User talk:Orangemarlin/Medical 1

CFS
Yeah, I saw that, I'm going through his sources now. ornis 05:43, 29 June 2007 (UTC)


 * I reverted. One was a review article that made a 1 sentence comment amongst pages of information.  Talk about undue weight.  The Vitamin B12 articles were inconclusive, or were stretching the conclusions based on a cohort of what appeared to be 12 women.  This is, plain and simple, not worthy of inclusion in a medical article.  Orangemarlin 05:47, 29 June 2007 (UTC)


 * Is this what they call unpublished synthesis? ornis 06:03, 29 June 2007 (UTC)

Adding Herbalism to List of pseudosciences and pseudoscientific concepts
While I don't dispute that Herbalism merits inclusion in this list, I had to revert it out due to lack of a source. With a list such as this, which provides a pejorative but well-defined label, we need to be very careful to cite reliable and appropriate sources for the inclusion of anything. Compounding this problem is that the current version uses "default sourcing" (anything unsourced is assumed to be from the Skeptic Encyclopedia; it's bad, I know), so anyone browsing would assume Herbalism was mentioned there. If you do have a sufficient source for this, feel free to add it back with this source referenced. --Infophile (Talk) (Contribs) 12:21, 29 June 2007 (UTC)


 * I believe that probably >99% of Herbalism or Naturalism or similar practices is of minimal value and possibly of negative value, with only some tiny minority of treatments being of use. It is probably all pseudoscience since the treatments are based more on folktales, tradition, rumors, etc than on allopathic procedures and the scientific method. I believe that is the purpose of the alternative medicine division at the NIH: to try to test some of these treatments. I think that Germany, and possibly other countries as well, has similar efforts underway, to try to turn some of this pseudoscience into real science. Perhaps suitable references might be available if these efforts are investigated?--Filll 12:27, 29 June 2007 (UTC)


 * Well Filll, since I know several people watch my page, I think it's time to clean up that article. I read it, and there is one section that deals with the science, but it is unsourced.  The lead doesn't have balance.  It's all POV.  Ready to get it to NPOV?  The POV warriors there will probably make the Creationist editors look like kittens.  Orangemarlin 14:37, 29 June 2007 (UTC)


 * This list had sources? I didn't see any.  But it's like the old duck joke.  If looks like pseudoscience, doesn't use the scientific method like pseudoscience, and the practitioners claim they don't need the scientific method like pseudoscience, it must be pseudoscience.  Well, there are dozens of references.  I'll find the most juicy one, and add it in.  Orangemarlin 14:35, 29 June 2007 (UTC)


 * Yeah, that's the default sourcing; I don't like it either. Simoes said he was going to add in sources for everything not long ago, but he hasn't gotten around to it yet. Of course, I agree with you here that it fits the label. It's just that if we leave it up without a source, we'll get herbalists coming around to make a big stink about it (it'll likely happen anyways, but this way we can point to the source and rely on that). Also, note that sources from either mainstream scientific bodies or skeptical organizations (or notable individual skeptics) are much prefered. --Infophile (Talk) (Contribs) 15:17, 29 June 2007 (UTC)


 * I took a quick glance at herbalism and it does look pretty unbalanced. I think that it is great to describe what herbalism is and what people believe and its history, however it is important to give the other side as well, and include what the scientific view is. I was shocked to not see a word of mention of the NIH division that studies herbalism or its German counterpart. Why not? Good heavens! I even saw some whining about how unfair it is that the US and the Europeans will not let in Indian medicines that have heavy metals in them. This stuff is pure witchcraft. And it is written in an encyclopedia with worldwide scope as it if was fact!--Filll 15:25, 29 June 2007 (UTC)

(RI) Yeah, I agree, an article on the history of herbal medicine would be great, but as it stands it's more of an add for new-age woo. Personally I'm inclined to simply nuke everything that's unsourced, but I think that would just start world war three. ornis 15:52, 29 June 2007 (UTC)


 * Here is whawt I propose. Let's start a sandbox version of some material on the scientific aspects of herbalism/naturalism etc. Then I propose we introduce a short summary section into the appropriate articles on herbalism or naturopathy, or homeopathy, or osteopathy or alternative medicine or any of the similar articles, directing them back to a more careful and extensive main article on the subject. That way, we try a compromise instead of just blowing all their work away (which appears to be a lot. The size of herbalism has bobbed up and down around 50K for quite a while. This probably suggests that similar articles have a lot of investment in them as well). I think that we could push for a short paragraph with some mild scientific caveats, and then a direction back to a longer main article in each of these cases. This will be a substantial undertaking, so it would help if we could get a few people together to try it. Also try to introduce it will require enough editorial muscle to make it clear that we cannot just be AfDed and reverted away. Comments?--Filll 17:18, 29 June 2007 (UTC)
 * It looks to me that at least on alternative medicine, some good start has been made in this direction already, which is good to know. I would like all of the similar articles to have at least some connection to real science and scepticism.--Filll 17:24, 29 June 2007 (UTC)


 * That a not a bad idea. What did you have in mind specifically? Sort of a scientific evaluations of alternative medicine ( or some less cumbersome title ), with a short summary of various alternative practices with their rationale and the criticism, testing, controversies, and where applicable the fundamental theories of chemistry, physics and biology they violate. ornis 17:41, 29 June 2007 (UTC)


 * I am thinking of maybe long articles like Science of alternative medicine, or Science and herbalism or Herbalism and science or Science of herbalism, and similar kinds of things for other CAM articles. I think we might be able to get away with one central article and sections at each individual article directing them to the central article, or the appropriate section of the central article. Hopefully, this way we would not ruffle too many feathers, and also have one article to defend and then just links at the other pages to the central article. This way, we might reduce the chance for full scale, all out war. I know how dogmatic some of these people can be. Other places online, I have just heard some amazing claims about mercury fillings, soy products, fluoridation, chelation, and all kinds of similar stuff. --Filll 17:52, 29 June 2007 (UTC)


 * I'm not a big fan of the sandbox approach, because it might appear to be underhanded to the POV warriors. I think the science section of the article is pretty good, but I didn't see a single source.  Let's build that part first, then the lead, then remove the new age "woo".  Orangemarlin 17:53, 29 June 2007 (UTC)

Allopathic
Hi. Thank you for your input on Osteopathic medicine in the United States. You are not the first person to raise the issue if the usage of allopathic in this article. However, I disagree with your analysis that the term "allopathic" is pejorative. It is used in the United States, by MD and DO physicians alike, to refer to one of the two major pathways to becoming a licensed physician in the U.S. There a fairly decent list of sources of this usage over on Wikitionary Talk:Allopathic. Not only does the AMA use the term, the American Association of Medical Colleges and the National Residency Matching Program use it, and it appears in major, peer-reviewed medical journals, like the New England J of Med. Bryan Hopping T  13:21, 17 March 2008 (UTC)
 * I am a licensed physician, graduate from a top Medical School in the United States. And frankly, until I read this article I have never once heard any physician refer to himself or others as "allopathic."  In fact, my first read of the article was that "oh here goes the CAM nutjobs, using one of their secret terms to make medicine appear to be something else."  Orange Marlin  Talk• Contributions 15:39, 17 March 2008 (UTC)

I understand your point of view. I agree it is pretty unusual (unheard of) for an individual physician to identify himself as "allopathic." It would be sort of silly. However, it not uncommon when discussing the US medical education & training system as a whole to divide schools and training programs into "allopathic schools" and "osteopathic students" or "allopathic graduates" and "osteopathic graduates."

As in these articles: It also frequently appears in more scholarly articles discussing government policy on medical education and physician workforce issues: The U.S. department of labor uses the term in the second paragraph of its description of Physicians and Surgeons. It reads "There are two types of physicians: M.D.—Doctor of Medicine—and D.O.—Doctor of Osteopathic Medicine. M.D.s also are known as allopathic physicians."
 * Record number vied for 2007-08 medical school slots. American Medical News.
 * Allopathic med school enrollment rises 2.2%. American Medical News.
 * Wilson, Jennifer Fisher. Osteopathic medicine's growing pains. American College of Physicians Observer. November 1997.
 * Salsberg, Edward and Grover, Atul. Physician Workforce Shortages: Implications and Issues for Academic Health Centers and Policymakers. Academic Medicine, Vol. 81, No. 9 / September 2006. PMID 16936479
 * Medical Student Performance Evaluations in 2005. Acad Med. 2008 Mar;83(3):284-291. PMID 18316879
 * Medical School Programs to Increase the Rural Physician Supply. Acad Med. 2008 Mar;83(3):235-243. PMID 18316867
 * Gregg A. Warshaw, MD; Elizabeth J. Bragg, PhD, RN; Ruth W. Shaull, MSN, RN; Christopher J. Lindsell, PhD Academic Geriatric Programs in US Allopathic and Osteopathic Medical Schools. JAMA. 2002;288:2313-2319. PMID 12425709
 * Sarah E. Brotherton; Paul H. Rockey; Sylvia I. Etzel. US Graduate Medical Education, 2004-2005: Trends in Primary Care Specialties. PMID 16145028

I don't agree that this article has the appearance of some "CAM nutjob". I definitely don't want it to be that, and I've worked hard to avoid it. I also don't want the article to simply repeat the self-promoting propaganda of the American Osteopathic Association as fact. I have really tried to include as many reliable, notable sources as possible in this article. One of the best I feel is the piece by JD Howell, MD published in New Engl J Med. I highly recommend reading this article in its entirety. It really presents the topic neutrally, in a way that is difficult to get from osteopathic publications. Incidentally, he uses both the terms "allopathic" and "allopathy."
 * JD Howell, MD PhD. The Paradox of Osteopathy. N Engl J Med. 1999 Nov 4;341(19):1465-8. PMID 10547412

I know this terms can feel awkward and arcane, but they are the terms that are used within certain discussions, by the experts and major publications. We can't ignore that.

I hope you understand, I am trying to make the article Osteopathic medicine in the United States the best that it can be. That means finding and citing great sources. Every source that I have found that discusses osteopathic medicine, published in the last 50 years, uses the term "allopathic," including articles published in highly prestigious medical journals like NEJM and JAMA. Bryan Hopping T  16:57, 17 March 2008 (UTC)


 * Hang on. I know the article wasn't written from the POV of a CAM nutjob, I said that when I see that word, that's the first thing that comes to my mind.  From my POV, Osteopaths are physicians who had a different type of medical training, one that I both respect and believe has value to the medical community.  In fact, my person physician happens to be a DO.  Moreover, I understand that people use the terminology in published articles from respected journals.  Until I read the article, I thought that "allopathic" was pejorative.  I don't like the term, especially when combined in any way with "evidence based medicine."  There is no medicine except "evidence based."  If it is isn't evidence based, it isn't medicine.  Again, my concerns with the article go well beyond "allopathy", and now I'm more or less on board with its use.  It may take about a year for me to get arms around the term.  Give me time :)  Otherwise, I hope it's clear to you, I do not think nor believe nor assume that Osteopathic medicine is an "alternative medicine."  It's just medicine (save for the OMM stuff).  So you've convinced me of it's use.  I'm going to have to drink now.  :)   Orange Marlin  Talk• Contributions 18:33, 17 March 2008 (UTC)
 * Wow. I'm happy to read this. And I hope this means you won't be revoking your membership with the AMA.  :)  I couldn't agree more that the only kind of medicine is evidence-based medicine.   Personally, I don't even see that osteopathic physicians receive any different training.  That's my experience anyway as a DO student, my entire 3rd year of medical school I've spent with MD students at an MD hospital with absolutely no mention of OMM.  I don't see anything allopathic or osteopathic about the medicine being practiced.  Rather, I've come to understand these terms to describe two traditions within medicine, two "clubs" within the profession.  I would like to see the article reflect this reality, and emphasize that there is no such thing as "allopathic" or "osteopathic" medicine, rather there are associations and institutions that are referred to as allopathic (the AMA, the ACGME, AAMC) and there are parallel osteopathic counterparts (the AOA, the AACOM, etc.)
 * Unfortunately, your initial response to the word is now part of the historical record for the FAC, perhaps bolstering others who might object reflexively to the use of the term in the context of this article. With your permission, I'd like to move the contents of this discussion to the Talk:Osteopathic medicine in the United States page.  Thanks again.  Pleasure working with you.   Bryan Hopping  T  21:25, 17 March 2008 (UTC)

For what it's worht, Hopping has pressed very hard for inclusion of the word allopathic across this encyclopedia. Even when I've made various suggestions for substitutions ("MD" being one example), he's been opposed. This term still carries a foul air, despite the fact that it is not exclusively pejorative. Ante lan  talk  08:37, 18 March 2008 (UTC)
 * These statements about my conduct & my position are simply not true, as well as being a violation of WP:NPA, "Comment on content, not on the contributor." My position has always been that this term belongs in a very limited number of articles, namely only those articles where major sources use the term in their analysis, i.e. articles where a distinction between allopathic and osteopathic physician education in the United States only is called for.  Bryan Hopping  T  11:09, 18 March 2008 (UTC)
 * It is surprising that some editors are complaining that Bryan Hopping is working "very hard for inclusion of the word 'allopathic' across this encyclopedia, especially when he is doing so with verification from notable and reliable sources. It would seem more appropriate to thank him (I do).  The additional benefit of knowing about the word, allopathic, is its historical context.  It is important to understand that allopathic physicians have asserted that their treatments are the most "scientific" and most "proven" since the mid-1800s.  Further, they have worked to limit their competitors.  Times have changes but some things haven't.  DanaUllmanTalk 13:45, 18 March 2008 (UTC)
 * Well if one of the world's top homeopathy promoters thinks allopathy should be used, then I become worried. There are historical words that were commonly used in 1850 that have either a different or even pejorative meaning in 2008.  And with regards to "competitors", Osteopaths are physicians.  Homeopaths are quacks, which is only competitive in that it keeps people from from getting appropriate medical treatment.  Please Dana, don't compare homeopathy to osteopathy, it's offensive.   Orange Marlin  Talk• Contributions 14:33, 18 March 2008 (UTC)

Hopping, I encourage you to demonstrate one place where my statement about your actions was false or misleading. Ante lan  talk  01:53, 19 March 2008 (UTC)
 * Antelan, thanks for the invitation. I'd rather focus my efforts on meaningful progress on articles.  Defending myself against your brand of personal attack is a waste of time. Bryan Hopping  T  04:51, 19 March 2008 (UTC)
 * OK, this is my talk page, and all of you are in an argument that only peripherally includes me. Please take it elsewhere.  Thanks.   Orange Marlin  Talk• Contributions 05:41, 19 March 2008 (UTC)