September 9, 2007

The Hubris of "Medical Professionals"

This morning's email brought an angry letter from an anonymous nurse who told me that my views were worthless because she was a "medical professional" and I wasn't. No further information backed up this claim.

That made me think of the story I'd recently read in the Washington Post that documented just how ignorant "medical professionals"--in this case Doctors--can be.

Doctors Flunk Quiz about Supplements their Patients Use

There are two disturbing things in this study. One was that one third of 335 doctors did not know that the FDA doesn't regulate supplements and that no proof of supplements' efficacy is required before they are sold to the public. Almost two thirds did not know that they are supposed to report side effects from supplements to the FDA.

That's bad enough. But what is worse is this: After being given a brief course about supplements 9% of the doctors who had taken the course still flunked a quiz about supplements.

The torrent of email I get from patients who have been misdiagnosed with the wrong kind of diabetes, undiagnosed with blood sugars repeatedly over 200 mg/dl, told by their doctors that a "diabetes diet" is a low fat diet full of carbs, and left untreated with blood sugars high enough to give them the a1c of 7-8%-which represents average blood sugar of 172-207 mg/dl, convinces me that many doctors would flunk any test they were given about the current understanding of diabetes and its effective treatments.

Unfortunately, once a doctor goes into private practice, there is no requirement that he or she pass any test demonstrating that they have kept up with diabetes treatment. This is true, no matter how many patients with diabetes they treat. Doctors do have to take "continuing medical education" to retain their licenses but it is up to them what courses they take. If they aren't interested in diabetes, they can ignore it for the rest of their professional careers and many do.

I run into medical professionals from time to time who support what I do here. They aren't all self-satisfied egoists. But for those who are, let me stress this again, the appeal to authority won't impress any of us who use a blood sugar meter and our access to up-to-date medical research to determine the quality of advice dished out by medical professionals.

Copyright Janet Ruhl 2007. If you are NOT reading this on the content has been STOLEN.


BamaGal said...

Jenny, I'm a registered nurse myself. But when it comes to diabetes---even though I have it also---I still defer to you. You keep me informed of new developments in the field.
Medical professionals are required ongoing training to keep their license active. I'll be honest with you---most of the seminars I have attended are corporate sponsored. They are usually free to attend. But they have an agenda to push what ever product they make.
The state of Alabama only requires 24 CEUs every 2 years. That is not much time spent learning new things. Anything beyond that we do ourselves. Most don't ever go beyond the requirements.
Just because you have a bunch of letters following your name doesn't mean you know everything.

Scott said...

Jenny, you're right about once a doctor goes into private practice, there is no real requirement that he/she must pass any tests demonstrating that they have kept up with current treatments. Individual states have their own continuing education requirements, and although most are obliged to continue their education with continuing medical education (CME) credits, unfortunately, the specialty area can be unrelated to their core field of practice, and until very recently, the course content were often sponsored by drug companies and consisted of a short quiz that in many cases, allowed doctors to go back and refer to the original training materials and look up the answers. The AMA tightened their criteria recently, but it troubles me that many family practice physicians last CME training in endocrinology may have been when they attended Med school 30 years ago. Nursing, on the other hand, is a different matter, and again, varies considerably from one state to the next.

Patients can ask their doctors (and nurses) for a listing of CME training they have obtained so they have an idea of whether they're up-to-date on current treatment protocols, but patients need to know they can ask, and few do.

Jenny said...

Scott and Bamagal,

I learned a lot about continuing medical education because my mother was the Director of the Post-graduate school of a famous teaching Hospital. She and her dean pretty much built their program from scratch in the 1970s. That was before the drug companies hijacked continuing medical education.

Now doctors can get CEUs by completing idiotically simple quizzes on Medscape. I taken plenty of them myself and always pass.

And you have to wonder how many of them have taken their continuing education in cosmetic surgery. Every doctor I've seen this year seems to be offering laser hair removal, including the GP and the OB/GYN.

jello5500 said...

I have been a diabetic for more than 50 years. Long ago, I realized that I was responsible for my own treatment. I took the advice of my doctor, who recommended that I see a nurse educator specializing in diabetes, and I learned far more from her than I ever learned from my doctor.