I agree that preventive medicine is not integrative medicine. However, integrative medicine has deceptively tried to claim preventive medicine as somehow being uniquely its own, which is not the case at all. 1/ https://twitter.com/agargmd/status/1057359994461544448 …
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It's also a MASSIVE straw man to claim that I think that pharmacological treatment should come before lifestyle interventions—or that medicine does. Look at the American Diabetes Association's guidelines for initial treatment of new onset type II DM, for instance. 2/
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Is the initial recommendation by the ADA to treat type II diabetes metformin or insulin? No, it's diet and exercise. There are many other examples in other specialties, including newly diagnosed hypertension and a number of other conditions. 3/
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Of course, there are conditions where the first intervention shouldn't be lifestyle, but pharmacological: Type I diabetes, severe bacterial infections, etc. The trick is knowing the appropriate science-based management for each condition. 4/
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That's where the whole "sick care" versus "health care" catchphrase/trope is a false dichotomy. Medicine isn't one or the other. It's both. Trying to force it into a nicer sounding label like "healthcare versus sick care" is marketing, not medicine. 5/5
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Replying to @gorskon
While I don't disagree with the above statement, and as a board certified FP I do both sick and healthcare, I think it's important to highlight that prevention and lifestyle should come first, and reimbursement should be looked at how we reward keeping people sick not healthy.
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What a weird thing to say. All this nonsense about rewarding MDs for keeping people sick is predicated on the idea that they're somehow desperate to drum up business. That's nonsense. Reality is the exact opposite. The challenge is finding MDs who are even accepting new patients.
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Replying to @JesparDalVar @gorskon
No kidding about this - I had interviewed for a job where I was told to my face that if I continued to practice prevention like my intent was, they could not hire me as the surgeons would get upset as I would reduce their business. The desire to drum up the business is real.
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I don't believe you. Not for one moment.
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I call BS as well.
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Replying to @gorskon
Thanks Dr. Gorski since I sincerely tried showing you resoect and you are dismissing me I will block as it seems like you are unhappy. Thank you again for the time.
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