Benjamin H. Natelson, M.D.
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 These doctors are the closest to the general practitioners of yesterday. In contrast to specialists who have to be expert in a tiny part of the body, the family practitioner is a gen-eralist and has extensive training in marrying the principles of psychiatry to those of medicine. The broad training of such doctors makes it less likely that you'll find yourself cut off in midsentence as you describe your symptoms.
Another way to reduce the chances of getting a doctor with the three Bs is to turn to a female physician. |
Anne Harrington
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 To see what others thought, they sent a survey around to a hundred and fifty San Francisco businessmen and a hundred general practitioners, asking them the same question: Were there any personality traits they believed characterized people who had heart attacks? From the list of options on the questionnaire, more than 70 percent of the businessmen and a majority of the internists picked "excessive competitive drive and meeting deadlines."52
This was clinical intuition. The question was, could it be validated objectively in a clinical study? |
Gerald E. Markle and Frances B. McCrea
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 They are general practitioners, and a newer specialty called family practitioners, but also included are specialists in general internal medicine. The American
Medical Association (AMA) also counts pediatricians and obstetrician-gynecologists as primary care physicians.
It is a growing—and evolving—profession. In the United States, in 1998, there were 264,000 primary care physicians, almost double the number from 1970. Of these, the most common specialty was internal medicine, 100,000 (41% of the total), followed by 66,000 (21%) in family practice—a specialty that did not exist in 1970. |
Bill Sardi
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 Attitudes Toward Mild Chemotherapy Source: Chest 109: 80S, 1996
With 1% cure rate With 3 month survival increase
Cancer nurses general practitioners Radiation oncologists Medical oncologists Patients
39% 44%
27% 52% 67%
25% 27% 13%
With symptom relief
26% 21%
45% 53%
2%
12%
59%
Source: Chest 109: 80S, 1996
Another problem is that patients who are diagnosed with cancer, but not told their prognosis, are more likely to be optimistic. Furthermore, the cancer patient doesn't know which questions to ask the doctor. |
Anne Harrington
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| He reached out to military psychiatrists concerned with the challenges facing soldiers in the new Cold War era; to restless psychosomatic medical clinicians looking for alternatives to the old Freudian nostrums; to general practitioners looking for new ways of making sense of patients with elusive symptoms; to special-interest lay groups (The Young Presidents' Club, the Million Dollar Round Table, the Maharishi Mahesh Yogi's International Meditation Society); and to ordinary people who read magazines like The Readers' Digest. |
Devra Davis
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 Vittone
WW Baughman
In 1967 a group of British general practitioners published a report in the British Medical Journal describing a man whose fingers had become stunted while he was working with levels of polyvinyl chloride believed to be perfectly safe.6 At the time one could still look on such incidents as singular occurrences. The man's employer took the position that he must have a genetic defect or some rare disease. But within a few years, many similar reports appeared of men who had worked with vinyl chloride and suffered stubbed fingers. In one case a man's jaw dissolved. |
Andreas Moritz
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 The whole drug side effect issue is complicated by the fact that drug reactions are only rarely reported by general practitioners. The British Journal of Clinical Pharmacology reported in 1997 that "most prescription drugs are more dangerous than they appear because doctors rarely report side effects to the appropriate authorities." This tragic situation was confirmed by French researchers, who discovered massive underreporting of adverse reactions to prescription drugs. |
Thomson Healthcare, Inc.
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 Evidence from the German Association of General Practitioners' multicenter placebo-controlled double-blind study. Arzneimittelforschung Oct;40(10):l 111-6. 1990
Meher S, Duley L. Garlic for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 3:CD006065, 2006.
McCrindle BW, Heiden E & Conner WT. Garlic extract therapy in children with hypercholesterolemia. Arch Pediatr Adolesc Med; 152(1):1089-1094. 1998
McGuffin M, Hobbs C, Upton R et al (eds). Allium sativum L. The American Herbal Products Associaton's Botanical Safety Handbook. CRC Press, Boca Raton, FL:6-7,183,188. |
Benjamin H. Natelson, M.D.
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| An older class of antidepressants, called tricyclic antidepressants, or TCAs, was also effective at reducing anxiety, but general practitioners avoided them due to their frequent and disturbing side effects including an often uncomfortably fast heart rate, weight gain, and very dry mouth. As an alternative to TCAs, practitioners often turned to benzodiazepines, like Valium and Xanax. I very rarely prescribe these drugs because people can become dependent on them. Moreover, the characteristics of these drugs may make it hard to determine whether symptoms are continuing or disappearing. |
Shannon Brownlee
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 Instead of producing more general practitioners, the new federal dollars dramatically increased the number of specialists."
All those new specialists would be kept gainfully employed by private insurance and Medicare. Far from reining in medical fees, as the AMA had feared throughout the Medicare battles of the 1950s and '60s, the federal program's enactment helped drive the steep and unprecedented escalation in the incomes of both hospitals and doctors that had already begun a decade earlier. |
Ann M. Coulston and Carol J. Boushey
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 Unfortunately, many normal individuals can have an elevated AGA IgG, causing much confusion among general practitioners. AGA IgG is useful in screening IgA-deficient individuals, because the other antibodies used for routine screening are usually of the IgA class. Whereas only 0.2-0.4% of the general population has selective IgA deficiency, as many as 2-3% of people with celiac disease are IgA deficient, complicating the screening procedure [58]. |
Shannon Brownlee
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| This was especially true for proceduralists—surgeons, orthopedists, gastroenterologists. general practitioners, now called primary care physicians, were the diagnosticians—thinkers—of medicine. They had more trouble maintaining their incomes by doing more, but even they could always tell patients to come back for a follow-up visit to keep their appointment books filled. Patients complied, because now most of them were buffered by insurance from the price of their care—and because they trusted their doctors. |
Mike Adams, the Health Ranger
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 Think about it: Oncologists openly push dangerous chemotherapy drugs that cause permanent damage to the brain, heart, liver and kidneys, even while insisting that patients take no vitamins, superfoods or nutritional supplements to protect their healthy cells during the chemo treatments. general practitioners send patients home with prescriptions for dangerous COX-2 inhibitor drugs, diabetes drugs, statin drugs and psychotropic drugs that kill, at minimum, tens of thousands of Americans every year through heart attacks, strokes, liver failure and suicides. |
Roberta Bivins
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 In Britain, the Thatcherite ethos of individual choice and decentralization left many general practitioners managing their own budgets, and with the liberty to purchase alternative medical services if they wished. Many did so, creating a patchwork of data, but few scientifically credible and comparable trials. |
Bottom Line Health
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| Abraham says gastroenterologists, who treat NSAID-related side effects, are obviously aware of the importance of preventing bleeding, but doctors in other specialties as well as general practitioners may not be as mindful.
"It's a common health-care issue for us, but if you're in general practice with, say 100 patients, 10 of whom are on NSAIDs and only one of whom may have had bleeding, unless you've had an experience with it, you might not know," she says. |
Ray Moynihan and Alan Cassels
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 Heath, who works with the Royal College of general practitioners as well as the British Medical Journal, rejects the "pill-for-every-ill" model, where the patient is characterized as "broken" and the physician is there to "fix" him or her. Instead, she sees the interaction with her patients as part of a much richer relationship. Her goal is to come to mutual agreement on the extent to which a person may want to see their difficulties as a medical problem that might require treatment. |
Greg Critser
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 Like Prozac and other similar chemicals, it was not much better than the previous generation of antidepressants, or mood stabilizers, but it did have one big thing, marketing-wise, in its favor: it was almost impossible to overdose from it, and that made selling it to general practitioners, until then uneasy about prescribing psychiatric drugs for fear of such complications, a snap. This feature created a huge new prescribing base. |
| As the SAD campaign got under way, a new opportunity arose — the growing awareness, partly driven by the industry itself, of child and adolescent depression, again a real disease but one that few general practitioners felt comfortable treating with drugs. And again, in some very preliminary studies, youngsters seemed to respond to Paxil. To pave the way for a hoped-for FDA approval, SmithKline began underwriting clinical trials and then distributing the data at various pediatric forums. |
Ray Moynihan and Alan Cassels
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| A hardworking inner-city general practitioner, and a long-time official with the Royal College of general practitioners, Heath brings a tough, ethical approach to medicine, and she has written extensively about the link between poverty and ill health. She and many of her colleagues are becoming increasingly concerned that there is far too much focus in modern health care on the "rich well" and not enough on the "sick poor. |
| Groups of general practitioners attending "continuing medical education" events were told that a third of people who walked into their surgeries were suffering a mental illness—and they were urged to be more aggressive in their detection and treatment of depression. Like a lot of medical education, the program was partly sponsored by a drug company. |
Mike Adams, the Health Ranger
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 And even though I'm not a big fan of general practitioners and their drug-and-surgery approach to medicine, I'm a huge fan of the technical expertise of emergency room doctors.
These people save lives each and every day, and they do a great job. I've always said that U.S. doctors are fantastic technicians, and when you get into a trauma situation, you want a great technician. These doctors handle high-stress situations and put in incredible hours with a lot of effort and determination. I think most of them are underpaid for the jobs they are required to do. |
Mike Adams, the Health Ranger
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 He's doing a fantastic job, and he can speak the language of general practitioners. He knows how to talk to MDs in their language. I don't, and I don't try to. I think MDs are irrelevant because naturopathic physicians are the future. I think MDs should go out and change their careers. Go to Bastyr University and get a real education in health. MDs, you’re on the way out.
We need a nation where the smartest people -- the professionals, the pharmacists, the doctors, the researchers, and so on -- actually engage in things that help people, not things that hurt people. |
Ray Moynihan and Alan Cassels
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| The target audiences for the three-year campaign included specialists, general practitioners, pharmacists, nurses, and, importantly, patients as well. Echoing the PR firm Cohn & Wolfe's strategy of "cultivating the market," this proposal talked about the "pre-launch" period being important to "establish the market" for the sponsor's drug. Most valuable to this process were the senior medical specialists referred to in the document as "Key Opinion Leaders"—or thought-leaders—who would be recruited to help "shape" the opinions of their colleagues and other doctors. |
Fred A. Baughman, Jr., M.D. and Craig Hovey
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 Even though patients present to doctors with complaints, or symptoms, as many as half of all patients seeing family or general practitioners are found to be free of disease. By process of elimination, their symptoms are determined to be due to the stress of everyday living and include psychological and psychiatric symptoms, and ailments such as depression, anxiety, panic, insomnia, and so on. These patients require an understanding, compassionate explanation of the nature of their symptoms and how the stress of everyday life can be overwhelming at times. |
Mike Adams, the Health Ranger
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 But by and large, the run-of-the-mill general practitioners are not teaching anybody anything. They're writing prescriptions and getting them out of the office.
Some say, "We don't have time to teach people." Then, what are you doing? What are you doing as a doctor? What are you doing in this profession if you don't have time to help people? Didn't you get into medicine because you wanted to help people? Stop wasting your time being a slave of the drug companies. You will be embarrassed about that some day, believe me; instead, go study naturopathy. Go learn nutrition. |
Mike Adams, the Health Ranger
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 The national doctor re-education program
The same would hold for all the doctors as well, the general practitioners who practice old school medicine. They wouldn't have as much work either. I think we'd have to retrain them. We could start by actually giving them a real education in health. We could start by teaching them about nutrition. The fact is they never learned that in medical school. Med schools don't teach nutrition. These doctors are clueless about it unless they went outside mainstream medicine and learned on their own. |
Dr. Jonathan Prousky, BPHE, BSc, ND, FRSH
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 In a recent survey of 2,316 randomly selected patients (age 18 years and older) seen by general practitioners, 42.5% of all patients had evidence of a threshold/subthreshold psychiatric disorder.5 In the same survey, anxiety disorders were found in 19% of all patients. In a survey of 88 outpatients in an internal medicine clinic, 30% of patients had mixed anxiety features, 33% had generalized anxiety symptoms, almost half reported obsessive-compulsive personality symptoms, and about one quarter had marked levels of worry. |
Kelly Patricia O'Meara
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 Given that the majority of prescriptions for mind-altering antidepressants now are written by general practitioners - the family physician - Spitzer's admission is a frightening commentary on the accuracy of psychiatric diagnosing.
Some physicians, so disturbed by the deterioration of their profession, have felt compelled to put pen to paper regarding their observations of the APA, one going so far as to resign from membership with the professional organization. The following excerpts are representative of what a growing number of doctors believe to be pervasive throughout the APA. |
Mike Adams
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 If the disease is, by itself, "high cholesterol", then the cure for the disease must be nothing other than lowering
The Royal College of general practitioners in the U.K. has accused drug companies of inventing fictitious diseases or exaggerating the severity of symptoms in order to boost drug sales. the high cholesterol, we're told by doctors and drug companies. |
| In 2004 the Royal College of general practitioners in the U.K. accused drug companies of over-hyping diseases to sell more prescription drugs, including hypertension, osteoporosis, high cholesterol, anxiety, and clinical depression.
Cocaine injection kit
Source: Courtesy of www.Cocaine.org
The exposed behavior of the FDA and Merck regarding the safety of Vioxx earned itself scathing criticism from The Lancet, where Dr. |
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