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No, not ignoring them at all! Taking everything into account. Yes, everything. Did you not see the bit where he talked about having a whole lot of conventiona

No, not ignoring them at all! Taking everything into account. Yes, everything. Did you not see the bit where he talked about having a whole lot of conventional doctors involved, and having practitioners from every discipline be made aware of the recommendations that each other were making?

DanBC 14y ago
Vulnerable people in England get some protection. One form of that protection is provided by local government Social Services. (Each scheme has a different name because they're provided by different regional authorities. And this one I'm talking about is obsolete.) MARMAP - multi agency risk management & assessment panel is a group of the people involved in the care and treatment of a vulnerable person who is at high risk of harming themselves or other people. Let's make a hypothetical patient, and call him Bob. Bob has a GP. Bob has a care coordinator. Bob has a consultant psychiatrist for outpatient care. Bob has a consultant psychiatrist for inpatient mental health hospital care. Bob has a community treatment team. Bob has a community psychotherapist. Bob has a crisis team. This is about ten people just for the mental health stuff. I can tell you now that these people do not agree about the best way forward for Bob. Even though they're all in the same room as Bob, and they all get minutes of the meetings, one doctor will call Bob non-compliant when Bob follows the conflicting advice of another doctor. (EG: The in-patient consultant tells Bob to avoid going to hospital. The out-patient team admits Bob, against his will. Bob is called manipulative by the in-patient doctor.) This is a lousy situation. Even though clinicians are talking face to face with each other communication gets garbled. Imagine the problem when communication goes from a nurse observing Bob to one doctor, through their juniors, to a secretary, to another team (sometimes using weird technology such as fax machines) through to a team leader, to a team member. ("Interface Problems") And this is within the same organisation. Moving data from the MH trust to a different medical trust is tricky, and to social services or law enforcement is even trickier. Getting more people involved causes problems, and that's when the people are in the same specialism and broadly agree on modes of treatment. Getting more people involved when those people have fundamentally different opinions about treatment is going to distract them from providing good treatment as they focus on debunking stuff that's useless but has vigorous advocates.
- tomhoward 14y ago
  Sigh. The approach described in this post is an attempt to find a method of delivering better health outcomes than current mainstream health systems (in addition to being one man's attempt to save his own life using whatever means available). Say all you want about how superior the conventional health system is: people keep dying of cancer, at increasing rates in come cases. This open-source approach may or may not yield better outcomes. Either way, won't it be interesting to see? Can't we wait to see some results before condemning it simply because acupuncture was allowed?
  - DanBC 14y ago
    > Say all you want about how superior the conventional health system is: people keep dying of cancer, at increasing rates in come cases. I haven't said the conventional system is better. I've used to flaws of the existing conventional system to point out the flaws of the proposed system. > This open-source approach may or may not yield better outcomes. How will we know? Seriously, how can we tell? There's no rigour to this. It's just idle self-indulgent noodling. That's fine, it's his life and body and he can do what he likes with it, but don't pretend it's useful when there's no possible way of it actually being any use. > Either way, won't it be interesting to see? I doubt it. But I'm happy to be wrong. Please, what could be some interesting things to come from this? > Can't we wait to see some results before condemning it simply because acupuncture was allowed? Again, that's not why I'm condemning it.
    - tomhoward 14y ago
      There's no rigour to this. It's just idle self-indulgent noodling. Seriously man. It's a lot of people and enough doctors working together to achieve something. Things like: - He is cured of cancer - Other people are cured of cancer - New things are learned about how to treat cancer more effectively ... and probably other things that can't be predicted, but which could possibly turn out to be far more valuable. That's the point to remember about innovation - which I consider this to be; you can't predict where things may lead, and often what you discover is different to what you expected. But to me that's why this is interesting; I've long thought that there could be place for the processes we see in open-source projects (as well as startup companies) in medicine.

DanBC 14y ago

Vulnerable people in England get some protection. One form of that protection is provided by local government Social Services. (Each scheme has a different name because they're provided by different regional authorities. And this one I'm talking about is obsolete.) MARMAP - multi agency risk management & assessment panel is a group of the people involved in the care and treatment of a vulnerable person who is at high risk of harming themselves or other people. Let's make a hypothetical patient, and call him Bob. Bob has a GP. Bob has a care coordinator. Bob has a consultant psychiatrist for outpatient care. Bob has a consultant psychiatrist for inpatient mental health hospital care. Bob has a community treatment team. Bob has a community psychotherapist. Bob has a crisis team. This is about ten people just for the mental health stuff. I can tell you now that these people do not agree about the best way forward for Bob. Even though they're all in the same room as Bob, and they all get minutes of the meetings, one doctor will call Bob non-compliant when Bob follows the conflicting advice of another doctor. (EG: The in-patient consultant tells Bob to avoid going to hospital. The out-patient team admits Bob, against his will. Bob is called manipulative by the in-patient doctor.) This is a lousy situation. Even though clinicians are talking face to face with each other communication gets garbled. Imagine the problem when communication goes from a nurse observing Bob to one doctor, through their juniors, to a secretary, to another team (sometimes using weird technology such as fax machines) through to a team leader, to a team member. ("Interface Problems") And this is within the same organisation. Moving data from the MH trust to a different medical trust is tricky, and to social services or law enforcement is even trickier. Getting more people involved causes problems, and that's when the people are in the same specialism and broadly agree on modes of treatment. Getting more people involved when those people have fundamentally different opinions about treatment is going to distract them from providing good treatment as they focus on debunking stuff that's useless but has vigorous advocates.

tomhoward 14y ago
Sigh. The approach described in this post is an attempt to find a method of delivering better health outcomes than current mainstream health systems (in addition to being one man's attempt to save his own life using whatever means available). Say all you want about how superior the conventional health system is: people keep dying of cancer, at increasing rates in come cases. This open-source approach may or may not yield better outcomes. Either way, won't it be interesting to see? Can't we wait to see some results before condemning it simply because acupuncture was allowed?
- DanBC 14y ago
  > Say all you want about how superior the conventional health system is: people keep dying of cancer, at increasing rates in come cases. I haven't said the conventional system is better. I've used to flaws of the existing conventional system to point out the flaws of the proposed system. > This open-source approach may or may not yield better outcomes. How will we know? Seriously, how can we tell? There's no rigour to this. It's just idle self-indulgent noodling. That's fine, it's his life and body and he can do what he likes with it, but don't pretend it's useful when there's no possible way of it actually being any use. > Either way, won't it be interesting to see? I doubt it. But I'm happy to be wrong. Please, what could be some interesting things to come from this? > Can't we wait to see some results before condemning it simply because acupuncture was allowed? Again, that's not why I'm condemning it.
  - tomhoward 14y ago
    There's no rigour to this. It's just idle self-indulgent noodling. Seriously man. It's a lot of people and enough doctors working together to achieve something. Things like: - He is cured of cancer - Other people are cured of cancer - New things are learned about how to treat cancer more effectively ... and probably other things that can't be predicted, but which could possibly turn out to be far more valuable. That's the point to remember about innovation - which I consider this to be; you can't predict where things may lead, and often what you discover is different to what you expected. But to me that's why this is interesting; I've long thought that there could be place for the processes we see in open-source projects (as well as startup companies) in medicine.