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A place to learn, mingle, and share

This room is dedicated to those who are facing the challenge of raising children without the support of a spouse. This is a place to share ideas and lend mutual support.

Saint Rita is known to be a patroness for abused wives and mourning women.
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Mar 3rd 2013 new
Lisa, I would say, after years of working alongside physicians and surgeons amd working on clinical studies, that yes, for the most part you do have to be skeptical of the medical information you are given. Often times it is not the physician and/or surgeon that is being deceptive but rather that they have been mislead by the pharmaceutical company (or medical device company, whatever the case may be). Truly GREAT physicians CAN be trusted! Houston is fortunately home to the Texas Medical Center and has some of the greatest physicians out there; not saying they are the "greatest" because they work for highly ranked hospitals but because they are truly passionate about what they do and will "get to the bottom" of an issue to find the truth. Some will even give you their personal cell phone number in case you need to reach them at any time--hardly anyone does that these days. Unfortunately, it is up to the patient to do their research on the physician. Google is a great tool. See what their ratings are, where they did their residency/fellowship, how long they have been in practice, etc. I tend to advocate for ONLY seeing academic physicians--that is those who are affiliated with a teaching hospital amd actively engaged in research. The reason for this is that they are literally at the forefrunt of their field; most private practitioners are not as up-to-date on their information and may only know about what is "best" for the patient because of what a pharmaceutical rep has convinced them or because of some study they have read in a medical journal. Academic physicians are the ones doing the studies! Now, not all studies are 100% accurate and with any study it must be conducted multiple times to be considered valid. Also, be careful which medical journal published the study; if it is mot reputable then it is more likely that the study is not as well. With vaccines there is often a lot of talk about side effects. Take for instance, the MMR vaccine given to small children. A study was published several years ago in the very prestigious British medical journal called Lancet. The study stated that MMR vaccines did indeed show that they have a high link to causing autism. Later it was determined that the author was not reputable at all nor was his study. Thus, it was a huge PR fiasco for Lancet but today many still think the MMR vaccine causes autism when in fact scientific evidence does not show this. So, in essence, just be careful whom you listen to and which doctors you see. It is up to the individual to do their own research.
Mar 3rd 2013 new

So all of us Einsteins are better suited to understand things which physicians are too stupid to grasp?


OK.

Mar 4th 2013 new

(Quote) Tiffiany-902101 said: Lisa, I would say, after years of working alongside physicians and surgeons amd working on clinical s...
(Quote) Tiffiany-902101 said: Lisa, I would say, after years of working alongside physicians and surgeons amd working on clinical studies, that yes, for the most part you do have to be skeptical of the medical information you are given. Often times it is not the physician and/or surgeon that is being deceptive but rather that they have been mislead by the pharmaceutical company (or medical device company, whatever the case may be). Truly GREAT physicians CAN be trusted! Houston is fortunately home to the Texas Medical Center and has some of the greatest physicians out there; not saying they are the "greatest" because they work for highly ranked hospitals but because they are truly passionate about what they do and will "get to the bottom" of an issue to find the truth. Some will even give you their personal cell phone number in case you need to reach them at any time--hardly anyone does that these days. Unfortunately, it is up to the patient to do their research on the physician. Google is a great tool. See what their ratings are, where they did their residency/fellowship, how long they have been in practice, etc. I tend to advocate for ONLY seeing academic physicians--that is those who are affiliated with a teaching hospital amd actively engaged in research. The reason for this is that they are literally at the forefrunt of their field; most private practitioners are not as up-to-date on their information and may only know about what is "best" for the patient because of what a pharmaceutical rep has convinced them or because of some study they have read in a medical journal. Academic physicians are the ones doing the studies! Now, not all studies are 100% accurate and with any study it must be conducted multiple times to be considered valid. Also, be careful which medical journal published the study; if it is mot reputable then it is more likely that the study is not as well. With vaccines there is often a lot of talk about side effects. Take for instance, the MMR vaccine given to small children. A study was published several years ago in the very prestigious British medical journal called Lancet. The study stated that MMR vaccines did indeed show that they have a high link to causing autism. Later it was determined that the author was not reputable at all nor was his study. Thus, it was a huge PR fiasco for Lancet but today many still think the MMR vaccine causes autism when in fact scientific evidence does not show this. So, in essence, just be careful whom you listen to and which doctors you see. It is up to the individual to do their own research.
--hide--

Tiffiany, I would have to take exception to what you say. I have been a nurse longer than you have been alive. I have worked in some of the most prestigous hospitals in Australia with 90% of my career in Teaching/Research Tertiary Hospitals. What you say of staff is true, they are, the researchers at the head of their fields, but the research, pre clinical trials are done in Universities, where the "academic" MO may or may not work. Not all doctors and nurses at teaching hospitals are research professors, in fact very few are. The economics of medicine and tertiary study makes it impossible for most Universties to have more than a few Professors and associate professors on staff.

Then come the availiability of teaching/research positons vacant at any one teaching hospital, they tend to be limited as the salaries are high and the lab costs enormous. What usually happens is the theoretical work is done in the University along with the development of the drug/vaccine/study and then the clinical trials are farmed out to the availible hospitals under very strict conditions and criteria for the trial participants. The trail has a lead researcher, a professor or associate, an associate at each clinical facility and is overseen by a Clinical Nurse Consult who travels from site to site to ensure the protocols are followed by medical and nursing staff.

To have a hypothesis clinically trialed the trial must be approved by the State/National and the individual participating hospitals Bioethics Committee.

Finally the results of all the hospitals are sent back to the research team who collate and publish the results and conclusions. For a research project to be accepted as valid, be it nursing or medical, it must be peer reviewed, and replicated as per the scientific method.

After clinical trials are done the treatment then has to go to the Central Government Health/Medicine regulators, who review the results and conclusions, plus those of the peer reviews before allowing the production or implementation of the therapy. It takes years 10-15 years on average to have a drug from hypothesis to pharmacy.

As to refering people to Academic doctor over the normal doctor, I would only say in my limited experience the majority of all doctors are dedicated and up-to-date as possible with their specialty and practice. As you know all clinical staff must undergo ongoing education and attend or do many hours per year to remain current. I would add finally that a large minority of Research academic clinicians have the bedside manner of a rotting potato. They are self centred, superior, self oppinionated and feel they should be occupying God Own Seat at the very least.

Pick your doctor on your feelings, how they talk and listen to you and how well they explain what you need to know, which is NOT everything, there are some things patients dont need to know as it will just confuse them, so filter your information to the audience in a way they can understand their options.

Mar 4th 2013 new

(Quote) Tiffiany-902101 said: Unfortunately, it is up to the patient to do their research on the physician. Google is a great tool...
(Quote) Tiffiany-902101 said: Unfortunately, it is up to the patient to do their research on the physician. Google is a great tool. See what their ratings are, where they did their residency/fellowship, how long they have been in practice, etc. I tend to advocate for ONLY seeing academic physicians--that is those who are affiliated with a teaching hospital amd actively engaged in research. The reason for this is that they are literally at the forefrunt of their field; most private practitioners are not as up-to-date on their information and may only know about what is "best" for the patient because of what a pharmaceutical rep has convinced them or because of some study they have read in a medical journal. Academic physicians are the ones doing the studies! Now, not all studies are 100% accurate and with any study it must be conducted multiple times to be considered valid. Also, be careful which medical journal published the study; if it is mot reputable then it is more likely that the study is not as well. With vaccines there is often a lot of talk about side effects. Take for instance, the MMR vaccine given to small children. A study was published several years ago in the very prestigious British medical journal called Lancet. The study stated that MMR vaccines did indeed show that they have a high link to causing autism. Later it was determined that the author was not reputable at all nor was his study. Thus, it was a huge PR fiasco for Lancet but today many still think the MMR vaccine causes autism when in fact scientific evidence does not show this. So, in essence, just be careful whom you listen to and which doctors you see. It is up to the individual to do their own research.
--hide--

Google is the worst source of information, second only to wikipedia. The rankings are based on an algorythmn that can and is manipulted by the payment of advertising and other "Fees". If you want to research peer reviewed information try http://www.mediscape.com or one of the many universities or hospitals that deal with the issue you are interested in.

It is not best practise to undermine the authority and trust of doctor/patient, as a nurse it is our job to direct patients in such a way as to always reinforce the patient/doctor trust.

The issue of the Lancets publication of the MMR vs Autism article on "research" on the subject was poorly written, not peer reviewed, and written by a team which did not disclose a conflict of interest, due to funding being provided by Autism UK and the oppossing manufacturer of another vaccine they wanted approved. The Lancet withdrew the article and published a full explanation in the following month. They also explianed that that they had changed they editorial policies to avoid having junior editors been given the power to accept for publication contraversal article, without first passing through a senior editior.

Similarly, too much research makes some people thik they know more than the clinicians and often present to hospital armed with dubious "facts" gleaned from morons who have expressed their bad experiences on the internet and passed them off as fact. I give as example a common myth published by many alternative "health" sites that foxglove tea is not a medicine but a health drink which wont hurt you. True it wont hurt you, just kill you. Cavet Emptor. Nihil nocent aliis.

Mar 4th 2013 new

(Quote) Patrick-624504 said: Tiffiany, I would have to take exception to what you say. I have been a nurse longer t...
(Quote) Patrick-624504 said:

Tiffiany, I would have to take exception to what you say. I have been a nurse longer than you have been alive. I have worked in some of the most prestigous hospitals in Australia with 90% of my career in Teaching/Research Tertiary Hospitals. What you say of staff is true, they are, the researchers at the head of their fields, but the research, pre clinical trials are done in Universities, where the "academic" MO may or may not work. Not all doctors and nurses at teaching hospitals are research professors, in fact very few are. The economics of medicine and tertiary study makes it impossible for most Universties to have more than a few Professors and associate professors on staff.

Then come the availiability of teaching/research positons vacant at any one teaching hospital, they tend to be limited as the salaries are high and the lab costs enormous. What usually happens is the theoretical work is done in the University along with the development of the drug/vaccine/study and then the clinical trials are farmed out to the availible hospitals under very strict conditions and criteria for the trial participants. The trail has a lead researcher, a professor or associate, an associate at each clinical facility and is overseen by a Clinical Nurse Consult who travels from site to site to ensure the protocols are followed by medical and nursing staff.

To have a hypothesis clinically trialed the trial must be approved by the State/National and the individual participating hospitals Bioethics Committee.

Finally the results of all the hospitals are sent back to the research team who collate and publish the results and conclusions. For a research project to be accepted as valid, be it nursing or medical, it must be peer reviewed, and replicated as per the scientific method.

After clinical trials are done the treatment then has to go to the Central Government Health/Medicine regulators, who review the results and conclusions, plus those of the peer reviews before allowing the production or implementation of the therapy. It takes years 10-15 years on average to have a drug from hypothesis to pharmacy.

As to refering people to Academic doctor over the normal doctor, I would only say in my limited experience the majority of all doctors are dedicated and up-to-date as possible with their specialty and practice. As you know all clinical staff must undergo ongoing education and attend or do many hours per year to remain current. I would add finally that a large minority of Research academic clinicians have the bedside manner of a rotting potato. They are self centred, superior, self oppinionated and feel they should be occupying God Own Seat at the very least.

Pick your doctor on your feelings, how they talk and listen to you and how well they explain what you need to know, which is NOT everything, there are some things patients dont need to know as it will just confuse them, so filter your information to the audience in a way they can understand their options.

--hide--

Well, the way teaching hospitals and clinial trials are conducted in America in far different from how you conduct them in your country. Furthermore, by Google I mean utilizing Google to find the physician, find out where they did residency/fellowship, what research they are actively pursuing and/or have pursued, and also get actual real reviews from patients who have seen that physician. The American health care system is not the same as your country. Besides, this is about being a nurse, it is about knowing how clinical trials are conducted. Again, they are not done the same way in New Zealand as they are done in the United States. I am fully aware of the NIH, governmental regulations, IRB's, etc. I may be young, but I am well experienced and knowledgeable in my field. Thanks for the input though. :)

Mar 4th 2013 new

(Quote) Tiffiany-902101 said: Well, the way teaching hospitals and clinial trials are conducted in America...
(Quote) Tiffiany-902101 said:

Well, the way teaching hospitals and clinial trials are conducted in America in far different from how you conduct them in your country. Furthermore, by Google I mean utilizing Google to find the physician, find out where they did residency/fellowship, what research they are actively pursuing and/or have pursued, and also get actual real reviews from patients who have seen that physician. The American health care system is not the same as your country. Besides, this is about being a nurse, it is about knowing how clinical trials are conducted. Again, they are not done the same way in New Zealand as they are done in the United States. I am fully aware of the NIH, governmental regulations, IRB's, etc. I may be young, but I am well experienced and knowledgeable in my field. Thanks for the input though. :)

--hide--

I appologise if you thought I was disparaging your nursing career, I am sure you have and are a very experienced nurse. But all studies for medicines and treatments have to pass the bioethics committee even in America. I have participated in several national and 4 international clinical trials in my time in Critical Care, and 1 in Psychiatry. I have even been a coparticipant in a trial for a new technique for ventilation and intubation nursing care in Australia where I did most of my clinical career. I have worked at one time or another in every specialty, mainy Critical Care, but excluding peadiatric Critical Care.

Again the Google thing only gives that information which is public domain, no patient will every get to know the depth and the level of a doctors qualifications. Also high degrees dont always mean good medicine. I work with a very highly qualified doctor, who was known by the staff as Neofrighten a play on his name because of his appalling morbidity rates, and he had first class degrees in Medicine and Surgery.

All I am saying is buyer beware, do no harm.

If you really want information the patient can always ask for the clinical synopsis of the drug/treatment direct from the company. But I think they would it easier to listen to the doctor and the nurse. Afterall the nurse is the patients final advocate and source of information biggrin rose

Posts 161 - 166 of 166