How do *****s become doctors?

[softmed]

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Recently I attended a short presentation by an oncology fellow who was doing her project in acupuncture (and its applications in oncology).

I should have to end this post here. The fact that she's wasting her time on long "disproven" nonsense should be enough.

However, her study design was also horribly flawed. She performed both the real acupuncture and sham (fake) acupuncture. So at the end, during the question and answer, I asked her how it's double blind if she's doing both arms and she knows what her patients are receiving. She said she doesn't perform the stats, so it's double blind. WHAT?*

She obviously has never heard of investigator bias. This is something she should have learned in first year of UNDERGRADUATE (possibly even in high school).

So my question is, how do people like this become doctors?

*So I'm aware that her methodology may not have been as flawed as I thought it was. I still believe there is a better way to blind the subject than she used. If I read her study and it generated a significant result it wouldn't convince me acupuncture worked since she had contact and knew who the sham and real acunpuncture patients were.
**Obviously she's not a ***** because she made into and made it through medical school. My opinion in calling her a ***** was based on her attitude toward disproven nonsense.

 

[ensuii]

How can some people be such arrogant self-righteous *******s?

 

[NeuroChaos]

Based on your unbiased, and well balanced account of what occurred at the meeting, who is the ***** is still in dispute.

 

[DrSno]

Based on your unbiased, and well balanced account of what occurred at the meeting, who is the ***** is still in dispute.

Sounds like the oncologist had a very questionable definition of double blind to me. Can you explain your statement a little further?

 

[235009]

she's not wrong IF she preforms all the procedures but isn't the one who is asking the patients how they feel afterwards. If the person asking the patients how they feel is blinded to which procedure the patient got then it is double blinded.

i'm assuming this is what happened. so in fact she isn't the *****, you are. in addition to being arrogant.

 

[softmed]

she's not wrong IF she preforms all the procedures but isn't the one who is asking the patients how they feel afterwards. If the person asking the patients how they feel is blinded to which procedure the patient got then it is double blinded.

i'm assuming this is what happened. so in fact she isn't the *****, you are. in addition to being arrogant.

She's completely wrong about her test being double blind. She cannot know whether her subjects are receiving the real or sham treatment. The investigator knowing these factors can alter the results. For example, she could consciously or subconsciously act like her treatment won't work (or will work) when dealing with patients. The placebo effect is very much dependent on whether the subject believes it will or won't work.

 

[Lukkie]

So my question is, how do people like this become doctors?

What two letters appeared after her name?

 

[ZeusonRoids]

I often wonder how I got into medical school I am the dumbest person ever to be accepted I think...not only that but I am kind of an arrogant and very lazy person who speaks in monotone

 

[NeuroChaos]

Sounds like the oncologist had a very questionable definition of double blind to me. Can you explain your statement a little further?

Well, I never actually believed the OP about anything he/she said. The use of the word *****, disproven nonsense, horribly flawed hinted that OP had a bad day, writing the post in frustration, and is very likely to fabricate.

I was trying to be gentle in my word choice to say the same thing as ensuii and skinMD .

 

[Mattabet]

***** (@ 4 years) ≘ Jams licorice up nose
***** (High School) ≘ Drops out, becomes teenage parent
***** (SDN) ≘ Cannot properly design double-blind study for advanced research

Doctorate level *****dom.

 

[turkeyjerky]

I take issue with your characterization of the experimental therapy as "long disproven".

In fact, sham acupuncture has been shown to be effective in treating a number of complaints.

 

[softmed]

I take issue with your characterization of the experimental therapy as "long disproven".

In fact, sham acupuncture has been shown to be effective in treating a number of complaints.

Perhaps I wasn't clear: Her hypothesis is that acupuncture works and sham acupuncture does not work. So her control group is sham acupuncture and her experimental group is acupuncture. (in fact, the sham group does not even use needles, it uses "fake" needles)

Whether sticking needles into someone and telling them they're getting treatment helps people is left up for debate. It does look like it helps people right now, but it doesn't matter whether we follow ancient Chinese nonsense. She's using funding in her fellowship to try to prove that nonsense with a highly flawed experimental design.

 

[Forthegood]

So my question is, how do people like this become doctors?

Solid MCAT/GPA with good ECs, passing USMLEs, and perseverance through the hell commonly called internship/residency.


This world is crawling with idiots. They don't disappear because you "got in".

Yeah, the study was inherently flawed. Bigger blunders will be visible the longer you are in the hospital.

 

[musicaldna]

I think thats true anywhere and for anyone.

I am a graduate student yet I make stupid mistakes sometimes in my research somtimes...

 

[hopefuldoc87]

Perhaps I wasn't clear: Her hypothesis is that acupuncture works and sham acupuncture does not work. So her control group is sham acupuncture and her experimental group is acupuncture. (in fact, the sham group does not even use needles, it uses "fake" needles)

Whether sticking needles into someone and telling them they're getting treatment helps people is left up for debate. It does look like it helps people right now, but it doesn't matter whether we follow ancient Chinese nonsense. She's using funding in her fellowship to try to prove that nonsense with a highly flawed experimental design.

It seems like you have a real problem with acupuncture. Who stuck a needle up your butt?

 

[Hyperstudyosis]

I should have to end this post here. The fact that she's wasting her time on long "disproven" nonsense should be enough.

A little biased against Eastern medicine, OP?

 

[turkeyjerky]

Perhaps I wasn't clear: Her hypothesis is that acupuncture works and sham acupuncture does not work. So her control group is sham acupuncture and her experimental group is acupuncture. (in fact, the sham group does not even use needles, it uses "fake" needles)

Whether sticking needles into someone and telling them they're getting treatment helps people is left up for debate. It does look like it helps people right now, but it doesn't matter whether we follow ancient Chinese nonsense. She's using funding in her fellowship to try to prove that nonsense with a highly flawed experimental design.

I think we've proven who the ***** is

 

[hopefuldoc87]

i think we've proven who the ***** is

+1

 

[MossPoh]

While it is odd, I find the fact that you went out of your way to create a post talking about this person pretty douchebaggish. I have a friend that has a doctorate in chinese medicine and is working on her N.D.. She works exclusively with cancer patients. She works side by side with M.D. and D.O. and while the stuff doesn't jive with me, I don't really give a damn if it is placebo effect if the patient starts feeling better and has a better quality of life. Perhaps you should just focus on getting in and through medical school before creating threads tearing something down that really doesn't matter.

 

[runrunrudolph1]

***** (@ 4 years) ≘ Jams licorice up nose
***** (High School) ≘ Drops out, becomes teenage parent
***** (SDN) ≘ Cannot properly design double-blind study for advanced research

Doctorate level *****dom.

 

[Hyperstudyosis]

Whether sticking needles into someone and telling them they're getting treatment helps people is left up for debate. It does look like it helps people right now, but it doesn't matter whether we follow ancient Chinese nonsense.

Ancient Chinese nonsense? Try telling that to my friend with cancer who got great pain relief from acupuncture. Just because you don't understand how acupuncture works doesn't mean that it can't work. There is actually a lot of wisdom in ancient healing traditions- wisdom that Western medicine would benefit greatly from. To be completely honest, some of the treatments we employ in Western medicine are the ones I believe should be subject to criticism. The Chinese aren't the only ones who use "unproven" treatments. And also, science cannot "prove" everything.

 

[Chuck's Right Foot]

While it is odd, I find the fact that you went out of your way to create a post talking about this person pretty douchebaggish. I have a friend that has a doctorate in chinese medicine and is working on her N.D.. She works exclusively with cancer patients. She works side by side with M.D. and D.O. and while the stuff doesn't jive with me, I don't really give a damn if it is placebo effect if the patient starts feeling better and has a better quality of life. Perhaps you should just focus on getting in and through medical school before creating threads tearing something down that really doesn't matter.

Out of any of the "woo" therapies, I feel like accupuncture is the least "woo-ish" but I think as competent medical students/practitioners we should care very much why accupuncture may or may not work. In fact much of the "data" on accupuncture anethesia is flawed or distorted from actual reports.

 

[Hyperstudyosis]

Quite interesting is the fact that Harvard and Duke have been doing research on nonlocal healing-- yes, that is the effects of prayer and intention from a distant healer directed toward patients. Harvard even hosted a conference in 1997 called "Intercessory Prayer and Distant Healing Intention: Clinical and Laboratory Research." Over a hundred researchers from medical schools and universities throughout the US gathered to discuss experiments in nonlocal healing that they were performing at their various institutions. Nonlocal healing sounds far more "sketch" than acupuncture, however top institutions seem to be interested in studying it. They don't think it is a sham.

The associate professor of medicine and cardiology at Duke (who is also director of the cardiovascular labs at one of Duke's main teaching hospitals) co-founded the MANTRA Project (Monitoring and Actualization of Noetic Training). It is a cardio-spiritual program combining high-tech cardiology with intercessory prayer, music, mental imagery, and touch.

The point is, just because we are unfamiliar with something or just because it is not traditional, conventional Western medicine (ie drugs, surgery, chemotherapy, and radiation) doesn't mean that it is stupid or doesn't work. In fact, I have seen people heal from many diseases, including cancer, with a completely non-Western approach.

 

[Brent8927]

She's completely wrong about her test being double blind. She cannot know whether her subjects are receiving the real or sham treatment. The investigator knowing these factors can alter the results. For example, she could consciously or subconsciously act like her treatment won't work (or will work) when dealing with patients. The placebo effect is very much dependent on whether the subject believes it will or won't work.

👍👍 My dad is a professional statistician (for clinical trials), and double-blind means the person providing treatment does not know if the patient receives the real treatment or a placebo. The person/people who do know should never be meeting the patients at all.

Often, to prevent bias, a different company or statistical team will analyze the data. This is so that the team analyzing the data has no interest in the results (since they are paid to analyze data, not develop the drug/device).

Unfortunately a lot of research we read about falls short of being "real." Not everyone knows how to correctly design a research study (I don't!), and even fewer know how to properly use statistics to make sure that their data is valid.

If there's one thing I've learned, it's that the New England Journal of Medicine has both good science and good statistical analysis (I believe it's peer-reviewed by scientists and statisticians).

Also, as far as I know, acupuncture is one of the few traditional remedies (eastern or western) that western medicine has acknowledged as being effective (thought we don't know why). I hardly think it's a sham, especially when so many people benefit from it. If acupuncture doesn't work, it seems to have a pretty darn high placebo effect.

For the record... how do you test the placebo effect of acupuncture? It seems to me that you can't really create a "fake" needle because there really isn't anything special about an acupuncture needle in the first place, right? Other than that it is sanitary and thin/long. And it seems if you intentionally put the needle in the wrong spot (where it wouldn't be expected to do anything), not fully understanding the mechanism of action, you can't fully say that putting a needle in that spot would have no effect.

 

[SirGecko]

Is there even a way for her study to be double blind? In order to administer acupuncture you'd have to know if you were actually doing it or administering sham acupuncture. It seems to me based off of some of the descriptions on this thread that the experiment couldn't be designed to be double blind.

Edit: After reading LizzyM's post I see how you could do this and it could be double blind. I guess it's just more complicated. Also like other have said you should really focus that outrage at some of the more ridiculous CAM practices as acupuncture isn't that bad.

 

[Chuck's Right Foot]

Quite interesting is the fact that Harvard and Duke have been doing research on nonlocal healing-- yes, that is the effects of prayer and intention from a distant healer directed toward patients. Harvard even hosted a conference in 1997 called "Intercessory Prayer and Distant Healing Intention: Clinical and Laboratory Research." Over a hundred researchers from medical schools and universities throughout the US gathered to discuss experiments in nonlocal healing that they were performing at their various institutions. Nonlocal healing sounds far more "sketch" than acupuncture, however top institutions seem to be interested in studying it. They don't think it is a sham.

The associate professor of medicine and cardiology at Duke (who is also director of the cardiovascular labs at one of Duke's main teaching hospitals) co-founded the MANTRA Project (Monitoring and Actualization of Noetic Training). It is a cardio-spiritual program combining high-tech cardiology with intercessory prayer, music, mental imagery, and touch.

The point is, just because we are unfamiliar with something or just because it is not traditional, conventional Western medicine (ie drugs, surgery, chemotherapy, and radiation) doesn't mean that it is stupid or doesn't work. In fact, I have seen people heal from many diseases, including cancer, with a completely non-Western approach.

The CAM research coming out of Harvard has serious flaws. Kimball Atwood, MD has some good blog posts about it. And while there are studies looking at alternative therapies, nothing has stood up to the light of day.

 

[LizzyM]

👍👍 My dad is a professional statistician (for clinical trials), and double-blind means the person providing treatment does not know if the patient receives the real treatment or a placebo. The person/people who do know should never be meeting the patients at all.

Double blind means that neither the subject nor the person measuring outcomes knows whether the subject receives the real therapy or the placebo(or in this case, sham procedure).

Obviously, with sham procedures, someone who knows which treatment the subject is getting has to meet the subject to administer the treatment (e.g. how do you do sham surgery studies without having someone meet the subject.) The key is, the person measuring the outcome of interest should not know the subjects' group assignment.

This is a fine point of clinical trial design and one that gets overlooked in placebo controlled drug trials where it is easy to blind the phyisican-investigator who dispenses the study drug and measures outcome. The drug comes in a numbered vial and someone apart from the physician-investigator randomizes the subject and tells the doc which numbered packet to use for that subject.

 

[phospho]

lol!! I don't really care if the doc was practicing voodoo magic.

you're a premed calling an oncologist a *****...

enough said...

 

[JeetKuneDo]

Get good grades, score well on mcat, do some volunteer work.

 

[Hyperstudyosis]

The CAM research coming out of Harvard has serious flaws. Kimball Atwood, MD has some good blog posts about it. And while there are studies looking at alternative therapies, nothing has stood up to the light of day.

Nothing alternative has stood up to the light of day? How do you know? Do you know the outcomes of all the studies that have ever been done on alternative therapies? Try telling that to the hundreds of people I know who have healed from cancer with a completely alternative approach- no chemo, no surgery, no radiation. I'm not saying that conventional things are wrong and I'm not saying there are not cases where they are necessary. I'm just saying there's more out there.

Do you know that researchers have been banished from the country upon discovery of cures for certain kinds of cancer? Do you know about the Hoxsey Cancer Clinics and the persecution that Hoxsey himself was subject to at the hands of the government? Do you know about the other researchers, like the one who studied at a very renowned school where one of my professors was a postdoc? He was working on a cure for cancer and was banished from the United States as a result? Do you know that the American Cancer Society has to disband once a cure is found?

 

[Chuck's Right Foot]

hahahahahahahahahahahahahahahahahah.

 

[LizzyM]

Nothing alternative has stood up to the light of day? How do you know? Do you know the outcomes of all the studies that have ever been done on alternative therapies? Try telling that to the hundreds of people I know who have healed from cancer with a completely alternative approach- no chemo, no surgery, no radiation. I'm not saying that conventional things are wrong and I'm not saying there are not cases where they are necessary. I'm just saying there's more out there.

Do you know that researchers have been banished from the country upon discovery of cures for certain kinds of cancer? Do you know about the Hoxsey Cancer Clinics and the persecution that Hoxsey himself was subject to at the hands of the government? Do you know about the other researchers, like the one who studied at a very renowned school where one of my professors was a postdoc? He was working on a cure for cancer and was banished from the United States as a result? Do you know that the American Cancer Society has to disband once a cure is found?

Rubbish! The March of Dimes did not disband after the polio vaccine eliminated the disease in the US. It changed its mission.

Hoxsey was a quack and his treatment is quackery.
Be sure to wear a tinfoil hat with your interview suit. I want to recognize you when you come in.

 

[Brent8927]

Double blind means that neither the subject nor the person measuring outcomes knows whether the subject receives the real therapy or the placebo(or in this case, sham procedure).

Obviously, with sham procedures, someone who knows which treatment the subject is getting has to meet the subject to administer the treatment (e.g. how do you do sham surgery studies without having someone meet the subject.) The key is, the person measuring the outcome of interest should not know the subjects' group assignment.

This is a fine point of clinical trial design and one that gets overlooked in placebo controlled drug trials where it is easy to blind the phyisican-investigator who dispenses the study drug and measures outcome. The drug comes in a numbered vial and someone apart from the physician-investigator randomizes the subject and tells the doc which numbered packet to use for that subject.

Right! I was thinking more of a clinical trials that involve meds and overlooked the sham procedure aspect. All the trials I've known about (from my Dad's company) were with drugs, where there's generally a pharmacist or someone who assigns treatment and the patient and doctor don't know what treatment the patient gets. But I overlooked that that method doesn't really work with procedures!

Ack--I'd sure hope somebody doing a sham surgery knows what they're doing!

I learned something new today--I've never heard of sham procedures/surgeries before. Thanks for the enlightenment 🙂

 

[MegaProjectile]

lol!! I don't really care if the doc was practicing voodoo magic.

you're a premed calling an oncologist a *****...

enough said...

Medical students(and yes "premeds" )are trained to possess an independent thought accompanied with critical thinking. Calling the doctor a ***** might be out-of-line but questioning her work is not.Blind submission to authority won't get you very far as a scientist. I can't tell you the number of times residents have called out their attendings for the good of the patients at the hospital where I work.

 

[hopefuldoc87]

Medical students(and yes "premeds" )are trained to possess an independent thought accompanied with critical thinking. Calling the doctor a ***** might be out-of-line but questioning her work is not.Blind submission to authority won't get you very far as a scientist. I can't tell you the number of times residents have called out their attendings for the good of the patients at the hospital where I work.

Resident vs. attending is not quite at the same level as pre-med vs. someone who completed medical school, residency, and fellowship.

 

[Chuck's Right Foot]

Resident vs. attending is not quite at the same level as pre-med vs. someone who completed medical school, residency, and fellowship.

Just because someone is pre-med doesn't mean they can't smell poo when they've stepped in it.

Doesn't mean they have tact either... But it's amazing how poorly some pre-med/med students/doctors understand experimental design and the scientific method.

Start with Orac: http://scienceblogs.com/insolence/2009/07/oh_no_orac_has_been_too_insolent.php

 

[MegaProjectile]

Resident vs. attending is not quite at the same level as pre-med vs. someone who completed medical school, residency, and fellowship.

What does experimental design have anything to with medical knowledge? Its not like the OP is arguing oncological diseases with the doctor.

 

[phospho]

Medical students(and yes "premeds" )are trained to possess an independent thought accompanied with critical thinking. Calling the doctor a ***** might be out-of-line but questioning her work is not.Blind submission to authority won't get you very far as a scientist. I can't tell you the number of times residents have called out their attendings for the good of the patients at the hospital where I work.

I can't care less if he wants to argue about experimental design (or whatever the hell he's trying to argue about). I'm all for independent thinking, and I'm definitely not condoning "blind submission".

A premed calling a doctor a ***** is not "out of line" - he's a *****.

 

[hopefuldoc87]

I can't care less if he wants to argue about experimental design (or whatever the hell he's trying to argue about). I'm all for independent thinking, and I'm definitely not condoning "blind submission".

A premed calling a doctor a ***** is not "out of line" - he's a *****.

👍 This was my point

 

[Hyperstudyosis]

Rubbish! The March of Dimes did not disband after the polio vaccine eliminated the disease in the US. It changed its mission.

Hoxsey was a quack and his treatment is quackery.
Be sure to wear a tinfoil hat with your interview suit. I want to recognize you when you come in.

No worries. There will be no need for the tinfoil hat because you will probably know me from my PS (remember my PM?) and I probably won't get invited for an interview! Actually, there is a good chance that I am not applying at the school you are at because I'm only applying to 6 schools. Maybe I am wrong about the ACS. I admit that sometimes I take from what I hear and don't do enough of my own research. I guess that trait has been bred into me from childhood, when I had to listen to my parents and teachers and their word was law. But I do know for a fact that there have been things throughout history pertaining to medicine that have been covered up. Anyhow, I am not afraid of what people think of me and my opinions. Actually, if I am honest with myself, I am afraid. I am deathly afraid of what you and other people think of me. But that is a character flaw that I am working to overcome and that is why I spoke my mind today.

 

[LizzyM]

No worries. There will be no need for the tinfoil hat because you will probably know me from my PS (remember my PM?)

No, I don't. I delete them unread. I don't read SDN PSs.


Also, in terms of teachers and parents being authorities... learn now to think for yourself rather than parrot what you've been told. Learn to examine the evidence and make your own decisions or stay the hell out of medicine.

 

[Kaustikos]

Who cares? There are *****s/idiots in every field and profession. Let's not knock someones accomplishments because they had a blunder such as "double-blind". It could possibly be that she was confused or said something wrong. I know I've done that, especially in speeches, and I would hate to have people think I'm an idiot because of that. Stop being such an arrogant prick.👎

 

[rkaz]

Hoxsey was a quack and his treatment is quackery.
Be sure to wear a tinfoil hat with your interview suit. I want to recognize you when you come in.

These sort of comments are offensive and completely unnecessary. Your status as a school admin doesn't give you privileges to be abusive to applicants.

Although I am not quite aware of your opinions on complementary medicine, don't be so quick to dismiss it as quackery. I personally have benefited enormously from 'natural' medicine, and have been studying it passionately for over 10 years. I don't agree with everything they put out, as I demand a therapy be evidence-based; however, there is a lot of great stuff out there today. Although you are very correct that students need to be diligent in examining the evidence, at the same time it is important to keep an open mind instead of dismissing potentially valuable therapy prematurely.

 

[rkaz]

I am deathly afraid of what you and other people think of me. But that is a character flaw that I am working to overcome and that is why I spoke my mind today.

Don't try to conform yourself so much to what you think other people want you to be. There is no need to be intimidated. Of course you need to do what it requires to get admitted to medical school in the first place. But at the same time, we certainly need people like yourself who can think outside the box. Lizzy might be correct that medical students need to focus on the evidence, but at the same time, we need people who realize that there is much wisdom in certain (though not all) medicine from the past. Thus we need to be willing to sort through things to see what works and what doesn't. I have talked with and read through many books of leading holistic physicians, and there is so much that modern medicine hasn't connected with yet. Don't back down or give up your interest in thinking outside the box of conventional treatment- as the public needs more people like you and me. My parents are both MDs and they consult with me all the time as they know that I keep up with all the latest research. Their own health has improved by following my recommendations.

 

[KingstonPre]

***** (@ 4 years) ≘ Jams licorice up nose
***** (High School) ≘ Drops out, becomes teenage parent
***** (SDN) ≘ Cannot properly design double-blind study for advanced research

Doctorate level *****dom.

I think we've proven who the ***** is

lol!! I don't really care if the doc was practicing voodoo magic.

you're a premed calling an oncologist a *****...

enough said...

LMAOOOOOOOOOOOOOOOOOOOOOOOOOOOO

 

[Shaptown]

Hyper-

If you had a stage IV metastatic melanoma patient, guess what? Eastern Medicine will do NOTHING for this patient. Learn to question things which have yet to be extensively prodded by rationale thought.

 

[LizzyM]

These sort of comments are offensive and completely unnecessary. Your status as a school admin doesn't give you privileges to be abusive to applicants.

Although I am not quite aware of your opinions on complementary medicine, don't be so quick to dismiss it as quackery. I personally have benefited enormously from 'natural' medicine, and have been studying it passionately for over 10 years. I don't agree with everything they put out, as I demand a therapy be evidence-based; however, there is a lot of great stuff out there today. Although you are very correct that students need to be diligent in examining the evidence, at the same time it is important to keep an open mind instead of dismissing potentially valuable therapy prematurely.

My comment was on Hoxsey and not on any other alternate and complementary medicine. My institution is conducting some research on acupuncture to see if it improves outcomes of mainstream treatment.

The federal government came down on Hoxsey back in 1960. He was a layman and a fraud. Here's the American Cancer Society's commentary:
http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Hoxsey_Herbal_Treatment.asp

Perhaps I was a little hard on someone but really 😕 the conspiracy theorists are a little worrisome.

 

[Chemdude]

What two letters appeared after her name?

That's a very good question...OP she must have been a DO!!!

 

[DocDrakeRamoray]

lol!! I don't really care if the doc was practicing voodoo magic.

you're a premed calling an oncologist a *****...

enough said...

👍

 

[turkeyjerky]

For the record... how do you test the placebo effect of acupuncture? It seems to me that you can't really create a "fake" needle because there really isn't anything special about an acupuncture needle in the first place, right? Other than that it is sanitary and thin/long. And it seems if you intentionally put the needle in the wrong spot (where it wouldn't be expected to do anything), not fully understanding the mechanism of action, you can't fully say that putting a needle in that spot would have no effect.

There are well-validated sham-acupuncture devices where a needle pokes a patient, but isn't actually inserted. Rather it goes back up into a tube (like the "disappearing knife" gag). Patients generally aren't able to tell that the needle isn't actually inserted.

Well-designed studies employing this control generally show that acupuncture has no effect beyond that of a placebo.