Type Of Treatment (X One: Fill & Download for Free

I live in Ireland, where the 8th Amendment of the Constitution banned abortion.The trouble was, it also banned any form of treatment for pregnant or even potentially pregnant women.No chemo if you were pregnant.No pain meds if you had gallstones and might be or become pregnant.No anti-depressant meds unless they were sure you were not pregnant.Not even an x-ray after a car accident if you had not passed a pregnant test.So it’s not going to be just about performing an abortion, it’s about any form of medical treatment which MIGHT have some impact on a pregnancy. And considering there are doctors who think that eating yogurt can harm a pregnancy, it’s effectively going to mean that women will be denied a whole slew of normal medical treatments.

My daughter was treated with tri-modality therapy (surgery, chemotherapy and radiation therapy) a few years ago for an extremely rare form of cancer. I have recently received all three forms of treatment for stage IV bladder cancer, so I’ve had the opportunity to see things from both the patient’s and the family’s perspective.I am a radiation oncologist and prescribe the radiation therapy component of cancer treatment. The medical oncologist prescribes chemotherapy and generally coordinates the overall care of patients who require chemotherapy as part of their treatment. Not all patients require all three forms of treatment. One characteristic of a good cancer program is that all three specialists communicate on a regular basis. A favorite saying of mine is that none of us is as smart as all of us.There are roughly 300 types of cancer. They are usually divided into anatomic groups, such as brain, lung, head and neck, lymphomas, gastrointestinal, musculoskeletal, pediatric, genitourinary, and so on. We have one or more multi-disciplinary conference for each of these categories each week.Each cancer patient is unique and requires an individualized treatment plan. If you have observed that there is a wide variation in the type of treatment prescribed for individual patients, that’s because it’s supposed to be that way. Mr. Smith’s lung cancer is not treated the same way as Mr. Johnson’s lung cancer. So, for the highly ethical group of oncology professionals with whom I practice, every patient gets the best treatment possible, as did I, and as did my daughter. I consider myself fortunate indeed, to be associated with the group of doctors I get to work with.There is, however, a dark side of oncology, where treatment is not based on what’s best for the patient, but rather on optimizing procedures for the purpose of maximizing profit.Some background…A certificate of need (CON) is required in 35 states in order to build any type of medical facility. These are issued by the state and are based on demographics. For example, a CON would not be issued to build an orthopedic hospital one block away from an existing orthopedic hospital. In 15 states, however, no CON is required and any type of healthcare facility can be built anywhere someone wants to put it. Oklahoma is not a CON state, so there is a major duplication of services. For example, back when dedicated breast MRI machines were first put into use, at one point there were a total of ten in the US, and three of them were in Oklahoma City.During the time my partners and I were building the Procure Proton Therapy Center in Oklahoma City, a total of four freestanding conventional (x-ray) radiation therapy treatment centers were built by an entrepreneur and 4 large groups of physicians. These physicians now send almost all of their patients to the treatment center that they own, since, for a course of radiation therapy, they get a kickback of $10k - $40k per patient. They are able to do this because of a loophole in something called the Stark Law. The law’s intent is to prevent the very scenario I’m describing, but it’s not too hard to get around it with the loophole. It’s doubtful that the loophole will ever be closed since there is a powerful lobby funded by these for-profit cancer centers.The physician owners of these free-standing cancer centers send almost all of their patients there for imaging, chemotherapy and IMRT radiation therapy and get a huge kickback every time they do. (I say almost all, because they still refer some patients to me, namely their fellow physicians who have cancer and certain other “VIP” patients. Everyone else becomes fodder for their oncologic money machines.)In Oklahoma City, only about 20% of the patients who could benefit from proton therapy actually receive it. The majority of our patients come from outside of central Oklahoma. So far, they’ve come from almost all the fifty states and from eleven countries. The reason for this is that most of the local patients are funneled into these privately owned, for profit, free-standing cancer treatment centers.See the link below for a report on for-profit, physician owned, radiation therapy treatment centers.http://www.nytimes.com/2006/12/0...For a more detailed discussion of the problem with physician-owned cancer centers, see my answer toOncology: How much are oncologists paid?If you are interested in no nonsense answers to serious medical questions, please follow me. (>200 answers on cancer, medicine and human behavior.)

I have a good friend who is a chiropractor so this is NOT aimed at all chiropractors. Some try very hard to use evidence-based practice and increase the profile and credibility of the profession. More importantly some chiropractors try to bring the discipline up to date and perform research etc. I have no problem with that because evidence is very important. However there is a historical amount of woo associated with chiropractic that needs to be ditched, and there are some practitioners who appear to me to be acting well outside their scope of practice and expertise - anti vaccination for example. I will leave you to decide, here are some irrefutable evidence-based facts to work with:Chiropractic is based on something that a victorian grocer (Daniel Palmer) dreamed up whilst trying to contact the dead (no, I’m not making this up). He claimed that the ghost of a dead doctor revealed the secret to him. He was later arrested and charged with practicing medicine without a licence. Palmer was a fraudster - a criminal. To get around the law (and evade taxation) he tried to classify chiropractic as a new religion. That didn't work. Spiritualism and religion are diametrically opposed to science because science uses evidence whereas religion and spiritualism rely on belief and faith. Science tends to be quantitative in epistemology, religion and spiritualism tend to be qualitative, because belief and faith are not physically measurable. They are only in the mind.Chiropractic uses a term “vertebral subluxation” as one of the main causes of illness that they treat. Note that this is NOT the medical definition of the term which would (loosely) refer to this:You can clearly see that one of the neck vertebrae has slipped forwards. This would more accurately be called spondylolisthesis.The correct definition of subluxation is:subluxationnounsub·​lux·​a·​tion | \ ˌsə-ˌblək-ˈsā-shən \Definition of subluxation: partial dislocation (as of one of the bones in a joint)The WHO definition of a subluxation in chiropractic is:"A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact.”..and therefore is something that (somewhat conveniently) cannot necessarily be seen on a radiograph. Chiropractic’s own regulatory body realises that this is a bit dodgy (and potentially a cause for litigation) - they state:The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease.REFLet’s just summarise that last point. The regulatory body for chiropractic states that the main foundation of their own practice is not actually a cause of disease (according the best current evidence or indeed any evidence collected over the last 120 years).Personally, I do not agree that it can be called a theoretical model because it is not based on theory (under the primary definition of the word). The reason that the regulatory body insist that chiropractors abide by this definition is because……Research shows chiropractic to be largely ineffective (or completely ineffective) for any medical condition (Pozadski and Ernst, 2011). The only area where chiropractic may offer value is in low back pain (Rubinstein, et al., 2018) - but, again, that is something that you should consult a doctor or physiotherapist about. Chiropractic users often cite low back pain from a disc herniation stating that after “x months/years of treatment by a chiropractor they were pain-free”. A disc prolapse often causes no symptoms at all, and will usually heal without treatment within 2 to 3 months. Someone having chiropractic manipulations over those 2 - 3 months may falsely attribute the benefit to the treatment. Years of treatment? That’s not good.When faced with this statement regarding the ineffectual nature of their treatment, chiropractors usually present “research evidence”. However, this evidence is usually from chiropractic journals - not bona fide medical journals. If something is being presented as medicine it should be based on research published in medical journals. Apart from the obvious inherent bias of trying to self-validate their practice via non-medical publications, chiropractic journals are typically of very poor research quality. Again, this is not my opinion - you can test this for yourself by looking at the Scimago ranking of the journal in question. I found one with a ZERO ranking - literally worthless. Nature magazine (by comparison) has a ranking of 1096 ( at the time of writing), here is the current ranking of a typical Chiropractic Journal (an embarrassing ranking of 2 at the time of writing).UPDATEI have disabled comments and deleted ones that were using random websites as “research evidence” as is often the case on Quora.Despite my answer not touching upon the number of people who are injured and killed by chiropractic manipulation, a couple of responses claimed that doctors kill more people than chiropractors. I can’t see what that has to do with the question being asked but let’s wait until such time as chiropractors are performing heart transplants, clipping aneurysms and removing brain tumours before making those types of ridiculous comparison.One comment stated (backed up by a random website) that medical malpractice is responsible for 1/3 of deaths (in the USA) per year. That would be approaching 1,000,000 deaths per year - so from a common-sense perspective, untenable. It is, however, a fairly commonly held belief apparently - so I will just dispel that myth:Here are the actual statistics (below). Accidents are the third biggest cause of death in the USA. Particularly falls, traffic accidents and unintentional poisoning. If you are interested in the “3rd leading cause” myth (seized on by quacks everywhere)it is dispelled here.