buckeyes Posted September 9, 2012 Share Posted September 9, 2012 tah731, I have been considering how your beliefs will translate into your clinical skills and decision-making. Will you not vaccinate your patients with Tdap, MMR, etc.? Will you not order a mammogram on a patient with a strong history of breast cancer and family history of known BRCA mutation, presenting to your office with a breast mass and concern for breast cancer? Will you not administer the flu vaccination to a 22 year old with cerebral palsy presenting to your clinic for seasonal vaccination? Do the "toxic" materials in a Tdap vaccination outweight the benefit of you ordering this vaccination for a patient that you recently repaired a laceration? What would you tell a patient with a mass consistent with lung cancer found on a CT angiogram ordered to R/O a pulmonary embolism? What would your plan be for this patient? How do you plan to use these beliefs you have shared on this forum in your practice? What are your goals in your practice? Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 9, 2012 Moderator Share Posted September 9, 2012 STOP FEEDING THE TROLL TAH joined in Aug 2012 banters and baits everyone doesn't even claim to be a PA replies more to his/her own posts then anyone elses stop feeding the trolls and they will go away Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted September 9, 2012 Moderator Share Posted September 9, 2012 I really really really don't want to dip my pinky toe in this puddle but i think what tah is missing is that while the vaccine may not be as effective as we hope, That's not the only thing he's missing Link to comment Share on other sites More sharing options...
bradtPA Posted September 9, 2012 Share Posted September 9, 2012 God, I hope a program director didn't waste a valuable PA student slot on this guy. He/she needs to go to witch doctor school instead.... Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted September 9, 2012 Moderator Share Posted September 9, 2012 numbers aside, my main concern in this entire encounter is your willingness to disclose to your patients the unconventional nature of your philosophy. by extension, i think you should be entirely upfront with your potential employers on your own accord... to the point of bringing up areas of diversion from the norms. im really not familiar with the lattitude providers are given by regulatory bodies as far as how far across the border they can roam and still be able to practice. It varies on a state-by-state basis. Some will not come down hard on a provider who practices what they believe to be evidenced-based medicine, even if it's not the standard of care; whereas others will apply suspensions of licenses due to gross negligence or extreme deviation from the standard of care. Most of the time it has to be brought to the attention of the regulatory board in each state by a complaint, whether by a patient, a practice entity or another provider. These aren't "criminal" violations either- it's all civil. Even though EMTALA is federal law, I don't know that if a provider fails to carry out what EMTALA is (performing a medical screening exam at a hospital that accepts federal funding to rule out a life-or-limb threatening illness or active labor, and provide necessary stabilization) would constitute a crime punishable in a criminal proceeding. Anyone can sue for anything, we all know that. The question is whether it would even have a remote chance to be successful, and a lawyer will not pick up a case if it doesn't have a snowball's chance in hell of succeeding. So in the end....this guy can very well run the risk of being sued for malpractice, but there are three parts of malpractice you have to prove to be a successful suit- it's not as easy as it sounds. Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted September 9, 2012 Moderator Share Posted September 9, 2012 Please tell me what I am missing? Did I miss something on a research article? It is not effective and the benefits are not there. Nope, you have to guess! I have it hidden in a little box, right over there in the corner. See it? Link to comment Share on other sites More sharing options...
thinkertdm Posted September 9, 2012 Share Posted September 9, 2012 [ATTACH=CONFIG]931[/ATTACH]More proof the vaccine is not doing any good. Holy ****! You broke the case! Now I believe you! All it took was an unreferenced powerpoint slide! You are a goddamn genius! And there's an arrow too, for people too dense to understand the slide! Dear god, what have we done? I'm just joking. I think you are full of ****. Tenacious, too, but then again, so is herpes. Link to comment Share on other sites More sharing options...
thinkertdm Posted September 9, 2012 Share Posted September 9, 2012 Nope, you have to guess! I have it hidden in a little box, right over there in the corner. See it? Is that an absolute corner, or a relative corner? Link to comment Share on other sites More sharing options...
thinkertdm Posted September 9, 2012 Share Posted September 9, 2012 Looks like you don't believe me because you can't read or just too lazy to read, there is a source @ the bottom of the power point plus I have numerous articles stating the flu vaccine has no benefit...read up on the forum and you will see. No, I don't believe you for a number of reasons: 1. The examples that we were discussing earlier (remember the febrile reactions to people given the vaccine AND not given the vaccine)? You seemed to think that the fact that only 2 groups did not have a reaction was significant, while ignoring the fact that the people who had NOT been given the vaccine also had a febrile reaction. Additionally, your "statistical analysis" of "Table 5" made absolutely no sense. Thus, you have a predilection for just picking random numbers and applying funny math to "prove" your hypothesis. 2. You may have numerous articles stating that the flu vaccine has no benefit- I'm sure you do. -However, these have not been presented to us (me, at least) in any sort of coherent argument. It's a simple matter of using your "absolute vs relative" statistical skills to write up a simple EBM paper, with analysis. 3. The fact that you are right, and EVERYONE else is wrong is a major red flag to me. True, there have been some scientists throughout history who went against dogma, but I'm afraid you are not one of them. There are a number of very smart people on this board who have presented extremely thought out rebuttals to your goofy arguments, and yet they are wrong to you. In fact, you seem to think that people haven't researched this simply because they disagree with you. This is a logical fallacy that supposes you are correct. 4. You should put your money where your mouth is, and publish your findings in a peer reviewed journal. You haven't, or at least, indicated that, if you did. 5. Frankly, I just don't believe you. Why did I waste all this time to respond to a quack? Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 9, 2012 Moderator Share Posted September 9, 2012 5. Frankly, I just don't believe you. Why did I waste all this time to respond to a quack? It's painful when you realize how much time you waste talking to a zealot on an Internet forum. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 9, 2012 Moderator Share Posted September 9, 2012 [ATTACH]932[/ATTACH] You crazy Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 9, 2012 Moderator Share Posted September 9, 2012 Looks like you don't believe me because you can't read or just too lazy to read, there is a source @ the bottom of the power point plus I have numerous articles stating the flu vaccine has no benefit...read up on the forum and you will see. [ATTACH]933[/ATTACH] Srsly ur jus 2 smurt fir us Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 9, 2012 Moderator Share Posted September 9, 2012 Holy ****! You broke the case! Now I believe you! All it took was an unreferenced powerpoint slide!You are a goddamn genius! And there's an arrow too, for people too dense to understand the slide! Dear god, what have we done? I'm just joking. I think you are full of ****. Tenacious, too, but then again, so is herpes. TADA Ding Ding Ding We have a winner PLEASE STOP FEEDING THE TROLLLLLLLSSSSSSSS TAH is obviously a zealot confused manic crazy non-pa that is just goadin you all into getting into a debat - likely they do not care about the topic - just engaging people and wasting their time....... FIVE pages of poop Link to comment Share on other sites More sharing options...
thinkertdm Posted September 9, 2012 Share Posted September 9, 2012 If somebody could close the thread, and ban the troll... Link to comment Share on other sites More sharing options...
Moderator ventana Posted September 10, 2012 Moderator Share Posted September 10, 2012 If somebody could close the thread, and ban the troll... second that Link to comment Share on other sites More sharing options...
Contrarian Posted September 10, 2012 Share Posted September 10, 2012 Please Close this thread...!!!!!! Link to comment Share on other sites More sharing options...
Craigk Posted September 10, 2012 Share Posted September 10, 2012 Is it just me or doesn't the article you posted and claim that is shows the vac's don't work but the authors of the article state in their conclusion that the evidence does support the findings that increased vac's rate in elderly decrease risk: conclusions In the elderly, vaccination against influenza is associated with reductions in the risk of hospitalization for heart disease, cerebrovascular disease, and pneumonia or influenza as well as the risk of death from all causes during influenza seasons. These findings highlight the benefits of vaccination and support efforts to increase the rates of vaccination among the elderly. You can cherry pick at the numbers but these folks : Kristin L. Nichol, M.D., M.P.H., M.B.A., James Nordin, M.D., M.P.H., John Mullooly, Ph.D., Richard Lask, M.D., Kelly Fillbrandt, B.S., and Marika Iwane, Ph.D. seem to think their evidence supports efforts to improved vaccination among elderly pts to decrease risk. Talk about whatever table or number or 1/2 percent of a donkey arse but this is their conclusion, the wrote it, they did the numbers and they decided this was the results. You can throw out big words all you want but the article supports vaccination. Period, end of the discussion. Link to comment Share on other sites More sharing options...
Joelseff Posted September 10, 2012 Share Posted September 10, 2012 You guys know that my Niners just won IN Lambeau for the first time in 22 years! I'm hella happy! Yayyyyy! Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 10, 2012 Moderator Share Posted September 10, 2012 How about you please respond to my articles and show me the evidence instead of avoiding the question. [ATTACH]935[/ATTACH] Yea, u mad Link to comment Share on other sites More sharing options...
marvi1kd Posted September 10, 2012 Share Posted September 10, 2012 Link to comment Share on other sites More sharing options...
Planteater Posted September 10, 2012 Share Posted September 10, 2012 Ack I said I was done, but I just have to play. TAH- you are forgetting confounding factors in all this. Also, a .1 % reduction is significant to that 1 person (in 1000) who didn't die or have to be hospitalized (or the 3 in 1000). Oh and multiply that across a large population of, let's see, 312000000 (keeping it real in the USA) and you have 320,000 (by the conservative number) less hospitalizations. That's a lot of cash. Now, moving on. An absolute risk argument doesn't hold. There are too many CONFOUNDING FACTORS. Do you need examples? What people eat, if they are taking their vitamin D, if they work in a daycare, if they are obsessively clean at home and have weak immune systems, etc. So, calculating an absolute risk GIVES NO CONTEXT. That's what relative risk is. It is a way to say to people: Gee, if you get the flu vaccine, you are 66% less likely to get the flu. So, maybe I am extremely healthy and fit and have basically no chance of contracting influenza and having serious complications from it. So my 66% reduction in risk means a whole lot less than it does to someone who is compromised in some way. DATA mean nothing without proper context and interpretation. I know my numbers are not exactly correct, but I am not spending hours wading through your studies to make it real. I'm just showing you some errors in your logic. Oh, and while we are at it- can you point me to the STUDIES that confirm the absolute risk of getting the flu vaccine- with regards to the toxins and health risks? See, I need ALL the information before I can can truly weigh my risk vs. benefit. Link to comment Share on other sites More sharing options...
Craigk Posted September 10, 2012 Share Posted September 10, 2012 since you think those are such modest results and they are insignificant lets look at it from a dollars standpoint. PNA average length of stay 4.47 days, cost avg $16,959 per pt at 86 pts is $ 1,457,614 saved CAD avg LOS 4.6, avg cost $18,000 at 141 pts is $2,538,000 saved CVA avg LOS 6.7, avg cost $18,000 at 29pt is $435,000 saved CHF avg LOS 6.2, avg cost $22,076 at 72 pt is $1,589,472 saved Total saved from your less than 1% decrease is just over $6,000,000.00 That 0.3 percent your screaming about adds up pretty fast huh? Link to comment Share on other sites More sharing options...
Joelseff Posted September 10, 2012 Share Posted September 10, 2012 But for realz though how bout them ninerz! Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Planteater Posted September 10, 2012 Share Posted September 10, 2012 http://www.breastcancer.org/risk/understand/abs_v_rel.jsp“Absolute risk is the size of your own risk. Absolute risk reduction is the number of percentage points your own risk goes down if you do something protective, such as stop drinking alcohol. The size of your absolute risk reduction depends on what your risk is to begin with.” http://www.breastcancer.org/risk/understand/examples.jsp The 2% drop in absolute risk is a 20% relative risk decrease because you divide 2% by 10% (.02 ÷ .10 = .20, or 20%). In other words, relative to the 10% absolute risk, the 8% absolute risk is 20% lower. You can say that only using powder detergent results in a 20% reduction in relative risk. Even though the relative risk decreases 20% if you use only powder detergent, the absolute riskdecreased by only 2% (8% vs. 10%). So that's all you're going to address- one quote that still does not acknowledge that people are individuals and that is why a PROVIDER is needed? Oh, and your quote does nothing to refute my point BTW. You're just not reading it correctly. Where's my proof for the harm of the flu vaccine? Oh and your reply to craigk? If we use the .1% and say that's 320,000 in the US and multiply that by $17,000 (a conservative estimate by his numbers) we get 5,440,000,000. Oh that's 5.4 billion. A lot closer to your 6 billion figure AND it saved all those people that time and trouble- not to mention what it means if they were uninsured in the first place. That was the conservative estimate. IF we take a closer to actual estimate ($19,500 per patient), we get closer to 6.24 billion saved.....hmmm...what's the math on .3%? Are you ready to address my other points? Link to comment Share on other sites More sharing options...
vaston Posted September 10, 2012 Share Posted September 10, 2012 Holy crap, the thread is still going. I like this one too: This, though, probably goes against the above suggestions. But it's pretty descriptive: Link to comment Share on other sites More sharing options...
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