Re: "Medical model"

[SMNagel29]

In a message dated 12/5/2004 3:51:44 PM Eastern Standard Time, [EMAIL PROTECTED] writes: >At 3:27 PM -0500 12/5/04, [EMAIL PROTECTED] wrote: >Paul -  I am wondering on what you base your confidence in the >practice of medicine? . . . that practice is empirically safe and >effective? . .  that sanctions are applied when these practices are >deviated from without adequate support? On the fact that there is a medical literature based on experimental research which distinguishes between practices which are safe and effective and those which are not. Physicians who do things that depart from accepted medical practice do so at the risk of their licenses.  "Clinical intuition" is not an adequate defense in a malpractice suit. This system is not perfect, admittedly, but it at least has forced blatant quacks out of medicine and into pseudo-medical practices such as chiropractic. At this point in time, one has more confidence that a medical practice is based on sound data than a psychological practice. -- "No one in this world, so far as I know, has ever lost money by underestimating the intelligence of the great masses of the plain people."  -H. L. Mencken * PAUL K. BRANDON                    [EMAIL PROTECTED]  * * Psychology Dept               Minnesota State University  * * 23 Armstrong Hall, Mankato, MN 56001     ph 507-389-6217  * *        http://www.mnsu.edu/dept/psych/welcome.html        * Hi Paul -   I agree that, in general, medicine surpasses psychological practice in terms of an empirical basis. My professional experiences working in hospital settings (e.g., morbidity and mortality meetings/stats and the follow-up to such data, the practice of unsupported treatments (many, but not all, in the domains of psychiatry, neurology and neurosurgery) without IRB due process, etc.) have provided me with a different, perhaps more modest, level of confidence. Even with the best of physicians that I have worked with and respect, I have seen the difficulties experienced in the process of applying data on group differences to the individual case. In my experience, clinical intuition is very much a part of the medical diagnosis and treatment process. What happens in our courtrooms, I believe, often depends on the spin and other interpersonal factors that have little to do with the data.   As an aside, I remember when acupuncture was viewed as complete quackery. More recently, however, NIH has funded research into the mechanism and effectiveness of this treatment technique: http://nccam.nih.gov/health/acupuncture/  Findings are equivocal, yet "promising", and on this basis acupuncture is now used widely in the US. The FDA approved the use of acupuncture needles in 1996.   I am beginning to work on a paper to be presented at Oxford next summer. . . and researching in preparation, the FDA process of approval for psychotropic medications. At this point, I am left to wonder about the level of empiricism in this process as well.   I am not trying to be argumentative, just deep in thought about the state of health interventions in general lately. . .  and thinking that we *all* have a very long way to go before we learn how to deal most effectively with immediate needs in light of our ignorance.   (Also, procrastinating)   Sandra     ******************************************************          Sandra M. Nagel, Ph.D.          Associate Professor, Psychology          Saginaw Valley State University          166 Brown Hall          7400 Bay Road          University Center, MI 48710 http://www.svsu.edu/~smnagel/research/          Office: (989) 964-4635          Fax: (989) 790-7656          E-Mail: [EMAIL PROTECTED] *************************************************** --- You are currently subscribed to tips as: archive@jab.org To unsubscribe send a blank email to [EMAIL PROTECTED]