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Will the real holistic medicine please stand up?

Started by Golden Applesauce, November 17, 2013, 11:10:56 AM

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The Good Reverend Roger

Quote from: Q. G. Pennyworth on November 17, 2013, 02:09:39 PM
People aren't just chemicals, they're also the sum of their experiences and their internal narrative of self. A proper holistic approach to treating mental illness would be therapy AND drugs (as needed) AND exercise AND diet AND accessing environmental problems AND, yes, a dash of woo, because woo is actually pretty effective at some mental health problems and pain management. The problem is the current crop of morons are ALL WOO and very little else. and refuse to acknowledge that what they're doing is woo and that woo is only effective in a very narrow scope of cases. Woo will not cure your damn cancer, but it may help you get through chemo happier, and that's a valuable thing.

If I have strep throat, I don't need any woo or any counseling.  The "whole person" approach is a waste of time.

If I have heart disease, then I probably need everything including my own brand of woo (which does NOT include "Chinese traditional medicine").

If I have stage 4 pancreatic cancer, then I need the clergy.  And morphine.  Lots and lots of morphine.

So, yeah, the "whole person" approach is sometimes useful.  "Holistic medicine", taken literally, is not a bad thing, if by "holistic" you mean "all facets approach" and not "some filthy hippie shit".  Unfortunately, when people say "holistic", they almost certainly mean the latter.


" It's just that Depeche Mode were a bunch of optimistic loveburgers."
- TGRR, shaming himself forever, 7/8/2017

"Billy, when I say that ethics is our number one priority and safety is also our number one priority, you should take that to mean exactly what I said. Also quality. That's our number one priority as well. Don't look at me that way, you're in the corporate world now and this is how it works."
- TGRR, raising the bar at work.

The Good Reverend Roger

Quote from: V3X on November 17, 2013, 11:52:18 AM
People really are puddles of chemicals, though.

I reject this on account of Papa Hemmingway and Rudyard Kipling.
" It's just that Depeche Mode were a bunch of optimistic loveburgers."
- TGRR, shaming himself forever, 7/8/2017

"Billy, when I say that ethics is our number one priority and safety is also our number one priority, you should take that to mean exactly what I said. Also quality. That's our number one priority as well. Don't look at me that way, you're in the corporate world now and this is how it works."
- TGRR, raising the bar at work.

Mesozoic Mister Nigel

Quote from: Dirty Old Uncle Roger on November 18, 2013, 03:07:59 PM
Quote from: Q. G. Pennyworth on November 17, 2013, 02:09:39 PM
People aren't just chemicals, they're also the sum of their experiences and their internal narrative of self. A proper holistic approach to treating mental illness would be therapy AND drugs (as needed) AND exercise AND diet AND accessing environmental problems AND, yes, a dash of woo, because woo is actually pretty effective at some mental health problems and pain management. The problem is the current crop of morons are ALL WOO and very little else. and refuse to acknowledge that what they're doing is woo and that woo is only effective in a very narrow scope of cases. Woo will not cure your damn cancer, but it may help you get through chemo happier, and that's a valuable thing.

If I have strep throat, I don't need any woo or any counseling.  The "whole person" approach is a waste of time.

If I have heart disease, then I probably need everything including my own brand of woo (which does NOT include "Chinese traditional medicine").

If I have stage 4 pancreatic cancer, then I need the clergy.  And morphine.  Lots and lots of morphine.

So, yeah, the "whole person" approach is sometimes useful.  "Holistic medicine", taken literally, is not a bad thing, if by "holistic" you mean "all facets approach" and not "some filthy hippie shit".  Unfortunately, when people say "holistic", they almost certainly mean the latter.

One of the places that the traditional Western approach to medicine fails is that not only do we tend to compartmentalize people and illnesses into body parts and categories of disease, but we are, functionally, disease fetishists. We don't tend to focus on how to be healthy, we focus on how to treat disease, and all too often we treat it as if the rest of the person is not connected to the diseased part. A patient with strep throat does call for a holistic approach, and there's nothing woo about that. Strep throat can cause, or be caused by, health issues that affect the whole body.

The focus is gradually shifting, as it should, toward preventing disease, and toward wellness care. There is a growing awareness that a patient's strep throat might actually HAVE a connection to their heart disease. It's taking too long, but it's happening.

"I'm guessing it was January 2007, a meeting in Bethesda, we got a bag of bees and just started smashing them on the desk," Charles Wick said. "It was very complicated."


Junkenstein

QuoteThe focus is gradually shifting, as it should, toward preventing disease, and toward wellness care. There is a growing awareness that a patient's strep throat might actually HAVE a connection to their heart disease. It's taking too long, but it's happening.

Is there any significant shift yet towards incorporating mental health into run of the mill diagnoses? "You've got strep throat, that's sorted. How's work and the family?" kind of thing. I've seen a more of it in the UK approach in the last 10 years or so, while I don't think it's always going to catch anything it does occasionally get something (usually depression) from time to time.

With the general fuckup that is the USA attitude to mental health, I somehow doubt it but that could potentially do a lot to lower all sorts of bad shit. Catching one guy pre-shooting-spree would probably make it worthwhile and I suspect you'd stop more than one guy.
Nine naked Men just walking down the road will cause a heap of trouble for all concerned.

Reginald Ret

Antibiotics are a good subject when discussing holistic medicine.
They are too often used to fight something that is at most an annoyance, and which would clear up in one to two weeks anyway.
In these cases the disregard for the effect of antibiotics on mouth, skin and intestinal biota is really really stupid. Antibiotics do horrible, horrible things to the poor little E. Coli and his friends. Won't someone think of our little dependents? Especially when you are treating someone who had his appendix cut out. From what i hear that functions as a seedbank for the cool shitty bacteria.
Lord Byron: "Those who will not reason, are bigots, those who cannot, are fools, and those who dare not, are slaves."

Nigel saying the wisest words ever uttered: "It's just a suffix."

"The worst forum ever" "The most mediocre forum on the internet" "The dumbest forum on the internet" "The most retarded forum on the internet" "The lamest forum on the internet" "The coolest forum on the internet"

The Good Reverend Roger

Quote from: :regret: on November 18, 2013, 06:47:32 PM
Antibiotics are a good subject when discussing holistic medicine.
They are too often used to fight something that is at most an annoyance, and which would clear up in one to two weeks anyway.

Can you give me an example?
" It's just that Depeche Mode were a bunch of optimistic loveburgers."
- TGRR, shaming himself forever, 7/8/2017

"Billy, when I say that ethics is our number one priority and safety is also our number one priority, you should take that to mean exactly what I said. Also quality. That's our number one priority as well. Don't look at me that way, you're in the corporate world now and this is how it works."
- TGRR, raising the bar at work.

The Good Reverend Roger

" It's just that Depeche Mode were a bunch of optimistic loveburgers."
- TGRR, shaming himself forever, 7/8/2017

"Billy, when I say that ethics is our number one priority and safety is also our number one priority, you should take that to mean exactly what I said. Also quality. That's our number one priority as well. Don't look at me that way, you're in the corporate world now and this is how it works."
- TGRR, raising the bar at work.

Reginald Ret

Quote from: Dirty Old Uncle Roger on November 18, 2013, 06:48:47 PM
Quote from: :regret: on November 18, 2013, 06:47:32 PM
Antibiotics are a good subject when discussing holistic medicine.
They are too often used to fight something that is at most an annoyance, and which would clear up in one to two weeks anyway.

Can you give me an example?
Regular throat infections. They tend to clear up in 7-14 days. Of course, if you have pervious experience that indicates that yours never clear up in that timeframe, by all means commit bacterial genocide. as soon as you want (Oh, and go to a doctor anyway, don't mess around with your health).
On average people do not benefit from antibiotics in such instances, but you and i both know how averages do not apply to everyone.
Oh. and don't take risks if you have other risk factors.

My source (Dutch, sorry):
This Blog from a Doctor
Where he mentions the Dutch College of General Practitioners Guidelines. (Also Dutch, sorry again. Maybe Google-Translate won't garble it too much?)
Lord Byron: "Those who will not reason, are bigots, those who cannot, are fools, and those who dare not, are slaves."

Nigel saying the wisest words ever uttered: "It's just a suffix."

"The worst forum ever" "The most mediocre forum on the internet" "The dumbest forum on the internet" "The most retarded forum on the internet" "The lamest forum on the internet" "The coolest forum on the internet"

Golden Applesauce

Building on what Regret said - I'm one of the "other risk factors" exception. The drugs I take stop my arthritis from eating my finger bones are immunosuppressants. So I'd definitely need to consult with my rheumatologist. She'd probably yank me off the immunosuppressants, maybe switch me to something else for the duration, or something. That's within the amount of overhead that I as a patient can manage, but it's still a pain in the butt and it would be nice and less error-prone if I didn't have to do that manually.
Q: How regularly do you hire 8th graders?
A: We have hired a number of FORMER 8th graders.

Mesozoic Mister Nigel

Quote from: Junkenstein on November 18, 2013, 06:39:21 PM
QuoteThe focus is gradually shifting, as it should, toward preventing disease, and toward wellness care. There is a growing awareness that a patient's strep throat might actually HAVE a connection to their heart disease. It's taking too long, but it's happening.

Is there any significant shift yet towards incorporating mental health into run of the mill diagnoses? "You've got strep throat, that's sorted. How's work and the family?" kind of thing. I've seen a more of it in the UK approach in the last 10 years or so, while I don't think it's always going to catch anything it does occasionally get something (usually depression) from time to time.

With the general fuckup that is the USA attitude to mental health, I somehow doubt it but that could potentially do a lot to lower all sorts of bad shit. Catching one guy pre-shooting-spree would probably make it worthwhile and I suspect you'd stop more than one guy.

Yes, that's happening, but it's gradual and the problem with implementation is that doctors are often pushed to move patients through rapidly without adequate time talking to them about their lives. Making matters worse, some insurance companies have figured out that they can cut expenses by eliminating the specialist-referral system, so many patients can make appointments with specialists without ever seeing their GP. Specialists NEVER ask those kinds of questions.
"I'm guessing it was January 2007, a meeting in Bethesda, we got a bag of bees and just started smashing them on the desk," Charles Wick said. "It was very complicated."


Mesozoic Mister Nigel

Quote from: :regret: on November 18, 2013, 06:47:32 PM
Antibiotics are a good subject when discussing holistic medicine.
They are too often used to fight something that is at most an annoyance, and which would clear up in one to two weeks anyway.
In these cases the disregard for the effect of antibiotics on mouth, skin and intestinal biota is really really stupid. Antibiotics do horrible, horrible things to the poor little E. Coli and his friends. Won't someone think of our little dependents? Especially when you are treating someone who had his appendix cut out. From what i hear that functions as a seedbank for the cool shitty bacteria.

Many people can automatically count on getting a secondary infection as soon as the antibiotics run their course, too. Women in particular are prone to outbreaks of candidiasis or other forms of vaginosis, and antibiotics can set off a yo-yo of infections that can take years to correct.
"I'm guessing it was January 2007, a meeting in Bethesda, we got a bag of bees and just started smashing them on the desk," Charles Wick said. "It was very complicated."


Golden Applesauce

Quote from: Dirty Old Uncle Roger on November 18, 2013, 03:07:59 PM
Quote from: Q. G. Pennyworth on November 17, 2013, 02:09:39 PM
People aren't just chemicals, they're also the sum of their experiences and their internal narrative of self. A proper holistic approach to treating mental illness would be therapy AND drugs (as needed) AND exercise AND diet AND accessing environmental problems AND, yes, a dash of woo, because woo is actually pretty effective at some mental health problems and pain management. The problem is the current crop of morons are ALL WOO and very little else. and refuse to acknowledge that what they're doing is woo and that woo is only effective in a very narrow scope of cases. Woo will not cure your damn cancer, but it may help you get through chemo happier, and that's a valuable thing.

If I have strep throat, I don't need any woo or any counseling.  The "whole person" approach is a waste of time.

If I have heart disease, then I probably need everything including my own brand of woo (which does NOT include "Chinese traditional medicine").

If I have stage 4 pancreatic cancer, then I need the clergy.  And morphine.  Lots and lots of morphine.

So, yeah, the "whole person" approach is sometimes useful.  "Holistic medicine", taken literally, is not a bad thing, if by "holistic" you mean "all facets approach" and not "some filthy hippie shit".  Unfortunately, when people say "holistic", they almost certainly mean the latter.

That's another often overlooked point. You can't specialize in one kind of woo and then expect to be able to bend your patients to fit it. Someone who was actually serious about woo as a component of holistic therapy would learn as many different styles & traditions of it as they could, figure out the core structural elements, and be able to produce a woo-system tailored to each specific patient's expectations and needs. I.e., treat the specific patient in front of you instead of the disease in your book, which exactly the thing they accuse the establishment of not doing. But that requires the ability to distinguish between "stuff that works" and "stuff that is true" and critical thinking skills, so I'm not going to hold my breath.
Q: How regularly do you hire 8th graders?
A: We have hired a number of FORMER 8th graders.

The Good Reverend Roger

Quote from: Golden Applesauce on November 18, 2013, 10:39:59 PM
That's another often overlooked point. You can't specialize in one kind of woo and then expect to be able to bend your patients to fit it.

Um, my woo would come from the clergy, and they most certainly do specialize.

Mostly in listening to outrageous death bed confessions to EVERYTHING.

If you have late stage pancreatic cancer, that's all you have left.  To fuck with people on the way out the door.
" It's just that Depeche Mode were a bunch of optimistic loveburgers."
- TGRR, shaming himself forever, 7/8/2017

"Billy, when I say that ethics is our number one priority and safety is also our number one priority, you should take that to mean exactly what I said. Also quality. That's our number one priority as well. Don't look at me that way, you're in the corporate world now and this is how it works."
- TGRR, raising the bar at work.

Junkenstein

Quote from: Mrs. Nigelson on November 18, 2013, 10:25:01 PM
Quote from: Junkenstein on November 18, 2013, 06:39:21 PM
QuoteThe focus is gradually shifting, as it should, toward preventing disease, and toward wellness care. There is a growing awareness that a patient's strep throat might actually HAVE a connection to their heart disease. It's taking too long, but it's happening.

Is there any significant shift yet towards incorporating mental health into run of the mill diagnoses? "You've got strep throat, that's sorted. How's work and the family?" kind of thing. I've seen a more of it in the UK approach in the last 10 years or so, while I don't think it's always going to catch anything it does occasionally get something (usually depression) from time to time.

With the general fuckup that is the USA attitude to mental health, I somehow doubt it but that could potentially do a lot to lower all sorts of bad shit. Catching one guy pre-shooting-spree would probably make it worthwhile and I suspect you'd stop more than one guy.

Yes, that's happening, but it's gradual and the problem with implementation is that doctors are often pushed to move patients through rapidly without adequate time talking to them about their lives. Making matters worse, some insurance companies have figured out that they can cut expenses by eliminating the specialist-referral system, so many patients can make appointments with specialists without ever seeing their GP. Specialists NEVER ask those kinds of questions.

Nigel, appreciate that, thanks. I've got thoughts coming about mental health and insurance companies but it's late and I'm not thinking too well.
Nine naked Men just walking down the road will cause a heap of trouble for all concerned.

Golden Applesauce

Quote from: Hoopla on November 18, 2013, 02:52:32 PM
Quote from: Golden Applesauce on November 17, 2013, 11:10:56 AM

Where are all the people who say, "I believe in treating the whole person. That's why I have thorough training in psychology, psychiatry, special needs education, endocrinology, regular education, relationship counseling, physical therapy, gynecology, career counseling, oncology, nutrition, and the top seven most common religions in my area." ???

That sounds like some serious schooling.

I'll admit I was thinking of the comic book character Dr. McNinja, who earned a Ph.D. in every field except Agriculture by cloning himself (with the help of Ben Franklin), having each clone get a different doctorate, and then merging them all together. (The clone with the doctorate in Agriculture was late to the merging party, and decided to live on a farm instead, calling himself "Old McNinja".) That absurd level of education, in one person, is clearly fantasy.

On the other hand, a lot of regular folks are in school from 4 to 24. That's twenty years of schooling, but you can't really claim that results in twenty years of education. A high school diploma means nothing, and you'd hardly call someone a "scholar" just for attaining a 4 year degree. There's room for improvement here.

The other thing is that we suck at educating adults. Once you've acquired enough job skills to get hired, there's little to none institutional support for continued education. If you're lucky your job gives you time off to attend seminars and workshops. But if your'e working 40-60 hours a week, when are you supposed to make time to practice new skills and do exploratory learning?
Q: How regularly do you hire 8th graders?
A: We have hired a number of FORMER 8th graders.