Ticking away the moments that make up a dull day

You fritter and waste the hours in an offhand way.

Kicking around on a piece of ground in your home town

Waiting for someone or something to show you the way.

Pink Floyd: Naturopathy. Sort of.

Over at Respectful Insolence, a commenter Brad (#50) mentions, among other things, that naturopaths are

…spending much more time, often hours HOURS with patients…

as if this were a good thing and evidence of their superior clinical ability.

I think not.

I am on my 32nd year in medicine since graduating medical school. As part of my job I teach residents and medical students. Most of the real training in medicine comes after graduating medical school. I have yet to meet an intern, fresh from graduation, who is even remotely ready to take care of patients without extensive oversight. Of course no ND has a rigorous post graduate education; they go straight from inadequate education to inadequate practice. ND's are the result of a Nutri-Matic education, producing something 'almost, but not quite, entirely unlike a physician.'

Part of the practice that demonstrates NDs are almost, but not quite, entirely unlike a physician is spending hours HOURS seeing a patient.

Medicine can be very difficult, but common things are common and a good clinician should be able to get to the essence of most cases rapidly. It is part of what demonstrates mastery of a topic.

More me the actual arriving at a diagnosis and treatment can take a few minutes. Tops. I can rapidly note all the pertinent parts of the ID problem and ignore all the superfluous information. What took 90 minutes in the beginning of my practice now takes 5. But that is just the getting to the core of the case. Patient care is much more than that, although I do like to describe my speciality, facetiously,  as 'me find bug, me kill bug, me go home.'

Then there is doing a complete H&P to make sure that my initial diagnosis is correct and look for any curiosities. And there is the explanation to the patient and family, the discussion with the referring doctors, looking up references for the housestaff to support my recommendations and searching the web for the curious questions the answers to which tend to show up over at Medscape. So a consult still takes a long time, but the time now is not in determining the diagnosis and treatment.

My medical students and new graduates, because they do not know what they are doing, can take hours HOURS to work-up a patient, doing a history, physical and analysis of case.  It is now newbies practive and NDs are perpetual newbies.

The inability to determine what the patient has and needs in an expeditious manner also suggests that NDs have no clue what they are doing. And shows a lack of respect for the patients time. If it takes hours HOURS to misdiagnosis a patient, perhaps you should send the patient to someone with real training who knows what they are doing.