"My wrong opinion is better…than any layperson's, even if it's wrong, and they are accidentally right."

Just own up to being a snob about your education/opinion. It's ok.

Yes, I have a doctorate too, and recognize training matters, but you…are a snob about yours. Beside that, your example is also spurious, specific to a Caesarian section, at least earlier you advised as to your expertise in treating covid patients for covid, not all manner of medical practice. Geeze, just own your attitude, no reason to deflect.

I stand by my judgment and characterization, it's kind of sad you think you need to deflect from yours.

The people who holler "Believe the science!" are the same people who think that there are more than 2 genders....

ramblin_ag02 said:

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Compare that to a layperson. They can pretty much say anything with no evidence or experience and end up being right eventually. Even broken clocks are right twice a day. But it's not like we're going to take Joe Blow's unfounded opinion seriously even if he eventually ends up being correct.

I'm not always right, and no doctor or part of our medical system is. But my wrong opinion is better informed and judged than any layperson's accidentally correct opinion

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Let me give an example. 40 years ago niacin was given for cholesterol problems. We know from good studies that high HDL and low LDL are associated with less heart attacks. Niacin is known to cause HDL to rise and LDL to lower, and therefore was also thought to reduce heart attacks. Based on everything we knew at the time, including a lot of studies, this was a good preventative medicine. However, it turns out that we were wrong. Studies tested the direct effects of niacin on preventing heart attacks and the results were controversial but did not show any effects. So despite having excellent, well-informed reasons for using it, we were wrong.

Around the same time, some people were taking an herbal medicine called red yeast extract to lower cholesterol. You could find it in herbal medicine shops that also see rhino horn, tiger testicles, saw palmetto, and a hundred other "remedies" that don't do anything. However, once this medicine was tested, it was found to actually prevent heart attacks. Turns out the active ingredient of red yeast extract is a statin, and that established the standard of care all the way until now.

The wrongness in the first paragraph is a considered, measured, and tested wrongness. It incorporated the latest knowledge in biochemistry, pharmacology, and medical studies. The second paragraph was literally just someone using an herb based on a verbal tradition. These same people peddle a hundred ineffective treatments. Even though red yeast extract works, they had no idea why, what dosing to use, the possible side effects, or possible interactions with other medicines. The herbalists were right and the doctors were wrong. But the herbalists were lucky and ignorant, while the doctors were knowledgable and unlucky. It happens, but give me the doctors in the first paragraph over the herbalists in the second every day of the week.

The system used by doctors is also self-correcting, so even when we are wrong we fix it. We now know 1000x more than the herbalists pushing red yeast extract. We've created better versions of statins and we know the side effects and drug interactions. We know the target doses and what to measure when treating people with this. The herbalists were ignorant and right, but now the doctors are knowledgable and right. At least until we find more information to correct ourselves like we always do. Contrast this with verbal tradition and politics. These things do not tend to correct themselves when better information is available.

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Great post! The bolded sentence above made me think of a recent exchange in my family text group. Even though my brother and I are not on speaking terms anymore, I see the stuff he shares. Well, he shared some nonsense from Joe Rogan and my mom started talking about how doctors "flip flop". But as I explained, it's not "flip flopping". It's the scientific method at work. Trained professionals/scientists observe and gather information. They test their hypothesis. They make corrections based on the new data. This shouldn't be controversial. We should encourage it, because as you point out, that's how we grow in understanding. That's how we move forward.

Thaddeus73 said:

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The people who holler "Believe the science!" are the same people who think that there are more than 2 genders....

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Sex and gender aren't the same thing. And there are more than 2 of both. Unless you don't believe intersex people exist. But that's not the point of this thread. Start a new one if you want to argue that.

Gender non-conforming & trans people always make for an easy deflection for those who understand neither. No point in taking the bait.

How'd the opioid epidemic self correct? Lots of doctors doing their homework before prescribing it?

Arguing that if you have enough time you'll get it right kills a lot of people in the meantime. Pride may keep you warm at night but this isn't a village of one.

AGC said:

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How'd the opioid epidemic self correct? Lots of doctors doing their homework before prescribing it?

Arguing that if you have enough time you'll get it right kills a lot of people in the meantime. Pride may keep you warm at night but this isn't a village of one.

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You probably won't like this answer, but doctors didn't create the opiate epidemic. Bureaucrats did. Overdose deaths from opiates track directly with stricter drug laws and stricter controls on physician prescribing. We're professionals after all, and even the docs who hand that stuff out like candy are smart enough not to kill their own patients. The rare doctor exceptions to this end up in jail on manslaughter charges and rightly so.

When narcotics laws get more strict, less patients get narcotics. These people are addicted, so it's not like all of them are going to just stop being addicted now that I can't write their meds. So they start getting meds from friends and family, and then they start buying narcs off the street. Shockingly, friends, family and street dealers don't know how to treat pain and addiction in a safe and controlled way. So these patients end up with widely varying doses, many of which are lethal.

The opiate epidemic is an argument that even a terrible doctor is better than an interested layperson. First, because even a drug pushing hack doesn't kill their own patients. Even if they did, there's a nice paper trail and they end up out of the profession and in jail.

ramblin_ag02 said:

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AGC said:

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How'd the opioid epidemic self correct? Lots of doctors doing their homework before prescribing it?

Arguing that if you have enough time you'll get it right kills a lot of people in the meantime. Pride may keep you warm at night but this isn't a village of one.

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You probably won't like this answer, but doctors didn't create the opiate epidemic. Bureaucrats did. Overdose deaths from opiates track directly with stricter drug laws and stricter controls on physician prescribing. We're professionals after all, and even the docs who hand that stuff out like candy are smart enough not to kill their own patients. The rare doctor exceptions to this end up in jail on manslaughter charges and rightly so.

When narcotics laws get more strict, less patients get narcotics. These people are addicted, so it's not like all of them are going to just stop being addicted now that I can't write their meds. So they start getting meds from friends and family, and then they start buying narcs off the street. Shockingly, friends, family and street dealers don't know how to treat pain and addiction in a safe and controlled way. So these patients end up with widely varying doses, many of which are lethal.

The opiate epidemic is an argument that even a terrible doctor is better than an interested layperson. First, because even a drug pushing hack doesn't kill their own patients. Even if they did, there's a nice paper trail and they end up out of the profession and in jail.

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Not all doctors agree. Really, the answer is to follow the money. You're a doctor, you know that most aren't ever punished, I am sure.

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First, in all fairness, I will start with physicians. We overprescribe opioids, just as we overprescribe antibiotics. But it is generally well meaning; we don't want our patients to experience pain. But then we prescribe 30 or 60 pills when 5 or 20 would have been adequate. We do that because we are used to prescribing in multiples of 30; 30 days for a month supply of a once a day medication, 90 days for a mail-order prescription. Prescribing 6 or 10 pills will undoubtedly result in a phone call from a pharmacist asking for a round number of pills, taking up time better spent entering meaningless information into our electronic health record systems. It is the leftover pills that sit forgotten in the medicine cabinet which often lead to trouble, stolen by a relative or visitor and abused. But sometimes it is that prescription that was provided for true pain that leads rapidly to tolerance and addiction. Healthy Living magazine recently published a heart wrenching story of a woman whose life was nearly destroyed by two weeks of oxycodone prescribed by a well-meaning physician for arthritis.

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You misunderstand the opiate epidemic. It's not about addiction, it's about deaths. Drug overdoses are now the leading cause of accidental death in the US, higher than car accidents, drowning and firearms. It has quadrupled since 2000. That spike in deaths started when prescribing laws became more strict, and doctors are prescribing less.

https://www.ama-assn.org/press-center/press-releases/report-shows-decreases-opioid-prescribing-increase-overdoses

So if we're prescribing less and more people are dying, then it's illogical to blame all these deaths on us.

Addiction is a separate ballgame. Everyone know addiction is a possible effect of opiates. Every doctor who prescribes to every patient knows this, it is in the handouts when you get the medication, and it's ubiquitous in the media. Sometimes it's still the best medicine to use, but it gets really complicated and difficult. How do you weight someones chronic severe pain with no quality of life against the only good treatment for that pain if you will almost certainly make them an addict? These questions don't have right answers, only least bad answers based on each individual. So yes, doctors do get people addicted to opiates, and it's almost always due to someone suffering and begging us to do ANYTHING to fix it. It's a sad game all the way around, full of some awful human tragedies.

The opiate epidemic is about deaths. So I addressed that. You countered with an article about presription drug abuse and addiction. Those aren't the same things even though they are related. So if you understood the issue, then why did you respond with a tangent? We can talk addiction if you want. It's incredibly fascinating. We've learned more about addiction in the last 10 years than the prior 100 years. Might want to start another thread though. Pretty far off the OP of vaccination for COVID.

It seems you and a few others here are just mad at doctors in general for not falling lockstep behind your political ideology when it comes to treatments, perceived severity of disease, vaccines, and public health measures. Basically, anyone (such as nearly all doctors and the medical system at large) who thinks COVID is a deadly disease, advocated for any public health measure whatsoever, is pro-vaccine, and disputes the effectiveness of ivermectin and HCQ is suddenly your enemy and must be attacked. So all of sudden we're arrogant jerks that caused the opiate epidemic and joined the Nazi party in record numbers. The attacks are petty, uninformed and transparent. It's simple but exhausting to keep having to address them when they are completely off topic.

Yep. Government has historically made substance abuse issues exponentially worse through strict laws, including prohibition.

ramblin_ag02 said:

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AGC said:

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How'd the opioid epidemic self correct? Lots of doctors doing their homework before prescribing it?

Arguing that if you have enough time you'll get it right kills a lot of people in the meantime. Pride may keep you warm at night but this isn't a village of one.

---

You probably won't like this answer, but doctors didn't create the opiate epidemic. Bureaucrats did. Overdose deaths from opiates track directly with stricter drug laws and stricter controls on physician prescribing. We're professionals after all, and even the docs who hand that stuff out like candy are smart enough not to kill their own patients. The rare doctor exceptions to this end up in jail on manslaughter charges and rightly so.

When narcotics laws get more strict, less patients get narcotics. These people are addicted, so it's not like all of them are going to just stop being addicted now that I can't write their meds. So they start getting meds from friends and family, and then they start buying narcs off the street. Shockingly, friends, family and street dealers don't know how to treat pain and addiction in a safe and controlled way. So these patients end up with widely varying doses, many of which are lethal.

The opiate epidemic is an argument that even a terrible doctor is better than an interested layperson. First, because even a drug pushing hack doesn't kill their own patients. Even if they did, there's a nice paper trail and they end up out of the profession and in jail.

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On the contrary, the drug industry and how they've sold products completely undermines the idea of 'doctors understand the literature and muh science.' It's pretty well understood a nice pair of boobs and a round of golf sealed the deal until a few decades ago (when it became illegal). You'd like to wash your hands now but it's amazing what you'll give a patient for a few bucks.

Edit: getting a bunch of people addicted and then washing your hands of it is ****ed up. You and your 'we know the science' industry did this (and let's be honest, you're an industry, not some go it alone moral gold standard).

"I am vaccinated for Fauci/Covid-19"

What does this mean? Are you one of those people that think Fauci had a hand in creating the virus? Or just want to link him to it somehow?

follow the science

nypost.com/2021/09/08/covering-up-faucis-role-in-covid-leak-devine/

schmendeler said:

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Rumor/Speculation is not science.

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Implementing vaccine mandates and shutting down cities is not science. Using words like should, need, ought, etc. is not science and yet this has been used endlessly since 2020 to fulfill political agendas.

Orthodox Texan said:

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schmendeler said:

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Rumor/Speculation is not science.

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Implementing vaccine mandates and shutting down cities is not science. Using words like should, need, ought, etc. is not science and yet this has been used endlessly since 2020 to fulfill political agendas.

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These things are based on epidemiologic research. Vaccine mandates have been used for centuries now and have been extremely successful.

Orthodox Texan said:

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schmendeler said:

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Rumor/Speculation is not science.

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Implementing vaccine mandates and shutting down cities is not science. Using words like should, need, ought, etc. is not science and yet this has been used endlessly since 2020 to fulfill political agendas.

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What an incredibly silly statement. there is absolutely 100% science behind all of this. Geez

The thing that keeps making my head want to explode is that there are ways to legit quantify this. There were actual examples of countries that did things correctly and the positive results followed. It's just willful ignorance.

I will say that I have 4 coworkers that had covid pretty bad pre-vaccine. And all of them were noticably dumber when they came back to work.

1 is still no where near as sharp as he was pre covid, the other 3 took weeks to months to return to a pre-covid mind set.

A lot of lost trains of thought and diminished ability to math in their heads were the most noticable.

The ones that have caught it post vaccination haven't seemed to have the same issue.

And no more than I have to work with, I never wanted to risk it

Science:
-Getting the vaccine to elderly as they are the highest risk group.
-Shown reduction in symptom severity of those who got COVID after being vaccinated.
-Viral theory that mutations will be less deadly and more transmittable
-Decline in symptoms of COVID with decreasing age paired with real vaccine side effects for low risk populations.
-Real, serious, and even deadly vaccine injuries for COVID. Not an imaginary risk.

Not Science:
-Misleading the public about the efficacy of the first wide spread mRNA vaccine and obvious risk of easy mutations with coronaviruses.
-Pushing vaccines on populations with greater side effect risk than covid risk.
-Masks mandates, plexiglass, everyone sanitizing surfaces for an airborne virus and other sanitization theater
-Hiding information about side effects
-Medical boards threatening to pull licenses if the care providers write 'not medically necessary' covid exemptions.
-Hospitals being incentivized to lie about covid numbers to get reimbursed more money
-Hospitals stopping any other therapeutics that might help even if it was just anecdotal evidence
-Hospitals administering Remdisvir in the first place (see point about money)
-Congress exempting vaccine manufacturers from all liability
-Workplaces demanding vaccinations
-Shutting down the economy
-Lockdowns getting mocked by the virus as they finally spike areas that have held out through isolation. (New Zealand and HK)

Ramblin_Ag is just another doctor who does exactly what his bureaucratic owners tell him to do. He doesn't see the regulatory capture that invades every aspect of his job.

Most of what you're claiming as "not science" actually has very good data and epidemiological evidence to support it. Of course not every countermeasure taken for a completely novel virus will work. It's a ****ing novel virus. We had to take high levels of caution until the threat was better understood.

Some of what you're claiming is "science," particularly around the danger posed by vaccines compared to Covid is bull**** and not supported by the research.

Sapper Redux said:

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Most of what you're claiming as "not science" actually has very good data and epidemiological evidence to support it. Of course not every countermeasure taken for a completely novel virus will work. It's a ****ing novel virus. We had to take high levels of caution until the threat was better understood.

Some of what you're claiming is "science," particularly around the danger posed by vaccines compared to Covid is bull**** and not supported by the research.

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You are assuming the best path for millions of Americans ranging in age/health/income can be lumped into a mandate for all. Narrow view of reality.