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this post was submitted on 11 Jul 2023
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I feel like Canadians are weirdly receptive to homeopathic/naturopathic bullshit.
I think BC and QC have concetrated communities of anti-science individuals, which makes the ignorance seem more prevalent than it actually is. Then again, the number of people I know who recognize naturopathy is bullshit but then routinely see a chiropractor is WAY too high
Frankly as a doc myself, I'd sort of rather my patients see a naturopath if they have to choose one. I'm not a fan of either but at least I know the local naturopaths will provide a nice listening ear, while the chiropractors just seem to do everything they can to actively hurt people.
My regular doctor refused to engage with research-based approaches to long-term health that cure underlying disease. Referred me to a naturopath instead. I'm talking about a study supporting targeted anti- and probiotics as a possible cure for a chronic condition.
Most doctors seem to busy to even consider preventative medicine.
Depending on the thing you're discussing, it sounds like your doctor referred you to a person who they felt would be appropriate for the request you had, so in general I'd say that's kind of a harsh summary. We can't be trained in all the things at all the times.
In the case of antibiotics and probiotics for chronic conditions in particular, there is - and I cannot understate this - an unbelievable amount of woo and misinformation around that topic. That isn't to say your specific concern falls in there, but I can understand why some docs feel overwhelmed with it. We get flooded with an incredible amount of pseudoscience in that specific domain, and it takes a huge amount of work to sort through what's real and what isn't.
Yeah, that's fair. My difficulty is feeling like chronic conditions are mostly ignored. In this particular case, I had a study that recommended a very specific course of action for my specific conditions, which didn't seem particularly woo to my eyes.
But yeah, every doctor should instead be 3 doctors, plus a dietician, pharmacist, and other health care providers. All working for holistic health of the patients.
The fact that this isn't happening isn't the fault of the doctors, but a lack of societal care for health.
I'll have to be vague to avoid too much specific info, but I have worked in both contexts where I have a full team at my disposal and where I'm just a lone doctor, and I agree wholeheartedly we need the team. Best if it's under the same roof. It isn't necessary for every patient but for the people who need it it makes a huge difference.
If it helps, many provinces have been trying to push something like that for a long time, but there are an entire host of problems that go along with getting it rolling. BC's interprofessional team systems are sort of that, but they're weak.
I would imagine funding and public support is among the biggest problems. Any other massive ones you see?
Well, a huge one is finding ways to make them easily accessible to doctors without uprooting the entire current infrastructure. The average doc can't just host a physiotherapist, dietician, and social worker in their clinic, and to work best there needs to be open communication between the different branches.
That's a fixable problem, probably starting by opening clinics where all the professionals work under one roof and the doctors are subcontractors to the clinic rather than owners and managers. That's a structure that wouldn't appeal to everyone but it would appeal to many. Then those clinics could take specific patient populations preferentially to do their primary care, eg. elderly people, people with multiple chronic illnesses, etc - helping to take the load from docs in independent practice who would rather not be part of a larger team. There are already clinics like that out there, and they've been pretty successful.
Ultimately though the biggest barrier is just money and trained professionals. The interprofessional teams in BC should fill this role fairly well, but don't have enough employees to reliably meet the gaps
I'm pretty sure other provinces have their fair share of loons as well.
It's pretty popular in NB as well, which shouldn't be surprising considering half the province is functionally illiterate.
NS has a concerning number of them.
Never been to a chiro, and vaguely understand they're under-regulated quacks. But, I don't know, if someone can comfortably afford it and they perceive some benefit, is it a bad thing? Part of me wonders if things like chiro are popular because people get human touch in that setting and maybe it fills some psychological need? Evangelists of any sort are annoying, any anyone who tells me to go to a chiropractor I kind of, am suspicious of. But science evangelists too can miss the point. Carl Sagan communicated so many powerful ideas so eloquently, and spoke so scathingly of what he saw as pseudoscience. But if someone quietly reads a horoscope or goes for a tarot card reading & it helps them to see something in a different & constructive way, I kind of want to say, y'know, fill your boots.
I'm also a bit of a defeatist when it comes to magical thinking. I'm not sure that people who are prone to that kind of thing can actually be talked out of it by reason and good arguments.
Chiropractic is sneaky bullshit. At the root of it is a belief that all kinds of ailments can be cured by chiropractic "adjustments" - and we're not talking back aches and sore joints here. It's woo along the same lines as homeopathy and acupuncture.
But many/most chiropractors hide that bs, and seem to stick to back/joint issues. But in that case, are they really as qualified as a physiotherapist, osteopath, RMT or actual doctor? I mean, if their schools are teaching that you can cure, say, autism with a back adjustment, do you really want them treating you???
Sure, I get that. I hear a story occasionally where, I don't know, someone's ankle is fucked up or something, and they went to a chiropractor, and it got better. Would it have gotten better if that person took no action at all? Maybe, I think probably. I don't really contemplate chiropractics more than that.
There's a deeper story here about the availability of healthcare that's way more concerning to my mind. In any city in this country, you can probably find and walk into a chiropractor office this afternoon and be seen immediately (maybe I'm wrong?). While the waitlists for specialist medical doctors are absolutely insane, and bordering on immoral that people are forced to wait for months or years in pain.
I can walk into a fortune teller's office and be seen immediately. Skilled medical professionals are both in high demand, and limited supply. It's a problem, but we don't learn anything by comparing them to people who don't have those constraints. I do agree with you that there will one day be a reckoning that putting people on long wait lists without fixing the problems for decades amounted to something immoral.
For sure, & I didn't intend to appear as though I was equivocating real medical specialists with chiropractors. Just observing that their popularity might be less about a population filled with woo ideas, and more about a deficit of real doctors & a bogged down & underfunded healthcare system. I agree, those chickens will come home to roost.
Well, they could be going to someone for an actual treatment for their issues, which would do them better in the long run. Plus, many people can claim chiropractic therapy costs can as medical expenses for tax purposes, meaning all of us are paying for it. And for those who can't, many insurance plans cover chiropractics, meaning those with supplementary health insurance plans are paying more or getting less for their money because it's propping up sham therapies and poorly regulated physiotherapy LARPers.
Fair point.
Watch these videos (1, 2, 3)
by Myles Power on YouTube and then tell me how harmless you think chiropractors are. Spoiler: There are many actively harmful chiropractors and it’s unclear how to distinguish them from “tarot card reading” level harmless chiropractors.
Here is an alternative Piped link(s): https://piped.video/3dz2VjDtJFg
https://piped.video/hjxf4iFkhQw
https://piped.video/FyZSWS6FdTA
Piped is a privacy-respecting open-source alternative frontend to YouTube.
I'm open-source, check me out at GitHub.