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Medical Forum / Diseases and Disorders / Tinnitus / March 2004Why don't most doctors know how to treat tinnitus?
My experience has been that most doctors, including many ENT specialists, do NOT know how to treat this ill. Did they get some kind of teaching or training on this ill? FP I tried for 2 years with my doctor and saw an ENT. Their attitude once I told them what I was experiencing was basically.. "Not another one of these". My doctor told me that there was nothing that could be done, his partner was a little more understanding and had a lot of tests done. But, once he determined that there was nothing physical that could account for the tinnitus he said that I was going to have to learn to deal with it as best I could. I believe that if there isn't something that bites them on the a.s, something that says this is what is causing the condition, they are at a loss. Tinnitus is mostly a subjective condition, they can't hear what you hear, they can't directly measure it, if they can't find a physical reason why you have it, then they don't know how to deal with it. It goes completely against all the methods that they are taught in school on how to deal with a condition, so they write it off. Greg > My experience has been that most doctors, including many ENT > specialists, do NOT know how to treat this ill. Did they get some > kind of teaching or training on this ill? > > FP > I tried for 2 years with my doctor and saw an ENT. Their attitude once I > told them what I was experiencing was basically.. "Not another one of [quoted text clipped - 5 lines] > a.s, something that says this is what is causing the condition, they are at > a loss. I think most doctors don;t have the time a/o the incentive to find the cause of your T. Without knowing the cause, the way to treat the T is to cover it, either with drug or exercises. FP =================================== Tinnitus is mostly a subjective condition, they can't hear what you > hear, they can't directly measure it, if they can't find a physical reason > why you have it, then they don't know how to deal with it. It goes [quoted text clipped - 8 lines] > > > > FP > I think most doctors don;t have the time a/o the incentive to find the > cause of your T. Without knowing the cause, the way to treat the T is > to cover it, either with drug or exercises. > > FP Unfortunately, that is not necessarily true. I would say that the vast majority of people with tinnitus have underlying outer/inner hair cell loss due to presbyacusis or noise exposure. In these cases, knowing the cause doesn't imply that there is a treatment, although there are reasonably good strategies to manage the tinnitus so that it becomes far less of an intrusive factor. HNG >My experience has been that most doctors, including many ENT >specialists, do NOT know how to treat this ill. Did they get some >kind of teaching or training on this ill? > >FP I remember someone saying years that doctors are taught nothing in medical school about tinnitus - except how to pronouce the name. And when they go into practice they are probably too busy to read any new literature. Tinnitus is a pain in the neck Elly's Tinnitus Resources http://eebee.net/ http://meniere.eebee.net/ For email: elly at eebee.cjb.net > >My experience has been that most doctors, including many ENT > >specialists, do NOT know how to treat this ill. Did they get some [quoted text clipped - 7 lines] > And when they go into practice they are probably too busy to read any > new literature. It isn't fair to generalize since we really don't know what every medical school teaches or what every student cares to learn. What we do know is that there are various treatments, none of which lead to a cure and most of which aren't supported by valid studies. A broad approach to treating tinnitus, based on what one reads in this group, would include massage, acupuncture, hypnosis, TRT, unknown herbs in unknown amounts, oxygenating the blood, mirror feedback and a myriad of drugs promoted by anecdotal evidence. In the absence of a cure, the best we can do is help people learn to live with tinnitus, something most of us who frequent this group have learned to do. >> I remember someone saying years that doctors are taught nothing in >> medical school about tinnitus - except how to pronouce the name. ................ >It isn't fair to generalize since we really don't know what every medical >school teaches or what every student cares to learn. .............. Well, I actually think that Elly is pretty much on the mark. It is true that in medical school doctors are taught nothing about tinnitus. But it isn't true that they are taught how to pronounce the name. They aren't taught that either! However, *after* medical school - in residency and in post-residency courses - there is opportunity (fortunately increasingly so) for doctors in various disciplines who might be interested in the auditory system to learn about tinnitus from grand rounds presentations, courses sponsored by (for instance) the American Society of Ololaryngology / Head & Neck Surgery, and from text material (like the Otolaryngologic Clinics of North America. Things are really looking up in that regard. But we still can't settle on how to pronounce the damned thing! :-) smn > >> I remember someone saying years that doctors are taught nothing in > >> medical school about tinnitus - except how to pronouce the name. [quoted text clipped - 9 lines] > But it isn't true that they are taught how to pronounce the name. > They aren't taught that either! Huh? I just went to the University of Minnesota Medical School, searched their site, and got 70 hits on a search for tinnitus. Someone there must take an interest in it. >Huh? I just went to the University of Minnesota Medical School, searched >their site, and got 70 hits on a search for tinnitus. Someone there must >take an interest in it. ............... Sure somebody takes an interest in it. But it isn't formally taught to medical students as part of their curriculum. smn > >Huh? I just went to the University of Minnesota Medical School, searched > >their site, and got 70 hits on a search for tinnitus. Someone there must [quoted text clipped - 8 lines] > > smn Neither is psoriasis. Still, I would imagine the U. of M. would discuss it along with a myriad of other ailments. One can teach a treatment (TRT has been taught at a medical school) but there really isn't a lot to be said about tinnitus beyond defining it and pointing out that it is most likely a reaction in the auditory cortex for which there is no known cure. Anyway, the subject is "why don't most doctors know how to treat tinnitus" and the answer is "there is no treatment to teach". One can poke around at the symptoms but that is about all. >Neither is psoriasis. Still, I would imagine the U. of M. would discuss it >along with a myriad of other ailments. One can teach a treatment (TRT has [quoted text clipped - 4 lines] >answer is "there is no treatment to teach". One can poke around at the >symptoms but that is about all. ................ What I am saying here is that in medical school you are taught that tinnitus is what they call it when peoples' ears ring ... and that's it. Psoriasis gets tons more attention than tinnitus does in medical school. Could there possibly be an exception? Sure. You could as a fourth year medical student at Tulane University Medical School happen to be assigned to Dr. Ronald Amadee's service as an ENT elective and possibly see one tinnitus patient with him in clinic among the twenty or so patients he sees that afternoon. And since Dr. Amadee has a particular interest in tinnitus and the effects of lasix on tinnitus, he might spend five minutes talking to you about it. Sure, that could happen. But there is no effort to formally include tinnitus or tinnitus-related syndromes in medical school curricula. Psoriasis on the other hand (no pun) is well-covered. smn The closest thing to a cure is here: http://meniere.eebee.net/tinnitus.html Tinnitus is a pain in the neck Elly's Tinnitus Resources http://eebee.net/ http://meniere.eebee.net/ For email: elly at eebee.cjb.net I once went to the med school and looked in all the otolaryngology text books (they have 1 really big one that comes in five or six volumes, like of like their bible) and I went back about 20 years and as the years passed, the page for Tinn got smaller and smaller and in about 1999 it was one or two paragraphs. Said nothing could be done, was a benign condition, reassure the patients, rule out a tumor.....and guess what? That is what most of them do. Can't blame them. Gotta join them and educate them every chance we get........ MJ But Assar Bjorne has made the most significant discovery in treating tinnitus. http://meniere.eebee.net/tinnitus.html Tinnitus is a pain in the neck Elly's Tinnitus Resources http://eebee.net/ http://meniere.eebee.net/ For email: elly at eebee.cjb.net >I once went to the med school and looked in all the otolaryngology text books >(they have 1 really big one that comes in five or six volumes, like of like [quoted text clipped - 8 lines] > >MJ >But Assar Bjorne has made the most significant discovery in treating >tinnitus. ............... I am told that Assar Bjorne applied for research funding one time, and the grant application was rejected. Most folks in that situation correct the deficiencies in the grant proposal as outlined by the funding organization (NIDCD, Tinnitus Research Consortium, ATA, etc.) and reapply. If the discovery is so significant, I am surprised that Assar Bjorne hasn't tried to get funding more seriously. Believing a discovery is significant is one thing. Formally testing it in a research protocol and publishing the data in a peer-reviewed journal is something else. Since you have been in communication with Dr. Bjorne, perhaps you could tactfully suggest something alomng those lines? smn >>But Assar Bjorne has made the most significant discovery in treating >>tinnitus. [quoted text clipped - 14 lines] > >smn Why don't you call him so you can have another name to drop? Terri http://pub219.ezboard.com/btinnitusactivismandsupport |
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