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Medical Forum / Diseases and Disorders / Tinnitus / May 2006What is a modern doctor?
A modern doctor is someone who is versed in a combination or mixture of both the synthetic and herb medicines and treatments of various types ever used in the world. The reason why he has made himself so is because he is concerned with the welfare of his patients. On the other hand, a traditional or antiquated doctor is someone who stays in the school of discipline for which he has been trained and defends it fiercely against competition. His concern is with his bank account and what he can do with his leisure time. By this definition, both the herb doctors and the doctors practicing western medicines are traditional or alternative doctors while the modern or conventional doctors are the ones with the knowledge in both disciplines. FP >A modern doctor is someone who is versed in a combination or mixture of >both the synthetic and herb medicines and treatments of various types >ever used in the world. ...but only medicines and treatments that have been proved effective by scientific experimentation. Of course, albeit what is scientific experimentation is debatable. For example, controlled study is a form or kind of study that has its limitations like any other kind and as such should not be used as the benchmark to measure against all treatments and medicines. >Of course, albeit what is scientific experimentation is debatable. For >example, controlled study is a form or kind of study that has its >limitations like any other kind and as such should not be used as the >benchmark to measure against all treatments and medicines. I don't think what is scientific experimentation is debatable. Controlled study isn't what scientific experimentation refers to. It refers to double blind experimentation. (1)Is double blind experimentation an absolute measure of 'truth'? (2)What are its limitations? (3)What happens when several groups of double blind experimentation performed to prove the same issue conflict in their results? Which one should we take? (4)How about clinical experiences? Do these experiences count when they conflict with the findings of 'a' double blind study done on the said issue? > (1)Is double blind experimentation an absolute measure of 'truth'? It's a measure of how well the medicine works. > (2)What are its limitations? It only measures how well the medicine works. > (3)What happens when several groups of double blind experimentation > performed to prove the same issue conflict in their results? The results are inconclusive. >Which one should we take? None of them. > (4)How about clinical experiences? They use medicines that have been shown to be effective based on scientific experiments. > Do these experiences count when they > conflict with the findings of 'a' double blind study done on the said > issue? By the time a medicine gets to clinical use by a "modern" physician, it has been shown to be effective based on scientific experiments. Martin wrote:"By the time a medicine gets to clinical use by a "modern" physician, it has been shown to be effective based on scientific experiments. " How about 'folk medicines', which have been used by people over centuries through trials and errors? Should a "modern" doctor use it without having the med brought through a 'scientific experiment'? > Martin wrote:"By the time a medicine gets to clinical use by a "modern" > physician, it [quoted text clipped - 3 lines] > centuries through trials and errors? Should a "modern" doctor use it > without having the med brought through a 'scientific experiment'? Not without exhausting all scientifically proven medicines first. Some folk medicines have been scientifically tested and found effective. I think most are found to be not effective. Why haven't all of them been tested? It is *how* to test it that puzzles people. Accordingly to the 'controlled' studies done by *some* groups, gingko biloba is useless for treating tinnitus. However, I personally found gingko to have transformed my 'brain ring' into a 'drum ring'. Some in this ng in the past did indicate gingko 'softens' their t sound. There has been testimony by a patient (other than me) in this ng that acupucture cut down his tinnitus, but the results of controlled studies done by *some* groups contradict the findings. So what do you believe aside from trying it yourself? > It is *how* to test it that puzzles people. Accordingly to the > 'controlled' studies done by *some* groups, gingko biloba is useless > for treating tinnitus. However, I personally found gingko to have > transformed my 'brain ring' into a 'drum ring'. That isn't a successful treatment. Eliminating the 'brain ring' is a successful treatment. > Some in this ng in the > past did indicate gingko 'softens' their t sound. There has been > testimony by a patient (other than me) in this ng that acupucture cut > down his tinnitus, but the results of controlled studies done by *some* > groups contradict the findings. So what do you believe aside from > trying it yourself? Trying it yourself is fine, but that wasn't the question. the question was: Should a medical doctor prescribe it as a treatment for tinnitus? I say no. A medical doctor can suggest the patient try it to see if it works. Martin wrote:"A medical doctor can suggest the patient try it to see if it works." When a medical doctor prescribes something to the patient, he has to have the basis of (1)this something has worked for some people in _clinical experiences_. (2)this something does not have IRREVERSIBLE consequences when used in treating patiens through _clinical experiences_ too. >Martin wrote:"A medical doctor can suggest the patient try it to see if >it [quoted text clipped - 5 lines] >(2)this something does not have IRREVERSIBLE consequences when used in >treating patiens through _clinical experiences_ too. Prescribe and suggest are not the same thing. When a doctor prescribes a medication, he is saying that medication is proven to be effective for treating the disease. When he suggests trying ginko, he is not. He makes it clear he is not prescribing medication by (a) not writing a prescription and (b) telling the patient ginko hasn't been proved effective for tinnitus but some people say it helped them. Martin wrote:" telling the patient ginko hasn't been proved effective for tinnitus but some people say it helped them. " There is a difference between being helping and being effective. The difference is in degree but not in kind. Some studies prove it helpful to some patients while others of no help at all. So how can a doctor tell the patients that gingko has been 'proved' to be effective to treat tinnitus? The doctor should tell his patients that gingko _according to some studies_ helps some to various extents while other studies show no help at all. And as long as no irreversible consequences are expected, patients should be encouraged to try out unless the doctor definitively knows what causes the patient's T and definitively knows the use of gingko will not help in this specific case. >Martin wrote:" telling the patient ginko hasn't been proved effective >for tinnitus but some people say it helped them. " > >There is a difference between being helping and being effective. The >difference is in degree but not in kind. No, it is a difference in kind. If a doctor says a medicine is effective, he means it has been shown to work in a certain percentage of cases, where that percentage is significantly higher than using a placebo. If a doctor says some people say ginko helped them, he is not saying it has been shown to be more effective than placebo. He is saying: I don't know how to cure your illness, but some people found relief with ginko and it won't hurt you so go ahead and try it if you wish. In the final analysis, it goes back to that particular patient's body reaction to something as being just helpful or effective. >In the final analysis, it goes back to that particular patient's body >reaction to something as being just helpful or effective. No, in a single case, helpful and effective are synonymous. The word effective means different things depending on the context. When a doctor says a medicine is effective for T, he means it works in a certain percentage of cases, and that percentage is significantly higher than the percentage of cases where placebo works. When you say a medicine is effective, you mean it works for you. No, when I say a medicine is effective it is because of the experiences of the patients who have use it. These successful experiences can show up either in doctors' clinical observation a/o from the market demand for these products. Your definition of effectivesness keeps going back to the placebo study. I don't question that placebo study is a good method but like any other studies it has its limitations. > No, when I say a medicine is effective it is because of the experiences > of the patients who have use it. That doesn't say anything. It says this: Gingko is effective for the patients for whom gingko is effective. > These successful experiences can show > up either in doctors' clinical observation a/o from the market demand > for these products. It doesn't matter. You are saying people should try gingko because it works for 10% of people. But even placebo has a higher success rate than that, so you are actually saying people should try placebo for treating tinnitus. > Your definition of effectivesness keeps going back to the placebo > study. I don't question that placebo study is a good method but like > any other studies it has its limitations. Yes, it limits you to recommending medicines that are effective. Martin wrote:"It doesn't matter. You are saying people should try gingko because it works for 10% of people." I don't know the % but was making a hypothetical statement. Either you try it or you don't. Do you have the need to do so? This is more important. If you are experiencing positive results from other treatments and are very satisfied with them. Then don't try. Because of the limitations of placebo study, one can only conclusion that in the absence of clinical experiences related to a new drug, don't recommend a drug if it fails a placebo study. But if a drug has already been in use and is highly praised by patients, the use of placebo study should not be used to discredit its validity. > Martin wrote:"It doesn't matter. You are saying people should try > gingko because it [quoted text clipped - 10 lines] > already been in use and is highly praised by patients, the use of > placebo study should not be used to discredit its validity. There isn't any validity to discredit. The issue was whether a doctor should *prescribe* medicine that has not been proved effective. The issue is *how* it can be proved. A med can be proved effective (or useful) either through clinical observation or placebo study. If a med had already been used for years and the market demand has been increasing for this med, a doctor should consider prescribing it without having to wait for the results of placebo study. >The issue is *how* it can be proved. A med can be proved effective (or >useful) either through clinical observation or placebo study. If a med >had already been used for years and the market demand has been >increasing for this med, a doctor should consider prescribing it >without having to wait for the results of placebo study. A clinical trial, in this context, refers to a controlled study. Your objection was to the requirement for controlled studies before doctors could ethically prescribe a medication. That is where we disagree. >From my point of view, a doctor is free to prescribe something as long as it can be documented (1)this med in the past has been in demand for certain illnesses and the response from patients having used the mad been positive and (2)no irreversible side-effects have been reported on this med. In this case, even if 'a' placebo study demonstrates a result that contradicts what has been commonly known, the doctor should still adhere to the experiences of the patients in the past rather than using the result of 'a' controlled study to override this med. After all, many controlled studies have done on a particular med and thus *one* or *some* controlled studies done on this med is NO authority but of only reference value in relation to the validity of this med. Now i have just told you case from my ENT doctor that a T patient of his has been cured of T completely by having gone to a hot spring for a vacation, and this cited experience and the other experiences cited by my ENT doctor are good basis for another doctor to bring to the attention of his T patients as long as the side effects from this hot spring treatment has no irreversible consequences. You replace the word treatment with the word med, you will see that the methodology is the same. Of course, when recommending a med that has not gone through a controlled study, a doctor has to make sure that in the past this med does show a relationship to a particular illness. Now, Martin, are you going to try out this hot spring treatment soon or are you going to wait for a controlled study to be done first on hot spring treatment before trying? > That is where we disagree. > [quoted text clipped - 9 lines] > *one* or *some* controlled studies done on this med is NO authority but > of only reference value in relation to the validity of this med. But no one said a doctor isn't "free to prescribe." The issue was what a doctor *should* prescribe. Furthermore, the response from most patients who use gingko for T is not positive. A few patients report positive results. So gingko fails your test. Also, gingko doesn't require a prescription. > Now i have just told you case from my ENT doctor that a T patient of > his has been cured of T completely by having gone to a hot spring for a > vacation, and this cited experience and the other experiences cited by > my ENT doctor are good basis for another doctor to bring to the > attention of his T patients as long as the side effects from this hot > spring treatment has no irreversible consequences. First, that isn't a clinical trial. It is an anecdotal report. A clinical trial is a type of controlled study. Second, going to a hot spring for a vacation does not require a doctor's prescription. Third, everyone knows that hot baths have beneficial effects. Fourth, and most important, the case you cite does not even prove that the hot bath cured that person's T. Maybe she flew on an airplane to get there. When I fly on an airplane, my T disappears for about a week. Maybe she took some other medication. Maybe she got a job and her worry stress diminished. You haven't cited any evidence that argues for the hot bath being the actual cure. > You replace the > word treatment with the word med, you will see that the methodology is > the same. Of course, when recommending a med that has not gone through > a controlled study, a doctor has to make sure that in the past this med > does show a relationship to a particular illness. Now you are replacing "prescribe" with "recommend." The issue concerns what a doctor should prescribe, not recommend. These are different things. You keep changing the parameters. > Now, Martin, are you going to try out this hot spring treatment soon or > are you going to wait for a controlled study to be done first on hot > spring treatment before trying? I have told you I know how to eliminate my T. I go for a morning swim. Martin wrote:"Furthermore, the response from most patients who use gingko for T is not positive. A few patients report positive results. So gingko fails your test." How do you know that? Have you counted the number of T patients who report either positive or negative responses all over the world? Martin wrote:"You haven't cited any evidence that argues for the hot bath being the actual cure. " Yes, perhaps he got lucky with a woman in the hot spring and...perhaps another patient got a lottery on his way to the hot spring...and perhaps because of a myriad of possibilities but these possibilites are also available to people involved in the controlled studies. Thus from your reasoning it can be said that a controlled study _is as valid as_ an uncontrolled study because the relationship between the med/treatment and tinnitus can at the most be said to be CORRELATIONAL as opposed to CASUAL in nature. The difference between prescription and recommendation is a matter of degree rather than kind. After all, no doctor can force a patient to take a med so prescribed if the person refuses to take it. Martin wrote:"I have told you I know how to eliminate my T. I go for a morning swim." How do you know it was swimming that eliminated your T. According to your imagination, it might have been that you oogled at a big tit woman swimming in the pool and as a result your mind was invigorated to the point where your T was eliminated. > Martin wrote:"Furthermore, the response from most patients who use > gingko for T is not [quoted text clipped - 3 lines] > How do you know that? Have you counted the number of T patients who > report either positive or negative responses all over the world? I'm going by the results reported here. I haven't heard anyone here report gingko cured their T. > Martin wrote:"You haven't cited any evidence that argues for the hot > bath being the actual cure. " [quoted text clipped - 7 lines] > med/treatment and tinnitus can at the most be said to be CORRELATIONAL > as opposed to CASUAL in nature. No, one data point is not a clinical trial. It can not be compared to the result of a controlled study. Furthermore, I take hot baths all the time, and they don't help my T. Then was it the minerals that cured your friend? What minerals are in that hot spring? Can you find out? Then we can just buy those minerals and try them. > The difference between prescription and recommendation is a matter of > degree rather than kind. After all, no doctor can force a patient to > take a med so prescribed if the person refuses to take it. No, it is not. When a doctor prescribes medication, he is saying that what he is prescribing is treatment for the problem that is accepted as such by the medical community. He is saying the medication has been shown to be effective by controlled, scientific experiment. > Martin wrote:"I have told you I know how to eliminate my T. I go for a > morning swim." > > How do you know it was swimming that eliminated your T. I don't. What I know is that when I go for a morning swim, my T is gone for the rest of the day. I assume this is caused by swimming. I don't know it. > According to > your imagination, it might have been that you oogled at a big tit woman > swimming in the pool and as a result your mind was invigorated to the > point where your T was eliminated. No, I know that's not it. Martin wrote:"I'm going by the results reported here. I haven't heard anyone here report gingko cured their T. " The reports, including my own experiences, are that gingko 'softens' the T sound but do not indicate any 'cure' in the sense of complete silence. Martin wrote:"Furthermore, I take hot baths all the time, and they don't help my T. Then was it the minerals that cured your friend? " Good point! I recall my ENT doctor specifically advised me to go to that hot spring because that hot spring is rich in 'sodium or something' but next time when I see him I will ask him this question. I went to that hot spring myself and as I said there were several silent night, but i thought it was due to the use of a new med. Now when I think of it, that hot spring or whatever in it may have something to do with it. On 5/18/06 2:36 AM, in article 1147945007.258561.175400@j33g2000cwa.googlegroups.com, "fyfpoon@gmail.com" > A modern doctor is someone who is versed in a combination or mixture of > both the synthetic and herb medicines and treatments of various types [quoted text clipped - 11 lines] > > FP Actually I expect Voodoo and Witch doctors would do a better job of helping Tinnitus.Matter of belief, etc. You haven't said what you think of doctors who practice via the scientific method. Voodoo and witch doctors may be compared to psychological councilors or motivators but psycho healing is only part of the picture. Is the power of psychic healing 'scientific'? > Voodoo and witch doctors may be compared to psychological councilors or > motivators but psycho healing is only part of the picture. Is the > power of psychic healing 'scientific'? No.
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