That should be a deal-breaker in itself. Even without a big markup it is ethically dubious at the very least for a physician (assuming that’s what this “doctor” was) to sell supplements out of his/her office* (the A.M.A., for example, strongly discourages such activities, particularly if the supplements don’t have a sound scientific basis).
And of course a general statement like the patient’s “whole system” is inflamed, comes off as utter quackery, along with recommendations for multiple vitamin pills (which the vast majority of people do not need).
*and while ethical guidelines likely don’t exist for many sort of alternative practitioners, it is equally sleazy in my opinion for any of them to sell the products they promote to patients. Just a wee bit of conflict of interest there.
All doctors make mistakes and no one can be relaxed about that; we have to pay attention, ask questions (especially when something unexpected or out of routine appears to be happening) and watch what is going on. We also have to realize that no medical professional cares about us (they can’t and keep their sanity, no matter how caring they seem) so we have to realize that the extra little bit of effort may not come unless we or a loved one is aware.
While the internet can be misleading, it is immensely useful in weeding out incompetence and dishonesty in the medical advice we seek; we should just be sure we know from reliable sources as much about the condition we are seeking advice on as any GP (short of the requisite anatomy).
At the same time, be as sure as possible that all the doctors and nurses genuinely like you. When you are sick this can be really hard to pull off.
A couple years ago, there was a bit of publicity about some Muslim medical students boycotting a lecture on evolution. Naturally, a debate arose around whether a doctor could be competent while clearly believing in non-scientific ideas.
Here’s the way I see it: a doctor is not a scientist, he’s a professional. Medical school does not necessarily teach critical reasoning skills: it teaches you how to make a diagnosis and how to treat different diseases, based on what current recommendations are (hopefully the recommendations are created by scientists). It does not teach you why a certain treatment works or doesn’t work. And you therefore get some doctors believing in pretty nutty things.
It’s not unique to the medicine profession. I’ve driven over bridges designed by creationists and been in airplanes piloted by homeopaths.
The deciding factor is whether I think it will affect my quality of care. If they offer to sell me their overpriced water, or pray over my sick kid, I’m out of there. But a dentist who follows some new old Maya religion? Whatever. Doctors opposed to abortion? If it was a GP or especially an ObGyn I’d be concerned, otherwise not so much. The truth is that even in the sciences there are plenty of nut-jobs, so I think it’s way too much to realistically expect a professional to not hold any nutty beliefs. There are just not enough rational people to go around to all the vocations that really need them, so we have to settle for just not being nutty in their area of expertise.
That’s actually pretty much the opposite end of the spectrum from the “woo” (I still hate that word) believers being discussed in this thread. Your doctor’s approach is exactly the one doctors are being trained to take nowadays, with the emphasis on “evidence based medicine.” This is the view that only double-blind, randomized, placebo-controlled trials published in peer-reviewed journals can tell us what really works and what does not. Anecdotal experience based on a low n count was the source of a lot of treatments from the past which are now thought ineffective. It sounds ridiculous, when your own experience was that treatment X relieved symptom Y, to be told “treatment X does not relieve symptom Y,” but that is exactly what evidence-based medicine does.
And I’d be fine going to a dentist who believes the cold weather is based on the Mayan calander, but I probably wouldn’t be very comfortable going to one who thinks root canals are teh evil.
My GP is a nice guy, and I’ve been going to him for years. Last year, when I went for my checkup, I noticed a number of brightly colored, hand-lettered signs around his office promoting ear candling.
When he and I were going over my lab results in the exam room, I mentioned the signs and asked him if he really thought ear-candling worked. He said he’d seen good results from it. I referred him to the Dope and said “I’m fairly certain it’s been disproven.”
When I went back several months later for something else, the signs were still up. I lost a little bit of faith in him as a result. Not enough to stop going to him, but enough that it bothers me he allows that stuff to be promoted in his office.
I’m going through a rough bout of tendinitis in my left elbow at the moment, and saw an orthopedic surgeon last week. He did some x-rays to rule out anything more serious, and then began discussing treatment options with me. I mentioned my wife, the lovely and talented Aries28, was a strong believer in the efficacy of essential oils, and he was very agreeable to that. “I’ve seen people have good results from essential oils,” he said. “I wouldn’t recommend them for something truly serious, but to relieve pain and swelling I think they’re fine.”
Just thought I’d throw those two data points out there.
It strikes me a doctor who is also a creationist is very weakly based in fundamental biology. It is not the sort of thing I would ask a possible doctor, but if I found out I would lose confidence in a hurry. After all, a basic intelligence and biological knowledge and absence of certain bias is essential
I once worked with someone who came in one day literally jumping for joy because her daughter, who’d just finished the main part of medical school, had been accepted for training (not quite the right word, but you get the point) in Obs & Gynae. She’d been worried her daughter wouldn’t get in because she (the daughter) was anti-abortion and would refuse to perform them, and said this in the interview. But she got in anyway.
I wish I remembered the daughter’s name, so that I could ask for a different doctor if I were ever referred to her. Why didn’t she just choose a different area of medicine to specialise in? Bizarre.
My GP practice is connected to a church and it has crosses and religious stuff in some prominent places. I’m quite happy there, but my GF is rightly concerned that their beliefs are affecting her referral for donor insemination. Christianty’s not even a “woo” belief exactly, but in this particular case it is a concern. And it’s led to me holding off mentioning my sexuality to them even when partners, etc, have come up and it could actually matter (sexual health).
A moral objection to abortions is something a lot of us share, although the sensible ones in my opinion think it should be a personal and not a legal matter.
An unwillingness or inability to understand the truth of biological evolution is something different and indicates an incompetence to me that would disqualify someone from giving me medical advice.
This is certainly a critical point, and I think the sword cuts both ways.
There’s another thread around here where we generally seem to agree on the inapplicability of woo to medical problems, particularly cancer, strokes, etcetera. I recently emphasized to a friend that there’s an issue of focused expertise that is highly relevant here: You don’t send a lumberjack to do brain surgery; you don’t send the Pope to assassinate a terrorist; you don’t let a homeopathic sports therapist to treat a brain aneurism; and you don’t send Seal Team Six to negotiate peace talks in the Red Sea/southeastern Mediterranean Sea region. It’s just not what these guys are trained to do. More narrowly focused, and worth reiterating Incidental’s quote above, is that having expertise (credentialed, titled, recognized, or not) in one field doesn’t necessarily make you an expert, or equally expert, in other fields that might even be closely related. My coworker thoroughly understands CISCO networks and protocols and how to get the computers in the office to talk smoothly with the computers in the data center and the contractors’ offices. However, he boasts that he hated programming and has shown that he doesn’t understand the fundamentals of programming language structure; he is not qualified (or allowed) to program the applications. We have a team of application developers to do the programming, and they don’t concern themselves with the minute details of networked interoperations; they work with him when they need to set up channels of communication between one server and another.
I’d be inclined to suggest that if your dentist subscribes to pray-away-cavity ideas, or anti-fluoridation paranoia, or even anti-anesthesia theories, then he or she is failing to provide the best care that the modern knowledge-base of his profession offers. If you’re comfortable with that (hey, I have no cavities, don’t need anesthesia for basic cleanings, and can’t take the fluoride of out of the tap water anyway) then there’s nothing wrong with sticking with him/her – at least until you chip a tooth…
But, broadening it out again, one of the loudest voices against human responsibility for contributions to climate change is a dentist with a Young Earth fundamentalist background. He seems to have a lot of people reading his stuff, but he’s also particularly biased and particularly unqualified to comprehend and analyze the publications of geology, astronomy, meteorology (a subdivision of geography), oceanography, natural history, etcetera. What we do have is experts in those fields sharing data and models and overwhelmingly agreeing on the calculations, results, and unbiased interpretations.* My point is that, while he has many people calling him Doctor ____, his doctoral degree is not in the kind of specialty which would make his pronouncements on climate (or change) worth reading* (much less heeding).**
Which brings up one of the fundamental issues I used to emphasize when I was teaching kids to write: Don’t just cite sources to back your claims, know your sources and know when and how to cite them. If someone publishes an article saying genetically modified corn is perfectly safe to eat, it’s important to know whether that author is an executive at Monsanto, an Ice Road Trucker, an eighth grade English student, or a physician with an extensive background in nutrition and allergies – and who’s paying him to publish that opinion. [We’ve mentioned Tho. Midgely Jr. a couple times around here already.]
–G!
*This is a whole thread of its own that would have hijacked the “Unpopular Beliefs you hold” thread (or some similar name) from long ago. I’ll get off this soapbox now, before it’s too late.
**To be fair, I wouldn’t take my kid to the geologist for braces, either.
Sheesh. Why all the hate for woo-practicing doctors???
Seriously, I hold medical doctors to a higher standard than others and I do expect outstanding critical thinking skills from them. That, in combination with knowledge and experience (and tests and observation etc.) is how you arrive at a diagnosis and determine an appropriate course of treatment. So that’s my objective viewpoint.
Subjectively, woo irritates the crap out of me, and I have switched practitioners because they espoused it. I got fed up with an esthetician I once went to because she kept talking about “toxins” (I’ve come to hate that perfectly reasonable and useful word) and then I realized those pretty crystals in her reception area weren’t (to her) just decorations. I know that’s pretty harsh - that field is rife with new age crapola and you’re lucky if the extent is just non-stop Enya music while they’re applying cow pies to your face or whatever.
When I get really old I think I’m going to specialize in crankyness about woo. None of this “you kids get off my lawn” - I’m going to be all “stop believing in stupid shit you stupid bleepers”!
I’d add the caveat that information is not to be denigrated or dismissed simply because the source is questionable.
Way too often I see good evidence ignored because of perceived bias on the part of the presenter, without any real effort made to evaluate the material itself. This behavior is prevalent among wooists, who behave as though anything produced by the scientific Establishment is automatically biased/bought by special interests. On the other hand, if someone cites an article by Mercola or NaturalNews, it behooves rational people to first tackle the claims made in the article, instead of just dismissing the article because it comes from source(s) highly prone to misinformation, exaggeration, or outright lying.
Another example of what would be a deal-breaker for me. Ear candling is so far out in the realm of quackery (and potentially dangerous to boot) that I wouldn’t want a practitioner who promotes it to handle any aspect of my medical care.
You know that abortions are sometimes performed for other reasons than “oops,” right? And my point was that I don’t trust her. I wouldn’t trust her judgment on many other areas of sexual health either, some that affect me directly some that don’t.
How could her opinions on homosexuality, multiple partners, and contraception not be affected by her religion when she’s already admitted that her religious views are strong enough to prevent her actually performing part of her job?
Not everyone who’s anti-abortion is religious, but this woman is, and not every religious person is extremely strong in their beliefs to the point of it affecting their work, but this woman, by her own admission, is.
In addition, she goes to Hyde Park to preach at Speaker’s Corner, with all the insane people, and her mum is proud of this. Yes, one of the crazy people there ranting about how you’re going to hell is a medical doctor who can make significant decisions about women’s sexual health. I think most people would find that concerning.
I agree with this. I would keep seeing a doctor if I otherwise liked them and I didn’t see how their crazy beliefs could affect my quality of care. I think a dentist could be good even with crazy beliefs about the Mayans.
I wouldn’t go to the anti-abortion doctor in the second example though. I am pro-choice, but I think it’s possible to be a reasonable person who holds to facts and be against abortion on moral grounds. However this specific woman was citing incorrect videos, and did not respond well to factual information. This makes me wonder how well she listens to facts, and if she would let her moral beliefs guide her more than what’s best for the patient. If she knows that the best medicine for migraines is X, but studies and evidence overwhelmingly show that the best medicine is actually Y, and that X is actually harmful, will she keep prescribing X, since that’s what she knows?
Or there’s some medicine that’s very strong, but can have bad side effects and is strongly recommended to not be taken by women who are pregnant or who could be pregnant. If I wasn’t pregnant and I needed it, would she prescribe it to me? Or would she avoid it, since I am a woman in my late 20s and could possibly get pregnant sometime while taking the drug. Would she tell me all my options, or just not tell me about that drug at all, and prescribe to me a less effective drug that has no chance of harming my non-existent fetus? Or if I was pregnant, would she tell me about that drug and the harm it could cause to my fetus and let me make a decision? I’m guessing she might not tell me about the drug if I wasn’t pregnant, and she definitely wouldn’t tell me if I was.
There are some crazy beliefs that aren’t related to medicine, and I might continue to see a doctor who believed some crazy things that aren’t related to medicine. But considering how interdependent a lot of medical stuff is, I’d be really hesitant to see a doctor who believed anything crazy relating to medicine or the body.
On a different note, I feel an odd sort of pride that you’ve been here 12 years, have posted less than 200 times, and yet you responded to my post. It’s like I’m in an exclusive club, or something.
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Another example of what would be a deal-breaker for me. Ear candling is so far out in the realm of quackery (and potentially dangerous to boot) that I wouldn’t want a practitioner who promotes it to handle any aspect of my medical care.
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If I didn’t have a long-standing relationship with this doctor (almost 15 years), I’d agree with you. I didn’t question him too deeply on it, but if I had to guess I’d say one of his staff members is doing this, and he’s letting him/her advertise it in the office. Still not great, but I don’t think he’s personally doing it.
Having said that, I’m not going to consult him if I ever have any ear issues.
