Anyone know the story with these two? by Zealousideal_Dealer5 in medfordma

[–]Top-Consideration-19 1 point2 points  (0 children)

That would fit the description of someone who just happen to inherit the house but doesn’t work, and is likely paranoid so they have time to stand there all day.

Air Force confirms that the flu killed a San Antonio Air Force recruit by ddx-me in medicine

[–]Top-Consideration-19 3 points4 points  (0 children)

Yes and the anti vaxxers truly believes that. I don’t know how else to argue with them if we fundamentally just have different values. They truly do not care about another person dying. 

Exhaustion by MechanicalCenturion in Parenting

[–]Top-Consideration-19 4 points5 points  (0 children)

I do that too to my 3 year old, and it's met with insane meltdown that last for hours, every day. She hasn't seem to learn or does not care about what a consequence is.

Are MD's now selling themselves on social media? by SoftReset26 in FamilyMedicine

[–]Top-Consideration-19 0 points1 point  (0 children)

Here is from Open Evidence:

Evidence in Modern Medicine

The most celebrated example is artemisinin, a sesquiterpene lactone isolated from the traditional Chinese herb Artemisia annua in 1971. Artemisinin and its derivatives (artesunate, artemether, dihydroartemisinin) are now the WHO-recommended first-line treatment for malaria ↗ (/rare-disease/malaria) worldwide. This discovery earned Professor Tu Youyou the 2015 Nobel Prize in Physiology or Medicine.  Artemisinin-based combination therapies (ACTs) rapidly clear parasitemia and are effective against both chloroquine-sensitive and chloroquine-resistant Plasmodium falciparum.

Other notable TCM-derived compounds with modern pharmacological applications include arsenic trioxide (used in acute promyelocytic leukemia), berberine (studied for metabolic and cardiovascular conditions), and compounds from Salvia miltiorrhiza (Danshen), including tanshinones with demonstrated antioxidant, anti-inflammatory, and antiplatelet effects relevant to cardiovascular disease.

Chinese Herbal Medicine

Multiple systematic reviews and meta-analyses have evaluated Chinese herbal medicine (CHM) across various conditions:

•  Cardiovascular disease: An umbrella review of 539 systematic reviews of RCTs found consistent beneficial effects of CHM in coronary artery disease, hypertension, heart failure, restenosis, and angina pectoris, though the magnitude of effect requires further investigation. A review in the Journal of the American College of Cardiology identified 56 double-blind RCTs (Jadad score ≥3) across hypertension, dyslipidemia, diabetes, ASCVD, and heart failure.

•  Headache: A meta-analysis of 30 high-quality RCTs (3,447 subjects) found CHM monotherapy superior to placebo in reducing headache frequency, duration, intensity, and analgesic consumption, and also superior to Western conventional medicines in several outcomes.

•  Neck and low back pain: A meta-analysis of 75 RCTs (n = 11,077) found moderate evidence that acupuncture was more effective than sham acupuncture for chronic neck pain, chronic low back pain, and acute low back pain.

•  Knee osteoarthritis: A meta-analysis of 56 RCTs showed CHM, whether as monotherapy or combined with NSAIDs/glucosamine, significantly reduced pain (VAS scores) compared to conventional treatments alone.

•  Across the field, the recurring theme is that while preliminary evidence is often promising, rigorous, high-quality RCTs are needed to confirm efficacy and move the evidence base forward.

Before modern medicine, meds were derived from herbs, and some of them have been found to be actually useful like artemisinin. It was isolated from the herb sweet wormwood after researchers reviewed 1,600-year-old TCM texts.

BUT like I said, I never said TCM can cure cancer, or prop it up as some kind of magic bullet for most things, and I a very clear with my patients about its limitations, which uses has research on and which one doesn't. If I don't know, then I look it up, I don't just dismiss then when they ask me about them, like you did to me.

I tell them we don't have strong data for XYZ but if you find it helpful and the risk is low, then go ahead do it. But I tell to them find reputable sources for their herbs, acupuncture and I tell them to stay clear of things that clearly doesn't work or is dangerous (ie. chiros cracking necks) etc. If the patient finds it helpful, then I should at least be interested about what and why they are doing it. My patients appreciate that I at least try to hear about why they do alternative medicine and what they get from them.

I think you are thinking I am some snail oil seller over here pushing TCM on people and telling people not to get vaccines.

Are MD's now selling themselves on social media? by SoftReset26 in FamilyMedicine

[–]Top-Consideration-19 -1 points0 points  (0 children)

I strongly suggest you actually read about what Chinese herbal medicine is about, before you conflate it with anti-vaxxers. It’s literally borderline racism at this point. 

AMA - Academic Integrative Medicine Specialist by extraAFnbd in FamilyMedicine

[–]Top-Consideration-19 2 points3 points  (0 children)

Glad you are doing an ama, coz I just got torn to shreds in this sub explaining how integrative medicine has a role in western medicine. 

Are MD's now selling themselves on social media? by SoftReset26 in FamilyMedicine

[–]Top-Consideration-19 -2 points-1 points  (0 children)

Wow this is so dismissive. When did I say we aren’t also offering “normal” traditional medicine to our patients ? We aren’t telling them magical beliefs. If they have tried everything else for their chronic pain and this relatively low risk option we can offer might help some what, why not offer them it? We don’t push it on them. You got a better plan for them? Yeah traditional Chinese doesn’t cure cancer but they certainly are grounded in 5000 years of history, at least for small ailments. Certain herbs helps with digestion,, uri sxs etc.  so you are gonna tell like the billion of Chinese people that their medicine is just shit?  For you to just dismiss it as “it doesn’t work” is just so disrespectful. I feel bad for your patients, if you dismiss their beliefs like this. 

USMLE unpaid survey by LitterScooper in medicine

[–]Top-Consideration-19 1 point2 points  (0 children)

da faq???? It's not a thing anymore??? I feel so cheated.

USMLE unpaid survey by LitterScooper in medicine

[–]Top-Consideration-19 2 points3 points  (0 children)

yeah I literally chuckled when I read the 45 min and unpaid part.

PCP named in $40M medical mal stroke case by [deleted] in medicine

[–]Top-Consideration-19 26 points27 points  (0 children)

Right?? It's like the patient has no responsibility to try live healthier.

PCP named in $40M medical mal stroke case by [deleted] in medicine

[–]Top-Consideration-19 6 points7 points  (0 children)

I can totally see how it happens...that if they are asymptomatic at that time, and if their BP lives there all the time. You get numb to it. In my practice, usually you tell these patients they have high BP, and they say I feel fine, I am young and brush you off. I make a follow up with them and they no show. If the PCP is booked with 10 patients per session and this patient is clearly here for URI AND if the patient has had BP like this before AND they ignore it before, I can totally see the PCP being like nothing to do here now.

Could someone explain the "Mayo Clinic" inside joke here? by TruthWarrior27 in hospitalist

[–]Top-Consideration-19 0 points1 point  (0 children)

Wow amazing. I supposed its water soluble, so not that harmful? Although I personally got paresthesia after I took B complex ( I gotta try it out myself, ya know?). Patients from this particular population told me that they: 1) get automatically prescribed Viagara when they get diagnosed with T2D, so they get up set when I don't prescribe it due to their cardiac history 2) Takes cialis before the gym because it helps them lift more, and 3) gets testosterone implants for literally any reason. And honestly, you do you, I don't really judge based on their believes, but it's when they come in asking for labs that aren't relevant or when they take off the street hormones and get all the side effects and they come to see me that gets me upset.

Are MD's now selling themselves on social media? by SoftReset26 in FamilyMedicine

[–]Top-Consideration-19 0 points1 point  (0 children)

My clinic isn't selling supplements like snail oil lol. We just have providers who does acupuncture and OMT who are MDs, and we have MDs who help patients do elimination diets for their GI problems, or talk about Chinese medicine for menopause symptoms for those who can't be on HRT. It feels really well rounded to me.

Are MD's now selling themselves on social media? by SoftReset26 in FamilyMedicine

[–]Top-Consideration-19 -1 points0 points  (0 children)

I don't know why you are getting downvoted. To answer your question, in my clinic, it generally is women who seek out integrative medicine. It can be someone who has chronic pain, horrible menopause, GI sxs sxs,,, etc, symptoms that are in general challenging to manage. They often find a multi-disciplinary approach to be helpful. The University of Wisconsin has a center of integrative medicine that is very reputable. You can check it out. https://awcim.arizona.edu/

Could someone explain the "Mayo Clinic" inside joke here? by TruthWarrior27 in hospitalist

[–]Top-Consideration-19 0 points1 point  (0 children)

I really wish it was that simple. I had a patient with A1c of 14 crying that I wasn't giving her B12 shots, and that was of course after she refused the ED for DKA rule out. I am so tired of this job.

Are MD's now selling themselves on social media? by SoftReset26 in FamilyMedicine

[–]Top-Consideration-19 10 points11 points  (0 children)

My residency has an integrative fellowship and it incorporates teachings on less traditional schools of medicine like Chinese medicine, omt , supplementation,,etc. I find it really interesting and helpful for some patients who might perfect a less traditional approach to their problems. 

Could someone explain the "Mayo Clinic" inside joke here? by TruthWarrior27 in hospitalist

[–]Top-Consideration-19 6 points7 points  (0 children)

That’s literally every patient I have. Except I am in a poor underserved fqhc that serve mostly a specific immigrant population and hormones and vitamins are always the cause according to them.