Kevin, M.D. - Medical Weblog

So true. The incentive is there in capitation, but to what end is there an incentive? For twenty bucks a head or so per month there is only one incentive - get rid of the sick patient. I could spend a lot of effort to 'fix' my overweight, smoking, lousy lifestyle and bad genetic risk patients, but in the end they will still have most of their original problems.
Well people tend to stay well, sick people tend to stay sick, and capitation only ensures that the sick are a drain on a practice's bottom line.
 

Who are you kidding gas, you are a anethesia doc. When is the last time you did a wellness/preventative medicine exam?
 

Wow. That guy is a nut. A super nutty-nut at that.
 

i guess no one values personal responsiblity anymore . . . Since when do we give naturopaths ANY credibility on ANY topic . . .
 

Since never. They are frauds, only out to cheat gullible people out of their money.
 

yeah, because nobody knows about eating fruits and vegetables and exercising a lot. And of course those things are 100% effective at preventing all disease - even genetic ones like PCKD and cystic fibrosis. If you're a doctor and one of your patients has cystic fribrosis - YOU SUCK!!!
 

The author also states:
"Absolutely no prescription drugs or pharmaceuticals whatsoever.
No visits to M.D.s or western medical doctors (visiting naturopathic physicians only)"

This is a dangerous advise. Parents not taking their children to an M.D. for abdominal pain that's actually acute appendicitis.
Or a child or anybody with severe asthma attack not being treated with western meds. Corollary to this advise is advocating not having any immunization for anybody. And so on and so forth.

I don't have any problem with his recommendation for us to be vegetarians. He won't kill anybody with that advise.

I agree, this guy is nuts.

-amd
 

does that anonymous guy really think you can cure PCKD or CF w/ diet? LOL wow, you think you've heard it all but i quess a quack-job is born every minute
 

Josh, I think he is being sarcastic. - amd
 

I had an interesting interaction with someone last week that illustrated why "naturopaths" and others are able to pay their mortgage.

This man came to see me to have me fill out a physical form for his job so he could go to their gym (and the gym could defer liability to me if he died, but I digress). I found his blood pressure to be elevated and as it was borderline when I saw him last I told him we should start him on a blood pressure pill. He proceeded to explain to me that he knew I got a kickback from the drug company and pharmacies for doing that and he wasn't about to line my pockets.

At first I politely explained I do not receive kickbacks from the drug company (in reality, I do not--I don't see drug reps, haven't had a drug rep meal in 5 years and don't own any drug rep sponsored text books). When he called me a liar, I told him I would not sign his physical form and asked him to leave.

I suspect a sizable part of the population believes that "western medicine" is no more science that the moon landing. (sarcasm) These people seek our other skeptics who "see through" the lies and reinforce their world view.

These naturopaths are actively harming people, but at the end of the day you have to let people make their own decisions about whether they want to be treated by someone with logic and reasons as their tools, or by shark cartilage. Both parties are to blame.

And of course I agree with gasman. Capitation only makes doctors avoid taking sick people. Again, physicians are people. People respond to financial incentives. In order to get the desired outcome, you have to have consistent incentives.
b
 

amd - i hope he was being sarcastic, but my wife's co-worker (a nurse) takes her daughter to a chiropracter/naturopath for tx of type 1 DM. and the nd swears DM is a factious dz . . . life is stranger than fiction
 

A patient of mine five years ago came to see me for a breast lump. I had prescribed the usual standard of care treatment when the pathology returned as cancer. However, she refused and instead followed the advice of a "specialist" and was placed on a macrobiotic diet. She recently presented with brain metastasis and a fungating, large mass of her breast extending to her chest wall. She came back to see me because she stated that her "specialist" told her that she had an "infection" because of the odor emanating from the cancerous wound.
 

Its funny how the link rails against doctors for "making money by treating disease" but every single nation in the world works that way.

Show me one nation in which there is not a disease-based model of care.

Maybe this guy thinks Europe is healthcare utopia. Funny thing is, if he went there, he would find out that docs in europe get paid for treating disease the same way american docs do.
 

Naturopaths are total scammers. They belive herbs can heal everything from diabetes to congestive heart failure.

Total quacks.

BTW, this discussion reminds me of how the chiropractors operate. They operate on a "wellness" model that the original link advocates. They claim that even after your back pain feels better, you have to come back to them once a week for LIFE to maintain adequate health.

That introduces scamming and money making opportunities that are worse than the current disease-based model we use.
 

There some MDs who also write books about the Macrobiotic diet curing cancer.

Any of you remember Dr. Anthony Sattilaro? He had been a MD for over 25 yrs. at some big metro. hosp. in Philly. when he was diagnosed with cancer and given 18 months to live.

"His X-rays revealed a large tumor in his left side; there was infiltration of cancer in the skull, the right shoulder, two backbones, probably the sternum and a huge tumor in the left sixth rib. It was also discovered there was cancer of the genital region; doctors weren't sure if it was the prostate or the testicles or both. The prognosis was that he had about 18 months to live"

Here is a website about it.

http://www.consumerhealth.org/articles/display.cfm?ID=19990817224439
Consumer Health Articles: AN M.D. WHO CONQUERED HIS CANCER

I read his book at a time I was fighting cancer. I tried to put myself on that diet. I bought 20lb bags of rice and bag after bag of seaweed sheets. The Japaneese store loved me. I couldn't eat that stuff.

I'm happy it worked for the doctor, but for me, it was western medicine that cured me.
 

Sure enough, there are a few quack MDs out there too. However, they are not nearly as numerous as the quacks in naturopathy, chiropractic, and the "other" health fields

Another quack MD that comes to mind is that blonde bimbo who advertises on TV for the "natural ways to beat cancer." She used to be an orthopedic surgeon at UCSF. Apparently she now considers herself a cancer expert.
 

MDs that categorically deny the value of naturopathic approaches are as bad as naturopaths that categorically deny the value of western medicine. Extreme viewpoints are rarely correct.

To be able to categorically deny value of anything is stating that you understand it so well that you can condemn it. This is an arrogant position and is a major problem in our health care today.

Why is it not OK to admit that something we don't understand might have value? It wasn't that long ago that we believed the world to be flat.

I am a molecular biologist and witness entire complex biological control systems unveiled by research every year. Systems that so important to our function, yet that we didn't even know existed last year.

Western medicine could use more open-mindedness and naturopathy could use more critical approaches. None of us know that much so get let's get over ourselves.
 

"Why is it not OK to admit that something we don't understand might have value? It wasn't that long ago that we believed the world to be flat."

Why? Because the peer-reviewed evidence doesn't support it. When this evience DOES support it "western" medicine does embrace it. If you bothered to read the guys blog, he states "lifestyles" (exercise, diet, etc) that good preventative health exams by "western" MD's have been addressing for decades. This isn't some "new" conclusion. But when he gloats how he hasn't seen a doctor in years (not that big a deal for a healthy 35 yo like himself but a big deal for a "unhealthy" 65 yo with diabetes and CAD) and he states he doesn't take "prescription" medicines, he is doing a disservice. Frankly I am surprised at you anon. Before I went to medical school I also was a molecular biologist. Though my reading has changed from Science and Cell to The NEJM and Annuals of IM, the common denominator is the scientific method. Yes there is much we don't know about the body, that is the purpose of forming a hypothesis and then trying to prove or disprove it. We need to use the scientific method to prove or disprove the "value" of non-studied treatments. You don't just "use" a treatment method without review. I think you have been spending too much time at the PCR machine without looking at the big picture. Food for thought.
 

I'm not arguing that everything the guy said is true. He certainly goes over the top suggesting that 'healers' should be penalized when the patients get sick. We all know that lifestyle can't fix everything and that pharmaceutical, surgical, or whatever intervention is necessary. But you should also admit that western medicine over-uses these tools (just look at antiobiotic use as an example) and that doctors could be more proactive in lifestyle education.
You also know that very few graduating MDs have any formal training in nutrition.

The scientific method is critical for our advanced understanding and I am an advocate for that. At the same time some things are just not testable with our current technology. Especially when it comes to nutritional research. Much of this type of research has used the 'drug study' design model, which doesn't work when dealing with complex system interactions with naturally occuring molecules required by the body.

I'm not advocating 'herbal mythology' but I am advocating that MDs don't dismiss the potential value of some of these approaches, as many of the above posts have done.

Us science types tend to always look for the flaw on others arguments. We find one thing that we know is wrong and we try to leverage that to discredit everything the guy said. That appears to me to be what is happening here.