As you can probably imagine, it's common that I'll be asked questions that call for a quasi-medical opinion. While I can't get too detailed in my responses, for obvious reasons, I do think it's crucial that injured people have a place to turn to get answers to these half-medical, half-legal questions. So once again, I've turned to our friend Marty Ginsburg and asked him to offer his expertise on one of the more prevalent legal/medical questions that I get asked. Once again, Mr. Ginsburg has delivered in resounding fashion.
Are some medical providers inherently "better" than others?
There is quite a bit of talk these days; actually, there has been for quite some time, over which type provider or school of thought is “better” or “best.” I’m old enough to remember when organic food stores could only be found on the roadside at a farm.
I grew up around people who believed that if it came from “the establishment” it just had to be bad. Frankly, I’ve agreed with a lot of that over the years. Of course, that means I’ve also had a lot of disagreements about that perspective, too.
I’ve long believed there is no “right” answer when it comes to what’s best for any person under any given set of circumstances. There are benefits and risks to every approach. All that being true, and while trying to not influence anyone with my personal preferences, I’ll try to offer up an idea on how to gather information to make a choice, or at least point out how that information may be gathered or presented by others.
Two of the biggest arguments I’ve heard, especially as a nurse, are over “Eastern” versus “Western” medicine, and “Conventional Medicine” versus “Alternative Medicine” (including Homeopathy, Chiropractic, Acupuncture, herbals and more).
I don’t want to get bogged down in the semantics of alternative medicine (which is actually the youngest) versus modern (conventional) medicine, but would rather talk about why certain things are considered “conventional.”
While homeopathic treatments and remedies have long histories of benefit, those histories are not well documented, and they come from personal experiences and memories rather than thoroughly documented and recorded studies. That has nothing to do with what works, only how well documented the result is. Modern studies may demonstrate widespread and magnificent benefits with little or no risk in some, many, or even all homeopathic therapies. It just hasn’t been documented yet, so it is inaccurate to say “proven” or that someone “knows” the therapy has some risk or benefit.
Knowing that most people reading this have been injured in some way, I’ll focus on the most common treatments in the United States for injuries and try to help readers make well informed decisions.
Medical doctors are trained to (i) see deviations from a patient’s “normal” as disease that requires treatment and (ii) use either chemicals (medicines) or surgeries to “cure” disease. Osteopathic physicians are medical doctors who traditionally were trained to incorporate both homeopathy and more modern medicine. The idea was to treat cause first, where many believe (rightly or wrongly) that medical doctors treat symptom first.
Oddly enough, skeletal manipulation was, at least for a time, taught in schools of osteopathy. Chiropractic grew as an independent discipline and was often considered a “lesser” form of treatment. I never recommend a particular practitioner or school of thought, but I do know from education and experience that certain conditions have been helped in different settings.
The soft tissue injuries often sustained in falls, slips, or other accidents are treated by both conventional medicine and chiropractic with some simple guidelines. I always liked RICE; Rest, Ice, Compression, Elevation. Rest, of course, reduces stress on an injured body part, while ice reduces swelling by changing blood flow to an injured area while also easing pain. Compression and elevation aren’t universal, but have to be thought of every time, just in case. For example, compression of a sprained wrist or ankle reduces swelling, supports the joint and promotes healing. Compression of a chest for injured ribs may interfere with breathing. These interventions are considered by MDs, DOs, DCs, nurses, and any first aid trained person around.
It’s really in the follow-up care where the differences lie. Both MDs and DOs as well as Chiropractors will recommend moving an injured part – within limits, of course. Some assist in the movement, like spinal manipulation. The results of both approaches are so well documented that it would be foolish to dismiss the benefits. There are, of course also risks. That is why I don’t choose for others, but try to help people understand that these questions need to be answered to the patient’s satisfaction.
Nurses talk quite a bit about “Dr. Google”. It’s a shame, really, that something as powerful as a Windows based internet isn’t better organized to help people find what they need. As a nurse I use a number of paid research sites, but there are several providing excellent information that is well researched and presented. Of these, many people are familiar with WebMD, fewer with MedScape, the National Institutes of Health, and many other sites that strive to present well researched and unbiased content.
Remember, above all else; if you are in need of care, you must be comfortable with the provider and method.
Thanks again to MarGin Consulting for being a fantastic source of medical expertise. If you have additional questions, check out MarGin's extensive online medical library or call the office!