From: cuegf@dcatla.uucp
Newsgroups: sci.med
Subject: Re: UGH. (Was B12)
Date: 25 Aug 92 18:09:25 GMT
Organization: Digital Communications Associates, Alpharetta, GA

In article <16172@pitt.UUCP>, km@cs.pitt.edu (Ken Mitchum) writes:
> not the point of this posting. The point is that there is a clear
> double standard here: if I tried to post something as factual data
> with the reference being a talk-radio show, I would be laughed
> off the net ("Hey, I know this doctor who gets his latest medical
> information off of WXYZ."). Yet, it is fine for the responder to
> post information obtained in this way as factual. Now, it is my
> duty to go look through the standard medical literature to try to
> find out just what research the man on the talk-radio show was
> referring to. In other words, it is now my responsibility to do
> the other poster's research for him. Otherwise, I cannot respond
> to his posting, and his statements go unchallenged. My data is
> supposed to come from standard medical sources, but his data can
> come from anywhere. So I will spend about an hour tomorrow doing
> literature searches on B12 to see where this stuff came from. UGH!

Yes, Ken, there are double standards between physicians and non-
physicians, black and white people, wealthy people and indigent
people.  You're right, it's not fair.

I am confused by your contention, however, that you must respond
with scientific factual information on this net. Is your job in 
jeopardy if you don't?  Is the state licensing board monitoring
your responses here?

If the above are not true, which I suspect, then the only person
who is holding you to a standard of responding in such a 
clinically rigid fashion is yourself.  I have visited several 
physicians who respond "I heard of an instance..." or "Wasn't it
on the news last year...?" when stating a condition which was
outside of their specialty.  To me, this does not constitute
unprofessionalism, just an indication that the physician is not
an expert in a condition or medication which is outside their
specialty. However, if a gastroenterologist said to me, "I 
heard on the radio that duodenal ulcers might be caused by too
much potassium", THEN I would be bothered.

If you think it's frustrating trying to respond to posters on 
the net who don't cite research studies, try responding to the
anti-psychiatry groups, like I do.  As someone who believes in
the biological basis of mental illness, I have to encounter
persons all the time who deny the existence of a biological
basis, even when you show them a MRI or PET scan, or a before
and after tape of someone on clozapine. Yet since this is a 
free country, they are free to propogate their viewpoints, 
although there is not an ounce of scientific evidence to support
what they contend.  They exasperate me, for sure, but since
we live in a democracy, they are free to state their viewpoint,
but I am also free to oppose it.

Gordon Banks had a good statement about the fringe groups in 
a previous post.  He accepted the inevitability of such posts
and stated his right to oppose posts based on non-scientific
evidence.

The bottom line here is you don't have to respond at all to the
B12 posts. Certainly if someone reads that 40% of persons over
70 have a B12 deficiency, and they get their mother or 
grandfather to the doctor for a B12 shot, I would doubt in many
cases that it would cause complications.  However, on the other
hand, if someone posted that LSD has recently been found to 
help depression, I would immediately respond to it.

Speaking of double standards, there are many psychiatric nurses,
psychologists and social workers (well, maybe not many, but some)
who are more knowledgeable at psychiatry than non-psychiatric
physicians, particularly GP's and internists, but the latter are
approached first when people have psychiatric problems. I am only
a psychiatric social work candidate, and already by knowledge of
psychiatry, brain physiology, and medications, my expertise runs
rings around most non-psychiatric physicians and some 
psychiatrists.  Of course, a person will approach the person with
"M.D." behind his name even though he may not know much outside
of his specialty.  This is a societal double standard.  

By the way, instead of spending an hour doing research, you may
just want to phone a gerontologist at the medical school or 
wherever.  He/she might be able to send you scientific evidence
more quickly.

To sum up, yes it's a pain responding to someone who does not
have supporting scientic evidence.  I went back to my office once
and did it only because I felt strongly on the issue.  Other stuff
I just let go.  You may want to try it this way. It mitigates the
feelings of frustration.


Ed Francell