Be careful out there, you have no clue what is in those supplements you
take. And if our fuckingly stupid federal legislators hadn't passed the
Dietary Supplement Health and
Education Act of 1994 (DSHEA): (DSHEA) defined dietary supplements as a
category of food, which put
them under different regulations than drugs. They are considered safe
until proven otherwise. Caveat Emptor. This recalls the patent medicines in the 18th and 19th centuries. It took the Pure Food and Drug Act of 1906 to reign these in.
https://www.statnews.com/2017/01/10/supplement-harvard-pieter-cohen/
Two paragraphs from there;
The entire episode opens a window into the Wild West world of
supplements. Unlike drug companies, supplement manufacturers don’t have
to show that their formulations are safe or effective before putting a
product on the market. They don’t have to run clinical trials. They
don’t have to consult federal regulators.
With little oversight, they can jump right into a highly lucrative
industry: Wheat, a convicted felon, said his company brings in more than
$100 million a year in annual revenue. His company’s social media pages are lined with images of bodybuilders with veins bursting out of their biceps.
Showing posts with label Caveat emptor. Show all posts
Showing posts with label Caveat emptor. Show all posts
Tuesday, January 10, 2017
Wednesday, October 26, 2016
Why dietary supplements are suspect - Harvard Health Publications
Be careful out there, you have no clue what is in those supplements you take. And if our fuckingly stupid federal legislators hadn't passed the Dietary Supplement Health and
Education Act of 1994 (DSHEA): (DSHEA) defined dietary supplements as a
category of food, which put
them under different regulations than drugs. They are considered safe
until proven otherwise. Caveat Emptor.
http://www.health.harvard.edu/staying-healthy/why-dietary-supplements-are-suspect?
Dietary supplements—including herbs, vitamins, minerals, and other products—are a $37-billion industry in the United States, and 60% of women are taking them regularly. At the same time, mounting research is suggesting that supplements—even mainstays like calcium—may be harmful at high doses.
The use of supplements and other alternatives to standard treatments is centuries old, but Dr. David Eisenberg, adjunct associate professor at the Harvard T.H. Chan School of Public Health, was the first to document the widespread use of alternative therapies in the United States. In a 1993 article in The New England Journal of Medicine, Dr. Eisenberg and colleagues reported that more than a third of Americans were using unconventional therapies, largely for chronic conditions, and most were doing so without letting their clinicians know. That report covered acupuncture, spinal manipulation, massage, and yoga, but it also focused public attention on all unconventional treatments, including the growing use of herbal remedies and other dietary supplements. In 1998, the Office of Alternative Medicine in the National Institutes of Health (NIH) was revamped as the National Center for Complementary and Alternative Medicine and charged with funding rigorous studies into the safety and effectiveness of alternative physical treatments as well as popular dietary supplements and herbs.
Black cohosh. A plant long used as a home remedy for arthritis, black cohosh has been recommended for hot flashes, night sweats, vaginal dryness, and other menopausal symptoms. Studies of its effectiveness have had mixed results. However, there are more than 50 reports of liver damage in people taking it, although it is unknown whether black cohosh or another substance in the preparation triggered the reactions.
Chamomile. This herb appears to be effective in relieving anxiety. Although less potent than prescription drugs, a cup of chamomile tea may soothe your nerves. Because chamomile is related to ragweed, marigolds, chrysanthemums, and daisies, it may trigger an allergic reaction if you have asthma or are allergic to these plants.
Echinacea. There is no conclusive evidence that echinacea either prevents colds or reduces cold symptoms. It may trigger reactions in people who are allergic to ragweed, marigolds, chrysanthemums, or daisies.
Ginseng. Although ginseng has been touted as a remedy for everything from colds to fatigue to forgetfulness, there isn't strong evidence from clinical trials that it has any of those properties. Ginseng may also interact with aspirin and the anti-clotting agent warfarin (Coumadin).
Ginkgo biloba. Extracts from the leaves of the ginkgo tree are promoted for improving memory and preventing and treating dementia. However, in the Ginkgo Evaluation of Memory study of 3,000 men and women over age 75, ginkgo didn't slow cognitive decline or reduce the incidence of dementia over a six-year period. Ginkgo may also increase bleeding risk.
Milk thistle. Laboratory studies indicated that this herb, also known as silymarin, had a protective effect on liver cells, but clinical trials haven't validated any benefit. Don't count on milk thistle to compensate for the effects of a few extra glasses of wine.
St. John's wort. A few early studies indicated that St. John's wort might alleviate depression, but larger trials failed to confirm those results. St. John's wort also interacts with a large number of prescription medications.
Calcium. Research has indicated that high doses of calcium from supplements don't have much of an effect on bone density and increase the risk of heart disease and kidney stones. If you aren't getting at least 500 to 700 milligrams (mg) of calcium in your daily diet, you may need a supplement, but it's a good idea to limit your supplement intake to 600 mg a day.
Glucosamine and chondroitin. These substances, both components of cartilage, are used to prevent arthritis and relieve joint pain. Clinical trials have shown that they have little effect.
Melatonin. A synthetic copy of a natural hormone, melatonin is used for jet lag, sleep disturbances, and insomnia. Research has determined that it can be effective at doses as low as 0.5 mg. If you're considering it, talk to your doctor about dosage and timing.
Vitamin D. Because most people who live in northern latitudes don't make enough vitamin D from sun exposure, a supplement may be necessary to fill the daily requirement of 800 international units (IUs). Whether higher, 2,000-IU doses reduce the risk of heart attack, stroke, or cancer will be determined by the 25,000-person Vitamin D and Omega-3 Trial (the VITAL study), whose results will be announced in 2017.
Omega-3 fatty acids. Although studies have linked consuming foods high in omega-3s to a reduced risk of heart disease and inflammation, it's questionable whether omega-3 supplements—available primarily in fish oil capsules—have the same effect. The VITAL study will help to answer that question, too.
Supplements for other purposes. The shelves of supplement stores abound with products that promise to make exercise easier and promote weight loss. These, too, are unproven, and some may contain stimulants that are harmful when used for extended periods.
Most important, taking supplements can be risky. A study published in October 2015 in The New England Journal of Medicine found that the adverse effects of supplements were responsible for an average of 23,000 emergency department visits per year.
If you are concerned that your diet isn't providing all the nutrients you need, don't shop for supplements before talking to your doctor. If you truly need a vitamin or other dietary supplement, your clinician can suggest an appropriate product and dose. If you're currently talking a vitamin or other supplement, let your health care team know.
The supplements used in government-funded clinical studies are analyzed for purity and standardized for dose. Supplement manufacturers are required to perform such analyses and to supply the results to the FDA. Yet, according to a report aired in January 2016 by PBS's investigative series Frontline, few of the thousands of supplement manufacturers do so, and the FDA lacks the staff and resources to analyze supplements or to compel manufacturers to comply.
As a result, the contents of a supplement capsule may not be what's described on the label. Canadian researchers who analyzed a random sample of 44 products from 12 manufacturers reported in 2013 that 60% of the products contained substances not listed on the labels, some of which were potentially harmful contaminants. And a 2015 investigation by the New York attorney general determined that only 21% of random samples of popular house-brands supplements purchased from GNC, Target, Walgreens, and Walmart contained the ingredients in the concentrations listed on the labels. Some contained no trace of the advertised active ingredient, and others consisted primarily of "fillers," including wheat and soy, which may trigger allergic reactions in some people. Other investigations have uncovered supplements adulterated with steroid hormones. When it comes to dietary supplements, the ancient warning "buyer beware!" is more relevant than ever.
http://www.health.harvard.edu/staying-healthy/why-dietary-supplements-are-suspect?
Dietary supplements—including herbs, vitamins, minerals, and other products—are a $37-billion industry in the United States, and 60% of women are taking them regularly. At the same time, mounting research is suggesting that supplements—even mainstays like calcium—may be harmful at high doses.
The use of supplements and other alternatives to standard treatments is centuries old, but Dr. David Eisenberg, adjunct associate professor at the Harvard T.H. Chan School of Public Health, was the first to document the widespread use of alternative therapies in the United States. In a 1993 article in The New England Journal of Medicine, Dr. Eisenberg and colleagues reported that more than a third of Americans were using unconventional therapies, largely for chronic conditions, and most were doing so without letting their clinicians know. That report covered acupuncture, spinal manipulation, massage, and yoga, but it also focused public attention on all unconventional treatments, including the growing use of herbal remedies and other dietary supplements. In 1998, the Office of Alternative Medicine in the National Institutes of Health (NIH) was revamped as the National Center for Complementary and Alternative Medicine and charged with funding rigorous studies into the safety and effectiveness of alternative physical treatments as well as popular dietary supplements and herbs.
The evidence for herbs
The traditional practice of herbal medicine involves combining different herbs and using them in a variety of preparations. Herbal remedies marketed today are usually powders or extracts derived from plant leaves, stems, or roots. Several studies, largely NIH-funded, have put some remedies often recommended for women to the test. The results are summarized below.Black cohosh. A plant long used as a home remedy for arthritis, black cohosh has been recommended for hot flashes, night sweats, vaginal dryness, and other menopausal symptoms. Studies of its effectiveness have had mixed results. However, there are more than 50 reports of liver damage in people taking it, although it is unknown whether black cohosh or another substance in the preparation triggered the reactions.
Chamomile. This herb appears to be effective in relieving anxiety. Although less potent than prescription drugs, a cup of chamomile tea may soothe your nerves. Because chamomile is related to ragweed, marigolds, chrysanthemums, and daisies, it may trigger an allergic reaction if you have asthma or are allergic to these plants.
Echinacea. There is no conclusive evidence that echinacea either prevents colds or reduces cold symptoms. It may trigger reactions in people who are allergic to ragweed, marigolds, chrysanthemums, or daisies.
Ginseng. Although ginseng has been touted as a remedy for everything from colds to fatigue to forgetfulness, there isn't strong evidence from clinical trials that it has any of those properties. Ginseng may also interact with aspirin and the anti-clotting agent warfarin (Coumadin).
Ginkgo biloba. Extracts from the leaves of the ginkgo tree are promoted for improving memory and preventing and treating dementia. However, in the Ginkgo Evaluation of Memory study of 3,000 men and women over age 75, ginkgo didn't slow cognitive decline or reduce the incidence of dementia over a six-year period. Ginkgo may also increase bleeding risk.
Milk thistle. Laboratory studies indicated that this herb, also known as silymarin, had a protective effect on liver cells, but clinical trials haven't validated any benefit. Don't count on milk thistle to compensate for the effects of a few extra glasses of wine.
St. John's wort. A few early studies indicated that St. John's wort might alleviate depression, but larger trials failed to confirm those results. St. John's wort also interacts with a large number of prescription medications.
What's up with supplements?
Vitamins, minerals, amino acids, and other compounds that are essential for good health have been marketed as supplements for decades. However, relatively few have been tested in clinical trials. Those that have been or are being subjected to scientific scrutiny include the following:Calcium. Research has indicated that high doses of calcium from supplements don't have much of an effect on bone density and increase the risk of heart disease and kidney stones. If you aren't getting at least 500 to 700 milligrams (mg) of calcium in your daily diet, you may need a supplement, but it's a good idea to limit your supplement intake to 600 mg a day.
Glucosamine and chondroitin. These substances, both components of cartilage, are used to prevent arthritis and relieve joint pain. Clinical trials have shown that they have little effect.
Melatonin. A synthetic copy of a natural hormone, melatonin is used for jet lag, sleep disturbances, and insomnia. Research has determined that it can be effective at doses as low as 0.5 mg. If you're considering it, talk to your doctor about dosage and timing.
Vitamin D. Because most people who live in northern latitudes don't make enough vitamin D from sun exposure, a supplement may be necessary to fill the daily requirement of 800 international units (IUs). Whether higher, 2,000-IU doses reduce the risk of heart attack, stroke, or cancer will be determined by the 25,000-person Vitamin D and Omega-3 Trial (the VITAL study), whose results will be announced in 2017.
Omega-3 fatty acids. Although studies have linked consuming foods high in omega-3s to a reduced risk of heart disease and inflammation, it's questionable whether omega-3 supplements—available primarily in fish oil capsules—have the same effect. The VITAL study will help to answer that question, too.
Supplements for other purposes. The shelves of supplement stores abound with products that promise to make exercise easier and promote weight loss. These, too, are unproven, and some may contain stimulants that are harmful when used for extended periods.
The bottom line
The value of most herbs and supplements has been discounted or remains unproven. Few are worth the money spent on them. Moreover, there is no guarantee that the pills, capsules, or tablets contain all—or even any—of the ingredients listed on the packaging.Most important, taking supplements can be risky. A study published in October 2015 in The New England Journal of Medicine found that the adverse effects of supplements were responsible for an average of 23,000 emergency department visits per year.
If you are concerned that your diet isn't providing all the nutrients you need, don't shop for supplements before talking to your doctor. If you truly need a vitamin or other dietary supplement, your clinician can suggest an appropriate product and dose. If you're currently talking a vitamin or other supplement, let your health care team know.
Serious issues with supplements
"Some non-vitamin supplements are marketed heavily in the absence of reliable evidence of efficacy or safety and may interact with prescription drugs. Moreover, some people may delay beginning proven therapies because they are relying on supplements. And some of these products are costly," says Dr. David Eisenberg, adjunct associate professor at the Harvard T.H. Chan School of Public Health.The supplements used in government-funded clinical studies are analyzed for purity and standardized for dose. Supplement manufacturers are required to perform such analyses and to supply the results to the FDA. Yet, according to a report aired in January 2016 by PBS's investigative series Frontline, few of the thousands of supplement manufacturers do so, and the FDA lacks the staff and resources to analyze supplements or to compel manufacturers to comply.
As a result, the contents of a supplement capsule may not be what's described on the label. Canadian researchers who analyzed a random sample of 44 products from 12 manufacturers reported in 2013 that 60% of the products contained substances not listed on the labels, some of which were potentially harmful contaminants. And a 2015 investigation by the New York attorney general determined that only 21% of random samples of popular house-brands supplements purchased from GNC, Target, Walgreens, and Walmart contained the ingredients in the concentrations listed on the labels. Some contained no trace of the advertised active ingredient, and others consisted primarily of "fillers," including wheat and soy, which may trigger allergic reactions in some people. Other investigations have uncovered supplements adulterated with steroid hormones. When it comes to dietary supplements, the ancient warning "buyer beware!" is more relevant than ever.
Wednesday, July 27, 2016
15 Supplement Ingredients to Always Avoid
How does this list compare to your doctors protocol on supplements? Yikes, I'll have to look at the Green Tea Extract again to see why I started taking it. And if our fuckingly stupid federal legislators hadn't passed the Dietary Supplement Health and
Education Act of 1994 (DSHEA): (DSHEA) defined dietary supplements as a
category of food, which put
them under different regulations than drugs. They are considered safe
until proven otherwise. Caveat Emptor.
https://www.yahoo.com/news/15-supplement-ingredients-always-avoid-100045917.html
https://www.yahoo.com/news/15-supplement-ingredients-always-avoid-100045917.html
With the help of an expert panel of independent doctors
and dietary-supplement researchers, Consumer Reports identified 15
supplement ingredients that are potentially harmful. The risks include
organ damage, cancer,
and cardiac arrest. The severity of these threats often depends on such
factors as pre-existing medical conditions as well as the quantity of
the ingredient taken and the length of time a person has been exposed to
the substance.
Many of the ingredients on this list also have the potential to interact with prescription and over-the-counter medications, such as cholesterol-lowering statins and blood-thinning drugs like aspirin and warfarin (Coumadin and generic).
Moreover,
our experts agree that none of these supplement ingredients provide
sufficient health benefits to justify the risk. Even so, we found all 15
ingredients in products available online or in major stores such as
GNC, Costco, CVS, Walmart, and Whole Foods. (Download this PDF to
find out more about how we selected these ingredients, our panel of
dietary supplement experts, and how we shopped for products.)
| Ingredient | Claimed Benefits | Risks |
| Aconite Also called: Aconiti tuber, aconitum, angustifolium, monkshood, radix aconti, wolfsbane | Reduces inflammation, joint pain, gout | Nausea, vomiting, weakness, paralysis, breathing and heart problems, possibly death |
| Caffeine Powder Also called: 1,3,7-trimethylxanthine | Improves attention, enhances athletic performance, weight loss | Seizures, heart arrhythmia, cardiac arrest, possibly death; particularly dangerous when combined with other stimulants |
| Chaparral Also called: Creosote bush, greasewood, larrea divaricata, larrea tridentata, larreastat | Weight loss; improves inflammation; treats colds, infections, skin rashes, cancer | Kidney problems, liver damage, possibly death |
| Coltsfoot Also called: Coughwort, farfarae folium leaf, foalswort, tussilago farfara | Relieves cough, sore throat, laryngitis, bronchitis, asthma | Liver damage, possible carcinogen |
| Comfrey Also called: Blackwort, bruisewort, slippery root, symphytum officinale | Relieves cough, heavy menstrual periods, stomach problems, chest pain; treats cancer | Liver damage, cancer, possibly death |
| Germander Also called: Teucrium chamaedrys, viscidum | Weight loss; alleviates fever, arthritis, gout, stomach problems | Liver damage, hepatitis, possibly death |
| Greater Celandine Also called: Celandine, chelidonium majus, chelidonii herba | Alleviates stomachache | Liver damage |
| Green Tea Extract Powder Also called: Camellia sinensis | Weight loss | Dizziness, ringing in the ears, reduced absorption of iron; exacerbates anemia and glaucoma; elevates blood pressure and heart rate; liver damage; possibly death |
| Kava Also called: Ava pepper, kava kava, piper methysticum | Reduces anxiety, improves insomnia | Liver damage,exacerbates Parkinson's and depression, impairs driving, possibly death |
| Lobelia Also called: Asthma weed, lobelia inflata, vomit wort, wild tobacco | Improves respiratory problems, aids smoking cessation | Nausea, vomiting, diarrhea, tremors, rapid heartbeat, confusion, seizures, hypothermia, coma, possibly death |
| Methylsynephrine Also called: Oxilofrine, p-hydroxyephedrine, oxyephedrine, 4-HMP | Weight loss, increases energy, improves athletic performance | Causes heart rate and rhythm abnormalities, cardiac arrest; particularly risky when taken with other stimulants |
| Pennyroyal Oil Also called: Hedeoma pulegioides, mentha pulegium | Improves breathing problems, digestive disorders | Liver and kidney failure, nerve damage, convulsions, possibly death |
| Red Yeast Rice Also called: Monascus purpureus | Lowers LDL ("bad") cholesterol, prevents heart disease | Kidney and muscle problems, liver problems, hair loss; can magnify effect of cholesterol-lowering statin drugs, increasing the risk of side effects |
| Usnic Acid Also called: Beard moss, tree moss, usnea | Weight loss, pain relief | Liver injury |
| Yohimbe Also called: Johimbi, pausinystalia yohimbe, yohimbine, corynanthe johimbi | Treats low libido and erectile dysfunction, depression, obesity | Raises blood pressure; causes rapid heart rate, headaches, seizures, liver and kidney problems, heart problems, panic attacks, possibly death |
Report It!
If you or someone in your family experience an adverse event after taking a dietary supplement, report it to the FDA.
Thursday, May 26, 2016
Want To Sell An Anti-Aging Pill With No Human Testing? Make It A Supplement - Basis
You have no fucking clue what's is this pill or if it even works at all. We have no idea what is in the supplements we buy. All because of the stupidity of our Congress passing the Dietary Supplement Health and Education Act of 1994 (DSHEA): (DSHEA) defined dietary supplements as a category of food, which put them under different regulations than drugs. They are considered safe until proven otherwise. Caveat Emptor.
Want To Sell An Anti-Aging Pill With No Human Testing? Make It A Supplement - Basis
For more than a year, New York startup Elysium Health has been selling a pill, formulated after decades of research at a famous anti-aging lab at MIT, that claims to make our aging cells healthier, leading to better energy, sleep, and memory.According to the company, “tens of thousands” of people have bought subscriptions of about $50 a month for a daily supply of the pill, called Basis, with the expectation that they will feel healthier even as the years fly by.
But some researchers who study aging are deeply skeptical that the compounds in the pill will have any effect at all, because there is no evidence that it works in people. The company has avoided the stringent clinical testing required of pharmaceutical drugs by selling Basis as a dietary supplement.
More at link.
Thursday, May 19, 2016
Natural Standard Herb & Supplement Guide app is an evidence based reference
We have no idea what is in the supplements we buy. All because of the
stupidity of our Congress passing the Dietary Supplement Health and
Education Act of 1994 (DSHEA): (DSHEA) defined dietary supplements as a
category of food, which put
them under different regulations than drugs. They are considered safe
until proven otherwise. Caveat Emptor.
Lately, in part due to TV shows like Dr. Oz, it’s becoming common practice among certain patient populations.
It’s uncommon for physicians to be very well versed in various herbal remedies, and this handbook attempts to help with this lack of knowledge.
Natural Standard Herb & Supplement Guide: An Evidence-Based Reference is an app developed by Elsevier that attempts to provide high-quality, up-to-date, information about herbs and other supplements.
The user interface is arranged into different tabs. One tab lists all herbs and supplements, with the rest working as bookmarks, history, and the about page. The app has a search function that is robust and important since there are over 400 herbs and supplements covered. Each entry is concise and the text is easy to read, including uses, dosage information, safety considerations, and interactions with drugs and other herbs and supplements. Loading times are long during the trial period of the app as it doesn’t allow data to be downloaded and each entry has to be accessed in real time.
Interestingly, we found that each entry also includes information on the evidence and Scientific Evidence Grades. This is excellent as it allows physicians to offer accurate advice for or against use of particular herbs. All herbs are included in a table and organized based on their evidence grade. Taking into consideration the large number of herbs, extra navigational features would be useful including sorting items per evidence grade or usage.
What’s in Those Supplements?
But if you want to know what that supplement might be for if it actually contains the supplement listed on the label, continue reading.Natural Standard Herb & Supplement Guide app is an evidence based reference
Herbal medicine — also called botanical medicine or phytomedicine — refers to using a plant’s seeds, berries, roots, leaves, bark, or flowers for medicinal purposes.Lately, in part due to TV shows like Dr. Oz, it’s becoming common practice among certain patient populations.
It’s uncommon for physicians to be very well versed in various herbal remedies, and this handbook attempts to help with this lack of knowledge.
Natural Standard Herb & Supplement Guide: An Evidence-Based Reference is an app developed by Elsevier that attempts to provide high-quality, up-to-date, information about herbs and other supplements.
The user interface is arranged into different tabs. One tab lists all herbs and supplements, with the rest working as bookmarks, history, and the about page. The app has a search function that is robust and important since there are over 400 herbs and supplements covered. Each entry is concise and the text is easy to read, including uses, dosage information, safety considerations, and interactions with drugs and other herbs and supplements. Loading times are long during the trial period of the app as it doesn’t allow data to be downloaded and each entry has to be accessed in real time.
Interestingly, we found that each entry also includes information on the evidence and Scientific Evidence Grades. This is excellent as it allows physicians to offer accurate advice for or against use of particular herbs. All herbs are included in a table and organized based on their evidence grade. Taking into consideration the large number of herbs, extra navigational features would be useful including sorting items per evidence grade or usage.
Friday, January 9, 2015
Why Maintenance of Certification Is Bad for Doctors and Patients
As a patient I can see no reason why I shouldn't expect my doctor to be up-to-date on all the latest. But read this doctor/apologist for the reasons why this is bad for you. Shit, I'm totally positive that my doctor hadn't read a single research article in the 25-30 years since medical school. I have probably referenced 10-15,000 articles in the last 5 years. I expect all stroke doctors to have at least the knowledge I have, if not better.
http://www.nejm.org/doi/full/10.1056/NEJMp1407422#t=article
This statement is f*cking appalling. At least every 5 years at a minimum. I wouldn't see any doctor who hadn't been up-to-date within the last month. Ask your doctor what practices they have changed in the last year and what research triggered that change.
Although some members of the medical community believe that it's not unreasonable to ask physicians to formally document their fund of knowledge every 10 years.
More articles on it although I doubt any of these take a patient view.
The Maintenance of Certification Fait Accompli Position and Why I Reject it
Focus Groups Say MOC Has Little Benefit for Doctors, Patients
MOC and the Physician Quality Reporting game hurts patients, physicians alike
MOC Requirements Don't Benefit Medicine
How the hell do we tell if our doctors are any good? Caveat emptor, "Let the buyer beware".
That's not good enough for me.
http://www.nejm.org/doi/full/10.1056/NEJMp1407422#t=article
This statement is f*cking appalling. At least every 5 years at a minimum. I wouldn't see any doctor who hadn't been up-to-date within the last month. Ask your doctor what practices they have changed in the last year and what research triggered that change.
Although some members of the medical community believe that it's not unreasonable to ask physicians to formally document their fund of knowledge every 10 years.
More articles on it although I doubt any of these take a patient view.
The Maintenance of Certification Fait Accompli Position and Why I Reject it
Focus Groups Say MOC Has Little Benefit for Doctors, Patients
MOC and the Physician Quality Reporting game hurts patients, physicians alike
MOC Requirements Don't Benefit Medicine
How the hell do we tell if our doctors are any good? Caveat emptor, "Let the buyer beware".
That's not good enough for me.
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