Random AsidesSkepticism

OMG WTF

I just went to my doctor that I have been seeing at the medical clinic down the road. I went because I thought I might need antibiotics because I’m sick. doctor We started talking about skepticism and long story short, he is a trained chiropractor, goes to a chiropractor, believes acupuncture works and cited a study saying prayer helps patients get better. He used the word allopathic. WTF? I asked him if I could interview him for a podcast. He didn’t say yes or no. He told me to look up muscle energy.

I looked up muscle energy.

OMG, I’m a skeptic and I’ve been going to an osteopathic doctor. I am so confused. Seriously, he is a really kind man who seems to genuinely care about his patients but shouldn’t I have been informed that the doctor treating me believes in prayer as treatment, holistic medicine and energy forces? I went to the doctor expecting to see an MD. I didn’t realize that I need to screen the doctor to find out what type of doctor I have. Maybe I should bring a questionnaire with me from now on. “Yes, while I am filling out my family history, I have a quick quiz for you as well, Doc. Please answer as truthfully as possible. Thanks.”

The bummer is, I really like the guy.

I have a fever. I’m gonna go lie down.

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Amy Roth

Amy Davis Roth (aka Surly Amy) is a multimedia artist who resides in Los Angeles, California. She makes Surly-Ramics. She is the fearless leader of Mad Art Lab. Support her on Patreon. Follow her on twitter: @SurlyAmy or on Google+. Tip Jar is here.

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58 Comments

  1. That’s weird. So his credentials …. does it say MD or DO or OD (doctor of osteopathy)? I used to see an DO years ago before becoming a skeptic. I didn’t like him much, but he didn’t really do anything strange accept “adjustments” like chiropractors. He did prescribe regular meds. I was on an anti depressant at the time.
    I usually read the doc’s diploma while I’m waiting in the examination room. Maybe a good test would be to tell any new drs your chakras are out of balance and judge by the response ….!!!!

  2. Shouldn’t the title of this post be, “Oh, MD WTF?” Just saying.

    There are a bunch of sites around that give patients a chance to comment on their doctors. I suggest googling your doctor’s name before making an appointment to learn what you can about them.

    That being said, I got my PCP because her name literally was the first one on the list of doctors I got from the nice folks at the hospital ER, so…

  3. I had a long talk with him today.
    He is very sweet and knowledgeable man but he definitely believes in innate intelligence and prayer and energy manipulation as effective treatments. He made it clear that he was a DO today not an MD after I brought up the topic of skepticism. Silly me, I have been seeing him for a while and it never occurred to me to look at his credentials or to even ask. Fail on my part. I mean, I went to a medical clinic, I just figured I would get an MD.

  4. My last 2 doctors I have actually asked them about a half a dozen questions on my first meeting and before I got into the sheet.

    It made me feel better about both that they were for starters happy to answer the questions and my guesses from the very short biographies were pretty spot on with both of them and I have been happy about it.

    I also stopped seeing a dermatologist because she was so wooey and am seeing a great nurse praticioner who is very antiwoo and is actually willing to listen when I say X doesn’t work for me.

  5. My family doctor is much along the same lines.
    One particular visit, she asked me if I’d taken anything for my symptoms, like the alternative medicines my parents continue to take. “No,” I answered, “because I’ve come to realize that that stuff doesn’t work”
    Her: ‘you mean, it doesn’t work for you.’
    Me: *facepalm*

    Luckily the university i attend has a health clinic that is quite good within walking distance, which also doesn’t charge a co-pay.

  6. In most states DOs have to have to fulfill the same requirements to practice as MDs. So they are real doctors however because of the history of osteopathy they are more likely to go in for the woo. However plenty of MDs fall for it too (I’m looking at you Dr Oz).

    My doctor is a DO and I’ve never had anything but good non-woo care, including mailing me reminders about vaccines, following p to make sure I took all my antibiotics, etc. He also does a wonderful job with stitches which I’m glad of since the nearest emergency room is 30 miles from here.

    Guess what I’m trying to say is talk to your doctor whether an MD or a DO to see what his or her views on alternative medicine are not just the initials after the name.

  7. @Noadi: The initials after the name are supposed to mean something. The lines are becoming too blurred for health consumers to make clear decisions about health providers. Considering the shortage in some areas, this is really unfortunate as it may mean you’re stuck with someone who isn’t science-based.

  8. My wife nagged me for years to go in for a checkup, and finally just made an appointment for me. I didn’t realize until I showed up that the guy was a DO. He was mostly competent, but my woo detector went “ping!” when I noticed that he had a side business selling all sorts of dietary supplements.

  9. My understanding, and it could be off, is that most osteopathic schools differ very little from standard medical schools anymore, and that the “osteopathic method” has long since been pretty much abandoned, but the name is kept out of tradition and a slight difference in focus that is generally negligible. So, Kimbo, you’re right that the initials should mean more than they do in order to help people figure out what’s going on, but the good news is that the OD/DO is moving closer to the MD rather than the other way around.

  10. As a practicing DO, I must defend the profession, sort of. The profession was founded with the idea that function and structure are reciprocally related – so that disease is manifestly reflected in the musculoskeletal system, therefore can be treated by various manipulative techniques. This however is very thin on evidence, and is generally ignored by the majority of practicing professionals. Even those that employ manipulation will generally roll their eyes at some of the more outlandish claims.

    You, unfortunately, got a “true believer”; this does not reflect the mainstream practitioner, but is much too prevalent for my tastes.

    An OD is an optometrist, by the way.

  11. @Amy

    Same thing happened to me. I went to my normal doctor to have a cut looked at and while in the exam room noticed all this natural and homeopathic “medicine” on the counter. It seems he sells it right out of the office.

    I didn’t ask about but after being bandaged up and getting my tetanus shot, I don’t think I will return.

  12. @Noadi: Absolutely true. There are some MDs who are not so great at critical thinking. At the same time, some of the best doctors that I trained with were DOs not MDs. You’ve got to look at the person, not the degree.

  13. There is very little difference between a DO and an MD. Many prefer to think of the DO = MD + DC but that doesn’t necessarily mean they all subscribe to woo.

    I knew I chose the right doctor when he commented on my new patient form. Under “Religion” I had put ‘anti’ and he told me it was the best answer yet. To be honest, I don’t know if he has an MD or DO but I do know he believes homeopathy, acupuncture, and chiropractic (other than the unlicensed physical therapy part) is crap. He’s also up on the research, doesn’t overprescribe antibiotics, and tells his patients not to use OTC cold remedies because half of the ingredients are ineffective and half are counter-productive.

    Plus he prescribed for me 30g of dark chocolate to be taken twice a day. How sweet is that?

  14. “I’m a skeptic and I’ve been going to an osteopathic doctor”.

    Huh. And here I’d have thought the exercise of skepticism included some attempt to avoid sweeping with that broad of a brush.

    Osteopaths are not automatically evil. The osteopathic approach to medicine does tend to be more welcoming of woo than, say, an MD program; but it’s just as possible for an osteopath to be a good doctor as it is for an MD to believe in crazy shit.

    The key thing, in your particular case, is whether the doc in question will respect that you only want evidence-based treatment.

  15. My two cents? Switch doctors.

    For simple things like cuts and colds he’s likely fine, but you’re never going to be happy with him again; you’re going to have that little nag (or huge nag) of doubt every time you see him from now on.

    Whether you decide to tell him *why* you’re switching is up to you.

  16. I know someone getting her DO right now. As far as I can tell, the difference is that DOs do a class or two on Osteopathic Manipulative Medicine, which is basically the same manipulations that chiros do, which is not per se woo. In fact, a mutual acquaintance is in chiropractic school (full-on woo style), and she’s commented disdainfully about his choice before.

    Also, regarding muscle energy, my understanding is that it’s nothing more than you stretch a muscle, flex it isometrically, then stretch again and you should find you’re able to stretch it further the second time. Anecdotally I’ve noticed it, but I’ll admit I didn’t get the yardstick out to see if the difference was real instead of perceived.

  17. Wow. Run, don’t walk! Even if he is nice and has good bedside manner, think of how much time he’s wasting on woo that he could be using to read the latest Lancet or whatever and improving your care by that much.

    Actually my doctor can be.. well…a bit dickish on occasion, but he sure does know his shit and is very rigorous and thorough. One time, in a moment of shameful weakness, I asked him for antibiotics when I had a terrible cold that I thought wasn’t getting better fast enough. I thought the chance of there being a secondary infection was enough to justify it, but he was having have none of it and gave me a bit of a scolding on why it wasn’t in order. And that’s exactly what he should have done, the cold got better on its own of course. When it comes to my health, unless he or she is excessively nasty, I will choose competence and intelligence over niceness in a doctor every time.

  18. I live in the country and there is ONE doctor in this part of the state that takes out wisdom teeth. He has woo alternative magaines in his office and gives out these papers about taking lots of vitamin C while you are healing. He’s a vitamin C Pauling nut job.

    I take copies of Skeptic magazine and leave them in the lobby and figure it’s this or driving 3 hours to get my daughters teeth pulled. I’m not happy about it and given a choice…

  19. Now you’ve seen the face of the enemy. This is what we’re up against.

    By and large, they don’t set out to be quacks. They don’t want to deliberately defraud people. Many of them genuinely want to help people.

    Imagine a homeopath; someone who heard about homeopathy, studied it, went to school to become ‘certified’ invested a great deal of time and effort to forge a career in it, because they thought they were doing something right, something that would help people. They don’t want to hear that it doesn’t work; not because they’re dishonest charlatans, but because they’ve invested a lot of time and effort into the field.

    If someone came along tomorrow and told me that… I don’t know… semiconductors or binary mathematics were hoaxes, and fraudulent, something I’ve based my entire career on, and dedicated a whole lot of time and effort to studying and striving to understand, I’d be pretty resistant too.

    The question is not whether your doctor believes in ‘alternative’ medicine, but whether he can be swayed by the evidence to the contrary. Or if not, is he at the very least willing to leave the woo in the holster when treating you. I’m afraid I don’t know enough about the difference between DOs or ODs or whatever to know if the latter is an option, but…

    Come to think of it, maybe I should check out my doctor’s credentials. Family doctors are so scarce around here that when my former doctor retired, I was just happy he was replaced by someone with the title “Doctor”. But she referred my wife to a naturopath without a second thought, so I’ve been kindof weary ever since.

    Her intern seems like a nice guy, though. Just hope the woo doesn’t rub off on him.

  20. What really freaked me out was when he looked at me and told me, “You what I know really works? Prayer.” Then he told me about a study that showed that people who were prayed for got better more often than people who weren’t prayed for. Now, I’m pretty sure he was referring to a study that actually showed that the opposite of that was true. Sigh.

  21. Ask him for the study. You can check if he has half a brain by seeing which study it is and pointing out in detail why he’s wrong. If he listens good. If not, then there’s a problem.

    That said, a doctor can believe in really weird ideas and still do his job decently. As long as he diagnoses correctly and prescribes the right medicine then his own ideas about prayer or homeopathy or anything else can (generally) be just disregarded.

  22. I’m really glad that you posted this. I just got insurance and I have to choose a GP. These are the kind of things that worry me about making that choice. How much am I allowed to question the doctor? If I get answers I don’t like, should I just walk out, try to educate, spotaneously combust? But I think there have been alot of good pieces of advice and anecdotes in this thread. I know I’ll take them to heart.

  23. I think you should write him (and his boss if he has one) a well-reasoned, succinct letter on why you are not going back to him. I know I would take that seriously if I was in his shoes.
    A lot of woo is consumer-driven. It would be worthwhile to try to remind drs that they have skeptical patients, too.

  24. As an MD myself, and in charge of an internal medicine residency program, I’ll add my voice to the fact that most DO’s are sane and science based. That said, much like the other commenters have pointed out, the origins of the DO branch of medicine lend them to be more open to woo than the average MD.

    I recently gave two lectures at a DO conference on MRSA and Lyme disease, where some of the participants were DO’s and friends of mine. Listening to the first presentation before I went on, I was treated to an unexpectedly credulous discussion of immune boosting and why natural immunity was better than vaccine-generated immunity. I was horrified at the woo torrent before me, and the many nodding faces in the audience, and was concerned about how my Lyme lecture in particular was going to go.

    In the end, all went well, and my friends (who are decidedly science-based DO’s) were as shocked as I was by the discussion.

  25. I was worrying about my own doctor for a while (for no particular reason) and when I went in to see him recently, I overheard him talking to another patient about the swine flu vaccine. The patient mentioned a few of our modern confusions (safety of the vaccine, reactions, etc.) and my doc gave all the right answers, and even politely pointed out where the patient was wrong.

    Whew. It’s hard to know, especially since I’ve been going to him for at least 20 years now.

    You know, when there’s something that YOU know (or think you know) and your doctor doesn’t agree, what do you do? If my doc prescribed chiro, I don’t know what I’d do. How do I, a 28-year-old graphic designer, tell a doctor who’s been working for decades, that he’s wrong?

  26. Out of curiosity, did he ever give you a prescription with his name and title on it? It just occurred to me that you thought you were going to an MD for a reason, and I would assume that you’d notice the letters “DO” after his name in place of “MD”.

    The doctor I saw my whole life (an MD, for what it’s worth) practices acupuncture and limited skeletal manipulation. He never once offered it to me. He never once told me to take Vitamin C for a cold. He & his partner gave me every vaccine I was required to get as a child (and backup boosters when I worked in a daycare). The only place he ever referred me to for treatment was legitimate physical therapy. There is no woo-based paraphernalia in his office or waiting room. The only way you would know that he does the other things is word of mouth. However, if you asked him directly if he believed that there was a benefit to certain woo-based practices, he would say yes. With his track record of being an excellent doctor and not self-promoting his side interests, I don’t think that doing those 2 things discredits him entirely.

    “American Osteopathy” is defined differently from osteopathy in general. Yes, there is still a woo-factor but it isn’t as heavily weighed as in other countries. I live around the corner from the Philadelphia College of Osteopathic Medicine. Their internship rotation year consists of 6-7 months of General Internal Medicine, 1-2 months Critical Care Units, 1 month Family Practice, 1 month ER and optional months of Surgery, OB/GYN and Pediatrics. They are required to complete a 4 year undergraduate program including clinical rotations. The difference lies in the specialization after receiving medical training.

    I am not defending the use of holistic medicine, but freaking out over a doctor who has thus far treated you properly doesn’t seem any more rational than assuming a medical clinic would make sure that none of their practicing physicians believe in anything but hard science.

  27. @Chelsea: Yes, Chelsea I did say that it was a total fail on my part for not looking to see if there was an MD after his name. My mistake. I also said that he is a kind man who has been very sweet to me. I am not “freaking out” because I have been treated unfairly I am simply upset that alternative practices are so embedded into mainstream medicine that someone such as myself who prefers to be treated with science based medicine sometimes can’t tell the difference. I would prefer a doctor who is interested in modern medicine and current clinical studies instead of acupuncture and energy healing, but maybe that’s just me.

  28. @Amy:

    What does “MD” have to do with it? It’s been pointed out several times here that the difference between MD and DO is negligible. I think we should all be continuously skeptical of our caregivers, no matter what the letters say after their name. Ask questions beforehand if possible, but otherwise be on the lookout for shibboleths like acupuncture or homeopathy.

  29. I don’t really have a problem with a doctor that says a prayer for a patient (assuming the patient is into that). On the other hand, actually misinterpreting the prayer study, to the extent of believing that it’s actually proven to work, is another thing entirely.

    I’ve gone to a local doctor for the last couple of years who’s an M.D., and he’s always seemed really science-based. A few months ago, though, he opened a separate clinic 1/4 mile down the road, offering hyperbaric oxygen therapy, with a massive list of conditions that it can treat (starting with autism). The doctor even talks about Jenny McCarthy’s claims that hyperbaric oxygen therapy helped her son.

    Time to find a new doctor, I guess.

  30. It’s unfortunate that woo has woo-rked it’s way into the mainstream that the burden falls on the consumer to perform due dilligence.

    Reminds me of how homeopathy has worked its way into the pharmacy shelf – sometimes mixed right in with the tylenol and nyquil.

  31. Being an osteopath shouldn’t in and of itself be a disqualifier, but the treatments he believes to be effective in spite of overwhelming evidence to the contrary should be. PalMD does briefly address osteopaths in this post about Dr Crisler.

    I find it interesting that my wife and I interviewed several pediatricians before settling on the person who would see after our children’s health but we simply opted for the most convenient doctor for ourselves. Our pediatrician is friendly but no-nonsense and the only thing I’ve seen her get very upset about is talking about the anti-vaxers, a topic which sets her off on the horrors of watching a child die of an easily preventable disease.

    Fortunately our most convenient generalist also happens to be science-based practitioner and when I go in we often talk about research we both read on scienceblogs or some such.

  32. My uncle is an MD and he’s full on woo. At christmas he was saying that western medicine was a total failure. When my mom had breast cancer he told her it was because she had unresolved issues with her mother. He has a full on messiah complex with a “private practice” that’s entirely based around him as a healer.

    I think it’s just something that snaps in some people’s brains when they see as much death and pain as most people in the medical profession see, regardless of their credentials.

  33. I had a homophobic psychologist once; kind of a bad thing, since the whole reason I was going to see him was to deal with the fallout of coming out. Stopped those sessions *really* fast.

    I’ve been lucky with doctors – I’ve only had three PCPs in my life, and all of them have been outstanding. The second even went well above and beyond standards trying to help me find out all the side-effects of my weird biology – things like “allergies” (really just severe toxic reactions) to cocaine and alcohol, and resistances to certain kinds of poisons (apparently my liver is all sorts of funky, amongst other things).

  34. Woahhhhh . I’m a D.O. Slow down people. There are two liscenced physicians in the USA – MDs and DOs. In the USA the training is nearly identical for both. I was taught manual medicine in additition to all the standard lessons of medicine. That is the main difference. Some DOs buy into the philosophic teachings ( that are also taught initially to the freshmen ) more than others. I do not. I use manual medicine in much the same way a physiatrist or a physical therapist uses their tools. I did a double residency in Internal Medicine and Pediatrics at a hospital associated with Columbia University College of Physicians and Surgeons. Thus I am a hybrid. But my conservative use of manual medicine is not the exception. If you came to me you would see me as an Internist or a Pediatrician first and formost, not a DO. I would venture to guess that well over 90% of all DOs practice without a biased philosophy or unsound physiology. DOs are neurosurgeons, pathologists, pulmonologists etc etc etc. Strange people do get through the system in every walk of life. There are oddballs with MDs ( Wakefield!!!) and DOs. There is a prayer God up here who is an MD. Don’t judge by the initials. Talk to your physician. Who is HE or SHE? Communicate. Learn. Don’t use short hand. It’s YOUR life.

  35. I just want to thank the MD’s, DOs and any OD’s that may have posted here. I have learned a lot over the past 24 hours. One main thing I have absorbed from this experience is don’t judge a doctor by his white coat or it seems by the initials by his name. Talk to people. There are good doctors and there are bad doctors and woo is running wild in all professions. I am working on my “search for a new doctor” questionnaire now.
    Question 1. Doctor, Do you like long walks in the park?
    2. Do you ever see fairies on these walks?
    3. If you saw a fairy on your walk would you offer to vaccinate her?
    4…

  36. @Mark Hall: The original idea behind osteopathic medicine is to treat with a holistic approach to medicine. Osteopathic doctors are also trained to diagnose with their hands using Osteopathic manipulative treatment in much the same way that chiropractors do. Apparently the doctor I was seeing took that seriously and while many other modern DO’s do not take that approach currently I stumbled one that not only took holistic medicine to heart but also promotes many other similar alternative beliefs.

  37. I went through a sort of similar decision when I visited a doctor who happened to be a DO. There are a couple of points that I want to emphasize:

    1) DOs are not the same as chiropractors. They don’t (or shouldn’t) pop your bones around like chiropractors. I don’t know what the risks are for osteopathic adjustments, but at least these people have medical training. I wouldn’t let the doctor touch my neck, but the “adjustments” he did were more like stretches than the popping and cracking I have experienced from chiropractors in the past.

    2) DOs have medical training. If you’re going to one for routine stuff and s/he isn’t too much into the woo, then you should be fine. They should theoretically be able to diagnose and treat common diseases like strep throat and diabetes in the same way the MDs do. Of course you’ll get some weirdos, so just keep your skepticism up. If you have any problems with your DO’s treatment, then you should just find someone else, the way you would with any other doctor.

    As it turns out, I still prefer not to see that particular DO, so I just see someone else at the same office, but I’ll still see him if I need to get a quick appointment and he’s the only one available. The only time I saw him he ordered all the blood tests I would expect for my symptoms. He actually did better than a few MDs I’ve seen.

  38. I agree that the distinction between MD and OD may not be so important. DOs get very similar training to MDs, and whether they pursue woo is a personal choice. I had a very sweet MD who never met a fad she didn’t like, and was often trying to sell supplements and nutrition shakes, or breast-reshaping bras, or whatever the SCAM trend du jour was.

  39. Oh, I also had an MD who filled his waiting room with christian pamphlets and encouraged my girlfriend (of four years at the time) and me to try abstinence.

    When I told him I didn’t really know my biological dad, he offered me the assurance that “we all have a father above watching over us always.”

    I didn’t go back or pay my co-pay.

  40. This point has kind of been beaten to death, but I’ll throw in my 2¢ as well. I’m a second year DO student and I’ve published more scientific research than many of my professors. There is quite a large amount of woo in our class Osteopathic Philosophy and Practices (OPP, sometimes Osteopathic Manipulative Medicine [OMM] or Osteopathic Manipulative Therapy [OMT]) but the woo mostly ends there. Few students are true believers of the woo and most are identical to MD students. I would encourage you to not discriminate against a doctor based on their degree but rather judge them on their treatment paradigms. I think PalMD, Orac, Novella and many others at SBM would agree with that as well. When I first shadowed a Family Medicine DO for a letter of rec, he used a little bit of manipulation in his practice to treat back pain and also sent the patients to physical therapy. The MD he shared an office with used homeopathy then he used manipulation. Heck, you can even find Science based D.C.s as Samuel Homola of SBM has shown.

    I would encourage you to screen you doctors by asking them about Vaccines, Homeopathy, or sCAM before you worry too much about whether they are a DO or MD.

    As for me, I have only shadowed one DO who has used OMT in front of me and I see little use for it outside of a course on logical fallacies or examples of the failures of alternative medicine.

    -Harry

  41. A grapefruit is pretty much the same as an orange.
    They both grow the same way.
    They both come from the citrus genus.
    They’re both round, have seeds and are full of citric acid.

    So my should I pick a grapefruit and expect an orange? Suddenly I’ve got a spoon and maybe some sugar to add to the mix when all I wanted was an orange. They aren’t the same no matter how you spin it.

    Before I go any further, I _do_ know what osteopathy is, so… why would I go to a DO when that just increases my chances of some degree of woo? Even the DOs defending it agree that the roots of osteopathy are full of woo. Just read the comments here.

    If we shouldn’t make a distinction, then why is there a distinction?

    Because there _is_ a distinction: osteopathy, in whatever strength that particular DO believes in. I’m going to have to figure out on my own whether my doctor is otherwise wacky. But why waste additional time by adding “definitely believes in osteopathy to some degree or wouldn’t have bothered” to the mix if I have no faith in osteopaths? So you’re an osteopathic manual practitioner with training as a physician. Fine. Salut.

    But if you’re a DO and you want me to see you as being the same as an MD, you should have become an MD. What type of training you have otherwise no longer concerns me as someone seeking a physician.

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