Back in the day (before 1997, when I officially became a Born-Again Skeptic [TM]), I used to go to woo-practicing doctors.
I saw a therapist – actually, three – from the American College of Orgonomy. They’re one of the groups that have carried on the torch of Wilhelm Reich’s orgone energy.
I saw a Vision Therapist. He was convinced that nearsightedness (like mine) could be cured with eye exercises. I took my failure to improve my own condition as my failure to try hard enough. He also tried applied kinesiology on me once, and determined thereby that I needed to eat more sunflower seeds.
I saw two Chiropractors. Oddly, the second one did set off some of my alarm bells, by claiming that aluminum caused Alzheimer’s disease. Even in my pre-1997 gullible state, I already knew that this was supported only by one study whose results had failed to be replicated in later studies.
Then in 1997, I encountered National Trust Services, and my failure to make their never-pay-income-tax-again scheme work finally woke me up. I’ve been turning a jaundiced eye on my most cherished beliefs ever since.
I stopped seeing a doctor that shared building/clinic space with woo-specialists, like homeopaths and reiki, in a “Medical / Alternative Cooperative”. While she was legitimate, the coop as a whole had a definite “scratch each others back” of internal referrals. I didn’t like going in for cold/flu and, affter getting my antibiotic prescription, having to turn down the obligatory “if you’re open to alternatives, Dr McQuack (PhD Theater History) has had great experiences with his patients using ultra-hydrated distilled placebomoronic supplements…would you like a referral? He’s just next door.”
On the other hand, Mrs G needed brain surgery a few years back, and we did choose a top surgeon who worked out of a private christian hospital. Having to politely smile our way through the hospital priest praying over us before and after surgery was an acceptable price to pay from the hospital administration to get an good surgery team. In cases like this, we weren’t going to confirm the moral philosophies of each nurse, doctor, anethstetician, and surgeon on the staff.
Sadly one of the drawbacks of living in a highly progressive area (Washington State / Puget Sound) means that there is also a high level of political correctness of any alternative beliefs or practices. Of the dozens of doctors and specialists we’ve been through, I can count on one finger of one hand the number of doctors that will unapologetically call out crap for being crap in their fringe colleagues. Insurances are being pushed constantly to add stuff like rolfing and qigong to mandatory coverage plans. It’s a strange paradox that greater general education in professionals also gives rise to greater woo tolerance.
Sometimes I long for the days of simply tar-and-feathering the snake oil salesman when they ride into town.
I take exception to this. A good medical school does teach critical reasoning. When I was teaching I always stressed to my students to learn the mechanism of treatment rather than memorizing medications. For example, to treat atrial fibrillation, first control the rate, then anticoagulate then consider conversion back to normal rhythm. When I trained, the medications used might be metoprolol/coumadin/procainamide while now you might use diltiazem/ribaroxaban/amiodarone. It’s the same with infections. Rather than being taught to use X medication for Y infection, we were always taught to determine the most likely bacteria then choose the antibiotic best suited to cover those.
While I would admit that we do not yet know the mechanism of all the treatments we prescribe, good doctors do strive to know how medications work and can explain this to their patients.
My problem as a physician is how to deal with other physicians who promote alternative therapies. For example, how to explain that I don’t do ear candling to a patient who stated that her son went to an ENT who did ear candling and cured his ear problems. It’s hard to debunk woo without out and out stating that another doctor who I’ve never met is a quack. The nutritionists are the worst. I had one patient who had trouble losing weight. I pointed out that she took 75 supplement pills daily. If they were 3 calories each, that would add close to 1/2 pound a week. She insisted that her nutrionist doctor insisted she needed every one (which he conveniently sold in his office). When I was looking for jobs, I turned down a place with a very well-respected physician when I saw that he sold supplements from his office.
As far as posting about Obamacare goes, the physician does not have the choice whether to participate or not. One local insurance has already informed me that they are cutting me from all their obamacare plans in Virginia because I do not have privileges at one of their hospitals (nearest one is over 30 minutes away) but keeping me on plans in Maryland and DC (which somehow do participate with local hospitals).
Finally, the physician who does not see Medicare patients is required to inform patients. If you opt out of Medicare you not only cannot bill Medicare, but the patient cannot collect from Medicare for the visit and you are required to inform patients and to have them sign a statement that they understand this. In other words, if a standard visit is $100 and Medicare pays 80%, they will not just pay $80 no matter who you go to. There are 3 options:
#1) MD is a participating physician
-MD bills $150
-Medicare allows up to $100
-Medicare pays $80
-Patient pays $20
#2) MD is a nonparticipating physician-(which allows you to bill 115% but compensates patients only 65%)
-MD bills $150
-Medicare allows $115
-Medicare pays $74.75
-Patient pays $40.25
#3) Physician opts out of Medicare (requires at least two years before MD can participate again)
-MD bills $150
-Medicare allows nothing
-Medicare pays nothing
-Patient pays $150
You must choose one option for ALL patients and cannot switch back and forth. Therefore, physicians choosing option #3) will often post this so patients are aware.
If she choses to work for an institution that performs abortions and she refuses to participate in one, it will probably retard her career although probably nothing explicit would be said. If she is smart she will work somewhere where the issue won’t arise.
I had to have a root canal, and my dentist referred me to a [word for root canal performer] whose piped-in music was non-stop Christian. I actually grooved a bit on the old-timey gospel, but the contemporary stuff made me jittery. Still, I figured it was the guy with the drill who most needed to be relaxed, so when he took a break I just went for my iPod. But when he asked if I would like him and the hygienist to pray with me before he resumed, I said NO.