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I'm sure this has been discussed b4, but I thought I'd start up a newer thread... Which fields of medicine do you guys think are the most up and coming?
I'm sure this has been discussed b4, but I thought I'd start up a newer thread... Which fields of medicine do you guys think are the most up and coming?
I had a primary care doc tell me neurology is the Hot New Thang.
Geriatrics?
thatll happen when the extent of a primary care physician's job is popping zits, yet still getting the highest physician salary around (i.e. never). Ima say orthopedic surgery because of all the new technology surrounding it.Family Practice will be the new Dermatology.
chiropractics. theyre finding new ways to F**K people up every day.
because you know allopathic medicine has such a good handle on back/neck pathology, prevention, and treatment. Glass houses, buddy.
because you know allopathic medicine has such a good handle on back/neck pathology, prevention, and treatment. Glass houses, buddy.
Yeah, maybe chiropractics is on the upswing. With the increase in geriatric pts, stroking them out with their "neck manipulation" has excellent potential for pain management of their other comorbidities . . . .
How're we allopathics doing with spine pathology again?
Can we arrest facet syndrome, rib dysfunction syndrome, degenerative disk disease, spinal arthritis, and osteophytic nerve impingement?
We can't? But I thought doctors were all powerful and all knowing?
Can't we at least slow it down? Sort of. anti-inflammatories in massive doses do ****** the destructive processes at work. Corticosteroids can reduce osteophyte production and ossification of connective tissue structures...But they can also increase the rate of degradation of that same connective tissue.
Can we intervene? Spinal fusions sure do make a lot of orthos and neurosurgeons rich. But the increased load on the adjacent joints usually means that one fusion leads to more. And nothing says 'healthy' like a person with half the range of motion of someone with no back trouble.
Well, can we at least make people feel better?
Score one there. We can cover up symptoms, and we can manage pain. Yay for opiates?
Can we restore function in a biomechanically appropriate way? Nope.
Maybe it's time to admit a little humility. How much training do we get in neuromuscular physiology? None? How much training do we get in biomechanics? None? In nutrition? A meager and mostly wrong-headed and biased amount.
What is the quality of research we do in musculoskeletal pathology and intervention? Some of the worst I've seen. If i'd submitted a thesis that looked like most of the papers out there, I'd have been thrown out of grad school and asked to never, ever even think of breeding for fear of loosing even more stupidity into the gene pool.
We have no basic understanding of neuromusculoskeletal processes because it isn't taught. Is it any wonder that we are woefully pathetic in treating these ailments?
I'd imagine otolaryngology will grow in the next few decades due to people with hearing loss due to portable music players.
You may want to look into PM&R (aka Physiatry) as these topics are thoroughly taught as part of the core residency curriculum as well as being actively researched.
Needless to say, I believe that offering comprehensive non-operative care of neuro-musculoskeletal conditions will keep Physiatry on the list of specialties that will continue to grow in both popularity and demand.
1-3 strokes per million adjustments...what a HUGE risk.
In just another 3,332-9,998 years of going to see my chiropractor I might sustain a stroke! Oh the humanity!
We have no basic understanding of neuromusculoskeletal processes because it isn't taught. Is it any wonder that we are woefully pathetic in treating these ailments?
I'm going into psychiatry. But I think physiatry is an awesome field. Regardless, I think ANY physician needs to understand the basic science neuromusculoskeletal physiology and anatomy. And needs to be at least basically competent in the assessment of their patients for these conditions.
That's an interesting rhetorical device.
1) Downplay risks of chiropractic.
2) Long rant about failure of allopathic treatment of LBP.
There's only one part missing to your argument. I can't quite put my finger on it, something to do with.. evidence of chiropractic.. actually doing anything.. no, I can't quite figure it out. Hmm.
That's an interesting rhetorical device.
1) Downplay risks of chiropractic.
2) Long rant about failure of allopathic treatment of LBP.
There's only one part missing to your argument. I can't quite put my finger on it, something to do with.. evidence of chiropractic.. actually doing anything.. no, I can't quite figure it out. Hmm.
That's an interesting rhetorical device.
1) Downplay risks of chiropractic.
2) Long rant about failure of allopathic treatment of LBP.
There's only one part missing to your argument. I can't quite put my finger on it, something to do with.. evidence of chiropractic.. actually doing anything.. no, I can't quite figure it out. Hmm.
And I agree with above that Neurology will be a "hot" field in the future. Likewise, Anesthesia salaries aren't sustainable at the current level.
Definitely preventive medicine!I'm sure this has been discussed b4, but I thought I'd start up a newer thread... Which fields of medicine do you guys think are the most up and coming?
Definitely preventive medicine!
That's an interesting rhetorical device.
1) Downplay risks of chiropractic.
2) Long rant about failure of allopathic treatment of LBP.
There's only one part missing to your argument. I can't quite put my finger on it, something to do with.. evidence of chiropractic.. actually doing anything.. no, I can't quite figure it out. Hmm.
There's actually pretty darn good evidence for a lot of modalities in use that don't simply include "back-cracking" and their efficacy in LBP. But at the end of the day no 'treatment' will work for LBP unless the underlying muscular dysfunction is addressed. Lots of things bring symptomatic relief, but the only things that will actually stop the decline or end the interminable cycle of acute pain is working with the patient to lose weight, assessing them for pelvic tilt, and erector/abdmoinal/oblique/iliopsoas balance, and correcting the deficits. Likewise, when it comes to neck pain, how many doctors actually assess their patients' posture and know how to look for muscular imbalance with regard to the traps, strenocleidomastoids, scalenes and rhomboids?
I actually started seeing a chiro because the last in a long line of doctors threw his hands up and said 'well we really can't help you. Have you ever tried chiropractic?' I scoffed at him and said hell no, I don't trust the unscientific idiots. He said, unscientific they may be, but it seems to work for some people.
And I admittedly got lucky with a guy who's both a PT and a chiro and who is skeptical of the quacks in his own profession, but the guy has done wonders for me. Medicine offered me pain meds (no thanks), steroid injections (care to see what happens to connective tissue after 50 years of steroid injections?), and surgery (yay! the domino effect. Start wtih c4/c5 and start moving up and down!). Granted cervical traction has helped and got me to the point where I was at least able to start being active again.
I have never argued that chiropracty is the be all end all for spinal pathology. But the risks are tiny and the potential for improvement in symptomatic improvement is great. Cracking the back won't do much for muscle spasm, but ART is proven and sure as hell does. Especially when combined with a rehabilitative approach to underlying muscular imbalance. The gym is ultimately where the back and neck pain epidemic will meet its match, but doctors lack the basic education and knowledge to understand where to start. Many chiros do to admittedly.