Bad shadowing experience

[RoseHelene]

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Hey everybody.

I just walked out of a really icky shadowing experience yesterday with a DO in California. Serious quackery abounded, including hydrogen peroxide IVs, "lipid therapy", and "ozone therapy". This was my first time shadowing a DO. I know that not all DOs are like this, but it was still really disturbing.

I am concerned for the safety of the patients I saw. Is there a place I should report this physician to? Can I do so anonymously? Heck, can I even *make* such a report?

Any advice in this situation would be really helpful.

Thanks all.

 

[FrkyBgStok]

Keep your mouth shut because, frankly, you don't what you are talking about. Not to be condescending, but you don't have the training to determine whether or not that stuff is truly harmful or not. It may sound harmful, but that doesn't mean it is. And just because you may disagree with certain alternative medicines doesn't mean they don't work for some people. As you progress you will learn that people don't listen to their doctors. If you talk bad about a non harmful alternative medicine to a patient, the patient isn't going to stop. They are either going to find another doctor or start lying to you about it. But none of that pertains to the fact that in this case, it is definitely not your responsibility nor your right to say anything because you don't know what you are talking about.

 

[Darthberghen]

Yes, go ahead and report him to the authorities. Call your local congressman. Alert your local TV stations.

And don't forget to report all the MDs you find in Google who use any of those techniques.

 

[Mr Avante]

ozone therapy is legit

extra: everything in nature is harmful OP, including water.

 

[SurgeDO]

By the power invested in me, I hereby declare you the king of the pre-meds. Feel free to use your reign to create MD vs. DO threads and compare match lists.

 

[Drrrrrr. Celty]

Keep your mouth shut because, frankly, you don't what you are talking about. Not to be condescending, but you don't have the training to determine whether or not that stuff is truly harmful or not. It may sound harmful, but that doesn't mean it is. And just because you may disagree with certain alternative medicines doesn't mean they don't work for some people. As you progress you will learn that people don't listen to their doctors. If you talk bad about a non harmful alternative medicine to a patient, the patient isn't going to stop. They are either going to find another doctor or start lying to you about it. But none of that pertains to the fact that in this case, it is definitely not your responsibility nor your right to say anything because you don't know what you are talking about.

Eh, it's not difficult to assess the worth of a treatment if you know research methods.

 

[CooIBreeze]

Keep your mouth shut because, frankly, you don't what you are talking about. Not to be condescending, but you don't have the training to determine whether or not that stuff is truly harmful or not. It may sound harmful, but that doesn't mean it is. And just because you may disagree with certain alternative medicines doesn't mean they don't work for some people. As you progress you will learn that people don't listen to their doctors. If you talk bad about a non harmful alternative medicine to a patient, the patient isn't going to stop. They are either going to find another doctor or start lying to you about it. But none of that pertains to the fact that in this case, it is definitely not your responsibility nor your right to say anything because you don't know what you are talking about.

You don't have to be a licensed physician to spot harmful "medical" treatments, all it really takes is a little research. Also, in reference to alternative medicine, there is a name for medicine that actually works, "medicine".

 

[RoseHelene]

FrkyBgStok: It doesn't take a PhD to be able to spot a quack. Quackwatch has done a great job pulling together information. I recommend you check them out. And I did do research before posting. And there were a lot of other signs which I'm not going to detail here.

Eg, re: H2O2 intravenously...
http://www.cbsnews.com/2100-500164_162-703513.html
http://www.quackwatch.org/11Ind/shortt.html
http://www.ncbi.nlm.nih.gov/pubmed/1996030
http://www.sciencebasedmedicine.org...E3saP3WcGm7oR3y7w&sig2=gYll-Zh5fq3SK8VGuAoVBg

Darthberghen: To whom do you recommend I report to? That's where I'm sitting scratching my head. I feel pretty strongly that *someone* should investigate his practice to make sure it's ethical (which I doubt based on what I saw), but I don't know who to call.

 

[FrkyBgStok]

Well my opinion is that you guys are wrong even with the research methods. We can agree to disagree.

The thing is that acupuncture works for some regardless of the research. Every piece of complementary medicine is the same. So in a family practice setting, this physician chooses to employ certain things that may work for his patients. Regardless of the research, the physician can say better what methods work for his patients. And having the mentality that a doctor should discourage alternative medicine in a patient that believes in it is not only wrong, it can be harmful to the patient. Like I said, if you say "don't do x because it is stupid," they will continue doing x just not telling the physician. And if a physician prescribes something that has adverse effects, it will end up being a problem.

You guys do your thing and I will do mine, just don't be surprised if patients lie to you and are non compliant with medications.

 

[CooIBreeze]

Well my opinion is that you guys are wrong even with the research methods. We can agree to disagree.

The thing is that acupuncture works for some regardless of the research. Every piece of complementary medicine is the same. So in a family practice setting, this physician chooses to employ certain things that may work for his patients. Regardless of the research, the physician can say better what methods work for his patients. And having the mentality that a doctor should discourage alternative medicine in a patient that believes in it is not only wrong, it can be harmful to the patient. Like I said, if you say "don't do x because it is stupid," they will continue doing x just not telling the physician. And if a physician prescribes something that has adverse effects, it will end up being a problem.

You guys do your thing and I will do mine, just don't be surprised if patients lie to you and are non compliant with medications.

So you want to ignore the scientific method completely? Doctors are scientists not witch doctors and what you are describing is the equivalent of a tribal shaman. Have you ever considered that acupuncture and other forms of alternative medicine are only effective due to the placebo effect? It's ignorant and irresponsible as a scientist and a physician to consider any of these effective treatments.

 

[RoseHelene]

FrkyBgStok, there's a huge difference between being flexible and tolerant of things a patient is doing and promoting it yourself. I also think there's a huge difference between pseudoscience that directly harms (e.g., H2O2 therapy) and pseudoscience that doesn't (or at least, doesn't hurt anything more than the pocketbook). Placebo is a powerful thing.

I happen to agree with you that discouraging patients from doing behaviors doesn't work. That's not what was going on here.

I see no problem with a physician saying "You want to do acupuncture for X? Okay. I haven't seen research supporting that, but if you think it might help, I don't see any harm to it. Here's a reputable acupuncturist, give it a try. Let me know how it goes." I do, however, have a problem with a physician saying "You have a bladder infection? Here buy this silver solution for $80 from me instead of antibiotics."

 

[FrkyBgStok]

Yeah I am done arguing with you guys about this. It is absolutely a placebo effect, but explain to me why taking a medication that has side effects is better than something that doesn't if the ending result is the same. I am not disregarding the scientific method, but you are discounting the efficacy of a positive outlook and placebos in general. There are some things that medicine can cure that other things can't. But if a patient believes their apple water pill helps their back pain, and it actually works, why the hell would you tell the patient that they are wrong and they need to take this narcotic. This is ridiculous.

And rose there is a difference between something you disagree with and something being unethical. Sure report him, but understand that medicine is a small field and you do so at your own risk. There might be some dodgy things and if they truly are harmful, should be reported. But be able to back up why it truly is harmful.

By the way, all of these questions are rhetorical because i don't give a crap about your answers because i am done arguing about this. You do your thing, I will do mine.

 

[CooIBreeze]

Yeah I am done arguing with you guys about this. It is absolutely a placebo effect, but explain to me why taking a medication that has side effects is better than something that doesn't if the ending result is the same. I am not disregarding the scientific method, but you are discounting the efficacy of a positive outlook and placebos in general. There are some things that medicine can cure that other things can't. But if a patient believes their apple water pill helps their back pain, and it actually works, why the hell would you tell the patient that they are wrong and they need to take this narcotic. This is ridiculous.

And rose there is a difference between something you disagree with and something being unethical. Sure report him, but understand that medicine is a small field and you do so at your own risk. There might be some dodgy things and if they truly are harmful, should be reported. But be able to back up why it truly is harmful.

By the way, all of these questions are rhetorical because i don't give a crap about your answers because i am done arguing about this. You do your thing, I will do mine.

So, you admit you're wrong?

 

[FrkyBgStok]

I said I was done.

 

[RoseHelene]

Yeah I am done arguing with you guys about this. It is absolutely a placebo effect, but explain to me why taking a medication that has side effects is better than something that doesn't if the ending result is the same. I am not disregarding the scientific method, but you are discounting the efficacy of a positive outlook and placebos in general. There are some things that medicine can cure that other things can't. But if a patient believes their apple water pill helps their back pain, and it actually works, why the hell would you tell the patient that they are wrong and they need to take this narcotic. This is ridiculous.

And rose there is a difference between something you disagree with and something being unethical. Sure report him, but understand that medicine is a small field and you do so at your own risk. There might be some dodgy things and if they truly are harmful, should be reported. But be able to back up why it truly is harmful.

By the way, all of these questions are rhetorical because i don't give a crap about your answers because i am done arguing about this. You do your thing, I will do mine.

You misunderstand my position. Placebos are great. But placebos which carry a very real risk of harm are NOT OKAY. And the things he is suggesting are risky and harmful with no real benefit beyond placebo. I believe what he is doing may be unethical for that very reason.

 

[TriagePreMed]

Frybigstok,

Bull****. Questionable therapies should be reported. If nothing bad is going on, the people investigating won't find anything and his life will go on.

 

[NontradCA]

I suspect this is a troll thread aimed at sparking a huge debate.

 

[RoseHelene]

I suspect this is a troll thread aimed at sparking a huge debate.

It's not. Sorry that it got derailed - I probably should've ignored FrkyBgStok rather than engage.

I really did have a bad experience, and I really would like advice of where I should be reporting potentially unethical behaviors by a DO.

 

[Darthberghen]

Be sure to report these places also:

Medical College of Wisconsin
http://www.froedtert.com/SpecialtyAreas/Preventive-Cardiology-Lipid-Therapy/

Stony Brook University Hospital
http://heart.stonybrookmedicine.edu/Lipid-Therapy.html

And quit trolling the osteo forums.

 

[Skeeks]

So you want to ignore the scientific method completely? Doctors are scientists not witch doctors and what you are describing is the equivalent of a tribal shaman. Have you ever considered that acupuncture and other forms of alternative medicine are only effective due to the placebo effect? It's ignorant and irresponsible as a scientist and a physician to consider any of these effective treatments.

And you are neither

You misunderstand my position. Placebos are great. But placebos which carry a very real risk of harm are NOT OKAY. And the things he is suggesting are risky and harmful with no real benefit beyond placebo. I believe what he is doing may be unethical for that very reason.

Frybigstok,

Bull****. Questionable therapies should be reported. If nothing bad is going on, the people investigating won't find anything and his life will go on.

You know there are agencies that are responsible for auditing all medical practices. This person is subject to them like any other practicing physician let them do their job. Do you really think you are bringing something new to their attention? H2O2 therapy has been around for a while and it is legal. There are FDA regulations about it ,but no doctor is prohibited from practicing it. Here is a MD who practices it http://www.medical-library.net/hydrogen_peroxide_therapy.html. So dont go around starting a crusade over one bad doctor. The sad truth is there's plenty more where that came from among DOs and MDs.

 

[RoseHelene]

Be sure to report these places also:

Medical College of Wisconsin
http://www.froedtert.com/SpecialtyAreas/Preventive-Cardiology-Lipid-Therapy/

Stony Brook University Hospital
http://heart.stonybrookmedicine.edu/Lipid-Therapy.html

And quit trolling the osteo forums.

Just to clarify: the lipid therapy he referred to was where he would take blood from the patient, add a special lipid mix to it, and reinject into the patient. Frankly I don't know a lot about this particular practice. I believe it may be the same thing as "phospholipid exchange therapy" but I am not certain. This was not anything like diet/exercise/medication-type treatments, and was definitely not related to the links you posted.

I really am not trying to troll and I'm sorry if it seems like I am. I did not mean for this to devolve into an alt med argument.

The core of my post is: I saw some practices while shadowing that I am concerned are unethical. To whom do I consult and/or report this behavior to?

 

[TriagePreMed]

You know there are agencies that are responsible for auditing all medical practices. This person is subject to them like any other practicing physician let them do their job. Do you really think you are bringing something new to their attention? H2O2 therapy has been around for a while and it is legal. There are FDA regulations about it ,but no doctor is prohibited from practicing it. Here is a MD who practices it http://www.medical-library.net/hydrogen_peroxide_therapy.html. So dont go around starting a crusade over one bad doctor. The sad truth is there's plenty more where that came from among DOs and MDs.

Then they'll likely tell him/her that on the phone and that will be the end of the conversation, but the main problem I have is discouraging people from reporting things they find questionable.

 

[coolingglasses]

This is about what I expected reading the first post.

 

[milosavljevic]

I shadowed a DO once who focused on integrative, alternative, and preventative medicine. Did I believe in all the therapies his clinic was offering? I can't say for sure because I've never experienced them myself or done my research in order to take a side. But that doesn't mean these treatments can't work for some people. Just because it's not "traditional medicine" doesn't mean it must be harmful.

Do you have factual evidence of patients suffering from this physician's care? In that case, um call the police? Were people like dying or something?

Or was it just the fact that because the practices weren't familiar to you, you must have assumed they were dangerous?

Welcome to America, where people have the freedom to choose their own health practices and how they treat their body, whether you agree or not. If it works for them, they aren't being harmed, and they're willing to shell out money for it, who cares whether it is "scientifically proven"?

Old article about how Americans spend $33.9 billion/yr on alternative medicine:

http://news.consumerreports.org/hea...medicine-alternative-treatments-vitamins.html

 

[TriagePreMed]

I shadowed a DO once who focused on integrative, alternative, and preventative medicine. Did I believe in all the therapies his clinic was offering? I can't say for sure because I've never experienced them myself or done my research in order to take a side. But that doesn't mean these treatments can't work for some people. Just because it's not "traditional medicine" doesn't mean it must be harmful.

I shadowed a DO that does this. He advocated homeopathy and faith healing. Yes, these things are harmful because they create the false notion that they work. In addition, they delay treatment that actually works. Part of being a good physician should be to promote things that are based on facts, not hearsay. I'm often surprised how many on these boards are pro-alternative medicine. It's like you guys didn't learn anything in your science classes.

 

[milosavljevic]

I shadowed a DO that does this. He advocated homeopathy and faith healing. Yes, these things are harmful because they create the false notion that they work. In addition, they delay treatment that actually works. Part of being a good physician should be to promote things that are based on facts, not hearsay. I'm often surprised how many on these boards are pro-alternative medicine. It's like you guys didn't learn anything in your science classes.

Um no, I never said that I MYSELF am pro-alternative medicine. I never said I would promote this stuff as a future physician. Don't call me something I'm not.

 

[RoseHelene]

I had hoped with this post to spark discussion of ethics while shadowing, and discussion of various agencies one could report misconduct to. I'm sorry it derailed into pro/anti alt med stuff. I repeat, that was not my intent and I apologize for it.

Just to wrap this post up...

After poking around for places to report my concerns to, I finally found the web page for the Osteopathic Medical Board of California: http://www.ombc.ca.gov/ and used their online forms.

While in theory I think reports should be made in various other places (e.g., the AOA) I can't find a way of doing so. If anyone knows of a way, I'd appreciate a note.

 

[Skeeks]

Then they'll likely tell him/her that on the phone and that will be the end of the conversation, but the main problem I have is discouraging people from reporting things they find questionable.

While I agree that is a fair point, what FrKy and I have been saying is there isn't anything to report in this case. All of the things listed by OP are legal when practiced by a physician.

 

[oms2]

is any of that illegal or unethical, or even reviewable, under the laws of california?
read http://www.ombc.ca.gov/bd_activity/laws_regs/index.shtml

a word of advice for your future success in clinical rotations and residency: unless there is clear evidence of a criminal act or negligent conduct jeopardizing patient safety, keep your mouth shut.

 

[RoseHelene]

is any of that illegal or unethical, or even reviewable, under the laws of california?
read http://www.ombc.ca.gov/bd_activity/laws_regs/index.shtml

a word of advice for your future success in clinical rotations and residency: unless there is clear evidence of a criminal act or negligent conduct jeopardizing patient safety, keep your mouth shut.

Thank you for the link. In answer to your question, I don't know whether it is illegal or unethical according to CA law. That's why I was asking around. After reviewing the link you referred to, I believe Section 725 may apply in this case. But I am not a lawyer, nor a physician so I don't *know*.

Also, thanks so much for your advice. In this case I do believe that patients are at risk. Otherwise I would've definitely kept quiet.

 

[CooIBreeze]

And you are neither





You know there are agencies that are responsible for auditing all medical practices. This person is subject to them like any other practicing physician let them do their job. Do you really think you are bringing something new to their attention? H2O2 therapy has been around for a while and it is legal. There are FDA regulations about it ,but no doctor is prohibited from practicing it. Here is a MD who practices it http://www.medical-library.net/hydrogen_peroxide_therapy.html. So dont go around starting a crusade over one bad doctor. The sad truth is there's plenty more where that came from among DOs and MDs.

I don't need a medical degree to understand how ridiculous most alternative medicine is. Also, thank you for providing the link, it proved my point completely. The "MD" you mentioned is a perfect example of a quack.

Because actual research is obviously beyond you, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658134/.