SECOND OPINIONS
Doctors have opinions, second, third, fourth....on pretty much everything and I confess I'm no exception. Here are a few:
First of all, I can’t buy the Big Bang theory. If the universe began with a big bang, what came before? The Big Bang bugs me the way it upset Woody Allen as a child growing up under a Coney Island roller coaster in Radio Days. I’ll put my money on endless cycles of boom and bust. That’s Buddhist. That’s life. I’ll bet they find enough dark matter to bring the mindless expansion of the universe to an eventual end.
Second of all, I don’t believe in mental illness. No illness should be a matter of faith, of believe-it-or not and the idea that a linguistic entity, an intangible word - the mind - could fall victim of a disease just like diabetes is a risible insult to the intelligence.
Medical opinions are subject to 180 degree reversals.
Could there be a better example than:
Titanically
incorrect
diets
Check this out!
Gilman MW, et al. Inverse association of dietary fat with development of ischemic stroke in men. JAMA 1997;278:2145-2150
832 men between 45 and 65 followed for 20 years had 61 strokes. Believe it or not, those with the highest fat intake (51% calories from fat) had the lowest rate of strokes - 41 per 1000 while those with the lowest fat intake (26% calories from fat) had a rate of ischemic strokes (white or non-hemorrhagic strokes) almost 3 X higher - 112 per 1000.
How did I know there was nothing wrong with a good steak?
AND NOW FOR A FEW OPINIONS OF MY OWN:
BEST MOVIE OF ALL TIME
DR. STRANGELOVE
directed by Stanley Kubrik
It's won World War III
So far.
A two word reason
why Americans are getting fat:
CORN SYRUP.
The collapse of the gasohol bubble combined with ongoing subsidies left ADM with no choice but to turn the mountains of excess corn into syrup and sneak it down our gullets. Corn syrup is everywhere. At 290 calories per 100 grams, it is incumbent on consumers to read labels and stick to basic axioms:
- Never eat anything bigger than your head - Kliban
- Never eat anything you can't pronounce.
- Never eat anything with more than two paragraphs of ingredients.
For more on
Greek motto: nothing in excess.
HUMAN EXPERIMENTATION
It used to be when pharmaceutical companies needed human subjects for experiments, they went to third world countries. Now they go to the suburbs.
Janssen Pharmaceutical is paying "$8500 per head" (personal communication, medical director of Janssen) to enroll subjects into an experimental stroke treatment protocol using their experimental drug Lubeluzole. Even though this drug was associated with twice the cardiac mortality of placebo in Phase I trials, that hasn't stopped some neurologists and their hospitals from accepting the money and promoting themselves as offering stroke treatment. As one doc put it: "There's nothing wrong with profit."
While that may be true generally, when it comes to medicine, profit is a poor criteria: quacks have always made more money than honest doctors.
HMO's....
this is unfinished but promises to be good. It's a very long story - who cares for the infirm and the elderly?...and precisely how much do they care?
The most recent chapter began with President Clinton's commendable ambition to extend health care to everyone and expand Medicare coverage to medications and nursing homes. Remember?
Now I'm not suggesting he wanted her out of the house, but he turned the job over to Hillary who went into secret huddles with Ira and squads of pious paranoid policy wonks (Buchanan started alliteration as a weapon with his "nattering nabobs of negativim," written for Spiro Agnew's last great speech before he almost went to jail), enjoyed focus groups, spent lots of money and endless months and left the entire business of health care reform a stinking corpse with everyone running away.
Well, not quite everyone. There are those who thrive amidst stinking corpses e.g. vultures, hyenas, earthworms, hardworking ants...(to be continued)
- The concept of capitation, quite simply, is to pay for services ahead of time. Everyone knows that this is no way to get the best or the most but that's the point. It is heuristic to observe that payment "up front" is an uncommon form of exchange except in prostitution where it is traditional. Here is Dr. Robert Fink's opinion of CAPITATION.
Protect Honest Opinions
As of April 1998
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Mail to: DrJohn@idiom.com John M. Friedberg,
M.D.copyright 1995-98©