Antibiotics vs Probiotics

[Kasierith]

Yeah, but they don't confront their patients about weight...
http://www.cnn.com/2011/HEALTH/03/01...octors.health/

What is "normal" as per BMI is a lower weight than what is culturally understood to be normal. Largely because BMI is a horrid system that, while it's the only real standardized tool we have that is easily applicable to large populations, nevertheless gives a poor representation of what we consider healthy. Therefore, when you look at it objectively, the US isn't nearly as "overweight" as a newspaper headline tells you it is (though it is still very bad). As for doctors not telling patients that they are obese, sure that comes down to personal failings on the doctors part, counfounded by discomfort and a commonly held misconception, one that is currently being challenged in all areas of medical academia, that patients 1: already know that they have a problem, and 2: would refuse to follow advice given if it asks a lot of them, ie diet and exercise.

It all comes down to a sadly high percentage of doctors are old geezers who have aged out of modern medicine well before retiring from their professions.

[Pitkanen]

What is "normal" as per BMI is a lower weight than what is culturally understood to be normal. Largely because BMI is a horrid system that, while it's the only real standardized tool we have that is easily applicable to large populations, nevertheless gives a poor representation of what we consider healthy. Therefore, when you look at it objectively, the US isn't nearly as "overweight" as a newspaper headline tells you it is (though it is still very bad). As for doctors not telling patients that they are obese, sure that comes down to personal failings on the doctors part, counfounded by discomfort and a commonly held misconception, one that is currently being challenged in all areas of medical academia, that patients 1: already know that they have a problem, and 2: would refuse to follow advice given if it asks a lot of them, ie diet and exercise.

It all comes down to a sadly high percentage of doctors are old geezers who have aged out of modern medicine well before retiring from their professions.

Take it from a IRL Orc, I agree that BMI is bad. But those numbers are so high that the discrepancies in the accuracy of BMI can't explain away the data.

But it comes back to the system... if a community hospital got more profit for keeping it's community from needing treatment than it did from more treatment, then the administration would pressure the doctors. They might also put policies in place that would actually provide accountability and incentive for people to make the lifestyle change (like nutritionist 'social' workers).

[Kasierith]

Take it from a IRL Orc, I agree that BMI is bad. But those numbers are so high that the discrepancies in the accuracy of BMI can't explain away the data.

But it comes back to the system... if a community hospital got more profit for keeping it's community from needing treatment than it did from more treatment, then the administration would pressure the doctors. They might also put policies in place that would actually provide accountability and incentive for people to make the lifestyle change (like nutritionist 'social' workers).

A hospital has little relation to family practice. If someone is going to a hospital for routine checkups, there are already many things wrong with the situation. Likewise, someone paying a hospital a high amount for a surgery in no way benefits a family doctor... and in fact, such events are the primary cause for changes in medical care, because if you would have benefitted from XYZ, and your doctor never even mentioned them, why would you want to go back to that doctor?

A good way to understand this is that one part of the medical community profiting does not mean that everyone profits. Pharmaceutical drugs are making a massive profit right now. Do you know how much a CVS pharmacist makes off of selling you a 500 dollar drug? None. The massive profits go to the drug companies. Many hospitals are on the verge of going out of business, because if a homeless man comes in wtih a heart attack, a person that the hospital by law has to treat, who foots the bill? Some of it is passed on to other customers, some hospitals get government subsidies, but for the most part the hospital just has to eat the cost. When you get down to it, the only big profiteers in the medical industry are the pharmaceutical companies, and most of those like Pfizer don't just distribute that to their executives; they roll that profit into multi-million dollar drug research projects, thus investing their profits for more gain down the road, and at the same time providing more pharmaceuticals to benefit their customers.

[OzoAndIndi]

I just want to hear some discussion on this topic, and what you prefer.

I know people who swear by antibiotics every time they get a cold or flu, but in my mind that is the reason why they keep getting sick, because they are killing off all of the good bacteria. (NOTE - I realize that colds and flus are viral, I guess my point is that they seem to overuse antibiotics and appear to always have some sort of health issue)

Probiotics, instead of killing bacteria, helps you get the good colonies which in turn keep the bad bacteria in check. When my wife was pregnant, she tested positive for group-b strep (a bacteria that is normal, but testing positive means the colony has gotten too big, essentially). Well, she really did not want to have to take antibiotics so that our baby would benefit from the good bacteria in her system. We changed care providers to a midwife and she said there were other options, and put her on 5 days of a probiotic with a big number of bacteria. After 5 days, she was tested again, and the group-b strep test came back as negative. She then took a probiotic that didn't have as many bacteria until the baby was born.

So, I ask, if probiotics have no downside, and really are more effective than destroying every bacteria in your body, why take antibiotics, ever? Or am I missing something...

Anyone's doctor that is prescribing antibiotics for a virus is either stupid and/or just trying to do give something like a placebo affect when there isn't anything they can do for a virus. It is such a bad idea to take antibiotics unnecessarily though, frequent use gives too much opportunity to strength bacterial immunity to it and an infection that can't be cured with antibiotics is not good news.

Personally I don't think, and to my knowledge, probiotics are related at all. Those are, to my understanding, supposed to help create healthy forms of bacteria in your gut that help keep you healthy but is kind of a separate thing. Although an oral antibiotic can kill off some of the good stuff as well to a probiotic may help replenish it. But I don't think they are going to cure an infection elsewhere in the body though... been there, done that.

[Catta]

Anyone's doctor that is prescribing antibiotics for a virus is either stupid and/or just trying to do give something like a placebo affect when there isn't anything they can do for a virus. It is such a bad idea to take antibiotics unnecessarily though, frequent use gives too much opportunity to strength bacterial immunity to it and an infection that can't be cured with antibiotics is not good news.

Personally I don't think, and to my knowledge, probiotics are related at all. Those are, to my understanding, supposed to help create healthy forms of bacteria in your gut that help keep you healthy but is kind of a separate thing. Although an oral antibiotic can kill off some of the good stuff as well to a probiotic may help replenish it. But I don't think they are going to cure an infection elsewhere in the body though... been there, done that.

Or C. The docs are tired and trying to make patients who keep insisting on antibiotics go away. Private practices are just that - private. If you cant explain to them why they cant have it - they will just get a new one and you lose business. Much easier for them to just prescribe it and make them go away.

Sad but true.

[Kurioxan]

Its hard to just compare both and say X is better.
They have different functions OP, while in some areas they might share similar goals, general functions are different.
You can use both, it is actually recommended to take probiotics if you are taking antibiotics... Its not the case of which is best, its a case of what requires which.

- - - Updated - - -

Or C. The docs are tired and trying to make patients who keep insisting on antibiotics go away. Private practices are just that - private. If you cant explain to them why they cant have it - they will just get a new one and you lose business. Much easier for them to just prescribe it and make them go away.

Sad but true.

Yep... tbh, they should just give em sugar pills in those cases >_>

[Spectral]

This question makes as much sense as asking whether you prefer cycling or recycling. Having the same affix doesn't make two things similar.

[Catta]

Yep... tbh, they should just give em sugar pills in those cases >_>

Unethical though!

[Kurioxan]

Unethical though!

Psh, hardly! doing no harm, in fact, preventing it!

[Kasierith]

Psh, hardly! doing no harm, in fact, preventing it!

Lying about what you are prescribing them, and what they are buying, is pretty unethical; it pretty much comes down to the doctors need to act like grownups.

[kreationkin]

Lying about what you are prescribing them, and what they are buying, is pretty unethical; it pretty much comes down to the doctors need to act like grownups.

Thank you Kasierith for writing more eloquently than I could the important things people should know who come to read this discussion.

[Lynarii]

Or C. The docs are tired and trying to make patients who keep insisting on antibiotics go away. Private practices are just that - private. If you cant explain to them why they cant have it - they will just get a new one and you lose business. Much easier for them to just prescribe it and make them go away.

Sad but true.

Also not a serious consideration. Most general practitioners are not hard up for patients, it's far more likely for any given doctor in North America to be responsible for significantly more people than they can reasonably handle than it is for a doctor to be sitting around their office doing nothing and waiting for a new patient to present themselves. My doctor wouldn't lose any sleep if I decided to go somewhere else. He has a sign up on his front door stating that the practice can not accept any new patients, and yet every single time I've been waiting there, at least one person asks if an exception could be made 'just this once'.

The reality is that whether my doctor prescribes drug A, B, or none at all has a negligible effect on how much he makes. How often I come in to see him doesn't change it either. If I'm coming in every week he makes money off me every week, but if I don't come in for a year, those appointment slots go to other people and he makes money off them instead. He does NOT profit off of making me come in, it just means he sees me more and someone else less. He doesn't get dollar signs in his eyes if something goes horribly wrong with me, because if I need surgery then it's a surgeon that gets paid for doing it, not him. And if he got caught taking a kickback from a hospital for sending people over who didn't need it? That'd cost him his license at best, and could get him sent to jail. One of the things I like about my doctor is that he's not that kind of idiot. If you think your doctor /is/ that stupid, find a new doctor, because yours is dangerous.

The reality is that there are plenty of people looking to see a GP for plenty of valid reasons. The idea that most doctors are willing to lie to patients to get them to come in more is just arrogance by people who think that their personal money is worth more than the other people their doctor sees. Yeah, there are corrupt doctors who do unethical things for sure. But those are a big deal because an unethical doctor is horrifyingly dangerous to everyone they see, not because they're extremely common.

[Kurioxan]

Lying about what you are prescribing them, and what they are buying, is pretty unethical; it pretty much comes down to the doctors need to act like grownups.

ofc it is, and so is prescribing it recklessly. doctors acting like grownups when so much money is involved? i wish.

[Kasierith]

ofc it is, and so is prescribing it recklessly. doctors acting like grownups when so much money is involved? i wish.

Read Lynarii's post; it's pretty much right on. In the US at least, not sure about the UK, the ratio of patients to doctors is so high that even if you do somehow drive a patient away through your incompetence, there are dozens more people waiting to have a dedicated family doctor.

[Kurioxan]

Read Lynarii's post; it's pretty much right on. In the US at least, not sure about the UK, the ratio of patients to doctors is so high that even if you do somehow drive a patient away through your incompetence, there are dozens more people waiting to have a dedicated family doctor.

If we ignore corruption, sure.
after so many years and scandals, it still happens, here is an example
http://uk.reuters.com/article/2014/0...A320U720140403

its less "i dont want to lose a patient if i dont prescribe him those antibiotics" its more "$_$"