Really SDN?

[LIDO]

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Went to SDN homepage today and found the opening story:

20 Questions: Victoria L. Dunckley, M.D.
Dr. Victoria Dunckley takes time out of her busy schedule to answer questions related to having a private practice in the field of Psychology.

C'mon SDN. Get it together. 👎

 

[upright]

par for the course

 

[whopper]

Hmm, what's wrong?

Oh...now I get it. Didn't notice the M.D., and I checked just in case to see if she was a psychiatrist and she is.

I contacted the website management and will post this in the moderators' forum to see if we can fix it.

 

[splik]

i would not be in a hurry to correct it .... micronutrients, electronic fasting, electromagnetic fields.... quack quack quack

 

[IAmAUser]

.

 

[digitlnoize]

I hope/assume she means well, but physicians who practice this way really make me sad for the profession. On her website she talks about curing psychosis by removing "e-screens" and ocd caused by a nintendo wii. "Along with micronutrient testing, I’ll now be offering neurotransmitter testing, food and chemical sensitivity testing, and hormonal and metabolic panels. These tests serve to provide individualized supplement plans, optimizing treatment and minimizing psychotropic medication use. "

I honestly don't understand why state medical boards put up with this kind of bull****. If she wants to promote herself as a naturopath, homeopath, or whatever else then fine, but to act this way as a physician is just wrong. People without a scientific background would love for there to be some micronutrient or e-screen abstention regimen to cure their / their child's mental illness but it's just not reality. To take advantage of people and say that it is, as a physician, is obscene.

I am doing this exact rotation right now. The doc bills himself as "functional medicine" though, and is an FM doc acting as a kind of consulting herbalist for patients referred from other FM docs. From what I've seen, it's 90% crap and 10% possible, but unproven, truth.

Interestingly, this doc has had many documented successes with cancer patients using a combination of herbal crap, "real" medicine (but not standard chemo...stuff like cimetidine or whatever has the slightest "evidence"), and chemo from the Oncologists.

I like to think it's total crap, but FM docs in town refer difficult cases to him, and he often fixes (or improves) them.

Weird.

 

[splik]

I have no doubt that many patients who see these quacks get better - there is after all such a thing as natural remission, there is the placebo effect, and most important of all there is contextual healing. the rituals, the rapport, the relationship and the healing environment they cultivate is the one thing we can learn from shamans, traditional healers, and some of these quacks.

The issue is not about whether patients get better, it is about the deception. Now patients taking homoeopathic remedies get better all the time. That's without a doubt. The point is, it is a deception for a physician to claim homoeopathy works by the principles Hahnemann outlined when they go against the principles of science. Deception is a breach of trust, and breaching trust, undermines the profession, and undermines the foundation of the doctor-patient relationship.

Now I prescribe pills and potions I am not all the convinced about (e.g. SRIs) knowing full well the placebo effect, the messages I communicate with the patient (i.e. i'm giving you a 'way out'), and the contexual healing I use to build positive expectancy in that the potion will work have an effect. Is there anything wrong with that? Well I don't think its the same thing If I don't come up with some bs like 'depression is caused by a chemical imbalance and taking this medication will correct the imbalance and make you feel better'.

 

[F0nzie]

Now I prescribe pills and potions...

 

[splik]

Bacchus et afflictis requiem mortalibus affert,
Crura licet duro compede vincta forent.


Wine makes a troubled soul to rest,
Though feet with fetters be opprest.

(robert burton, the anatomy of melancholy)

 

[All4MyDaughter]

The issue of categorization has been fixed. My assistant editor (a student volunteer) is new and still learning the SDN publishing process and categories. For any future concerns, sending a message directly to me via the SDN Helpdesk is your best and fastest course of action. For obvious reasons, I'm not able to monitor every forum on SDN for complaints, concerns or compliments. 🙂

A4MD
EIC

 

[whopper]

I don't know enough of this lady to knock her...

But I do recall about 15 years ago antiaging clinics popping up here and there where M.D.s were charging big money to offer treatments to slow and stop aging. Suzanne Somers has banked big time off this questionable movement.

And yes, there are some studies here or there showing evidenced-based interventions that could possibly do this, but these doctors had no real training in it and were charging on the order of several hundreds of dollars/hr for an interview where the bottom line ended up being taking a multivitamin, green tea, a healthy diet, grape seed extract, and resveratrol. These are interventions that anyone could've figured out on their own had they simply read a few pamphlets from a GNC, and their benefits are not to the degree where I think anyone who's read the data would think it was worth paying hundreds of dollars/hour with an M.D. if at aplll valid. Resveratrol, for example, does not have a lot of data on humans as to it's benefits.

 

[sunlioness]

I had a patient fire me today within 20 minutes of first meeting her because I wasn't "holistic". Also, I took notes and she didn't like that. Sigh.

I am getting good at brewing potions in Pottermore though (Ravenclaw represent!), so maybe I should just retire to the world of Harry Potter. 🙂

 

[whopper]

I had one patient come in with about 30 bottles of herbal treatments. I'm actually into integrative medicine and have been a fan of Andrew Weil, so I'm not alien to most of them....

But this lady was on stuff I haven't heard of, and then told me she was having problems with her adrenal glands and had an "Amish" nurse treating it. I told her that some adrenal problems, if left untreated, could kill the patient, and that if she really did have such a problem she needed to see an actual M.D. at least for that issue.

Hey I'm open to integrative medicine if there's actual evidenced-based data (e.g. fish oil could help with mental illness, green tea can help with weight loss), but I'm no way going to condone treatment like what was going on above.

Well she didn't. I haven't seen her since. Oh well.

 

[digitlnoize]

I had one patient come in with about 30 bottles of herbal treatments. I'm actually into integrative medicine and have been a fan of Andrew Weil, so I'm not alien to most of them....

But this lady was on stuff I haven't heard of, and then told me she was having problems with her adrenal glands and had an "Amish" nurse treating it. I told her that some adrenal problems, if left untreated, could kill the patient, and that if she really did have such a problem she needed to see an actual M.D. at least for that issue.

Hey I'm open to integrative medicine if there's actual evidenced-based data (e.g. fish oil could help with mental illness, green tea can help with weight loss), but I'm no way going to condone treatment like what was going on above.

Well she didn't. I haven't seen her since. Oh well.

Oh yeah. These people are treating the adrenal like it's the freaking thyroid. Basically, anyone who's amotivational, they diagnose as having an "adrenal imbalance", sometimes using urine testing. Then, they prescribe these people an "adrenal regimen", which is usually a pill or combo of pills they sell in their office (how convenient).

My other favorite is the "provoked testing" for heavy metals in the urine. See here for more info: http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/urine_toxic.html

Oh, and my OTHER favorite is doing a zillion lab tests, then, when things are anywhere close to the limits of the reference range, telling them that they have a dire problem and have to correct it. Facepalm.

 

[sunlioness]

A patient today was telling me how she wanted some sort of saliva testing to rule out adrenal fatigue.

 

[digitlnoize]

A patient today was telling me how she wanted some sort of saliva testing to rule out adrenal fatigue.

Yes. They do THIS!!!

 

[F0nzie]

A patient today was telling me how she wanted some sort of saliva testing to rule out adrenal fatigue.

I would start Zyprexa at 5mg.

 

[digitlnoize]

And then there's this:

http://www.huffingtonpost.com/2012/...n-be-diagnosed-with-blood-test_n_1438914.html

 

[nitemagi]

A patient today was telling me how she wanted some sort of saliva testing to rule out adrenal fatigue.

Salivary cortisol is a commonly used test in research settings that's non-invasive. Not aware of any clinical utility, though.

 

[Apollyon]

What's funny is that you guys are talking about the MD/psychology thing and CAM. In the anesthesia forum, the only thing they were saying was about how wanted to bone her (based on her picture). Now, that thread is in their private forum!

 

[billypilgrim37]

The girls that anesthesiologists want to bone, psychiatrists (the few male ones of us anyway) think, "Huh, she has an X% chance of borderline traits. I think I will pass."

It protects us from the injury of rejection. 😉

Of course, this might come from years of anesthesiologists stealing our girlfriends.

 

[belle54321]

I had a patient fire me today within 20 minutes of first meeting her because I wasn't "holistic". Also, I took notes and she didn't like that. Sigh.

I am getting good at brewing potions in Pottermore though (Ravenclaw represent!), so maybe I should just retire to the world of Harry Potter. 🙂

I want my 5-year old daughter there while I get sorted in Pottermore. I am hoping to be a Griffindor, or just not slytherin.