| Replaced_Texan |
08-16-2006 07:05 PM |
Quote:
Originally posted by Replaced_Texan
I'm noting that you said this the next time the fat debate comes up. We've got a major obesity problem in this country because people don't think that extra donut is going to have an impact one way or another. And yeah, they're probably right about the single donut.
But then, the causal link between obesity and morbidity is about as tenuous as second hand smoke and cancer, so no worries.
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Also, you're confusing medicine with public health. Public health is about treating populations and finding out what causes disease so it can be avoided. Epidemeology, the field of study that you've ranted the most against, is a public health discipline. It's the reason we drink clean water. It's the reason we pinpointed the HIV virus as a sexually transmitted disease. It's the way we track Avian flu.
Medicine is about treating individuals. It is completely anecdotal in nature, and it depends almost entirely on the individual patient. If you flip through a medical journal, say JAMA or the New England Journal, you'll find a lot of case studies and randomized trials. (This week, it's all HIV all the time, because of the AIDS conference.) If you show up at grand rounds in any teaching hosptial, usually the presentations are on various individual cases. Drug and other interventional trails are also based on randomized reports of individual cases. When the results of an intervention start to a) be beneficial and b) generate the same results in different patients with the same disease, the intervention is adopted as the standard treatment.
In some respects, public health is an attempt to avoid having to resort to medicine. The goal of public health is to keep the population healthy so that medicine is not needed. Once you get sick, the public health part is irrelevant (except, of course, you're now a data point for future public health research) and the medicine part kicks in. Your doctor isn't worried about what got you there; they're worried about how to fix you. He or she is going to tell you about what's going on with you personally and he or she is going to make treatment and diagnosis decisions based on your individual history (including family history, social history, lifestyle and your physical condition (height, weight, blood tests, x-rays, CT scans, and any other diagostic tools that he or she uses in his or her practice)).
So your rant is against public health, not medicine. I, for one, am a fan of John Snow, and I vaguely subscribe to the germ theory of disease. Your milage may differ.
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