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The Direction of Western Medicine

This pandemic taught me to empathize with my patients who have disdain for western medicine and physicians. These patients feel let down by western medicine and view it as only a money-making enterprise.

These patients go to the doctor and get boilerplate answers. They don’t feel as though they are treated as individuals. And because of this, they are rarely satisfied with their care.

This pandemic created a great rift among physicians. Some have entered the camp of distrusting the CDC and the vaccines and the others have ganged up against those who have any doubt about the vaccines whatsoever.

Letter from the State Medical Board

When COVID-19 vaccines first rolled off the assembly line we got a letter from the CA medical board warning us that if we divert these vaccines to anyone outside of the priority group we would be facing consequences.

Then we got a letter from the CA medical board that writing vaccine exemptions for patients were unacceptable. And anyone who does will be guillotined.

State medical boards are there to represent the public and police physicians. So the state medical board doesn’t care about you as a physician. Really, it should be called the medical oversight committee. But state medical board sounds more professional – though I’m not sure why I’m the one paying the license fee when it should come out of the patient’s pockets…?

The state medical boards don’t do a good job letting physicians know what their main purpose is. But to their credit, they have a rather unified message: “We’re watching you and if you come on our radar you are guilty until proven otherwise. Woe is unto you because we don’t trust you. Now, pay your annual fee.”

Letter from the ABMS

We all recently got another letter – several, in fact, from the ABMS and the FSMB warning us that anything negative we say about the vaccine could cost us our board certification.

Kind of a strong statement, isn’t it? Got an opinion about a vaccine that doesn’t jive well with what the cool kids think, you better watch your back.

Fortunately, the vaccine data is decent enough that we can say it’s been effective, for the most part. But has it been totally effective and has it delivered as advertised? Um, no. That’s why there are physicians out there who are asking for more data and advising their patients accordingly.

Neither the state medical boards nor the ABMS wants anything to do with the doctors who are hesitant. So, either get on board or walk the plank. Your choice.

I’m going to make the argument that this is actually okay. If western medicine’s stance is clear and you’re in western medicine to make a buck, no reason to complain.

If you got into medicine for the science or the clinical challenge or want to grow as a clinician, well obviously that ship sailed with the start of the Hippocratic oath.

Physician Autonomy

Do we want physician autonomy? Do we want to come up with a single decision based on each individual patient? Think about how much work that is. To consider all the various environmental, public health, statistical, and individual patient data to divide if a vaccine should be recommended to a patient or ivermectin prescribed.

Wouldn’t it be easier to follow a guideline that states “stop ivermectin use”. I’m still scratching my head as to why the AMA got in on this conversation. Don’t they just collect dues and create ICD stuff?

If physician autonomy came with more perks then sure, sign me up. But it doesn’t. In our current western medical system, you as a physician stand to gain little by having practice autonomy.

No doubt that it’s a big loss to many of us. Most of us got into medicine because we loved the sciences, enjoyed the challenge, and wanted to become better doctors.

Standardizes Care Guidelines

One would think that having a set protocol is good for patient care. It’s not. It’s good for an HMO or a public health organization. Lumping many patients into one category and treating them the same only leads to shittier outcome statistics.

Are all UTI’s the same? Are all influenza cases the same? If you have practiced medicine you know that there is a gradient. Some of the UTI cases will likely resolve on their own and watchful waiting is appropriate. While some influenza cases should be admitted for observation.

All of us know this but most of us wouldn’t dare deny an oral antibiotic for a positive UA. If that patient develops any complications you’re on the hook. Few will care that you didn’t want to use antibiotics unnecessarily.

But you also have to deal with the flipside; if the UA is borderline and you prescribe a fluoroquinolone and the patient suffers a major side effect you are also on the hook.

In a way, then, guidelines protect the practice of medicine. I didn’t say it protects patients or doctors. The clique that is western medicine can stand behind a guideline and look like a distinguished, proper entity.

Guidelines also ensure that the medical device industry and pharmaceutical industry get their fair share of representation. Here’s a little head CT for Timmy according to the Canadian Head CT rules. And a little Tamiflu for the whole family according to the CDC guidelines.

Evidence Based Medicine

My attendings at UCLA had such an erection for evidence-based medicine. They would recite research papers by their catchy acronyms and feel so high and mighty.

I would feel so dumb because I could never remember those damn acronyms, couldn’t make sense of the statistics, and came away with absolutely nothing when reading the discussion section. “More research is needed…” Wait, what?

Eventually, I got into statistics. My nerdy brain gravitates towards this stuff. But that didn’t happen until a couple of years ago and I got deep into the weeds of clinical data, statistics, and really analyzing research articles.

That’s when you wonder why we are using a CI of 95%. And why is the research written in such an impossible to understand way?

Let’s set that aside for now. Let’s talk about who is doing the research. Not me. I can’t go and poll my patients or do my own research. I need tons of money and IRB approval and a lot of free time.

So the pharmaceutical industry funds the studies. The NIH helps with further funding. And then the FDA and medical associations give their seal of approval. This would be fine if it wasn’t for every single person on the FDA and MA boards being funded by one company or another.

At some point when you follow the trail of western medical guidelines you end up in the sewer. You’re holding the drain snake in one hand, the other hand has feculent drain pipe goo smeared on it, and you’re wondering how the fuck do we call this medicine?

Holistic Medicine

Western medicine is not holistic medicine. It’s quite proud to not be associated with holism.

But holistic medicine (alternative medicine) is just this stray from mainstream western medicine. It tries to consider the entire patient, all the pieces that make up the patient, and it says that there is no treatment but only support for the body.

I’m not saying that we should abandon western medicine. Some of the advances of western medicine still blow my mind. The things we can do in western medicine are on par with landing on the moon every other hour.

I’m not drinking the Kool-Aid, don’t worry. I believe in alternative medicine as much as I believe in western medicine. What I do believe in is that I am a highly trained, apprenticed physician who knows a lot about the human body.

I feel confident to say that you should get out of my way and let me practice medicine. But I also respect the fact that you are more powerful than me and have all the say as state medical board, as the AMA, and the ABMS.

So, I’m happy to acquiesce to what western medicine tells me I should believe. My only protest is that if you tell me what to believe then you better not be wrong.

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