Vinay, I am enjoying watching you be red-pilled on the horror of the government. Over the years I have come to believe that these people are not just stupid, but are actually evil in that their only purpose is to comport to the (generally left wing) narrative-du-jour rather than to any science.
Vinay, I am enjoying watching you be red-pilled on the horror of the government. Over the years I have come to believe that these people are not just stupid, but are actually evil in that their only purpose is to comport to the (generally left wing) narrative-du-jour rather than to any science.
I believe public health is beyond rescue in the American mind -- and I have come to believe it should be. My biggest worry, expressed here since you started writing, is the spillover to non-public health practitioners. The pediatricians are the worst and I get more calls from parents questioning the blather they keep spouting than from any other group. But no one intelligent is believing most anything that the medical community says today and, sadly, one can understand why.
There just is not bandwidth to explain everything one concludes about a patient during a visit -- four years of college, four of medical school, four of residency and two of fellowship, followed by 30 of practice, cannot be encapsulated in three minutes. But patients are losing trust in this essence of the physician-patient interaction because they have (with cause) come to believe that many doctors are just parroting the official line without understanding the facts (as so well explained in your article today) and without considering the individual patient's relationship to those facts.
We will likely not repair this during my lifetime which makes me very sad -- I have spent my entire life patient by patient, not government directive by government directive, but patients have been burned and will be a long time recovering.
Thanks for your strident take on this all. As another point (you still need a copy editor) in the final sentence "of" should be "off" -- powerful line, though.
I imagine your fears are quite real and I am unsure why so many have not been critically addressing government advice. Most doctors seem to take on the advice and not address their patients' concerns. Is it a matter of time for study and analysis, a lack of curiosity?
For the record, I enjoy your insightful comments on various stacks. Just in case you were wondering if they were read.
It is a pivotal comment, I believe. I think, even more than patients, most doctors (who overwhelmingly are interested in taking good care of their patients, despite much of the chatter on these stacks) find it even harder to believe that organizations on which they have built their trust framework (CDC, FDA [let us have a Thalidomide redux discussion now, etc.], NIH and their professional associations (especially AAP and AMA) are so untrustworthy.
Because the volume of information with which to deal is so large, one of the "legitimate cheats" for much of this is to assume that some set of organizations would only promulgate the best information. The facts are that COVID shows this is utterly untrue, and may have been untrue about who-knows-what-else for who-knows-how-long. That is a difficult bolus to swallow and erodes most of the "keep up with the advances in medical knowledge" framework that almost all docs use.
I have always been the token skeptic (it is in my personality, and I have enough publications and financial support that I am more unassailable than most in my academic home to the predations of the masses). For example, I have been railing against the AHA "low fat" guidelines since they came out (a very long time ago) and, of course, they have recently been shown to be the source of most of the fat people there now are. The list is long. But saying "low fat should make you less fat" and being credible as an organization makes it hard for most docs to do anything but nod and add that to their advice pile.
I am spending lots of time with the current crop of medical students (at least the smart ones) trying to teach them that what they think they know they may not and what they are being told may have other than pure motivations. It is a slow process against the current, but one has to hope that it eventually helps to correct the nonsense we see now.
Thanks. The story "difficult bolus to swallow and erodes most of the "keep up with the advances in medical knowledge" framework that almost all docs use." I assume few practitioners have the time to track the extraordinary explosion (and evolution) of pandemic debate.
Vinay, I am enjoying watching you be red-pilled on the horror of the government. Over the years I have come to believe that these people are not just stupid, but are actually evil in that their only purpose is to comport to the (generally left wing) narrative-du-jour rather than to any science.
I believe public health is beyond rescue in the American mind -- and I have come to believe it should be. My biggest worry, expressed here since you started writing, is the spillover to non-public health practitioners. The pediatricians are the worst and I get more calls from parents questioning the blather they keep spouting than from any other group. But no one intelligent is believing most anything that the medical community says today and, sadly, one can understand why.
There just is not bandwidth to explain everything one concludes about a patient during a visit -- four years of college, four of medical school, four of residency and two of fellowship, followed by 30 of practice, cannot be encapsulated in three minutes. But patients are losing trust in this essence of the physician-patient interaction because they have (with cause) come to believe that many doctors are just parroting the official line without understanding the facts (as so well explained in your article today) and without considering the individual patient's relationship to those facts.
We will likely not repair this during my lifetime which makes me very sad -- I have spent my entire life patient by patient, not government directive by government directive, but patients have been burned and will be a long time recovering.
Thanks for your strident take on this all. As another point (you still need a copy editor) in the final sentence "of" should be "off" -- powerful line, though.
I imagine your fears are quite real and I am unsure why so many have not been critically addressing government advice. Most doctors seem to take on the advice and not address their patients' concerns. Is it a matter of time for study and analysis, a lack of curiosity?
For the record, I enjoy your insightful comments on various stacks. Just in case you were wondering if they were read.
It is a pivotal comment, I believe. I think, even more than patients, most doctors (who overwhelmingly are interested in taking good care of their patients, despite much of the chatter on these stacks) find it even harder to believe that organizations on which they have built their trust framework (CDC, FDA [let us have a Thalidomide redux discussion now, etc.], NIH and their professional associations (especially AAP and AMA) are so untrustworthy.
Because the volume of information with which to deal is so large, one of the "legitimate cheats" for much of this is to assume that some set of organizations would only promulgate the best information. The facts are that COVID shows this is utterly untrue, and may have been untrue about who-knows-what-else for who-knows-how-long. That is a difficult bolus to swallow and erodes most of the "keep up with the advances in medical knowledge" framework that almost all docs use.
I have always been the token skeptic (it is in my personality, and I have enough publications and financial support that I am more unassailable than most in my academic home to the predations of the masses). For example, I have been railing against the AHA "low fat" guidelines since they came out (a very long time ago) and, of course, they have recently been shown to be the source of most of the fat people there now are. The list is long. But saying "low fat should make you less fat" and being credible as an organization makes it hard for most docs to do anything but nod and add that to their advice pile.
I am spending lots of time with the current crop of medical students (at least the smart ones) trying to teach them that what they think they know they may not and what they are being told may have other than pure motivations. It is a slow process against the current, but one has to hope that it eventually helps to correct the nonsense we see now.
Great question...thanks for making me think.
Thanks. The story "difficult bolus to swallow and erodes most of the "keep up with the advances in medical knowledge" framework that almost all docs use." I assume few practitioners have the time to track the extraordinary explosion (and evolution) of pandemic debate.