8 ms·

> If he/she did their job correctly and helped their clients stay healthy, there would be no need to perform surgery. Sheer nonsense. This assumes that

by abalone 10y ago

> If he/she did their job correctly and helped their clients stay healthy, there would be no need to perform surgery. Sheer nonsense. This assumes that all surgeries are a result of poor preventative care which is trivially false. Why does it seem like the folks criticizing the profit motive of pharmaceutical companies see no such perverse motive in those selling holistic treatments? I don't suppose that "alternative way of dealing with infections" happens to involve spending money regularly on herbs and acupuncture...

tabeth 10y ago
The top cause of death in the United States is heart disease, which is also the most preventable. Assuming all causes of death have surgical intervention proportional to their occurrence in the population that would mean yeah, maybe not all, but there would be significantly less surgery if there were more prevention. However, doctors only contribute slightly to the status quo. The food industry more generally is to blame. As well as the government, for subsidizing unhealthy things.
- ktRolster 10y ago
  doctors only contribute slightly to the status quo. The food industry more generally is to blame. Worth remembering whenever you see people comparing different healthcare systems based on longevity. Doctors are not always the primary factor in lifespans.
- abalone 10y ago
  > there would be significantly less surgery if there were more prevention. True but that's a considerably diminished claim from the OP's, which was that all surgery is a sign of doctor failure. Also, the unscientific treatments they linked to would do nothing to prevent heart disease, and may even discourage patients from seeking care that can help them.
Omniusaspirer 10y ago
Thank you for saying this. You'd think the HN audience would be smart enough to actually look at evidence in regards to medicine, but there's a lot of Steve Jobs types who'd rather pay for a well placebo-ed death. I wouldn't mind if they weren't so insistent on preaching their bullshit everywhere they go and trying to pass it off as having any basis. It's kinda disheartening to dedicate years and years to studying medicine, only to realize there's more money and satisfied patients to be made in hustling bullshit to new-age fools who will preach your crap right up until they die of an easily treated disease.
- sametmax 10y ago
  The problem is that we currently oppose the 2 views, and people defending one discard all benefit from the other. But it's true that you are happy to get surgery in case of a grave emergency, with heavy drugs and a strong hopital system. It's also true that the current most used health system is actually very bad at keeping people healthy. But no, all pharma related practice is not a z-serie drug dealer plot. And no, all alternative health practice is not hippie voodoo trying to cure cancer with placing hot stone on your third eye.
  - akiselev 10y ago
    No, people are very bad at keeping people healthy. Modern medicine has almost eliminated acute disease as a leading cause of death in the developed world and most of our health problems are now self inflicted. Evidence based medicine has extended the average lifespan by decades despite our best efforts. Alternative medicine may not all be hippie voodoo but it all has one thing in common: all the data all of its salesmen have gathered before profiting hand over fist has amounted to nothing. All of the data gathered since then has amounted to nothing except the rare fortunate placebo effect, early deaths, and needless suffering. Once every few decades we stumble on a gem like meditation because medicine works by testing and gathering data on everything, including folk remedies. Our most common treatment for metastaticized cancers is to inject radioactive material into our bodies in the hope that it kills cancer cells faster than healthy tissue! We will clearly do anything so all any "alternative" medicine has to do is prove its effectiveness. There is lots of value to a variety of traditional remedies that utilize the antimicrobial properties of tea and honey or blood thinners in many herbs but that isn't going to make anyone any money except your neighborhood grocery store or ethnic market. The rest of alternative medicine is just a bunch of snake oil salesmen whose livelyhoods depends on rejecting the foundations of evidence based medicine.
    - sametmax 10y ago
      > all the data all of its salesmen There is no way you can judge "all the data" because "alternate medicine" is as big as saying "languages in the world". It's all that is not sanctioned. It includes a lot of things good and bad, crazy and sane. E.G: calibrated fasting is alternate medicine. Data for fasting has amounted to many things including improving the immunity system response and lowering side effects of heavy drugs. There is nothing magical or mysterious about it. It is "alternate medicine" because you won't see most doctors recommend fasting to your typical patient. There is no moral judgment in that. I'm not saying it's good or bad, it's just a fact. You have one vision of "alternate medicine", and it's limited to a stereotype. I understand why. The louder champions of many alternate medicine are using pseudo science, repeated by stay-at-home mothers on facebook. It does make the credibility of many interesting informations crash. However, dismissing what can be valuable information because of that is missing opportunities. Especially, a lot of chronic diseases have treatments outside of traditional medicine that make living with it much more bearable. Again, it's not exclusive. You don't have to reject one to get the other. But trying a few things outside of ones own bubble can get some wonderful unexpected results. I make a point of trying many such things. I'd say 9 times out of 10 it's a waste of my time and money. Sometime it's even unhealthy. But when you do find out something that brings strong benefits, it's usually really worth it. It's a shame one's have to do it that way. I'd much rather have professionals advice me on those. And it's why it's so important no to close the door.
nothrabannosir 10y ago
Nonsense at n=1, but it starts to make sense at scale. And I don't like perverse incentives, but I'd die before I seriously considered homeopathy.
- mikecke 10y ago
  Herbal medicine is not homeopathy.
  - robbiep 10y ago
    Herbal medicine still isn't medicine
    - mantas 10y ago
      Quite a few light "drugs" are herbs-based. Over there, it's common for (real, medical, certified) doctors to prescribe (as in, write on a sheet of paper and stamp) specific herbal teas. Which are sold in pharmacies. And they do help for sure.
    - mschuster91 10y ago
      That depends on the herb. Just look at the many medical uses of marijuana, for example.
      - vitus 10y ago
        Less controversially: aspirin (willow bark), quinine (cinchona bark), opiates (poppy; as used for the painkiller effect).
    - mikecke 10y ago
      Herbs have pharmacological properties. Many medications are potentiated versions of their herbal counterparts. Some are just as efficacious. - Hypericum Perforatum [1] - Ashwhaganda [2] Please discern the difference. You are a "doctor programmer" in your profile. This is disturbing. [1]: https://www.ncbi.nlm.nih.gov/pubmed/18843608 https://www.ncbi.nlm.nih.gov/pubmed/18843608 [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/
mikecke 10y ago
Educate yourself on what exactly is holistic medicine.
Asooka 10y ago
Yes, you're right in that adopting verbatim the philosophy of ancient China isn't a perfect fit for our modern world. But the sentiment - that doctors should make more money when we're healthy vs not is one worth thinking about. Currently the entire medical field is reactive - you get sick, you get treated. I've never heard of doctors administering preventative care. We don't have a profession that fills the niche of "I'm feeling fine now, but I want to take the steps necessary to prevent things that might ail me in the near future".
- abalone 10y ago
  > I've never heard of doctors administering preventative care. You've never heard of preventative care visits? Annual physicals? Baby wellness exams? Vaccinations? I'm incredulous.
  - manarth 10y ago
    There is some evidence to suggest that annual physicals do more harm than good [1][2] (although it's fair to add that there are competing viewpoints on that). [1] http://articles.mercola.com/sites/articles/archive/2015/11/04/annual-physicals.aspx http://articles.mercola.com/sites/articles/archive/2015/11/0... [2] http://edition.cnn.com/2015/10/16/health/annual-physical-unnecessary/ http://edition.cnn.com/2015/10/16/health/annual-physical-unn...
- DanBC 10y ago
  > I've never heard of doctors administering preventative care. "Making every contact count", a UK initiative to make sure that doctors[1] use every opportunity to promote smoking cessation, alcohol use reduction, weight loss, and other lifestyle adjustments. http://makingeverycontactcount.co.uk/ http://makingeverycontactcount.co.uk/
  - Udik 10y ago
    If I need that kind of advice I'll just give a phone call to my parents, thank you. It's also free.
tomhoward 10y ago
> Why does it seem like the folks criticizing the profit motive of pharmaceutical companies see no such perverse motive in those selling holistic treatments? One reason is to do with scale, and perceived credibility. A pharmaceutical company is a vast organisation, which is able to invest huge sums of money on advertising, marketing, lobbying, PR, insurance etc, and they have the benefit of being seen as having scientific rigour and government-administered quality assurance as inherent features of their offering. This all means their products can be sold to many millions of people who trust the recommendation of their physician, even if it offers minimal benefit (e.g., antidepressants or statins prescribed to people who would benefit far more from lifestyle changes) or causes significant harm (see current spike in addictions and fatalities linked to opioid painkillers like Fentanyl). A natural/holistic health practitioner is a normally an independent small business operator, offering treatment to about 20-30 people per week, most of whom are generally healthy and just want to stay that way by having good nutrition, reduced stress, better muscular-skeletal alignment, etc. Most natural/holistic practitioners make a comparable income to a contract software developer, and have no intention or ability (or more importantly, stock market pressure) to make any more than that. They rely heavily on repeat business and word-of-mouth recommendations, and therefore must consistently help their clients achieve an improved quality of life. When people die whilst under conventional medical/pharmaceutical treatment, the general attitude is "that's sad, but hey it was a scientifically validated treatment, so, what else could we do?" Whereas any natural/holistic practitioner who causes serious harm or death of a patient is subjected to thorough scrutiny by regulators and the media, and indignant sharing on social media. Those found to be negligent are quickly put out of business.
- Lewton 10y ago
  It's a nice theory you got there, but it's trivially false Alternative medicine is a 34 billion dollar industry in the US alone http://mobile.reuters.com/article/amp/idUSTRE56T6MN20090730 http://mobile.reuters.com/article/amp/idUSTRE56T6MN20090730
  - tomhoward 10y ago
    That doesn't contradict anything I said. The crucial difference between the pharmaceutical industry and the alternative health sector is centralisation vs fragmentation. Due to being vast, centralised entities, pharmaceutical companies can utilise mass marketing, lobbying and the perception of scientific validity and government endorsement to get their products into the hands of customers, and can continue to do so even if their products cause widespread harm [1]). But every natural/holistic practitioner is an independent operator servicing a small local area, and must work hard to provide a high degree of satisfaction to every customer every day, and face the reality that a single instance of serious harm will put them out of business for good. The article you cited demonstrating the size of the industry only confirms that for the most part, practitioners are doing a pretty good job. I'm not arguing that mainstream medicine and pharma shouldn't exist, or should even be dramatically changed. I happily use it, and find it very beneficial. But I also know from personal experience and simple market economics, that the oft-touted-here attitude, that most/all natural/holistic/alternative medicine is useless/harmful snake-oil peddled by charlatans to morons, is misinformed and mostly false. [1] http://www.livescience.com/57268-fentanyl-overdose-deaths-double.html http://www.livescience.com/57268-fentanyl-overdose-deaths-do...
deleted 10y ago
[deleted]

by abalone 10y ago

tabeth 10y ago

The top cause of death in the United States is heart disease, which is also the most preventable. Assuming all causes of death have surgical intervention proportional to their occurrence in the population that would mean yeah, maybe not all, but there would be significantly less surgery if there were more prevention. However, doctors only contribute slightly to the status quo. The food industry more generally is to blame. As well as the government, for subsidizing unhealthy things.

ktRolster 10y ago
doctors only contribute slightly to the status quo. The food industry more generally is to blame. Worth remembering whenever you see people comparing different healthcare systems based on longevity. Doctors are not always the primary factor in lifespans.
abalone 10y ago
> there would be significantly less surgery if there were more prevention. True but that's a considerably diminished claim from the OP's, which was that all surgery is a sign of doctor failure. Also, the unscientific treatments they linked to would do nothing to prevent heart disease, and may even discourage patients from seeking care that can help them.

Omniusaspirer 10y ago

Thank you for saying this. You'd think the HN audience would be smart enough to actually look at evidence in regards to medicine, but there's a lot of Steve Jobs types who'd rather pay for a well placebo-ed death. I wouldn't mind if they weren't so insistent on preaching their bullshit everywhere they go and trying to pass it off as having any basis. It's kinda disheartening to dedicate years and years to studying medicine, only to realize there's more money and satisfied patients to be made in hustling bullshit to new-age fools who will preach your crap right up until they die of an easily treated disease.

sametmax 10y ago
The problem is that we currently oppose the 2 views, and people defending one discard all benefit from the other. But it's true that you are happy to get surgery in case of a grave emergency, with heavy drugs and a strong hopital system. It's also true that the current most used health system is actually very bad at keeping people healthy. But no, all pharma related practice is not a z-serie drug dealer plot. And no, all alternative health practice is not hippie voodoo trying to cure cancer with placing hot stone on your third eye.
- akiselev 10y ago
  No, people are very bad at keeping people healthy. Modern medicine has almost eliminated acute disease as a leading cause of death in the developed world and most of our health problems are now self inflicted. Evidence based medicine has extended the average lifespan by decades despite our best efforts. Alternative medicine may not all be hippie voodoo but it all has one thing in common: all the data all of its salesmen have gathered before profiting hand over fist has amounted to nothing. All of the data gathered since then has amounted to nothing except the rare fortunate placebo effect, early deaths, and needless suffering. Once every few decades we stumble on a gem like meditation because medicine works by testing and gathering data on everything, including folk remedies. Our most common treatment for metastaticized cancers is to inject radioactive material into our bodies in the hope that it kills cancer cells faster than healthy tissue! We will clearly do anything so all any "alternative" medicine has to do is prove its effectiveness. There is lots of value to a variety of traditional remedies that utilize the antimicrobial properties of tea and honey or blood thinners in many herbs but that isn't going to make anyone any money except your neighborhood grocery store or ethnic market. The rest of alternative medicine is just a bunch of snake oil salesmen whose livelyhoods depends on rejecting the foundations of evidence based medicine.
  - sametmax 10y ago
    > all the data all of its salesmen There is no way you can judge "all the data" because "alternate medicine" is as big as saying "languages in the world". It's all that is not sanctioned. It includes a lot of things good and bad, crazy and sane. E.G: calibrated fasting is alternate medicine. Data for fasting has amounted to many things including improving the immunity system response and lowering side effects of heavy drugs. There is nothing magical or mysterious about it. It is "alternate medicine" because you won't see most doctors recommend fasting to your typical patient. There is no moral judgment in that. I'm not saying it's good or bad, it's just a fact. You have one vision of "alternate medicine", and it's limited to a stereotype. I understand why. The louder champions of many alternate medicine are using pseudo science, repeated by stay-at-home mothers on facebook. It does make the credibility of many interesting informations crash. However, dismissing what can be valuable information because of that is missing opportunities. Especially, a lot of chronic diseases have treatments outside of traditional medicine that make living with it much more bearable. Again, it's not exclusive. You don't have to reject one to get the other. But trying a few things outside of ones own bubble can get some wonderful unexpected results. I make a point of trying many such things. I'd say 9 times out of 10 it's a waste of my time and money. Sometime it's even unhealthy. But when you do find out something that brings strong benefits, it's usually really worth it. It's a shame one's have to do it that way. I'd much rather have professionals advice me on those. And it's why it's so important no to close the door.

nothrabannosir 10y ago

Nonsense at n=1, but it starts to make sense at scale. And I don't like perverse incentives, but I'd die before I seriously considered homeopathy.

mikecke 10y ago
Herbal medicine is not homeopathy.
- robbiep 10y ago
  Herbal medicine still isn't medicine
  - mantas 10y ago
    Quite a few light "drugs" are herbs-based. Over there, it's common for (real, medical, certified) doctors to prescribe (as in, write on a sheet of paper and stamp) specific herbal teas. Which are sold in pharmacies. And they do help for sure.
  - mschuster91 10y ago
    That depends on the herb. Just look at the many medical uses of marijuana, for example.
    - vitus 10y ago
      Less controversially: aspirin (willow bark), quinine (cinchona bark), opiates (poppy; as used for the painkiller effect).
  - mikecke 10y ago
    Herbs have pharmacological properties. Many medications are potentiated versions of their herbal counterparts. Some are just as efficacious. - Hypericum Perforatum [1] - Ashwhaganda [2] Please discern the difference. You are a "doctor programmer" in your profile. This is disturbing. [1]: https://www.ncbi.nlm.nih.gov/pubmed/18843608 https://www.ncbi.nlm.nih.gov/pubmed/18843608 [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/

mikecke 10y ago

Educate yourself on what exactly is holistic medicine.

Asooka 10y ago

Yes, you're right in that adopting verbatim the philosophy of ancient China isn't a perfect fit for our modern world. But the sentiment - that doctors should make more money when we're healthy vs not is one worth thinking about. Currently the entire medical field is reactive - you get sick, you get treated. I've never heard of doctors administering preventative care. We don't have a profession that fills the niche of "I'm feeling fine now, but I want to take the steps necessary to prevent things that might ail me in the near future".

abalone 10y ago
> I've never heard of doctors administering preventative care. You've never heard of preventative care visits? Annual physicals? Baby wellness exams? Vaccinations? I'm incredulous.
- manarth 10y ago
  There is some evidence to suggest that annual physicals do more harm than good [1][2] (although it's fair to add that there are competing viewpoints on that). [1] http://articles.mercola.com/sites/articles/archive/2015/11/04/annual-physicals.aspx http://articles.mercola.com/sites/articles/archive/2015/11/0... [2] http://edition.cnn.com/2015/10/16/health/annual-physical-unnecessary/ http://edition.cnn.com/2015/10/16/health/annual-physical-unn...
DanBC 10y ago
> I've never heard of doctors administering preventative care. "Making every contact count", a UK initiative to make sure that doctors[1] use every opportunity to promote smoking cessation, alcohol use reduction, weight loss, and other lifestyle adjustments. http://makingeverycontactcount.co.uk/ http://makingeverycontactcount.co.uk/
- Udik 10y ago
  If I need that kind of advice I'll just give a phone call to my parents, thank you. It's also free.

tomhoward 10y ago

> Why does it seem like the folks criticizing the profit motive of pharmaceutical companies see no such perverse motive in those selling holistic treatments? One reason is to do with scale, and perceived credibility. A pharmaceutical company is a vast organisation, which is able to invest huge sums of money on advertising, marketing, lobbying, PR, insurance etc, and they have the benefit of being seen as having scientific rigour and government-administered quality assurance as inherent features of their offering. This all means their products can be sold to many millions of people who trust the recommendation of their physician, even if it offers minimal benefit (e.g., antidepressants or statins prescribed to people who would benefit far more from lifestyle changes) or causes significant harm (see current spike in addictions and fatalities linked to opioid painkillers like Fentanyl). A natural/holistic health practitioner is a normally an independent small business operator, offering treatment to about 20-30 people per week, most of whom are generally healthy and just want to stay that way by having good nutrition, reduced stress, better muscular-skeletal alignment, etc. Most natural/holistic practitioners make a comparable income to a contract software developer, and have no intention or ability (or more importantly, stock market pressure) to make any more than that. They rely heavily on repeat business and word-of-mouth recommendations, and therefore must consistently help their clients achieve an improved quality of life. When people die whilst under conventional medical/pharmaceutical treatment, the general attitude is "that's sad, but hey it was a scientifically validated treatment, so, what else could we do?" Whereas any natural/holistic practitioner who causes serious harm or death of a patient is subjected to thorough scrutiny by regulators and the media, and indignant sharing on social media. Those found to be negligent are quickly put out of business.

Lewton 10y ago
It's a nice theory you got there, but it's trivially false Alternative medicine is a 34 billion dollar industry in the US alone http://mobile.reuters.com/article/amp/idUSTRE56T6MN20090730 http://mobile.reuters.com/article/amp/idUSTRE56T6MN20090730
- tomhoward 10y ago
  That doesn't contradict anything I said. The crucial difference between the pharmaceutical industry and the alternative health sector is centralisation vs fragmentation. Due to being vast, centralised entities, pharmaceutical companies can utilise mass marketing, lobbying and the perception of scientific validity and government endorsement to get their products into the hands of customers, and can continue to do so even if their products cause widespread harm [1]). But every natural/holistic practitioner is an independent operator servicing a small local area, and must work hard to provide a high degree of satisfaction to every customer every day, and face the reality that a single instance of serious harm will put them out of business for good. The article you cited demonstrating the size of the industry only confirms that for the most part, practitioners are doing a pretty good job. I'm not arguing that mainstream medicine and pharma shouldn't exist, or should even be dramatically changed. I happily use it, and find it very beneficial. But I also know from personal experience and simple market economics, that the oft-touted-here attitude, that most/all natural/holistic/alternative medicine is useless/harmful snake-oil peddled by charlatans to morons, is misinformed and mostly false. [1] http://www.livescience.com/57268-fentanyl-overdose-deaths-double.html http://www.livescience.com/57268-fentanyl-overdose-deaths-do...

deleted 10y ago

[deleted]