STFM, Medlogs, etc

Like many, I've responded to the change of movabletype from a shareware product to a commercial one. As a colleage suggested to me … people gotta eat. I will not move to wordpress. Upgraded to MT 3.0 without too much trouble. It does seem more stable – though I lost my HTMLAREA WYSIWYG editing which I liked very much .. so will have to figure out how to reainstall that to MT3. The tempaltes have changed a bit so it may take some work to figure this out.

This morning's keynote speaker at the STFM conference was Andrew Weil. He gave a compelling talk on integrated medicine and I find myself agreeing with much of what he has to say. He appropriately described the obvious links between family medicine and integrative medicine – as we do see patients as the sum of a whole – rather than as a disease or diagnosis. The key is that we need to work the training of integrative medicine into our medical schools and residencies.

He told a compelling tale of Dr Laurence Craven (descibed in this pdf .. and some other places:

In the 1950s, a California physician named Lawrence Craven made a keen observation. For several years, Craven had been prescribing Aspergum, a chewable form of aspirin, as a pain reliever for patients who had undergone tonsillectomies. Craven noticed that these patients experienced an unusually high occurrence of bleeding problems. In a bold leap, Craven theorized that this apparent “side-effect” of Aspergum might have beneficial applications. Within the arteries supplying the heart, Craven reasoned, an increased bleeding tendency might prevent the formation of the clots believed to cause heart attacks. Though his hunch would prove prophetic, Craven’s data were far from conclusive, and he became little more than a footnote in the aspirin story. Craven’s reports on aspirin were uncontrolled clinical observations, which only reached relatively obscure regional medical periodicals. His data were not published in the prestigious journals of the established research community, where they might have sent other scientists scurrying onto the aspirin trail. Craven was a family doctor, not a trained researcher, and his studies did not employ the rigorous scientific methods necessary to test his intriguing hypothesis. For example, he eventually had thousands of patients chronically taking aspirin, but assembled no control group of patients not taking aspirin against which their cardiovascular disease rates could be compared. Craven also betrayed the sort of unbridled enthusiasm for his hypothesis that can sometimes serve to discredit even the most plausible theory. In one report, Craven said that he placed 8,000 patients on regular doses of aspirin and not one suffered a heart attack or stroke. This track record appeared too good to be true. There was a smattering of other reports from scientists who also theorized that aspirin might have beneficial effects on cardiovascular disease, but the exact biochemical basis for such an effect remained unclear.

Weil's point is that one fo our problems in medicine today is that physicians often consider the SOURCE of information before we consider the informationitself. Craven, a General Practitioner, was not considered to be authoritative – so it too the cardiologists another 30 years to "discover" the compelling benefits of aspirin in the prevention of cardiovascular disease.

My session on Medical Weblogs went well on Friday .. I'll post an update about that if I have a few minutes later today .. otherwise we'll get to that tonight .. 😉