Posts by richard
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Ben,
As it happens my Dad (a retired GP) does medical hypnosis :-) He lives in Hamilton, and sees a handful of people each week, mainly for smoking. If you want to get in touch with him, ask Russell for my email address (or just my last name, which is unusual enough that it would quickly lead to contact details for both me and my father :-)
Dad has little tolerance for woo-woo, and is very straightforward about the process.
Richard
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@peter
@Richard
What you say is true, providing it proves safe for Russell on an ongoing basis. As I have said before, if what is being offered is a placebo (and the evidence says Osteo is), then the risk/benefit equation is very different since benefit is in essence 0 then any risk gets magnified even if it is rare.But my point was that even if we assume it is a placebo, we know that Russell personally responds very well to that placebo. This is very different from looking at the risk / benefit analysis across the population.
For argument's sake, if you send N people to an osteo, and one of them drops dead within 24 hours, N/10 of them get significant relief and the rest are unaffected either way, you would probably conclude it was a dodgy proposition. And it would become even more dodgy if you saw the same N/10 response in a control group that was given sugar pills -- since then the osteo is doing actual harm, relative to the group who just took the sugar pills.
But if those N/10 people consistently see a response (and it was not just a spontaneous improvement that randomly coincided with the osteo treatment) and the condition was nasty enough you might conclude that the small risk of sudden death was worth it. And these are the "Russells"
However, what you would be less likely to do in those circumstances is send new patients to the osteo, but would just give them the sugar pills :-)
But I think we are talking about two slightly different probabilities.
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@sacha
Though I'm not holding my breath for the medical industry to grow some humility about its limits.
In the last 150 years, scientific medicine (including public health improvements, which you initially blew off as "engineering") has added something like forty years to average human lifespan.
In the same time, let us generously assume that homeopathy, acupuncture, chiropractic, Bach flowers, reiki and heaven knows what else have added a day to that lifespan (has anyone -- even a chiropractor -- even bothered to TRY to calculate this?? Let me guess why not?)
And you think it is the medical industry that should be humble about its limits?
I don't want to be a needless cheerleader here, big pharma and the medical industry has a number of deep structural problems, but the amount of human misery that has been alleviated by scientific medicine is breath-taking.
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@BenWilson
There is, for example, the hugely untapped (for me) mental side of eczema, since it is mostly exacerbated and spread by scratching. A means of controlling that alone would improve my situation a lot.
I am not wanting to offer advice, but have you tried hypnotherapy -- there is nothing intrinsically woo-woo about it (no crapola about meridians or energy fields or the rest of it -- I won't get kicked out of the scientists' club for suggesting it, although I suspect some practitioners do pile on the baloney a bit), and for some people it is efficacious.
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@peter
@Russell
The point of the Cochrane findings is not that Chiro and Osteo were as effective as standard medical treatments. It was that even standard medical treatments are not significantly better than either placebo or doing nothing.[...]
You have been wasting your money, suck it up.
Peter, I think this is harsh -- it would be silly to deny that Russell derives real benefit from visiting his osteo. However, the process by which one becomes a regular osteo (or whatever) patient is massively self-selecting -- the repeat business the osteo sees will be from the people who "got lucky" the first time, and even if it is solely a placebo, the effect is self-selecting and self-reinforcing. (Now that I think about it, problem gamblers often "start" as someone who gets very lucky the first time they gamble; I am not sure you can be a "problem osteo" patient, but Russell did get very lucky the first time he put ten quid on a horse called Osteo, and who can blame him for trying -- but no-one is going to round up a hundred Jimmies to repeat the experiment - - and Russell I hope you don't mind me making light of what must have been a very trying time in your life over this.)
The real question is whether you would routinely advise a person suffering from condition X to visit an osteo, and there the evidence is that they will get no more benefit than they would from any other "cure". But given that osteopathic treatment has already "worked" for Russell in the past, my guess is that the odds are much better that it will continue to "work" for him in the future.
It reminds me of a story my Dad likes to tell, about a chap in France who used to make his living traveling round village fairs and offering to predict the sex of a pregnant woman's baby (by what method I do not know, but clearly without the use of modern techniques like amnio or sonography). If he got it wrong he promised to refund the cost of the "consultation" on his next swing through the village -- he made a tidy living, even though he kept his promises about the refunds.
Your osteo likely makes his money in much the same way -- even if all he offers is a placebo, he will still see repeat business from the people who actually experienced the placebo effect. And since the osteo sees a stream of satisfied customers leaving his office (as well as some first-timers who never return), he may well be equally convinced of the efficacy of his treatment.
But that said, if it works for you Russell I would continue to make use of it :-)
On the other hand, the chiropractic profession does seem crooked to me, even if individual chiropractors are honest and upstanding members of the community. As I noted above they are very careful to adopt the outward trimmings of scientific medicine (the white coat, the title "Dr", and lots of latinate mumbo-jumbo) but refuse to accept its conclusions.
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When clinical medicine becomes as good as it thinks it is, my response to the rejoinders above will be more nuanced that "meh".
Ok. I'll see whatever it is chiropractors and osteopaths can for a sore back, and raise you polio, smallpox, scarlet fever, and tetanus. Oh, and modern public health.
Meh.
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I love the faith Peter has that if something is 'scientific and clinical' then it must therefore be okay.
Being a highly trained clinical professional does not give you a monopoly on health knowledge. There is more than one way of understanding the world and what makes humans tick, and evidence is not a synonym for science.
The funny thing is though, chiropractors dress themselves up as clinical professionals. There is one at the end of my street, and he has an office that looks like a doctor's office (and even has the title "Dr" on his nameplate), and most likely dresses in a white coat. They have journals which are peer-reviewed by other chiropractors, and do their level best to look like clinicians.
I am not saying that chiropractors cannot sometimes help people (although this help may largely be a testimony to the power of the placebo effect). but they make far stronger claims about their services than appear to be justifiable by the facts, and their overall theoretical paradigm appears to have no basis in biological reality.
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Speaking of chiropractors -- to quote from Simon Singh
"You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments."[12]
see http://en.wikipedia.org/wiki/Simon_Singh#Chiropractic_lawsuit
This article is now the basis of a libel suit against Singh (that also exposes the bogusness of British libel law, and the burden it puts on the defendant, but that is another story).
Moreover, chiropractors may actually be dangerous in that it is possible that neck manipulations can cause strokes (albeit in small numbers), so if it is doing no actual good, it could in fact be actively dangerous. (Sort of like Hormone Replacement Therapy, which certainly seems plausible, but turned out to do more harm than good for many women).
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There is a huge amount of "confirmation bias" with alternative therapies (ie "I tried it and got better" has far more impact on our psyche that the dozens of things you tried with no observed improvemnt), which is why any study needs to count the people for whom the therapy did NOT work.
But the one thing that can be said in favor of osteopathy is that at least it involves someone actually having a physical impact on your body, unlike tosh like homeopathy where the "medicine" is often diluted to the point it will contain not a single molecule of the supposedly active ingredient.
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Ooh, ooh, I know this one! That's sarcasm, isn't it? I've been hearing about that...
Like many people, I am occasionally a little bit sarky. But you say it almost like it's a bad thing :-)