A new book critiques medicine

And by what means has any correlation been studied? What specific data is used?

Has a machine learning approach that examines all vaccination records and compares it to all subsequent patient medical issues, of all kinds, not just autism? Does the necessary data for this even exist? I wonder if that fact could even be determined from reading any official websites on vaccine safety.

> let's start with an easy example where we all agree that is false in spite there is no hard evidence.

a) I wonder how unanimous the agreement really is. I have a feeling expressing dissent in the slightest would be about as good for a doctor's career as it is for one's karma on social media sites.

b) Have there ever been cases in the medical field where "all people agreeing" turned out to be less impressive than it sounds?

https://www.nature.com/articles/437801a

"Marshall and Warren went on to show that patients with ulcers can be treated with antibiotics. Unlike patients given acid-suppressing drugs, their ulcers do not return."

"But gastroenterologists resisted the idea. Francis Mégraud, a bacteriologist at the Victor Segalen University in Bordeaux, France, remembers attending the 1988 meeting of the American Gastroenterological Association in New Orleans and hearing outraged physicians. “They seemed insulted, saying, ‘we are being asked to treat stomach ulcers with antibiotics, as if it were gonorrhoea!’” he says. “It was hard for them to accept that the disease could be a simple infection.”"

> There are zealots and ridiculous claims in both sides, but at the end of the day smallpox is eradicated, polio is cornered (I hope to see the eradication day), meleases is reduced to very small levels (eradication looks more difficult). All of them used to kill a lot of people.

True, however:

a) were vaccines the only factor involved in this improvement

b) relative (net aggregate) vaccine safety and absolute safety are related, but distinct subjects. If I'm taking my children for vaccinations, I am interested in absolute safety, not net aggregate safety.

>> a) were vaccines the only factor involved in this improvement

> a) Yes

Once again, a confident binary answer to an extremely complex problem.

How did you form this conclusion? Do you have anything you could show to substantiate it? Something like some charts demonstrating that incidents of all of these illnesses were essentially constant, and then only upon introduction of vaccines they began to decline? I've done some reading on this specific topic, I am interested to know if you have. (I happen to have great philosophical interest in the actual vs self-perceived basis of knowledge among zealous advocates on any matter.)

> b) Absolute safety is imposible.

I notice you kind of jump between two conversational styles, the first style ("a) Yes" above) is confident proclamation of a specific truth with no substance to back it up, and then now more of a highly rhetorical, subtle changing of the subject style. And to make it even more interesting, you then include a mathematical formula to give an impression of certainty, but in the process you've completely removed the actual point of contention (harm due to vaccines) from the discussion. Things like this are what I am looking for in these conversations: how do pro-vaxxers come to believe ("know")the things they believe.

Even if absolute safety isn't possible (something you have no way of knowing), safety isn't a binary, it's a continuum.

Have we done everything we can to study vaccine safety? Are there any flaws in the current system? Have you even done any reading on what the system actually consists of?

I will offer you a second chance to demonstrate how much you know about this, by reminding you of a question in my earlier comment that you seem to have accidentally missed:

>> In both cases we only can show that the correlation is so small that we can't reject the null hypothesis.

> And by what means has any correlation been studied? What specific data is used?

> Has a machine learning approach that examines all vaccination records and compares it to all subsequent patient medical issues, of all kinds, not just autism, ever been performed? Does the necessary data for this even exist? I wonder if that fact could even be determined from reading any official websites on vaccine safety.

I'm interested to know your answer to this - perhaps you are aware of something I am not, and I can learn something new. (Also, please do not accidentally overlook the questions earlier in my comment, and if I happen to have failed to answer any of your questions, please point that out that failing as well and I will rectify it.)

A subtle form of trolling involving "bad-faith" questions. You disingenuously frame your conversation as a sincere request to be enlightened, placing the burden of educating you entirely on the other party. If your bait is successful, the other party may engage, painstakingly laying out their logic and evidence in the false hope of helping someone learn. In fact you are attempting to harass or waste the time of the other party, and have no intention of truly entertaining their point of view. Instead, you react to each piece of information by misinterpreting it or requesting further clarification, ad nauseum. The name "sea-lioning" comes from a Wondermark comic strip.

That's a new one to me, usually when I encounter someone who can't support an argument despite "all the facts being in their favor", the charge is typically gaslighting.

This reaction should not be surprising at all - if your beliefs are based on what you think are facts, but are actually something else (best guess generalizations with a lack of honest disclosure about the true underlying details, for example), a feeling of ~cognitive dissonance should be logically expected. "I know I'm right, yet I'm unable to explain how I know this. However, everyone else agreeing with me proves that I'm right, so therefore this person must be playing some sort of mind tricks on me."

This is a heuristic. Heuristics evolved because they are genuinely useful. But while often very useful, heuristics are not always correct. The history of medicine, or any other scientific field, is filled with examples of this (washing of hands, checklists, causes of ulcers, etc). And not just mild, honest mistakes, but strong, institutional resistance to the actual truth.

Perhaps there are some heuristics in play in this very conversation? Specifically, perhaps your evaluation of what the nature of the horse I have in this race is.

> may engage, painstakingly laying out their logic and evidence in the false hope of helping someone learn

I'd like to point out that in this case you haven't done this, which raises what I think is a fair question: what gives you the right to dismiss someone who disagrees based on factual statements and reasonable questions? How does one counter "sealioning" being played as a trump card? Do you think "sealioning" would be considered an acceptable form of disagreement in the field of physics? If not, then why do you believe it is acceptable in medicine?

> you are attempting to harass or waste the time of the other party, and have no intention of truly entertaining their point of view

Sometimes the case no doubt, but is that the case here? In fact, I have literally "truly entertained your point of view", and I happen to have some legitimate issues with it. If you believe my issues are unsound, why do you not demolish them with facts and logic? Perhaps you are not able to see a way to do that, so you have resorted to rhetorical techniques.

"When the facts are on your side, pound the facts. When the law is on your side, pound the law. When neither is on your side, pound the table."

> Instead, you react to each piece of information by misinterpreting it

I haven't done this.

> or requesting further clarification

If it is warranted (for example, when something is presented as fact, when it is actually just a generalization that happens to be very popular among people who haven't actually read "the science"), I will always do this. To me, this seems consistent with the scientific process, not opposed to it.

>> We do not know that vaccines do not cause autism.

> I get what you're trying to say, but no. In this case yes, we do.

This statement is epistemically flawed, which is why doctors and scientists do not make that claim.

Your stance is also inconsistent with what the authorities in the field say.

I will pose (a slightly refined version of) the same question that I asked of someone else, to you:

>> In both cases we only can show that the correlation is so small that we can't reject the null hypothesis.

> And by what means has any correlation been studied? What specific data is used? Are there any flaws in the current system? Have you even done any reading on what the system actually consists of, as opposed to what is implied, but never (or rarely) explicitly disclosed/described on authoritative websites?

> Has a machine learning approach that examines all vaccination records and compares it to all subsequent patient medical issues, of all kinds, not just autism, ever been performed? Does the necessary data for this even exist? If not, why not? And has this this shortcoming (with accompanying reasoning) been disclosed with complete transparency on official websites and within authoritative academic studies? Is it part of the "comprehensively truthful, completely science-based" discussion that everyone believes is the state of affairs, and considers themselves to be fully up informed about, or can a person only learn such interesting factual details in the conspiracy community?

What I'm doing here is checking to see if you have as much background in this topic as you imply (and possibly truly believe). These sorts of questions should not be threatening, and they shouldn't be very difficult to answer, if you have actually done a lot of reading and critical(!) thinking on the topic.

They then keep roughly the same business model, charging more or less what insurance would have paid them. They spend more time with patients because (a) not on the phone fighting, (b) though the patient pool goes down, they’re replaced by not having to pay for billing staff.

Very very few “concierge” practices aim for any more deviation from the standard business mode than that.

If you want someone to spend 40 minutes with you rather than 15, that’s your guy. If you want someone to spend a week analyzing all your old records and sleuthing it out, that model still doesn’t support it.