February 2, 1999
TwoSD

2SD(2 Standard Deviations)

The CMAJ Jan1/96 contained an article on training doctors to prescribe sedatives and Ritalin properly.

They went through (I imagine) the computer database of all the doctors in B.C. and took the 125 who had prescribed these "dangerous drugs" TWO STANDARD DEVIATIONS more than all the rest of the doctors in B.C.

This must have taken a lot of planning and thought!

In 1971 I was doing Visual Evoked Potentials, and if I pressed one key then the plotter would plot out the graph of the evoked potential, WITH A LINE ABOVE AND BELOW THE PLOT WHICH WAS TWO STANDARD DEVIATIONS FROM THE PLOT. My was not that difficult? I must add that the two lines either side of the main one, did not give me any increased information at all!!

It makes one wonder just what was their thinking as they never bothered to find out if the patients needed the pills or not, but just went on their merry way dividing the 125 doctors up into 3 groups and: they watched one group's prescriptions and not telling the doctors they were being spied on; one group they told they were watching their prescriptions for "Bad Drugs", and the third group they TRAINED to prescribe the pills the CORRECT way. This must be the way that they had planned somehow, that took several committee meetings to standardize, and set up GUIDELINES for.

They came to the conclusion that it was possible to train doctors to prescribe correctly (their guideline way).

The only trouble with this article is after all the statistics and tables and self congratulatory writing, they must have made a mistake and put in one sentence: THAT THEY DID NOT KNOW THE OUTCOME OF THE PATIENTS WHO DID NOT GET THEIR PILLS AND THEY MIGHT HAVE HAD TO GO TO THE HOSPITALS AND COST THE B.C. GOVERNMENT MORE MONEY!

Would this not have been a great tragedy. All their work for nought--working the computers till the computers got tired out.

It is too bad they did not work their brains a little harder and realized that they never finished their investigation if THEY DID NOT KNOW THE OUTCOME OF WHAT HAPPENED TO THE PATIENTS WHO WERE TAKING THE PILLS!

What this really means is that the Meeting of the Federated colleges of Physicians & Surgeons about in 1980-81 who brought up the subject of the "excessive amounts of sedatives and ritalin being prescribed in Canada"; that the B.C. group offered to investigate a way to stop this budding tragedy of the future, because they had the computer set up in all the pharmacies, and could check up everything that happened in the province.

Shades of BIG BROTHER--1984 by George Orwell!

Where were the ethics professors, Were there any at that meeting, on the B.C. College of Physicians & Surgeons, among the planners of the investigation, among the investigators, among the critics of the article to be published, among the peer reviewers, and why did the editor not think of the ethics of this investigation which never was completed?

I wrote a book on Narcolepsy, and sent copies to over 300 doctors, patients and friends. The Ontario College of Physicians & Surgeons- told me I had to get it scientifically assessed, as they could not assess it. I took the patients' histories (are these anecdotes?), made a diagnosis from the history e. g. on 932 patients with Narcolepsy from 1982-1993, and added up the numbers of symptoms and complaints, the medications they received, and the EFFECTS of the pills, as to whether they improved the patients symptoms or cause complication, and whether they relieved their depressions, their nightmares, their cataplexy, and helped to alert them in the day, reduced their sleep attacks, and helped them sleep better at night, and be more rested in the mornings, reduce their bad tempers, their drinking and drug abuse, and be better able to live with others.

It is interesting that of the ones who answered and said what they thought whether they were doctors, patients or friends, they liked the book, thought they had learned something of their illness, and that I should publish it, in approximately equal percentages.

I had asked a doctor how to get the book "Scientifically Assessed", and he said I had to get a lot of doctors to say it made sense. I said this was just opinions and wondere how "scientific" that was, and he said that it was the only way to get it agreed with.

This interests me that the doctors, the patients and friends having similar opinions. Does this mean that each group has equal "Scientific Judgement"? It looks that way to me.

I told this to another doctor at a dinner meeting last year, and he said he could not believe the patients or lay people, and only could believe my book when there were three articles in the literature agreeing with it. This means to me--that he does not allow himself to believe his own thinking.

When I show that Jan 1/96 article to my patients, and have them read that last comment that the writers did not know what happened to the patients who did not get the pills, they quickly understand that the investigation was not finished, and the article is worthless. Are these patients more "Scientific" than the writers, and peer reviewers of the article which got published?

I really do not have to wonder very long as to what I think of this situation.

I mentioned the lack of ethics in this situation in the article to a regulator, and he stated that he would continue to do what he does, just the same way as in the past. I immediately told him that his behaviou was unethical. He did not reply. This consists of jumping on any doctor who prescribes medication 2SD (or some funny number he thinks up) differently from the great average of some or all the doctors in Ontario. It boggles my mind, how he can make this statement, and not realize he is unable to think logically. I have several other examples of this lack of logical thinking as well, which I won't mention here.

Oct 12, 2002

I had seen 3773 patients in my office Jan 1, 1982 to Jul 15/1999, of which I had diagnosed 1346 as Narcoleptic. Now thils must be more than 2SD that the average psychiatrist in Ontario ever sees. Therefore I am prescribing too many pills of any kind that might help these patients in comparison to other psychiatrists. Many psychiatrists I have talked to only had one Narcoleptic patient.

This means that I was dammed by the computer algorhythm.

May 10. 2004

I will repeat here what I learned from the regulator at the Ont. College of Physicians & Surgeons. I had asked him a question as to why the MBA's making plans for the Reform of Medicine, seemed to know nothing about it, and he replied that they did not want to as: "They would be emotionally involved, and could not make an impartial judgment about it"!

My opinion of this is that their teachers who shoved this opinion into their heads were unethical. This is an illogical attitude to making decisions. It makes one wonder how they made plans with their wives, when they got married, or even the plans to get married, as they must have been emotionally involved. After marriage, did they find a girl friend and then make plans regarding their wives with her, and vice versa? Such rot!