Chris, TEC and all other medical professionals on this board, please know that the vast majority of us here do not dislike or distrust doctors. We dislike and distrust the organizations that purport to speak for doctors, namely the AMA, JAMA, NEJM etc. The same holds true for lawyers (except that people really don't like us). The ABA is a crap organization, but still has the prestige necessary to get the "important" people to listen to it. Doctors save many, many lives, obviously, and make our lives infinitely more livable. It is, however, a fact that negligence on the part of doctors and medical professionals costs many, many lives, something that never factors into articles such as the one being discussed here. The plain truth is that it is not even a close comparison. The numbers are so much larger on the med-mal side as to be a joke. If, for example, one were arguing that lawn darts should be banned because 17 people had been killed and 1,000 injured, but that bicycles should not be, even though thousands are killed and hundreds of thousands injured every year, we would have a more apt comparison. Oh, wait, that stupid comparison was argued, and successfully to boot. We are so screwed up . . .
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New England Journal of Medicine at it Again!
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Lone_Gunman
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Why is this sort of thing in a medical journal?
Because most of academic medicine is run by people with authoritarian/socialist agendas.
I have not been a member of the AMA for over 10 years. I resigned membership when the President of the AMA gave a speech on the public health crisis being caused by firearms.
That said, most physicians in private practice, and not involved in academic medicine, or public health medicine, are going to have the same distribution of pro- and anti- gun opinions as the general population.
There is no reason to attack the medical profession in general over this. The problem lies with a very specific group of physicians who are involved in academic medicine and public health.
TEC:
Going horribly off topic:
I'm a student working part-time. When I was full-time I had my medical plan offered through work, and then I got my medical plan from school. Finally I dropped the latter when I found out 'medical plan' was a way of charging $650 a quarter and not covering anything.
I've received quality care when I've been able to afford it, but some expenses are just crippling to we working poor. Dental implant and post? $6k. Wisdom teeth coming out? Another $6k. Total coverage under my work plan? $500. Total coverage under my school plan? $150. I make $20k a year! How does that add up?
Several years ago I accidentally tried swallowing a whole water chestnut. I know, dumb move, got stuck in my throat. I was barely able to swallow water breathing was constricted, I was covered by work. Tried to do everything right. I even waited from Saturday night when it happened until Monday morning, wondering when my air supply was going to get cut off, so I could go to a qualifying doctor on my plan. Removing the thing? $2500. Total coverage? $400.
I realize a socialized medical system will diminish the fast, easy health care for some, but it takes my current, broke health care budget (zero, looking for medical advice from friends in the profession) to something. Doesn't matter how bad that something is, because it's more than I have. And when I get sick next door, it's in your best interests to get me treated! Want TB, smallpox, scarlet fever, and the like to come back and run rampant? You need to treat poor people too. Disease doesn't know how fat your wallet is.
Anyhow. My two cents. It's all I have.
-Tim.
Golly, Oye and Frank -- bit critical of doctors aren't you? But not to worry. We doctors are about to get our come-up-ence from the current administration in the form of single payer (ie government) socialized health care. Thank you, God, that I am near the end of my professional career and not juts starting out.
How did that tune go? -- "Lord it always seems to go that you don't know what you've got 'till it's gone. Take paradise and put up a parking lot".
Well, Americans are about to find out you had when it's gone. And in the next scenario, it won't be the greedy doctors killing people, it will be big government bureaucracy and the lack of access to medical care. Such is life. But hey, at least it will be "free".
Going horribly off topic:
I'm a student working part-time. When I was full-time I had my medical plan offered through work, and then I got my medical plan from school. Finally I dropped the latter when I found out 'medical plan' was a way of charging $650 a quarter and not covering anything.
I've received quality care when I've been able to afford it, but some expenses are just crippling to we working poor. Dental implant and post? $6k. Wisdom teeth coming out? Another $6k. Total coverage under my work plan? $500. Total coverage under my school plan? $150. I make $20k a year! How does that add up?
Several years ago I accidentally tried swallowing a whole water chestnut. I know, dumb move, got stuck in my throat. I was barely able to swallow water breathing was constricted, I was covered by work. Tried to do everything right. I even waited from Saturday night when it happened until Monday morning, wondering when my air supply was going to get cut off, so I could go to a qualifying doctor on my plan. Removing the thing? $2500. Total coverage? $400.
I realize a socialized medical system will diminish the fast, easy health care for some, but it takes my current, broke health care budget (zero, looking for medical advice from friends in the profession) to something. Doesn't matter how bad that something is, because it's more than I have. And when I get sick next door, it's in your best interests to get me treated! Want TB, smallpox, scarlet fever, and the like to come back and run rampant? You need to treat poor people too. Disease doesn't know how fat your wallet is.
Anyhow. My two cents. It's all I have.
-Tim.
richyoung
Member
Tim, health care is a commodity - not a right. You have no more right to get in my wallet to buy your health care than you do to buy beer, or lap dances, or whatever. Zero, zip, NONE.
I just had to replace my washing machine. $1,000. My homeowners insurance covered $0. My truck needed service and a new air conditioner, $2500, my auto insurance covered $0. This sucks. We need universal appliance and auto coverage so I don't have to pay for that stuff anymore!!
Tim, you won't always be poor, unless, of course, we get your socialized medicine, then we'll all be poor, and sick, and in a line waiting for care.
To keep this on topic, firearms are not a public health issue anymore than car accidents, pool drownings or skateboarding injuries. People get hurt, people die, it's not a health emergency, it's life.
Tim, you won't always be poor, unless, of course, we get your socialized medicine, then we'll all be poor, and sick, and in a line waiting for care.
To keep this on topic, firearms are not a public health issue anymore than car accidents, pool drownings or skateboarding injuries. People get hurt, people die, it's not a health emergency, it's life.
Health care is a communal problem, not an individual problem It even has some tangible benefits to non-sick people!
You get a healthy work force. Healthy people tend to show up to work more often. Let's say you own a small business. You want your employees to be at work reliably, right? Generally preventative care is less expensive than treatment, and also pushed aside when not critically necessary.
What about that guy who has a rash he can't identify. He can't go see a doctor and ask because his $150-$200 is going towards rent, or a light bill. Instead he's popping pustules and spreading monkey pox to people he meets on the street. Had he seen a doctor, the treatment would be for one or two people, instead of a dozen. Costs are kept low.
Anyway, that's the end of my tangent.
You get a healthy work force. Healthy people tend to show up to work more often. Let's say you own a small business. You want your employees to be at work reliably, right? Generally preventative care is less expensive than treatment, and also pushed aside when not critically necessary.
What about that guy who has a rash he can't identify. He can't go see a doctor and ask because his $150-$200 is going towards rent, or a light bill. Instead he's popping pustules and spreading monkey pox to people he meets on the street. Had he seen a doctor, the treatment would be for one or two people, instead of a dozen. Costs are kept low.
Anyway, that's the end of my tangent.
HK G3
Member
@ Zane: I actually am mulling over writing a letter. To me, it's not so much that I disagree with them, it's really the fact that, as you say, they threw EBM out of the window, in a time where all medicine that is currently practiced needs to have solid scientific data behind it. And really, the complete disregard for facts is quite appalling in a medical journal. Just because the subject is loosely related to epidemiology, doesn't mean that they can ignore data and forego comparative analyses to try to measure the efficacy of gun-control. The whole article is based on a false epidemiological supposition which was never adequately proven by the authors, or even the authors of the previous studies.
One of the major things stopping me from writing a letter is the fact that I am studying for the USMLE Step 1 right now, so I have extremely limited time. Maybe if I just write a little bit each study break....
@ Chris: I am sorry you had to see that. As a medical student, my exposure to gun-violence has been limited solely to the aftermath of gang-shootings, where the "victim" has a GSW with blatant powder burns and speckling, and yet he "didn't see nothing" and has no idea who shot him. I also know that the loans stink. On the other hand, one of the worst things I've seen while in the ED/Trauma bay was a mother whose child drowned in the pool, but was still barely alive. She was hysterical, and there were LEOs all over the place just waiting for the kid to die, so they could charge her with negligent homicide. Through some stroke of luck the child survived, and ultimately the docs determined that it really wasn't negligence on the mother's behalf - the child had opened a locked gate to get to the pool.
I've been doing my best to minimize my loans, but it's hard. Some of my favorite docs to interact with have been trauma surgeons. They're a really great group at my hospital, some of which are military vets with incredible stories. I'm sure you'll have your loans paid off eventually, that's what all my attendings tell us, anyway!
@The Doctors=Bad crowd: I understand that lately modern medicine gets a bad rap, and it's especially upsetting to see doctors' groups lobbying for socialist agendas as of late. But keep in mind that doctors try to do everything right. No doctor ever wakes up and says to himself, "You know what? I'm not going to wash my hands today, because I really feel like spreading some MRSA around." Malpractice is also ridiculously overblown - take John Edwards for example. He made a fortune suing OB/GYNs, using flimsy evidence to claim that they induced brain damage in premature babies. Science later vindicated these docs and showed Edwards' evidence, which the juries lapped up, to be bunk and void - the brain-damage was simply unavoidable in children born that premature, and the doctors actually saved the children's lives by doing what they had done. These cases are still used to inflate malpractice rates, in spite of the evidence. Of course, their practices were ruined by an overzealous attorney and a public cynical of the medical profession, when in reality, all they were trying to do was save some lives. That's hardly just from where I sit, and is something to think about next time you start spouting off the inane "Doctors are Barney Fifes with scalpels!" nonsense. Every doc I have worked with has embodied professionalism, and does their absolute best to treat the patient in front of them, no matter how tired or irritated they may be, even if the patient is obnoxious beyond belief.
Finally, to steer this back on topic, the AMA is constantly trying to get me to join, but each time, I just throw away their letter. They've strayed from advocating for physicians and healthcare, and tend to advocate, as I said earlier, a fairly socialistic agenda under the guise of advancing healthcare these days. They are constantly pushing for more affirmative action, gun control, heavy taxation of various foodstuffs, and other policies that the Left holds dear. I wish there were some counter-physicians' organizations that would just promote greater medical knowledge and healthcare, while still remaining amicable to the various freedoms enjoyed in this country, and working within this system, as opposed to trying to find a way to legislate them away.
I truly believe that physicians need to advocate firearms safety and responsible gun ownership for those who choose to exercise their Second Amendment rights - not restrictive gun-control. Unfortunately, all I have heard from the medical "establishment" has been pro-gun control. One of the first things we were taught in school was to ask if our patients owned guns, and to chastise them for doing so, and encourage them to get rid of the gun. When I asked to know the medical evidence behind this, we were shown the heavily flawed, and thoroughly debunked Kellerman study. Thankfully, it seems to just be the academics that care about this, the private practice physicians scoff at the notion of asking patients about firearms.
One of the major things stopping me from writing a letter is the fact that I am studying for the USMLE Step 1 right now, so I have extremely limited time. Maybe if I just write a little bit each study break....
@ Chris: I am sorry you had to see that. As a medical student, my exposure to gun-violence has been limited solely to the aftermath of gang-shootings, where the "victim" has a GSW with blatant powder burns and speckling, and yet he "didn't see nothing" and has no idea who shot him. I also know that the loans stink. On the other hand, one of the worst things I've seen while in the ED/Trauma bay was a mother whose child drowned in the pool, but was still barely alive. She was hysterical, and there were LEOs all over the place just waiting for the kid to die, so they could charge her with negligent homicide. Through some stroke of luck the child survived, and ultimately the docs determined that it really wasn't negligence on the mother's behalf - the child had opened a locked gate to get to the pool.
I've been doing my best to minimize my loans, but it's hard. Some of my favorite docs to interact with have been trauma surgeons. They're a really great group at my hospital, some of which are military vets with incredible stories. I'm sure you'll have your loans paid off eventually, that's what all my attendings tell us, anyway!
@The Doctors=Bad crowd: I understand that lately modern medicine gets a bad rap, and it's especially upsetting to see doctors' groups lobbying for socialist agendas as of late. But keep in mind that doctors try to do everything right. No doctor ever wakes up and says to himself, "You know what? I'm not going to wash my hands today, because I really feel like spreading some MRSA around." Malpractice is also ridiculously overblown - take John Edwards for example. He made a fortune suing OB/GYNs, using flimsy evidence to claim that they induced brain damage in premature babies. Science later vindicated these docs and showed Edwards' evidence, which the juries lapped up, to be bunk and void - the brain-damage was simply unavoidable in children born that premature, and the doctors actually saved the children's lives by doing what they had done. These cases are still used to inflate malpractice rates, in spite of the evidence. Of course, their practices were ruined by an overzealous attorney and a public cynical of the medical profession, when in reality, all they were trying to do was save some lives. That's hardly just from where I sit, and is something to think about next time you start spouting off the inane "Doctors are Barney Fifes with scalpels!" nonsense. Every doc I have worked with has embodied professionalism, and does their absolute best to treat the patient in front of them, no matter how tired or irritated they may be, even if the patient is obnoxious beyond belief.
Finally, to steer this back on topic, the AMA is constantly trying to get me to join, but each time, I just throw away their letter. They've strayed from advocating for physicians and healthcare, and tend to advocate, as I said earlier, a fairly socialistic agenda under the guise of advancing healthcare these days. They are constantly pushing for more affirmative action, gun control, heavy taxation of various foodstuffs, and other policies that the Left holds dear. I wish there were some counter-physicians' organizations that would just promote greater medical knowledge and healthcare, while still remaining amicable to the various freedoms enjoyed in this country, and working within this system, as opposed to trying to find a way to legislate them away.
I truly believe that physicians need to advocate firearms safety and responsible gun ownership for those who choose to exercise their Second Amendment rights - not restrictive gun-control. Unfortunately, all I have heard from the medical "establishment" has been pro-gun control. One of the first things we were taught in school was to ask if our patients owned guns, and to chastise them for doing so, and encourage them to get rid of the gun. When I asked to know the medical evidence behind this, we were shown the heavily flawed, and thoroughly debunked Kellerman study. Thankfully, it seems to just be the academics that care about this, the private practice physicians scoff at the notion of asking patients about firearms.
Lone_Gunman
Member
Lone Gunman - your quote is from Cicero (or someone else Goldwater quoted)
I don't know about Cicero, but it was used by Goldwater, in his acceptance speech when he was the Republican nominee for president in 1964. The version I have in my sig line is actually a paraphrase, as his actual words were:
"I would remind you that extremism in the defense of liberty is no vice! And let me remind you also that moderation in the pursuit of justice is no virtue."
Cicero was before my time.
RapidFireBeak
Member
That said, most physicians in private practice, and not involved in academic medicine, or public health medicine, are going to have the same distribution of pro- and anti- gun opinions as the general population.
Ding ding ding!
As has been stated many times, the NEJM is primarily the product of ivory tower type academic physicians who are far removed from the reality of everyday private practice and are generally left-wing totalitarians. Similarly, I consider the AMA to be worthless, and my opinion isn't uncommon. The large professional medical organizations represent academic docs, who tend to have...different views than the rest of us, and they spend an inordinate amount of time pushing all sorts of left-wing political issues.
Do you folks hate all LEOs because certain big-city chiefs are totalitarian fascists who view every citizen as a potential arrest?
Not that there aren't pompous jerkwads in medicine (believe me, I've met more than most of y'all!) But I challenge the "everything gets better by itself" crowd to stay home from the ER if you break your femur, have chest pain, or suddenly can't move your right leg.
One of the major things stopping me from writing a letter is the fact that I am studying for the USMLE Step 1 right now
Ouch! I feel your pain, but things will improve substantially once that's over, trust me! Remember, EVERYONE thinks they bombed that thing.
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