(LONG)
OK, time for the (long) reply. So long, I got logged off.
Dennis,
Let’s shave the barber…
1. I don't know what you are referring to when you state a comment I made was personal and not adult. My best guess is "Nobody knows as much as Dennis about anything?" If that's not it then you can ignore the rest of #1.
What was the sequence leading up to that? I suggested that people hire professionals for their expertise in their profession. For instance, they hire electricians to do electrical work in their house. Your response about an electrician you hired was
“….I felt very free to update his understanding and work with him to change it, with a much better result.”. This reads containing a fair bit of condescension IMO. The logical progression of which is that the professionals never quite know what they are doing and need to be “updated” by you. Hence my reply, which does contain a certain element of sarcasm.
Is this slippery slope argument and sarcasm absent from your own posts? During your reply to Rick about the statistics of risk and population cholesterol distribution you make the observation “
Yeah Rick, I guess a background in physics leaves me woefully prepared for statistics.” Never mind that you are focusing on a single “tail” in the Bayesian distribution which Rick points out.
2. As to the example you cite, about number of individuals who have different opinions than you on IT issues at your work, it is quite incomparable to the patient/physician interaction. First, you are discussing issues where you have a common ground by both having prior educational and/or work experiences, yours perhaps being deeper than one of these other individuals. In fact, the relationship between patient and physician would be much closer to your IT guys trying to instruct a lawyer in how to try a lawsuit. Yes, it’s polite to listen, but you’d think the atty has a little better inkling of how to reach a successful conclusion.
Furthermore, this is not a brainstorming problem solving kind of issue. No new ground is being covered in these discussions, it’s a rehash of the same issues.
3. Physicians are not gods. No one is suggesting they are. However, they are professionals and the premise that they are incompetent, not up on the current literature, and that by doing a few searches anyone will know as much as or more than them is somewhat demeaning. At least you ended your anecdote with a small note indicating you realize its scientific fallacy. More importantly, the likelihood of negative outcomes is quite elevated when people travel to some special clinic in Mexico or Sweden etc. These people often end up back here in more dire straits than when they left. I could make some dig about the Canadian healthcare and cost containment in the case of your friend, and it might even be true (I’ve seen it in HMO’s south of the border too), but will refrain.
4. From your posts, it is obvious that you, along some others prefer to minimize the potential downside of a high cholesterol. No one has disputed the fact that high cholesterol is but one risk factor for the development of cardiovascular disease. More importantly your (and others) opinion(s) have suggested that it is of negligible benefit to intervene. There has also been a suggestion that high cholesterol is still being debated as a risk. It is true that at one time this was the case. However, there is a huge body of evidence indicating its risk, and more importantly, to date, no floor for the benefit of treatment has been found (ie lower chols = lower risk).
5. As to the state of medicine, it is a science when practiced in the allopathic manner, albeit an evolving one. This is no different than physics and mathematics which also continue to evolve. Leeches still are used successfully in medicine (FWIW). Large advances have been made over the last 50 yrs. Not only is there an extensive understanding of pathophysiology, but the science has actually focused on the success of therapies (whether they make pathophysiologic sense or not). This is the difference between allopathic medicine and so-called alternative medicine which actually hearkens back to the days of witchdoctoring and the tradition of generational (handed down recipes) medicine. Some of those techniques have been found to be of value eg/acupuncture for pain, while others not – reflexology or acupuncture for kidney failure.
And finally, I am not offended, merely frustrated. I see this as a forum where folks generally are above average in intelligence with some penchant for logic. To see the same discussions rehashed in the same manner....
Phew
PS Onramp, do you know Schramps entire set of risks or lipid profile?
PPS Thanks Rick. Add 3 years of fellowship, 1 year of subsubspecialty and few years of practice and do this a few hundred times a week. Yah, no idea of what I'm writing about