Put the Patient First

"The good physician treats the disease; the great physician treats the patient who has the disease." — Sir William Osler

Sir William Osler is considered the father of bedside medicine. 

Today, Dr Osler's advice is more pertinent than ever. I constantly hear about the medical system treating reimbursement instead of treating the patient. Our system is not a great system when it puts reimbursement from the government, or reimbursement from the insurance company, first. Why don't we create a system that puts the patient first? We have the technology to do it today.

To fix the system, patients need power and control over their money, so the first question when you go get healthcare would be, "How can we help you?" Not, "Are you Medicare or Insurance?"

We also need to stop having Guidelines. What we call guidelines today are usually just medical opinions from a government group. For example, we should call them CDC Opinions or NIH Opinions to recognize that any individual physician around the world might actually be the greater expert. Calling them opinions instead of guidelines would also recognize the subjective nature of the field of medicine. Medicine is not yet a hard science.

Guidelines are not evidence-based medicine.

Evidenced-based medicine means taking into account the values and preferences of the patient. Thus, evidence-based medicine is personalized medicine, not guidelines.

COVID-19 Lessons

An excellent article by John PA Ioannides, MD, and Professor Stephen H. Powis, points out that mathematical models did not do well during COVID-19.

The authors even suggest that models should not be called studies, but perhaps, "semi-formal speculations" instead.

I heartily agree with this. Models are not studies they are opinions. And, in addition COVID-19 guidelines should not be called guidelines, but should be called COVID-19 opinions. There should be no censorship, and physicians, and physician groups, all over the world should be free to post their opinions, and the evidence used to arrive at those opinions.

Observational studies also did not do well during COVID-19:

"In fact, the large background heterogeneity makes concrete assessment of the effectiveness of any and all non-pharmacological measures based on observational data extremely difficult, if not impossible."

For those interested in medical etymology the phrase "forme fruste" is used, which means the frustrated or weakened manifestation of a disease.

I highly recommend reading this article about COVID-19 lessons and going to some of the references described within the article.

Healthcare Freedom means no censorship, and having transparency, in medicine.

REFERENCE:

COVID-19 models and expectations - Learning from the pandemic - PubMed

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9546779/

https://pubmed.ncbi.nlm.nih.gov/36241518/ 

Ioannidis JPA, Powis SH. COVID-19 models and expectations - Learning from the pandemic. Adv Biol Regul. 2022 Oct 8:100922. doi: 10.1016/j.jbior.2022.100922. Epub ahead of print. PMID: 36241518; PMCID: PMC9546779.

Age-stratified infection fatality rate of COVID-19 in the non-elderly informed from pre-vaccination national seroprevalence studies | medRxiv

This study by Dr John Ioannides, et al. is highly educational, because the infection fatality rate (IFR) is a key statistic for an emerging virus.

The study looked at the infection fatality rate (IFR) for covid-19 around the world.

The most fascinating paragraph was this one:

"The median IFR was 0.0003% at 0-19 years, 0.003% at 20-29 years, 0.011% at 30-39 years, 0.035% at 40-49 years, 0.129% at 50-59 years, and 0.501% at 60-69 years."

The authors do an excellent job describing how they collected their data. The authors also do an excellent job listing the potential flaws of their study.

In my opinion, John P.A. Ioannidis, MD, who has multiple degrees, is one of the best physician mathematicians in the world.

SOURCE:

Angelo Maria Pezzullo, Cathrine Axfors, Despina G. Contopoulos-Ioannidis, Alexandre Apostolatos, John P.A. Ioannidis

medRxiv 2022.10.11.22280963; doi: https://doi.org/10.1101/2022.10.11.22280963

This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

https://www.medrxiv.org/content/10.1101/2022.10.11.22280963v1 

Innate Immunity Stimulation during the COVID-19 Pandemic: Challenge by Parvulan

This medical article is extremely interesting: "Innate Immunity Stimulation during the COVID-19 Pandemic: Challenge by Parvulan"

A killed strain of bacteria was administered to patients to increase their immunity:

"Corynebacterium parvum administration to 4000 fragile immune-depressed and multimorbid patients treated with a killed C. parvum strain to enhance innate immunity, integrating the adaptative immune response for long-standing antinfectious resistance."

It was 4,000 patients, and it was a retrospective survey, but some of the outcomes were very interesting.

The authors suggest that this treatment improved the physical and mental health of the patients, which in turn probably made them better off during the covid-19 pandemic.

"Our results confirm that C. parvum is quite safe and effective in supporting immune-compromised patients when epidemic or pandemic events increase ... risk...."

This was particularly surprising:

"A quick (48-72 hours) symptoms improvement and/or complete regression of the herpetic eruptions was observed in 1000 affected patients with disappearance or relieve of herpetic neuralgia (reduced in 80% of cases); also full recovery or frequency reduction (30%) of recurrent cystitis and prostatitis in 120 affected patients."

The authors are part of the Second Opinion Medical Consultation Network.

As noted in the article, Corynebacterium parvum has been  renamed Cutibacterium acnes.

LINK

The link to the full text article is here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076318/ 

REFERENCE

Palmieri B, Manenti A, Galotti F, Vadalà M. Innate Immunity Stimulation during the COVID-19 Pandemic: Challenge by Parvulan. J Immunol Res. 2022 Apr 29;2022:4593598. doi: 10.1155/2022/4593598. PMID: 35528612; PMCID: PMC9076318.