I am an epidemiologist and public health doctor who returned to being a family doctor because I could not stomach treating society to the detriment of the individual (and seeing society, too, worse off for the dictates). After long experience, I advise my patients (contrary to the answer they wanted on my FP Board exam last summer) to NOT have another pertussis (WC) shot if there is fever or was after the first one. This is heresy for herd immune rates, but saves individuals great grief and risk
Second, regarding antibiotics. I believe I avoid develoment of resistant bacteria better by prompt, thorough treatment of "bronchitis", keeping patients out of contact with "hospital staph". 65% of doctors use antibiotics there, contrary to dictates of academia. We serve individuals before society, and, in my opinion, thus serve society better: a recent study (BMJ) suggests treating the record (boss or lawyer), shortening exam and missing early pneumonia is all too prevalent. This multiplies the implications of my having to give antibiotic about weekly to a patient given "guideline" care (no antibiotic, only bronchodilater) because a managed doctor missed the rales of early pneumonia.
Third, Consumer Reports is academia-oriented and I have not found either reliable for individual applications. Doesn't variable effect apply to ionizing radiation? That brings art into the science and makes "going by the book" often unwise, as the military found. As if your work were not challenging enough, HPs!
(And, Bill, I believe it IS about dose. Pray that an HP -or anesthesiologist
- in whom we place our trust, does worry about dose, so that we CAN trust).
Howard Long
RuthWeiner@AOL.COM wrote:
A similar problem to the one Mike discusses has occurred with parents refusing to have their children immunized against whooping cough. Consumers' reports has even discussed the problem. Another example was the scare a few years ago that the amalgam in dental fillings was causing mercury poisoning.One of the real, actual, existing public health problems is the increase in "exotic" infections that are antibiotic-resistant. The anti-food irradiation and anti-sterilization-by-irradiation crowd has had some impact there
Ruth Weiner, Ph. D.
ruthweiner@aol.com