Although the requirements vary from state to state, all states require that physicians obtain a certain number of CME credits every licensure period in order to renew their medical licenses. Also, although again the specific requirements vary by specialty board, in order to retain board certification physicians and surgeons must meet certain specific CME credit requirements. Indeed, a particularly annoying new requirement is that a certain number of these credits be "MOC" credits, where MOC stands for "maintenance of certification," a particularly contentious topic among physicians. Basically, in surgery at least, an MOC credit means that the CME activity has to have a post-test of some sort that the participant must pass in order to claim the credits. The American Board of Surgery, for example, requires, in addition to the usual CME requirements, 60 of these "higher level" credits every three years, to be documented—you guessed it—every three years. Personally, I find these sorts of credits to be a major pain and not particularly helpful when it comes to actually learning what the CME activity is supposed to be teaching, but that's just me. However it's done though, the processes by which CMEs courses are accredited is a big deal in the world of medicine.
The number one defender of quacks perceives a threat
The reason I started out with a little primer on CME credits is because there is a form of CME that I very much don't like. I bet that you can probably guess what it is. Did you know that doctors can receive CME credits for studying pseudoscience and quackery as though they were medicine? Regular readers won't be surprised. After all, if we physicians have to imbibe a certain number of CME credits in order to maintain our medical licensure and specialty board certification, we'd like the information that we're expected to be exposed to and learn to be high quality, science-based information, preferably recent updates in our specialties, so that chasing CMEs isn't just a chore but a way that actually helps us to practice according to the latest science- and evidence-based standards. It's the minimum that our patients deserve.
What got me started on this topic was a post by someone we've met before, a post from the "other side." The man writing the post is Richard Jaffe. You might remember him as the longtime attorney for a man who has been a frequent topic of this blog, Dr. Stanislaw Burzynski, the Polish expat physician based in Houston who has been administering peptides he calls "antineoplastons" (ANPs) to cancer patients for four decades now, with authorities seemingly unable to stop him. Jaffe might well have ceased to be Burzynski's attorney last year, thanks to a falling out based (apparently) on Burzynski's failure to pay his legal bills accrued during his defense against the Texas Medical Board. (Unfortunately, Burzynski got off lightly yet again, even without Jaffe shepherding his defense across the finish line.) Their falling out aside, over more than two decades, Jaffe defended Burzynski from all threats, be they from the FDA or the Texas Medical Board. Indeed, he was the architect of a scheme that allowed Burzynski to set up over 70 dubious clinical trials of ANPs, a strategy he's been milking for 20 years to continue to administer ANPs without being prosecuted, despite ANPs lacking FDA approval. Even though he and Burzynski appear to have parted ways, though, Jaffe is still very much into defending quackery, as is easily verified by a perusal of his blog. Oh, and he's pro-"vaccine freedom"—cough, cough, antivaccine—too.
Right now, Jaffe is not pleased, and if he's not pleased that means I probably should be pleased. He expresses his displeasure in a post entitled "The next big CAM battle is here, and it's ugly." Guess what the battle is about?
CAM or integrative medicine doctors have had their problems with the state medical boards. And CAM organizations have had their run-ins with governmental agencies. However, the groups have always survived in large part because they have had a steady income from membership dues and from their annual conferences, where their members learn the latest and greatest from their thought leaders. But the CAM organizations’ income stream is now in jeopardy, and thus so is their existence, based on what looks to be well-planned, systematic effort to put CAM groups out of business, and stop the dissemination information about CAM therapies.
AND THAT MY FRIENDS IS A VERY BIG DEAL.
I can't help but wonder if Jaffe really wanted to start his post that way. Think about it. He's just basically admitted that CAM organizations exist on membership dues and by hawking their conferences as a source of CME. But wait, you say, isn't that what all professional societies in medicine do? Yes, but that's usually not all, and the big difference is that legitimate professional societies don't peddle pseudoscience. CAM (complementary and alternative medicine) organizations do. Being able to offer CME provides a patina of legitimacy, too, because the organizations that offer CMEs have to meet standards laid down by the Accreditation Council for Continuing Medical Education (ACCME). The AMA, which certifies a large proportion of the CME credit programs in the US, requires that the activity meet all the requirements by either the ACCME or a recognized state medical society (SMS).
So what is this horrific threat to CAM or "integrative medicine" (IM) CME? Jaffe is more than happy to tell us:
For months, at least two CAM groups have been under review/ investigation by the primary private CME accrediting company, the ACCME (Accreditation Counsel for Continuing Medical Education). Recently, the ACCME has determined that a significant portion of the groups’ prior year’s CME courses does not meet various ACCME standards. ACCME is demanding that everyone involved in these courses be informed that:
“they were presented invalid information….”
and that the groups:
“instruct them [everyone] to avoid making any clinical decisions for testing and/or treatment based on what was presented, and direct the registrants to accurate and valid sources of information for the problems or systems presented.”
I should point out that this “incorrect” information came from some of the most accomplished, respected and published thought leaders/teachers in the CAM community. These folks have been giving CME courses without incident for decades.
My first thought upon reading this passage was that this is exactly the problem. Physician "thought leaders" in integrating quackery into medicine have been giving CME courses without incident for decades. My second thought was a retort to Mr. Jaffe, "Gee, you say this as though it were a bad thing." My third thought was to wonder which two CAM organizations have run afoul of the ACCME, and how can we as skeptics get the ACCME to look into other CAM organizations running pseudoscientific conferences? After all, we've been complaining about the ACCME accrediting CAM conferences for CME for years, which makes the next passage in Jaffe's little screed music to my ears, if it is indeed true (remember, this is Jaffe who is relating this story):
Further, in terms of future CME courses at their conferences, ACCME has informed these groups – and this is the key to understand what this is all about – that:
“recommendations involving clinical medicine must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients and all patient care recommendations must conform to evidence emanating from guidelines and data that meet generally accepted standards of experimental design, data collection, and analysis.”
In short, ACCME is trying to require these groups to only teach mainstream medicine! This is crazy and a huge deal!
I actually half agree here. Yes, this would be a very big deal indeed if the ACCME is actually starting to enforce some scientific rigor on CME conferences seeking its accreditation. No, it would not be "crazy." It would be a long-overdue course correction, something the ACCME should have done at least a decade ago, if not much longer. You don't believe me? Let's take a look at what sorts of "courses" have received certification by the ACCME. Of course, it's not just CAM organizations that get these courses certified. It's some heavy hitters in the world of academic medicine too, an outgrowth of the problem of "quackademic medicine" (the integration of quackery into academic medicine) that has taken root in dozens of medical schools and academic medical centers across North America.
"Quack!" goes the CME course
There are a number of courses and conferences that offer CME credits for learning about "integrative medicine" or CAM. For example, Steve Novella once discussed how physicians can receive CME for acupuncture through Brigham and Women’s Hospital and Harvard Medical School's course on "structural acupuncture," as have others. I can't help but note that the webpage is no longer there, but thankfully the almighty Wayback Machine still has it. Not that it matters that much, because, alas, Harvard is still offering the course. Only this time it's called the The International Structural Acupuncture Course for Physicians: A Palpation Based Approach. Basically, at one of the most respected academic institutions in the world, you can take a course that spans nine months and requires you to come to Boston five times for live "hands-on" teaching about meridians and the latest quackademic studies trying to show that acupuncture "works." Somehow, I bet that they'll forget to mention how it doesn't matter where you stick the needles or even if you stick the needles in because acupuncture is all an elaborate, theatrical placebo.
You can earn a lot of CME credits, too. The Harvard acupuncture course as currently constituted offers 300.25 (why the quarter?) CME credits, of which "182 hours will focus on the theory and science of acupuncture and 118.25 hours will involve live, clinical experience." The course is run by Joseph F. Audette, MD, and an acupuncturist, David Euler, L.Ac., who in previous fliers was described as a "graduate of the Tristate Institute of Traditional Chinese Medicine in New York" and "a recognized authority in utilizing dry needling techniques for the treatment of pain." Mr. Euler is described as a "recognized authority on modern Japanese styles of acupuncture and its integration with traditional Chinese styles and Western medical practice." What amused me is that there is an actual professor of anatomy, Frank Willard, PhD, included in the course faculty, but he is not Harvard faculty. Rather, he is faculty at the College of Osteopathic Medicine, University of New England. Personally, as I did when I discovered that Georgetown University was "integrating" the teaching of acupuncture meridians into its first year anatomy courses, lo, these many years ago, I wonder just what the heck Prof. Willard will say about the anatomy of acupuncture, given that it's based on a prescientific understanding of the human body. Now there's a lecture I'd love to sit in on, if only for the yuks.
It's not just Harvard, and it's not just acupuncture, either, unfortunately. Harriet Hall has lamented how the American Academy of Family Physicians (AAFP) has succumbed to the quackery embedded "integrative medicine" in its CME program. Basically, the AAFP started including various "integrative medicine" modalities in its CME offerings without skepticism or critical thinking.
Then, in my own specialty, there's the Society for Integrative Oncology (SIO)—which really, really, really does not like me—and its annual conference, which this year will be held in Chicago. The schedule and speakers haven't been announced yet, given that the conference is in November, and its overarching goals are the usual CAM pabulum, but we can look at past conferences; e.g., when Dr. Francis Collins was the keynote speaker at the 2011 SIO conference. Let's just say that, in addition to the usual science-based medicine modalities rebranded as somehow "alternative" or "integrative" (e.g., diet, exercise, and lifestyle), there was a whole lot of pseudoscience as well, plus a lot of "spirituality" thrown in, allowing the SIO to be far too generous in its assessment of reiki and other "energy medicine" modalities (or, as I like to call them, faith healing). You can get an idea of the sorts of activities that the SIO allows from "integrative oncology" guidelines for breast cancer that it published two years ago. Let's just say that the science was...weak.
Of course, the SIO objected mightily when I published a perspective article on integrative oncology two and a half years ago. In particular, it objected to devoting so much verbiage to homeopathy in my article, where I used it as an example of how prior plausibility is so important in clinical trials. (Ironically, I expanded the section on homeopathy based on reviewer comments; the original version had a much shorter section on this, The One Quackery To Rule Them All.) "Oh, no," Great Minds in SIO protested. "We know homeopathy is pseudoscience. We are evidence-based! We would never, ever recommend the use of homeopathy, and it was a horrible distortion on your part to imply otherwise." I shut that down with one observation (well, three). First, SIO allows naturopaths in its organization. Second, homeopathy is an integral part of naturopathy. It's required in the curriculum of naturopathy schools and is included on the NPLEX, the test used for licensure in states that license naturopaths. So most, although not all, naturopaths use homeopathy. Finally, one of the authors of the SIO's breast cancer guidelines at the time had a clinical trial of homeopathy registered at ClinicalTrials.gov.
This is the sort of organization that offers CME for CAM conferences.
Mr. Jaffe has a plan
Based on learning that the ACCME might be cracking down on accrediting CME courses and meetings that promote pseudoscience, Mr. Jaffee is afraid:
Beyond these two professional groups, a disease based group has recently been informed that its CME status for future conferences has been rescinded by its CME intermediary. The intermediary denies that it received any pressure or orders from ACCME.
Three CAM groups which have previously received ACCME course certification without any undue problems who in the last few months have had their prior CME course approval rescinded and/or their future CME approval withdrawn or placed in serious doubt.
Is this all a coincidence? Not a chance in hell.
My guess is that more of the same has or is going to happen to other CAM groups.
I certainly hope so. After all, I've seen examples as egregious as the offering of CME credits for a course offered at that quackiest of quacky "autism biomed" quackfests, Autism One. Oddly enough, I would not favor retroactively rescinding CME credit, which would harm physicians who attended courses in good faith, believing they were offering CME credits. However, I would very much favor the ACCME shutting down CME credits for future CAM and integrative medicine conferences teaching pseudoscience like reiki, acupuncture, homeopathy, and the like.
Jaffe is also curious how this horrible (in his mind) state of affairs came about:
Someone out there has to know something or know someone who knows something about how this came about, and who or what group is behind it. (My guess is that ACCME is the vehicle not the originator.)
I think there is a smoking gun out there, and if we find it, we can probably reverse ACCME’s decision quickly, so my suggestion is that all the CAM groups and interested parties get the word out to search for the smoking gun.
How much does anyone want to bet against my prediction that in a future post he announces that he's discovered that big pharma or the FDA was behind this move on the ACCME? Yeah, you're probably wise not to take that bet.
Not surprisingly, Jaffe's plan is to go straight to state legislators, because state laws generally require ACCME accreditation of CME credits used for state medical licensure:
In all the big CAM states like Texas and California, I know there are legislators who are pro CAM. My suggestion would be to identify who they are (not hard in Texas). I think the boards in a few of these states need to hear from some legislators about how ACCME is undercutting board rules (in Texas) or the CAM statutes (like in California).
These legislators should copy ACCME on their concerns expressed to the boards. If one of them is on a legislative health committee, even better. Better still would be for a couple states to start an investigation on ACCME’s motives. Maybe even an invitation to appear at a specially called hearing. Legislators can hold hearings for all kinds of reasons. So can federal legislators. I think with all the politically connected CAM docs out there, mulitipled [sic] by their politically connected patients, well I think there’s a heap of trouble that could be stirred up for ACCME.
It doesn’t have to happen in every state, or even many states, just a couple of the big ones. The story is going to get out, and questions are going to be raised. The widespread dissemination of ACCME’s action might even turn-up that smoking gun I mentioned earlier. And once the nefarious motive and scope of the conspiracy publicly surfaces, I think ACCME will be forced to rescind its actions. So, we need to shine some light on these jokers.
Actually, it's the CAM groups who are promoting the teaching of this sort of nonsense who should have some light shined on them.
Still, this is classic Jaffe. It's the very technique he used to strike back in favor of his client Stanislaw Burzynski against the FDA. He'd use his connections, such as to Rep. Joe Barton, who in the 1990s would regularly haul the FDA Commissioner in front of his committee to demand why the FDA was "persecuting" Burzynski. It worked, too. There are a lot of quackery-friendly (or at least sympathetic) legislators out there, particularly in Texas, where appeals to "health freedom" are powerful enough to fuel a resurgent antivaccine movement. Then, of course, California is home to all manner of quacks.
Jaffe's plan might just work.
The real problem
I have no idea what two CAM organizations are the ones running into trouble with the ACCME over their CME offerings, and, to be honest, it doesn't really matter that much. The reason is simple. Jaffe is throwing red meat to his base over a perceived threat that is really not a huge threat at all. Yes, there are CAM groups that hold dubious conferences, and, yes, they are a problem. However, they're not the biggest problem. They are not existential threats to medicine as a science-based discipline.
The most serious threats to medicine as a science-based discipline do not come from most CAM groups. Rather, they come from within medical academia itself. Do you think that Harvard had any trouble getting the ACCME to accredit its CME offering for its acupuncture course? I highly doubt it did. Similarly, I really doubt that quackademic medicine conferences offered by high profile, respected medical schools and academic medical centers have trouble getting the ACCME to accredit the CMEs for their courses, either. The same thought applies to the AAFP; I'd be surprised if there were any pushback by the ACCME against its inclusion of dubious CAM in its "integrative" offerings. The list of academic medical centers offering dubious CAM courses for CME appears to be growing, as well, with examples like the aforementioned Harvard, the University of Arizona, the University of Florida, The Ohio State University, the University of Michigan, and many more. Add to that the infiltration of CAM into medical school curricula, the infiltration of integrative medicine residencies, and even board certifications, and Jaffe's getting the quacks riled up over a minor issue.
The real problem is not that the ACCME is targeting two CAM organizations, if it's really doing anything of the sort. The problem is that it's not targeting all the universities that offer courses integrating quackery with medicine and that medical academia is embracing CAM in its medical school curricula and residencies, two areas where the ACCME has no authority. The ACME really needs to go much, much farther in enforcing scientific rigor in its CME accreditation process, but, even if it does that, it won't mean much if the LCME (which accredits medical schools) and the ACGME (which accredits residency programs) don't do the same.
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This is a most difficult post to make a response.
If I understand your argument, doctors shouldn't teach or learn quackery.
Please clearly and definitively define the term "medical quackery" in less than 150 words so your readers can have further discussion on this very ambiguous subject.
No help from the minions, Orac.
Although let me help with the following:
The term "quackery" is defined as...
There is a Wile E. Coyote joke in here somewhere.
Did ACCME just fire Mr. Coyote, or did they just realized that Mr. Coyote is the negotiator for a bunch of CAM groups? Either one of those would work.
How odd ... there's a Michael J. Dochniak listed in the Encyclopedia of American Loons. Can it be?
MJD, you have been around this blog long enough to know what medical quackery or quackery are as defined by Orac. There is no need for him to lower himself to your level to answer your inane questions.
Real medical professionals need to learn more real medical processes and information. If you are a CAM pretender learning how to read nose hairs to determine IQ maybe of some value ($$$$).
This is exactly why I didn't want you to rely on the minions for a definition of "medical quackery".
Comment (#2) uses the fictional cartoon character Wile E. Coyote to dish-out respectful insolence.
Comment (#3) uses the word "Loons" to dish-out respectful insolence.
Comment (#4) bravely tries to shield you from attempting a definition of the term "medical quackery".
Be respectful and accountable to your readers, clearly and definitively define the term “medical quackery” in less than 150 words.
MJD, your reading comprehension must be low. I did not attempt to shield Orac from trying define quackery in a 150 words or less. I simply stated that if you have actually been reading this blog you would know Orac's definition of quackery.
In no way would I try to prevent or shield Orac from responding to your request. Hopefully if Orac does respond it is with less than respectful insolence.
The problem with licensing is it tends to reduce innovation and progress by reducing competition. The professional monopoly becomes the only judge of its own excellence. And even, as illustrated here, tries to force professionals within its own ranks to stick with the status quo to protect entrenched interests. In essence, it's a medical mafia, protecting its own interests under the guise of protecting the public--doing everything in its power to stop the rising tide of market demand for alternatives to the allopathic model.
Shiiiiiiiiiiiiiiit -Only a loon would think that our host would need the assembled minions to shield him from wit of MJD.
Of course MJD knows exactly what quackery means. Once our host responds, MJD can cry that he can't engage because he's in moderation, so he should be set free to post his silly ideas.
NWO Reporter has hit the nail on the noggin once again. Why should professional organizations have a monopoly on licensing and certifying individuals?
I should be able to design a bridge or fly a commercial jet without those silly requirements that are intended solely as economic protectionism. And we should all have the power to challenge the Medical Mafia by setting up oncology clinics in our garages.
I have every confidence that our new Administration will find a way to let the market decide these matters.
So I take it that you believe that The American Institute of Aeronautics and Astronautics should host a conference and allow speakers from the Flying Carpet industry?
I'm saying that the public has discerned, with good reason, that the medical monopoly is not quite as excellent as it proclaims itself to be. :)
NWO Troll: " with good no reason,"
Fixed it for you.
Seems to me that there are plenty of quacks who operate outside of their "professional" organizations.
The problems are that groups like the AMA are too stringent, its that they aren't stringent enough in dealing with quack operators....and heck, it has also been pointed out here, multiple times, that medical boards don't do enough to punish bad doctors.
Old news, once again. Don't you have another video to produce?
Citation, please, that any more than a smattering of loons and idiots believe that the "medical monopoly" doesn't embrace enough quackery.
Surgeons are skilled with their fingers. I'm sure our host will have little difficulty raising the appropriate one in response to the question posed - or rather the poser/poseur.
NWRO, you are confusing licensing with Continuing Education to maintain said license.
Probably in the next several weeks I will be having a fusion surgery performed on my C-5/6 disc. Now should I go to a general surgeon or should I go to a neurosurgeon. Of course you select a neurosurgeon.
In todays age you can check credentials, training and any enforcement action of a medical provider very easily. Would you use a medical provider that is not current in their field for whatever you are having done? I think not. If my neurosurgeon had just taken CME concerning the use of balsa wood in place of cadaver bone for the fusion, I would be running away screaming killer rabbit.
Case in point: Dr. Jay Gordon, who is allowed to add the otherwise unfortunate acronym FAAP after his name.
Serious question, since I'm not in the medical business: How does one become a fellow of something like the AAP? Can any member claim that title? Is it a higher tier of membership (akin to Patron or Sponsor in certain other organizations) that comes with an additional membership fee? Or is it like the scientific societies I am familiar with, in which one has to do more than open the checkbook to become a fellow? I know some people who have earned the title Fellow in my primary scientific society--they are among the best-regarded people in the field, which is why they have been chosen for that honor.
Linus Pauling said:
Like general relativity, amirite?
Well, special relativity has had it's critics.
There is exactly one "alternative to the allopathic model," and that is the homeopathic "model." Do try to better familiarize yourself with that whole "semantics" thing, as you've been performing very poorly overall.
Go to Orac and get a man-boob reduction in the process.
I thought the converse of allopath was naturopath?
This Chris appears to be the odious Travis J. Schwochert né Fucklesworth
Yeah, it's him. Rather interesting. He's impersonating someone who only ever commented once on this blog ever—in 2009.
He's gone now again—for now.
Well, now we know that we don't have a new Chris, but it's just another Travis J. Schwochert f 239 S Church St Endeavor, WI sock puppet, as noted in http://lizditz.typepad.com/i_speak_of_dreams/2017/02/the-fendlesworth-m…
No disrespect to Orac but I don't think I would want him (other than in an emergency) messing with my c-spine.
Wow, other Chris. First a quote from someone who died over twenty years ago, and a fifty year old paper. So very timely.
By the way, just because real science and medicine may have some issues, that does not prove alternative methods like acupuncture, homeopathy, acupuncture, and other forms of quackery work. Unlike quackery, real medicine and science actually evolve and change through time.
Travis I know a good vet that can transplant some goat balls in to you. That way you would have at least a minimum set of cojones to use instead of playing with Mr. sock
I know. We all know those don't work.
I am all for molecular treatments, but evidence shows that cheap and un-patentable molecules work the best such as: methylglyoxal, bromopyruvate, ascorbate, and curcumin.
And the avoidance (or admittance as such) of carcinogens like dairy, fluoride, and diagnostic radiation.
So you think that just because there's a huge demand for painless and risk-free relief from ailments, quacks should be allowed to offer treatments that are proven to do nothing beyond placebo, yet claim effectiveness?
Then you must be quite a fan of this old Latin adage: "Mundus vult decipi, ergo decipiatur"
Chris @28 " the avoidance (or admittance as such) of carcinogens like dairy"
Riddle me this: if dairy is so bad for you then why did the mutation to retain the ability to digest lactose beyond infancy arise 3 separate times?
Wow, other Chris is staggering! Hello, Travis, from America's Dairyland.
In addition to being a sock puppet troll, do you also engage in cow tipping?
The latest "Chris" is almost certainly Travis J. (for Jerk) Schwochert. The hammer has be summoned.
F@ck off travis.
I thought part of the point of being a sock puppet was to *hide* the puppetry. That doesn't work when you answer a question as another person.
Also, your first citation says that the evidence for dairy as a carcinogen is controversial and contradictory.
Bother, my 'nym didn't enter properly and I'm off to moderation.
Carmine or Travis go read about how dairy operations actual work and when cows are actually milked.
So now you've moved the goal posts from "dairy" to "milk from pregnant cows".
What about other forms of dairy? Goats? Sheep? Water buffalo? Camel? Horse? Yak?
Cows are not kept continuously pregnant and almost all milk production is after birth of the calf. The reason that veal is available is that most dairy calves are removed from the mother so her production can go to us.
I think I know a little bit about the causes of prostate cancer since I am so far a survivor of stage 3 prostate cancer.
JustaTech, I don't doubt this Carmine person would enter a wild bull milking contest. The knowledge base of dairy operations isn't there.
Latest Travis sock puppet: "Dairy cows are constantly kept pregnant so they can produce more milk."
Basic mammal biology fail. Your level of understanding is about the same as the Congress Critter who thought women could "shut things" down to avoid pregnancy from "legitimate rape."
I somewhat wonder whether whatever the ACCME is doing is the equivalent of leaving off the quack miranda: the organizations that got in trouble were talking about real medicine, and doing it wrong, as opposed to talking about homeopathics or whatever.
Wow, other Chris. First a quote from someone who died over twenty years ago
Does anyone have a source for the purported Linus Pauling quote?
I was going to save Travis Schwochert's comment but I see Johnny did it already, linking Travis to it. Don't see how that comment is "defending yourself" Travis. Spare us the nonsense Travis Schwochert; you're just a garden-variety scumbag.
There's also a rising tide of market demand for fentanyl. Let freedom ring!
This article from a pro-Pauling blog is doubtful about the veracity of this quote. They were unable to identify a reliable source despite what appears to be a thorough search. They also present a case that such a quote would be uncharacteristic of Pauling.
In any case, Linus Pauling, in his dotage, fell victim to Nobel disease, his being perhaps the most prominent case. Very sad.
Rich Bly: "Carmine or Travis go read about how dairy operations actual work and when cows are actually milked."
I have actually visited dairy farms, where much of this stuff is explained. Yes, they spray some of the manure on the fields they grow for winter siliage. They call the smell the "smell of money." ;-) It is also the reason we decided to not stay in the hotel in Tillamook, but move to another Oregon coast town (yes, it was central to places we wanted to visit, but it does turn out they are very serious about the several small dairy farms where they source the milk for their products).
But I also have more personal experience than Travis in milk production. I sincerely doubt Travis has given birth and breastfed three children. Total years in lactation was a bit more than five years.
Your comparison is somewhat flawed: fentanyl actually works. Quackery doesn't. Yet somehow, that doesn't stop NWO Reporter from advocating it.
Besides, his argument is also flawed in another way: the market for quackery isn't really demand-driven, it is supply-driven. Yes, there is a universal demand for easy, painless and non-invasive cures, but the demand for all sorts of quackery stems from the fact that actual people can and will offer such 'cures' with impunity, regardless of the fact that they don' t work. As often said before, it is nothing short of a legitimate scam, and with the most precious thing we have at that -- our health.
And since most people have insufficient medical/scientific knowledge to independently judge the validity of health claims, it is important that they are protected from these con artists. This protection is basically simple: all treatments offered should have scientifically proven effectiveness.
@Richard #51, I think your sarcasm detector is broken.
@Julian Frost. #52
Hehe, no, I get TBruce's point -- it was just an opportunity for me to contrast the ineffectiveness of quackery to something that actually works (even if it hints towards illegal use of a potent drug).
Yeah, but the problem with fentanyl is the stuff being used to cut heroin is not legally produced. Criminals produce it and import it from Mexico or China.
I get the point you're trying to make, but it distracts from TBruce's point: that just because something works, doesn't mean everybody should be using it willy nilly.
"“Carmine or Travis go read about how dairy operations actual work"
You don't want him to get excited.