[ASC-list] Statins and a smidgen of cultural theory, and rhetoric

Regan Forrest regan at reganforrest.com
Wed Nov 6 23:03:32 UTC 2013


I'm coming to this discussion late so apologies if this has already 
come up before, but Susan's comment about cultural context has 
encouraged me to weigh in.

I found it telling that most of the people interviewed in the program 
were American, and therefore, presumably working within the context of 
the US health system. This system is vastly different from our own, with 
a funding model that encourages a lot more prescription, testing and 
overall intervention (at least for those patients who are insured . . . 
)

There is an argument to be made that medical practice in the US is 
skewed by financial incentives, hence over-prescription of drugs such as 
statins may be an issue. In the US. It doesn't automatically follow that 
statins are over-prescribed here. I was surprised that this distinction 
was not made explicit in the program.

Regan

On 07-11-2013 09:01, Susan Kirk wrote:
> I think that the reason lots of people are dying from heart disease 
> [fact
> check it, the numbers change but will surprise you] is more 
> complicated, and
> at its heart is not biology but the management of the health system. 
> Heart
> attack symptoms are vague but the advice is clear.  Go to the 
> hospital.
> Why?  To safe your life, of course, but I believe the hospital is more
> efficient.  Not necessarily in its practice but in its diagnostics.  
> These
> doctors may still refer you to a specialist but it will be a lot 
> quicker.
> The facts are if you have severe blockage; you, may/will, die.  Statin 
> or no
> statin.  My brother just proved it.   He was lucky he didn't die but 
> it
> wasn't because he was taking statins.  He came to statins late in 
> life, like
> me, so was the damage done?  Of course it also raises the question of
> whether those with low risk should be on them, if they are as life 
> saving as
> we are led to belief.
> 
> I disagree with you Niall.  I think Dr Swan is using powerful rhetoric 
> in a
> biased manner.  People will die if they don't take statins?  Thats a 
> pretty
> powerful statement and one I can't honestly see is backed up with the
> research.
> 
> I'm so grateful for this debate.  It's good to question the 
> establishment.
> All of it.  Its making me think. Thoughts about the medical 
> establishment.
> A revered profession.  Not many are privileged enough to be able to 
> study
> medicine (it's practice anyway)  I believe the OP score precludes many 
> as
> does the cost of the education, then the cost of practising. So the 
> people
> with this elite education posses power.  Power is, still, knowledge.  
> To
> deny that would be to question our whole understanding of cultural 
> theory.
> Not that that would be bad, maybe another post?
> 
> So that leads me to comments about the constant attack on credibility 
> how
> could those (ill-informed) nutritionists or in the case of the 
> catalyst
> report, marketers of other products and nutritionists, know anything. 
> So do
> we only believe well-respected doctors of medicine? if that's the case 
> then
> which ones?  Why that one and not this one?  Is the reason some 
> refused to
> be interviewed because they don't want the aggravation of rocking the 
> boat?
> Other vested interests? Vested interests play a key role in a lot of 
> medical
> research lets not forget that. So it works both ways. Or what if, 
> worse,
> because they have no idea? they just write the scripts, because thats 
> the
> gold standard and thats what they were told to do?
> 
> Tip to heart foundation piggyback this media immediately!
> 
> Good solid reporting by Dr Cole :)
> 
> Now off for a stress testŠ
> 
> On 7/11/13 6:00 AM, "asc-list-request at lists.asc.asn.au"
> <asc-list-request at lists.asc.asn.au> wrote:
> 
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>> Today's Topics:
>> 
>>    1. Re: Statins proving to be a good debate for the understanding
>>       of medical research (Chris Forbes-EWan)
>>    2. ACT seed grants for National Science Week 2014 now open
>>       (A.Nguyen at csiro.au)
>> 
>> 
>> ----------------------------------------------------------------------
>> 
>> Message: 1
>> Date: Wed, 6 Nov 2013 13:55:45 +1100
>> From: "Chris Forbes-EWan" <forbes-ewan at tassie.net.au>
>> To: <asc-list at lists.asc.asn.au>
>> Subject: Re: [ASC-list] Statins proving to be a good debate for the
>> understanding of medical research
>> Message-ID: <002d01ceda9b$b08782e0$119688a0$@net.au>
>> Content-Type: text/plain; charset="us-ascii"
>> 
>> Some ASC members might also be interested in reading Bill Shrapnel's 
>> blog
>> entry about the Catalyst programs.
>> 
>> 
>> 
>> Bill is a prominent, if somewhat controversial nutritionist, whose 
>> ideas
>> often generate heated discussion on the Nutritionists Network.
>> 
>> 
>> 
>> Go to:
>> 
>> 
>> 
>> www.scepticalnutritionist.com.au
>> 
>> 
>> 
>> Chris Forbes-Ewan
>> 
>> 
>> 
>> 
>> 
>> From: ASC-list [mailto:asc-list-bounces at lists.asc.asn.au] On Behalf 
>> Of
>> Justin Coleman
>> Sent: Tuesday, 5 November 2013 11:53 PM
>> To: asc-list at lists.asc.asn.au
>> Subject: Re: [ASC-list] Statins proving to be a good debate for the
>> understanding of medical research
>> 
>> 
>> 
>> As Chris Forbes-Ewan suggested, for those interested in an analysis 
>> of the
>> ABC Catalyst programs on saturated fats and statin (anti-cholesterol)
>> medication, you couldn't go past reading
>> 
>> https://theconversation.com/viewing-catalysts-cholesterol-programs-through-t
>> he-sceptometer-19817
>> 
>> [If broken link, same hyperlink is here. ]
>> 
>> 
>> 
>> Disclaimer: I wrote it!
>> 
>> 
>> 
>> As a GP, I need to judge lots of evidence about health without 
>> necessarily
>> becoming an expert in the field. I find my best bet is to look at the
>> information presented through my 'sceptometer'.
>> 
>> 
>> 
>> In the article and in one of my comments below it, I explain how I 
>> applied
>> this 'healthy scepticism' process to the Catalyst statin debate.
>> 
>> 
>> 
>> By way of introduction, I have been an ASC member since 2010, but a
>> relatively passive one: I read posts all the time, but don't post.
>> 
>> 
>> 
>> In my defence, I have been busy being President of the ASC's cousin
>> organisation for four years; the Australasian Medical Writers 
>> Association.
>> 
>> 
>> 
>> The ASC aims and ideals about accurate and interesting writing are 
>> dear to
>> my heart-I just apply the same thing to the field of medicine 
>> instead.
>> 
>> 
>> 
>> I have a particular interest in the pitfalls of overtreatment, and 
>> blog
>> <http://blogs.crikey.com.au/croakey/2013/06/23/the-naked-doctor-an-indepth-l
>> ook-at-the-pitfalls-of-cutting-edge-medicine/>  about this on 
>> Croakey.
>> 
>> 
>> 
>> Cheers
>> 
>> Justin
>> 
>> 
>> 
>> Dr Justin Coleman MBBS FRACGP MPH
>> 
>> President, Australasian Medical Writers Association
>> 
>> GP, Inala Indigenous Health Service, Brisbane
>> 
>> Senior Lecturer, Griffith University
>> 
>> Blogger, the Naked Doctor
>> <http://blogs.crikey.com.au/croakey/2013/06/23/the-naked-doctor-an-indepth-l
>> ook-at-the-pitfalls-of-cutting-edge-medicine/>
>> 
>> Web http://drjustincoleman.com/
>> 
>> Tel +61 433 824931
>> 
>> Email drjustincoleman at tpg.com.au
>> 
>> 
>> 
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>> Message: 2
>> Date: Wed, 6 Nov 2013 04:27:09 +0000
>> From: <A.Nguyen at csiro.au>
>> To: <asc-list at lists.asc.asn.au>
>> Subject: [ASC-list] ACT seed grants for National Science Week 2014 
>> now
>> open
>> Message-ID:
>> <761F56793672104FA8D5489F77FA5B544F9BD408 at exmbx05-cdc.nexus.csiro.au>
>> Content-Type: text/plain; charset="us-ascii"
>> 
>> Dear ASCers
>> 
>> The ACT National Science Week Coordinating Committee is offering seed 
>> grants
>> of between $500 - $2000 (incl. GST) to support science engagement 
>> events,
>> programs and activities conducted between 1 July and 31 October 2014. 
>> There is
>> a total of $10,000 available in this round. We are after proposals 
>> that will
>> attract new audiences, and actively engage people in NatSciWk 
>> activities.
>> 
>> To apply, complete and submit the online application
>> form<https://docs.google.com/forms/d/1hqwiXwhMBrSSnTYqXIfAjEic5e11t4jJ0IN2M3Iv
>> s-I/viewform> before 5pm AEST, Friday 13 December 2013. Applicants 
>> will be
>> notified of their application's outcome via email before Christmas.
>> 
>> Please circulate this information to anyone who may be interested, or 
>> who you
>> think should apply.
>> 
>> For enquiries, please email me on 
>> a.nguyen at csiro.au<mailto:a.nguyen at csiro.au>
>> or call 02 6246 5432.
>> 
>> Regards
>> Anh
>> 
>> Anh Nguyen
>> Treasurer and Secretary
>> ACT National Science Week Coordinating Committee
>> 02 6246 5432 / 0477 327 132
>> North Science Rd, Acton ACT 2601 | GPO Box 1700, Canberra ACT 2601
>> 
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-- 
Regan Forrest

regan at reganforrest.com



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