Sunscreen Pill

[Dominoes]

very mature

Very mature to use emoticons to belittle someone who is actually trying to help you. The only advice I have given is for accurate information to speak to a dermatologist. I found one of my own little emoticons to use.

 

[organicmama]

Very mature to use emoticons to belittle someone who is actually trying to help you. The only advice I have given is for accurate information to speak to a dermatologist. I found one of my own little emoticons to use.

Skunky and I have a "long history" of disagreement on many things regarding health. Sarcasm is just part of it.

ITA about speaking to a dermatologist for SPECIFIC, accurate info on the skin.

However, the skin is connected to and affects/is affected by the rest of the human body, so my frustration also is in the specialization of medicine that tells you to see an endocrinologist for your adrenals (and other endocrine glands), a dermatologist for your skin, a cardiologist for your heart, an internist for various other organs, and so on. If you have an illness that emcompasses all systems (which is usually true, although not readily admitted in modern medicine), you're screwed by the inability of MDs to treat your body as a whole system.

 

[30A Skunkape]

Skunky and I have a "long history" of disagreement on many things regarding health. Sarcasm is just part of it.

ITA about speaking to a dermatologist for SPECIFIC, accurate info on the skin.

However, the skin is connected to and affects/is affected by the rest of the human body, so my frustration also is in the specialization of medicine that tells you to see an endocrinologist for your adrenals (and other endocrine glands), a dermatologist for your skin, a cardiologist for your heart, an internist for various other organs, and so on. If you have an illness that emcompasses all systems (which is usually true, although not readily admitted in modern medicine), you're screwed by the inability of MDs to treat your body as a whole system.

There you go again

The fact is that all the specialists you mention above (save dermatology) complete a 3 year residency in internal medicine before undergoing training in a specialized area (for adult sub-specialists it is usually 2 years on top of the 3 years of internal medicine;for pediatric specialists it is usually 3 years on top of 3 years of a peds residency). During that time they learn first hand how to address the health care of the integrated systems. I promise you, a cardiologist does not flush her knowledge of gastroenterology once she completes her cardiology fellowship. And the counterpoint I present is that when a patient truly has a problem, say, with the heart that needs attention, you are much better served by somebody who understands the physiology, pathology and interventions regarding the heart like the back of their hand than someone who dabbles in a little bit of everything.

I think this business of 'traditional' physicians, ie allopaths/osteopaths 'not providing care for the whole person' is hogwash and suggests a poor understanding of what a good internist or family practitioner does many times over, day after day! When I see somebody who complains of abdominal pain I don't just poke around their belly-I take a full history of how they are doing globally, then perform a physical exam from head to toe that does include an abdominal exam-then I try to figure out based on the patient's history and physical what the problem most likely is and press on toward making a diagnosis. If we didn't think 'holisitically', we would be out of business!

And a word about dermatology before I finish. In a sense Dominoes is correct about dermatology education in med school in that it does not receive as much time as other topics, although she is greatly underestimating the classroom hours devoted to derm. Case in point, I remember first year of med school learning the biochemical mechanisms behind a few derm maladies. Later that year we had histology where we learned every layer,cell and microanatomical structure of the skin;still later we had physiology where we learned how our skin 'works'. In second year we had pathology where we learned about a staggering number of skin diseases. We also had pharmacology where we learned about medications used for the skin. Finally, we had our 'medicine' class where we probably had about 5 lectures given by staff dermatologists on bread and butter dermatology we might reasonably expect to encounter in the real world. Any further exposure to derm in the 3rd or 4th year came via electives in the subject or (more likely) our patients asking "look at this that popped up on my skin, what is it?"and it was our challenge to figure this sort of thing out. Once in residency (and this varies by what track one pursues-surgery, internal medicine, peds, OB-GYN or what have you) all of the derm encountered is in the clinical setting, and believe me when I tell you, when people have something going on with their skin they are going to ask you what is going on, even if they are recovering from a heart attack! So to say that only dermatologists are qualified to opine on matters of the skin demonstrates a certain sense of naivety. With that said, dermatologists get a horrific rap for being 'zit poppers', and this is absurd. The fact is that dermatology is by and far the most difficult specialty to get into after med school-when you look upon a dermatologist I want you to realize that you are seeing somebody who probably managed to pull off damn near a 4.0 GPA while doing tons of extra independent derm research while in med school which is (I promise) the most grueling academic challenge in this country. And to suggest that a dermatologist addresses the skin and the skin only, again, suggests limited understanding of how a dermatologist (or most internists for that matter) can detect systemic pathology based on a skin exam. Dermatologists recognize the implications of acanthosis nigricans, jaundice, and Grey-Turner's sign (go on and look them up) and don't just go "gee, now thats weird looking skin" and walk away from the patient after giving them a prescription for prednisone.

On that note, goodnight, and sorry that this thread got hijacked.

 

[organicmama]

There I go again? I'm sorry, Dr. Skunky. It looks as if it's more of a there you go again.

First of all, I am amused at your use of language. You can totally and should talk in layman's terms on this board, as it's not a medical board. Yet, you don't. Obviously, there are some superiority issues going on here.

Plus, I didn't get on this thread except to check to see if Punzy had tried a sunscreen that I have seen used on very sensitive skin. You are the one that is seeking out an "issue" on this particular thread. "Hey, I just wanted to see if you would come to the aid of 'health food store nuts'. C'mon, there is blood in the water... " That sounds like picking a fight to me.

I wasn't bashing dermatologists in any sense. That is a very difficult & specialized field of practice. You are trying to make a negative out of what I was saying and make me into an doctor hater or something along those lines. Nope, I just have dealt with the inefficiencies of our current health care system regarding my husband's health and in the distant past, my own health issues. I found that a balance of using a number of forms of health care works better AND that was what I was expressing regarding integrative medicine.

There you go again

The fact is that all the specialists you mention above (save dermatology) complete a 3 year residency in internal medicine before undergoing training in a specialized area (for adult sub-specialists it is usually 2 years on top of the 3 years of internal medicine;for pediatric specialists it is usually 3 years on top of 3 years of a peds residency). During that time they learn first hand how to address the health care of the integrated systems. I promise you, a cardiologist does not flush her knowledge of gastroenterology once she completes her cardiology fellowship. And the counterpoint I present is that when a patient truly has a problem, say, with the heart that needs attention, you are much better served by somebody who understands the physiology, pathology and interventions regarding the heart like the back of their hand than someone who dabbles in a little bit of everything.

I think this business of 'traditional' physicians, ie allopaths/osteopaths 'not providing care for the whole person' is hogwash and suggests a poor understanding of what a good internist or family practitioner does many times over, day after day! When I see somebody who complains of abdominal pain I don't just poke around their belly-I take a full history of how they are doing globally, then perform a physical exam from head to toe that does include an abdominal exam-then I try to figure out based on the patient's history and physical what the problem most likely is and press on toward making a diagnosis. If we didn't think 'holisitically', we would be out of business!

And a word about dermatology before I finish. In a sense Dominoes is correct about dermatology education in med school in that it does not receive as much time as other topics, although she is greatly underestimating the classroom hours devoted to derm. Case in point, I remember first year of med school learning the biochemical mechanisms behind a few derm maladies. Later that year we had histology where we learned every layer,cell and microanatomical structure of the skin;still later we had physiology where we learned how our skin 'works'. In second year we had pathology where we learned about a staggering number of skin diseases. We also had pharmacology where we learned about medications used for the skin. Finally, we had our 'medicine' class where we probably had about 5 lectures given by staff dermatologists on bread and butter dermatology we might reasonably expect to encounter in the real world. Any further exposure to derm in the 3rd or 4th year came via electives in the subject or (more likely) our patients asking "look at this that popped up on my skin, what is it?"and it was our challenge to figure this sort of thing out. Once in residency (and this varies by what track one pursues-surgery, internal medicine, peds, OB-GYN or what have you) all of the derm encountered is in the clinical setting, and believe me when I tell you, when people have something going on with their skin they are going to ask you what is going on, even if they are recovering from a heart attack! So to say that only dermatologists are qualified to opine on matters of the skin demonstrates a certain sense of naivety. With that said, dermatologists get a horrific rap for being 'zit poppers', and this is absurd. The fact is that dermatology is by and far the most difficult specialty to get into after med school-when you look upon a dermatologist I want you to realize that you are seeing somebody who probably managed to pull off damn near a 4.0 GPA while doing tons of extra independent derm research while in med school which is (I promise) the most grueling academic challenge in this country. And to suggest that a dermatologist addresses the skin and the skin only, again, suggests limited understanding of how a dermatologist (or most internists for that matter) can detect systemic pathology based on a skin exam. Dermatologists recognize the implications of acanthosis nigricans, jaundice, and Grey-Turner's sign (go on and look them up) and don't just go "gee, now thats weird looking skin" and walk away from the patient after giving them a prescription for prednisone.

On that note, goodnight, and sorry that this thread got hijacked.

 

[Dominoes]

healthcare is in big trouble

Skunkape's take on healthcare training is spot on. I underestimated the amount of dermatology learning done in pathology, physiology, pharmacology, etc. Also a shame that the best and brightest are no longer going into the fields that we really need them. We have our governments crappy Medicare reimbursement system to thank for that. I also think that he is mostly right about specialists understanding the whole picture, but I have seen a few that do their best to "forget" about those important associations or create new "associations", so they can generate more procedures. e.g. the cardiologist that wants to get to the cath lab for a new onset a-fib. Or the GI doc that wants to do a colonoscopy on an asymptomatic IBD patient. We can forgive the surgeons, because they only learned how to cut. But I have been somewhat disappointed with some of the IM specialists. Other things to be wary of: When you go to a hospital ER, who employs the ER docs... the hospital. If there are a ton of empty beds, do you think there is some incentive to admit you to the hospital??? In many cases now, the hospitals have hospitalists who take care of the inpatients. They are also employed by the hospital. Now the hospital doesn't get extra pay for keeping you longer, but they do get paid more for the additional diagnoses that are made and procedures that are done. I am not a doctor hater either, there are very good ones out there and when you find the ones you trust hang on to them tight. And especially when you are in the hospital you'd better have a good advocate in your family or support group because the days of the doctors making all of the decisions are over. Its the CEO's who are writing their paychecks.

 

[organicmama]

Skunkape's take on healthcare training is spot on. I underestimated the amount of dermatology learning done in pathology, physiology, pharmacology, etc. Also a shame that the best and brightest are no longer going into the fields that we really need them. We have our governments crappy Medicare reimbursement system to thank for that. I also think that he is mostly right about specialists understanding the whole picture, but I have seen a few that do their best to "forget" about those important associations or create new "associations", so they can generate more procedures. e.g. the cardiologist that wants to get to the cath lab for a new onset a-fib. Or the GI doc that wants to do a colonoscopy on an asymptomatic IBD patient. We can forgive the surgeons, because they only learned how to cut. But I have been somewhat disappointed with some of the IM specialists. Other things to be wary of: When you go to a hospital ER, who employs the ER docs... the hospital. If there are a ton of empty beds, do you think there is some incentive to admit you to the hospital??? In many cases now, the hospitals have hospitalists who take care of the inpatients. They are also employed by the hospital. Now the hospital doesn't get extra pay for keeping you longer, but they do get paid more for the additional diagnoses that are made and procedures that are done. I am not a doctor hater either, there are very good ones out there and when you find the ones you trust hang on to them tight. And especially when you are in the hospital you'd better have a good advocate in your family or support group because the days of the doctors making all of the decisions are over. Its the CEO's who are writing their paychecks.

I totally agree with your whole post. Your statement about "the days of the doctors making all the decisions are over" is so key here. It's the policies and procedures & doctors hands being tied in many instances that frustrate me the most.

I've had a GP that was willing just to give me the meds for ulcerative colitis before running tests. Then when I requested the barium enema, I wished they had run a quick pregnancy test (even though I wasn't late) prior to the test because I was pg with #2. Then, they never contacted me to tell me that I didn't have UC. And I attribute his "failing" to do the obvious things with the fact that he seemed so awfully overworked and exhausted from the swinging door system that so many practices have fallen in to, in order to keep up with what they are required to do.

I simply feel the scope of a doctor's ability to heal has been hampered by the abovementioned policy/procedure issues, along with other obvious craziness, like malpractice fears because many in our society loves to blame others & try to make a buck off anything.

 

[organicmama]

BTW, Skunky, I am publicly apologizing without editing the "superiority issues" statement. I do wish you'd talk in layman's terms, but that was me being snarky.

 

[30A Skunkape]

BTW, Skunky, I am publicly apologizing without editing the "superiority issues" statement. I do wish you'd talk in layman's terms, but that was me being snarky.

Sorry if I am guilty of geek-o-speak. What did I say that confused you? I am actually sensitive to this issue and am open to criticism.

 

[organicmama]

Sorry if I am guilty of geek-o-speak. What did I say that confused you? I am actually sensitive to this issue and am open to criticism.

Nothing confused me. Sometimes I have to read anything technical twice, while dodging footballs thrown by 22 month old crazy boy. Mr. OM gets me for being overly technical in my talk sometimes, so I'll lay off you.

 

[greenroomsurfer]

Where is the chainjerkin smiley at?