never know that the overtesting and the woo that FM slathers over the few good things it does had nothing to do with the patient improvements reported. Maybe that's the point. After all, the main purpose of the "research" Hyman is doing at the Center for Functional Medicine seems to be to show that FM saves money, in order to persuade insurance companies to reimburse for FM services.
Same as it ever was. The only "disruption" going on at the Cleveland Clinic involves finding a way to extract more cash out of offering pseudoscientific medicine in the form of "functional" medicine, traditional Chinese medicine, and all manner of quackery.
After all is said and done, I still don't really know just what functional medicine is despite having read today's article (and even attending a lecture about it presented by a "doctor" of chiropractic). I'd very much appreciate it if someone can come up with a concise and informative definition that even a layman can understand.
Great article… Operation Backbone has been a disruptive mechanism in active duty,military and VA in a positive way…. The issue is not so much the disruptive nature in a positive way… It's the leadership at the CEO and CFO level, that doesn't understand what a mechanism can do in a positive way if it seems At First to go against the grain… It's the leadership that becomes Buried in paperwork bureaucracy… Not even so much the bottom line… But stepping outside the office and seeing the actual flow… That's what vision does - not the status quo. No excuses… There are tremendous success out there however red tape is not an alternative to constantly challenging the status quo, or the flow and nature of a disruptive new mechanism that can alter the path for so many people now and in the future
Ah, the old Galileo Gambit: People who disagree with us really are just trying to protect the status quo for some nefarious reason.
Functional medicine = Functional entertainment
I so thoroughly detest the abuse of those words "disrupt" and "innovation." They do not mean what their chirpy promoters think they mean.
"Oh boy!, let's go _break something!_" "And let's _make new_ regardless of whether new is better or worse, or even if 'new' is old, _and_ worse, as in homeopathy." The first sounds like Steve Bannon ideology, and the second sounds like planned obsolescence, and now it also sounds like quack-o-rama. Bleh.
What I'd really like to see some day: a line of peaceful protesters making their way through the Board meeting of one of these institutions that touts "disruption" and "innovation," chanting "Dis-RUPT! Dis-RUPT!" loudly enough to do just that for, oh, five or ten minutes, and then they all leave, having made the point.
Speaking of disruptive innovations in quackery, here's a prediction: e-Iridology. The computer takes a photo of your iris and spits out a diagnosis. There will also be an app that enables using your i-Thing to do it as a form of "selfie," and send in the photo for a "diagnosis" any time you like (only $49.99, act now!).
It will seem "sciency" because it comes with an app and a robot, and as we all know, anything with an app and a robot is super-duper cool. Someone will make a lot of money on this and patients will die from false negatives for dangerous diseases. FDA might shut it down in 2022 or so, depending on election outcomes in 2020. Hurry! hurry! hurry!
You want to know the crazy thing, Mr./Ms. Squirrel? If I marketed a b.s. auto-diagnostic I could make a fortune - my financial troubles would be over forever. Or be a professional science denier. Or a professional RW troll.
So many times have I refused to participate in lucrative swindles, and my reward is poverty. At least the old lady next door whose walkway I shovel for free thinks I will be rewarded by Jesus. Sometimes I wish I could make myself believe this. But good deeds aren't if you do it in anticipation of reward.
Those that readily accuse RI commenters of being 'shills' are not simply wrong - they have things exactly backwards. Very, very bad taste. It is principled advocates of reason who willingly accept financial loss to defend what is right.
Walk in peace, scientific skeptics, and always remember that the principle of charity can go too far. You are morally superior to Kennedy, Gordon, Wakefield, and that entire cast of venal clowns. You don't have to be self-righteous or a 'dick' to have pride in yourself.
"After all is said and done, I still don’t really know just what functional medicine is despite having read today’s article (and even attending a lecture about it presented by a “doctor” of chiropractic). I’d very much appreciate it if someone can come up with a concise and informative definition that even a layman can understand."
Functional medicine: a system which functions to provide a beneficial outcome for farsighted practitioners.
I so thoroughly detest the abuse of those words “disrupt” and “innovation.” They do not mean what their chirpy promoters think they mean.
The game here, as when these words are similarly abused in technophilic and Silicon Valley contexts, is buzzword bingo. Certain people have gotten used to allegedly novel schemes being marketed in just this way. Why should medicine be different? "Disruption" is made to sound exciting. Never mind that it tends to be "interesting" in the Chinese curse sense of the word.
And as in Silicon Valley, a handful of people who have the luck to be in the right place at the right time make out like bandits.
The main difference between disruption in medicine and disruption in the tech business is that occasionally the latter ends up helping the consumer directly. Several iDevices have served as examples over the years. When this kind of disruption helps a patient, it is invariably a combination of luck and the placebo effect.
“Oh boy!, let’s go _break something!_”
What I’d really like to see some day: a line of peaceful protesters making their way through the Board meeting of one of these institutions that touts “disruption” and “innovation,” chanting “Dis-RUPT! Dis-RUPT!” loudly enough to do just that for, oh, five or ten minutes, and then they all leave, having made the point.
There's a Been Down So Long reference to be had here, too, but the word on the street is that there's a bunch of mass storage to be had in the campus library's electronic recycling, which has been vitally important to me lately.
No need to worry about the chemical medicine paradigm. It will continue to thrive and be hailed by unquestioning believers, even as our population steadily becomes even more unhealthy than it is already, while spending more than ever.
Trauma care is great in the US, but there's a relatively small market for it. The real money is in the creation and perpetuation of chronic disease, because there's a constant supply of symptoms to mask and tests to perform.
Even when it's performing at its optimum, the modern medical system is the third leading cause of death in the US--as researchers from Johns Hopkins pointed out in studies from 2000 and 2016. See http://www.drug-education.info/documents/iatrogenic.pdf; and Makary Martin A, Daniel Michael. Medical error—the third leading cause of death in the US BMJ 2016; 353 :i2139.
So-called "integrative medicine" is just responding to a demand that was inevitable. Sure, there have always been opportunistic "quacks," but they'll never rise to the level of the official quacks running a system that kills, conservatively, over 250,000 people every year.
Lol. If only the problem were isolated to a single source, it could be pretty easily resolved. :D
But 'disruptive' sounds so, so... rebellious and paradigm shifting!
Let's f@ck up the establishment and usher in a new era ...
NWO; yes medical error does either directly or indirectly cause the deaths of a number of people per year (I believe the 250,000 number is has been strongly reputed). However, how many people every year die from using FM, ND, HM, wheatgrass, etc, etc. Ask the young model how well having a chiro twist you neck works: oh sorry you can't she's dead.
Real modern medicine works and I am proof. In the last 3 years my prostate cancer is cured or in total remission and I survived a heart attack in which I had less than a 7% survival chance. I've had even better news on the heart attack: my ejection rate during the attack was below 35% and as of December my ejection rate in now over 60% (55% being average) which suggests little to no heart muscle damage.
First off the number if deaths CAUSED by medicine is a flat out lie. Someone who is diagnosed as terminal is not killed by science. Second, live expectancy is longer now than pre science based medicine, suggesting that we are healthier. Death is pretty unhealthy. Third, new diseases and disorders are found as we discover them, primarily because we now know what we are looking for in research. It is foolish to talk as if society was better off in the 1890s.
Well, Dr. Starfield's study identified 106,000 deaths per year caused by properly prescribed and administered, FDA approved drugs. So that would be the most direct "cause" by medicine--along with 12,000 deaths per year from unnecessary surgery.
In other paradigm-shifting news...
It seems that woo-meister extraordinaire, Gary Null, may be soon dismissed by his long time land-based (free) airtime provider, WBAI. He lost one day a week months ago and ranted that he may lose even more. They allowed him time to run a promo for his 'health retreats' that will benefit the station as well as himself. Long story about retreats available upon request.
Although he maintains that he has other outlets broadcasting his dreck, ( unnamed ), an internet locus and woo by phone, I believe that he gets the most money via the radio station because of his longtime association with it and the fact that it reaches NYC money. Who else can afford powdered, dried vegetables at high prices?
Trauma care is "great", because it is based on the results of scientific research. Chronic care is terrible because it's based on the results of scientific research.
How does that work?
Denice @ 17:
You have made my day.
I always wonder how they manage to separate the two types of care.
Aren't education, research and training in medicine beyond such artificial and unrealistic distinctions?
It's hilarious to hear them harp upon this tune.
"No need to worry about the chemical medicine paradigm." Oh good. That means the chemical constituents of plants will continue to show activities, long after extracts of the plants themselves fail to live up to their purported use in folk-medicine, or the hyperbolics of marketers.
Chemgeek you ass-ume so much.
Most prostate cancer is genetic, dairy products have nothing to do with it. Let me think; the last time I had a glass of milk is around ten years ago. I did more than a google u research on the subject.
The reason I am in the 7% has to do with where I work (medical facility) and the care I received from here to the treatment hospital. I also lucked out I had the best cardiologist in the area treat me.
I know that he has been dismissed and recalled previously BUT we can hope. If he only gets one day a week, it might really eat into his profit margin.
Oh, and we have to stop meeting like this, Bruce.
There are hormones in Dairy products and the Chinese have very low rates.
Did you have any specific career paths in mind for your new job search, Fucklesworth?
From American Cancer Society:
Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors aren’t sure which of these factors is responsible for raising the risk.
Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer. Dairy foods (which are often high in calcium) might also increase risk. But most studies have not found such a link with the levels of calcium found in the average diet, and it’s important to note that calcium is known to have other important health benefits.
Research shows that there may a slight increase in prostate cancer risks from dairy and red meats but whether it is a causation or a correlation is unclear.
Well, Dr. Starfield’s study identified 106,000 deaths per year caused by properly prescribed and administered, FDA approved drugs.
The real follow up question would be, how many are saved each year with the same drugs. Anticoagulants are one of the more dangerous prescription drugs by number of side effects and are often used as examples when talking about drug-related deaths. Except demonstrably they keep high risk patients alive longer than comparable patients without the drug. Chemotherapy also has nasty side effects, and sadly, many cancer patients undergoing chemo die. Now is this due to the drug, or the cancer? (you can argue for or against on individual cases, but again, statistically, patients on chemo survive much longer than comparable patients without).
There's also this:
Two main points to take away from this link is a) the average age of those patients dying from medical complications. And b) the overall decline in the rate - obviously the evil nefarious international disease-mongering conspirators are constantly getting better at keeping people alive. How utterly wicked of them.
Regarding Dr Starfield's article (JAMA 2000 v284(4):483): Among the caveats noted by her in the article, the first is "most of the data are derived from studies in hospitalized patients" - remember that these patients were hospitalized for a reason. These are not deaths occurring in otherwise healthy patients looking for some dietary counseling during their annual well-care checkup. It is not possible to assess how many of these patients would have died regardless of treatment chosen.
A "caveat"? Seems more like a limitation. Most patients who die from unnecessary surgery, medication errors and other errors in hospitals, and hospital-acquired infections, would likely die in a hospital, but by no means all. And considering that many people outside of hospitals are also imbibing properly prescribed and administered, FDA approved drugs, the total deaths from them each year are likely much higher than the 106,000 that occur just in hospitals.
My limited experience with things like biopsy confirmed metastatic cancer is that conventional medicine flies blind with too few markers and panels to see the bullet coming, and fails frequently for this reason.
And then mainstream medicine fails to treat specifically enough with targeted, targetable mild materials (meds) for this reason , too. What I've seen with other patients' regular bloodwork makes me shudder. No wonder at all why so many crash and burn.
My limited experience with CAM/integrative medicine/FM is that morbid inflammatory processes can be attacked sooner, more thoroughly, more successfully, with less risky ammo than in regular clinical medicine.
That headline "Disruptive Functional Medicine Innovation Drives Value-based Future at Cleveland Clinic" really makes me think of the Weird Al song "Mission Statement", which is to say it's filled with meaningless buzzwords.
prn @28: If conventional medicine doesn't have enough markers and panels how would you suggest that we go about creating more? And what do you want the markers to be used for? Prognosis estimation, treatment planning, something else?
(I'm assuming that you're talking about biomarkers, please correct me if you mean something else.)
Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer.
OMG. I wouldn't think that the ACS would set-up a strawman.
Huggins first demonstrated the androgenic dependence of prostate cancer as a potential cause, as well as a point of intervention and therapy, ultimately leading to a Nobel prize in 1966 [1,2].
It's hormones stupid.
Mr. Jost has not commented here since 2012. Travis Schwochert from Endeavor, Wisconsin, how is that job hunt going? Sorry, you can't blame us for your bad behavior. You should have thought about that before posting so much vile on the Internet.
A medium that never forgets.
Good bye, Travis Schwochert from Endeavor, Wisconsin.
I learned early on that the Internet does not forget, therefore I have always been careful about my behavior. Which was helped by having a very very common name. Still, I knew better than to post obscene photos, obscenities and meltdowns online.
Perhaps you should apply for Supplemental Security Income (aka disability payments) because your troll history is interfering with your job search.
Here is a quote from the cop when he was arresting some goons across the street for stealing barbecue supplies from a neighbor when they cried "But there are kids in the house!" (who they were ignoring)....
"You should have thought about that before you decided to steal."
Those goons provided a great deal of entertainment in our neighborhood. Instead of taping a piece of cloth over the window to block the street light, the idiot would go out and throw rocks at it to knock it out (stopped when we stood at the top of our steps to watch him). Then they had loud parties, but would not answer the door when when hubby pounded on their door with a rubber mallet. And it was fun standing next to my garage staring at this old guy as he honked his car horn that he summoned a female resident... he kept waving me away while I was standing on my own property! Cop cars made it a habit to park on our street during their breaks to watch that place.
It was so lovely when the guy who owned the rental next door begged their landlord to sell it to him. The landlord did... and before they moved out the idiots literally trashed the place. The building was expensively rebuilt, and nice folks moved in. Then the neighborhood became lovely and quiet.
Travis, we are waiting for you to shut up and leave. You are a stench on society. Don't expect us to help you find a job, you need to own up to your idiocy.
One big idiocy is that pharmaceutical companies get big bucks from preventing diseases... when in reality they make more by treating them:
a href="http://pediatrics.aappublications.org/content/early/2014/02/25/peds.201…">Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009
Also, for the record: I am a former aerospace engineer who just happens to be the mother of a young man with autism who has had a trip by ambulance because of a "grand mal" seizure from a now vaccine preventable disease.
I am not worthless because I fight for my kid. My kid is not worthless because he has potential. Mr. Schwochert, you need to reassess your priorities as you search for a job. Learn how to live with others who are different.
What "now vaccine preventable disease" are you alleging caused your child to have a seizure? I was browsing through the causes of non-epileptic seizures...I didn't see any "vaccine preventable" diseases on there--and that's in the Merck manual, where I assume they'd be anxious to mention such a cause. Just curious.
Disruption is so yesteryear. All the cool kids are pivoting.
Speaking of pivoting, Travis J. Schwochert, aka Fendlesworth, aka Fucklesworth, spin on this
And speaking of cool, man, that guy's got it made! If you do a Google search and misspell his name, Google suggests the correct spelling. How many of us can claim that kind of fame?!.
Heheh. Well, as you can see, the latest Fendlesock is gone. Sorry. I was up late multiple nights this week and fell asleep in front of the TV. So he had a few hours to play without my intervention. Such is life...
NWO @34: Are you familiar with the concept of a febrile seizure, the kind caused by high fevers, most often seen in children? Those can be caused by any number of pathogens that induce a high fever, some of which are vaccine-preventable and some are not.
HiB meningitis can also cause seizures, and thanks to the HiB vaccine, is now very rare.
If conventional medicine doesn’t have enough markers and panels how would you suggest that we go about creating more? And what do you want the markers to be used for? Prognosis estimation, treatment planning, something else?
JT, conventional medicine simply doesn't use enough of what panels and markers that it's already got. There are several problems. Clinical medicine is so used to shortcuts and assumptions for the broad field, that doctors seem unfamiliar with a lot of useful literature and extended analyses in detail in any specific area. With the extra lab data, a lot of minor problems that can unravel you are easier to spot, delineate and/or adjust.
The extra markers improve monitoring and detection. problem detail, prognosis estimation and alteration, treatment planning and targeting - as much of the whole enchilada as one can research.
Of course I'll hear "cost", "overdiagnosis", "polypharmacy", "futility", "iatrogenic risks", (assuumed) "net benefit" (of assumed tretments) etc. These objections more reflect the problems of the current conventional medical models than (alternate medical) reality to me.
Also I'm finding that some panels are already run. Even if I didn't initially ask for them, some are recoverable after the initial results are in, or that they were running them anyway.
if ONLY the problem was limited to the Cleveland Clinic.
Deep Throat advice is more relevant than ever; "Follow the money!"
There are pros and cons of every issue, and there are always are some that twist things around as a money making scheme. As an RN working with the geriatric population, I wish we could all come together and find a happy medium. My patients are prescribed beneficial medicine, but are receiving little to no education on their nutrition and exercises plans. I feel like a better plan for all of us would be to go back to the basics of nutrition, exercise, sleep, stress relief, and hydration. And then on top of that, we could educate the children and families of these patients to help further the prevention of diseases. I believe functional medicine's core is getting back to these basic underlying issues, and although it might not be as scientific or glamorous, I feel that these are the basic components that the general population need help with to increase their quality of life.