![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 62 to 86 of 154. Go back in thread:
Posted by notfred on November 30, 2006, at 20:59:22
In reply to Lou's response to aspects of notfreds post-, posted by Lou Pilder on November 30, 2006, at 20:53:38
You asked me not to post to you, so as I understand the rules here, by you putting my name in the subject this no longer holds.
Lou, please do not post to me.
Posted by Lou Pilder on December 1, 2006, at 5:53:34
In reply to Re: Lou's response to aspects of scott's post-, posted by gardenergirl on November 30, 2006, at 18:49:03
friends,
It is written here,[...they would be mistaken...] This is a response to,[...there could be IMO members to think that the forum is to get medical advice because the owner is a doctor...].
Regardless of any statements to the contrary in the FAQ, it is in my post what is IMO the >potential< for some others here {to think} that they could get medical advice.
The owner here offers guest >experts< on various |medical| topics. In the following case, a doctor, (Kramer), is given a forum to have members pose questions that are of medical importance to them , the member >seeking answers< from the expert. These answers could be written to not be accepted as fact in the FAQ, but regardless of that, the member is receiving an answer from a guest >expert<.
In the following, a member asks about the use of benzodiazepines for longer,I guess, than the PDR states. The guest expert posts the following which says that if the member needs a longer acting drug than Ambien (and Sonata), that they are not for that member and that [...benzos are wonderful,>safe<,and effective drugs...].
Now is there not the potential for some readers to give great credibility to the guest expert's statements about benzodiazepines?
Lou
http://www.dr-bob.org/babble/20020327/msgs/101368.html
Posted by SLS on December 1, 2006, at 6:21:20
In reply to Lou's response to aspects of scott's post-, posted by Lou Pilder on November 30, 2006, at 17:43:35
> It is written here,[...this (forum) is not a venue...for medical advice...].
> But could there be those that think that it is?.Yes. Let us say for the sake of debate that there are a few people who make this mistake.
What do you suggest that we should do about this?
- Scott
Posted by Lou Pilder on December 1, 2006, at 7:16:29
In reply to Lou's response to aspects gg's post-, posted by Lou Pilder on December 1, 2006, at 5:53:34
> friends,
> It is written here,[...they would be mistaken...] This is a response to,[...there could be IMO members to think that the forum is to get medical advice because the owner is a doctor...].
> Regardless of any statements to the contrary in the FAQ, it is in my post what is IMO the >potential< for some others here {to think} that they could get medical advice.
> The owner here offers guest >experts< on various |medical| topics. In the following case, a doctor, (Kramer), is given a forum to have members pose questions that are of medical importance to them , the member >seeking answers< from the expert. These answers could be written to not be accepted as fact in the FAQ, but regardless of that, the member is receiving an answer from a guest >expert<.
> In the following, a member asks about the use of benzodiazepines for longer,I guess, than the PDR states. The guest expert posts the following which says that if the member needs a longer acting drug than Ambien (and Sonata), that they are not for that member and that [...benzos are wonderful,>safe<,and effective drugs...].
> Now is there not the potential for some readers to give great credibility to the guest expert's statements about benzodiazepines?
> Lou
> http://www.dr-bob.org/babble/20020327/msgs/101368.htmlFriends,
In response further to gg's statement,[...they would be mistaken...], let us look at another offered statement from a guest expert provided by DR. Hsiung to the members her. Dr. Kramer answers questions from members seeking medical answers from him as an offered expert.. In the following, a member poses a question about Ambien to Dr. kramer. Dr. Kramer replies,[...there is >no< data that shows that long term use is a problem...]
But let us look at the facts drom {controlled clinical trials} from >sanofi aventis<.
The list of {problems}include >tolerance< and >dependence< and >withdrawal< and >changes in behavior and thinking<. These are not [...long-term problems |from data|?
Yet the doctor states that there is nodata that shows that long term use is a problem.
I ask;
Is there not the potential for some members to consider the statement by the guest expert to be fact and accept the statement if they do not do research on their own outside of after reading Dr. Kramer's statement that [...>there is {no} data< that shows that long term use is a problem...]?
Lou
PS1:here is the link to Dr. Kramer's statemnt
http://www.dr-bob.org/babble/20020327/msgs/101376.html
pS2:here is the link to the data that shows the long term effects of Ambien from sanofi aventis
http://www.ambiencr.com/default.aspx?s=about&c=side_effects
Posted by Lou Pilder on December 1, 2006, at 9:27:15
In reply to Scott's question to Lou, posted by SLS on December 1, 2006, at 6:21:20
Friends,
It is written here,[...yes...there are a few people who make this {mistake}...].
But is it a {mistake} to >them< that are seeking medical infomation here?
In any reply , I am asking that the following be considered:
A. Does the owner/moderator play an active role in developing the information that was posted?
B. Does the owner/moderator have an editorial function?
C. Is there personal participation by the owner/moderator?
D. Are there assistants that have some instruction as to the operation of the site and have authority to sanction the content of the site?,(deputies),and act in the owner/moderator's behalf?
E. Can they also have an editorial function?
G. does the owner/moderator prohibit anyone, for any reason, to notify him to remove what the member considers to be defamatory posts about that member?
H. Has the forum's rules been made to accommodate the {less-confident member}, exclusivly, and no rules have been made to accommodate the ,let's say, {those that have a less-ability to remember member}? Could not a member that could be clasified as a {less-ability to remember member}forget that there is a statement from Dr. Hsiung that the forum is not for medical advise when they read statements from guest experts here as the one's cited and act upon those statements as {medical advice}?
K.other considerations not specified
Lou
Posted by Jost on December 1, 2006, at 11:28:09
In reply to Lou's response to Scott's question to Lou, posted by Lou Pilder on December 1, 2006, at 9:27:15
Lou, I don't understand your last post as a response to Scott's question.
This was Scott's question:
" Yes. Let us say for the sake of debate that there are a few people who make this mistake [ie, think this is a venue for medical advice].
What do you suggest that we should do about this?"
Although your response follows Scott's question, and you call it a response in the header, I don't see how your post connects back to Scott's question.I myself have wondered at times about your view about question Scott asks.
Maybe you could address that concern directly, viz.:
1. What specific actions do you think should be taken if some people incorrectly believe that everything posted here is medical information approved by the administrator of the site?
2. Additionally, how much time would it take to accomplish those actions;
3. and I think finally, what would the effect be on the ongoing free interchange of members posting and reflecting upon one another's posts?
Thanks,
Jost
Posted by Lou Pilder on December 1, 2006, at 16:31:57
In reply to Re: Lou's response to Scott's question to Lou, posted by Jost on December 1, 2006, at 11:28:09
Friends,
It is written here,[...what actions do you think..be taken..some people..believe..medical infomation approved by the administrator of this site...?].
Any infomation offered here in a very broad sense could be considered IMO to be medical infomation by the overiding nature that this is a site for support and education involving mental health issues.
There could be direct medical posts about drugs and treatments, there could be medical infomation relative to psychiatric/psychological aspects or even the other boards such as the faith board or the eating board and the other boards which could be considered IMO to be part of the whole in mental health issues.
One way that infomation offered that could be considered to be false or misleading or have the potential to cause harm if the statement is followed, is for the forum to have the a symbol placed next to the statement in question that could cause harm and such. A hand with an open palm indicating to halt is one of my suggestions. That symbol could be made known to the forum to mean that what is posted there is not something that the medical profession endorses, so that caution is indicated. I think that Dr. Hsiung could do this himself and by having the {report this post feature} used by members that question the authority of the statement(s) in question. Another way would be for others to be allowed to post that they do not think that what is posted is what they believe to be true, personally to them, and be allowed to offer their perspective in the thread. If this sounds unusual, I could email to clarify this if you would like.
Another way could be that DR. Hsiung and also the deputies not be permitted to play a role in {developing} a topic. This could mean IMO that they could not >innitiate< a topic, or {advance} an idea presented. They would have a neutrality function. This could mean that they possibly could not be posting in any function except as a deputy.
There is much more to this...
Lou
lpilder_1188@fuse.net
Posted by Phillipa on December 1, 2006, at 18:03:22
In reply to Lou's response to aspects gg's post-, posted by Lou Pilder on December 1, 2006, at 5:53:34
Well guess in 30 some odd years I'll be able to sleep. Hummm I'll also be dead. Love Phillipa ps maybe I'll be centuritarian? Something to consider.
Posted by SLS on December 1, 2006, at 18:42:12
In reply to Lou's response to Scott's and Jost's question, posted by Lou Pilder on December 1, 2006, at 16:31:57
Hi Lou.
You have offered some good ideas. However, I don't trust that Dr. Bob or any other single expert knows enough information or possesses the breadth of perspective that a group of people can represent. With neuroscience in particular, there is no textbook or reference that can keep up with the pace of discovery. It is unreasonable to assume that one man can. I think that the needs of the people coming to Psycho-Babble searching for help in treating difficult cases is best served by allowing forum participants to interact without administrative editing. Afterall, what guarantee is there that the medical opinion of the administration is the right one?
- Scott
Posted by Lou Pilder on December 1, 2006, at 20:36:05
In reply to Re: Lou's response to Scott's and Jost's question, posted by SLS on December 1, 2006, at 18:42:12
Scott,
you wrote,[...You offered some good ideas..I don't trust..(DR. Hsiung)..knows enough..that a group..can represent...there is no textbook..that can keep up...It is unreasonable...best to interact without administrative editing...what guarantee..opinion..is the right one?...]
I think that by Dr. Hsiung being an expert, that his opinion trumps a member's opinion untill his opinion can be demonstrated to be false by another expert. Could not the symbol of the hand to be cautious, comming from an expert, facillitate discussion as well as hamper it?
I think that there is a growing body of knowlege concerning neuroscience and pharmacokinetics that is available to DR. Hsiung perhaps before others have it available to them and that he could have the updates available from many sources. An expert keeps up with developments in his/her field, just as ,let's say, an expert on the History of the Art and Archeology of the Near East and Mesopotamia keeps up-to-date in his/her field. New discoveries are found about the Great Pyramids, as new infomation is found about pharmacology.
Today, I saw a newspaper report about new infomation about taking (name of psychotropic drug redacted by respondant) durring pregnancy. Yesterday, I read a report about the effects of drugs like Ritilin on children. I think that DR. Hsiung is very well up-to-date in his field IMO because he publishes. As to {what guarantee}, does not Dr. Hsiung write to {trust} him? And that he writes that he does what in his thinking will be good for the community as a whole? If I was chairing a forum for,let's say, skydivers, I would want to be up-to-date on skydiving , would I not if I wanted to do what is best for the members?
Lou
Posted by Jost on December 1, 2006, at 21:03:20
In reply to Lou's reply to Scott- » SLS, posted by Lou Pilder on December 1, 2006, at 20:36:05
Neuropsychology and the knowledge of how psychoactive drugs work, and the many complexities of how/at what dose/who they help is pretty primitive and subject to controvery, and confusion.
I think at this stage in its development, when information is fragmentary, often divergent and not scientifically certain, we benefit greatly from input from those of us who have had good advice, from various sources, and our own experience.
I came to this site because there was so much information out there, which I had noway of analyzing. Plus, my pdoc has only a small amount of time, and I only a chance to bring up and puruse a small number of my questions, esp. as my questions evolved the more I learned, and thought about what I learned.
Plus there's so much I couldn't possibly have known, without reading the many contributions and thoughts by others similarly situated here who have had drug trials, of many kinds, whose results they reported.
If everything were subject to being authorized by Bob, or valid according to his particular point of view or information-- esp. when he may not be specifically a practicing psychopharmacologist-- we would lose a very valuable resource.
Bob does say that you have to use your judgment in reading here.
For me, the loss to many people looks very great if we restricted what it was possible to post here, or required that it be certified by any one person.
Jost
Posted by Lou Pilder on December 1, 2006, at 21:39:43
In reply to Re: Lou's reply to Scott-, posted by Jost on December 1, 2006, at 21:03:20
Friends,
It is written here,[...we benifit.. from.. those..who have had {good advice}...{If} everything was subject to being authorized by (Dr. Hsiung)..he may not be..we would lose...if we restricted what was possible to post here...].
It is not my intention to have a system incorperated here that could allow Dr. Hsiung to subject everything to his authorization, but to have him note something that is contrary to the accepted practice. This note, in the form of a symbol of a hand raising caution, only alerts a statement to have the potential to be contraindicated according to known parameters. An example could be if someone posted that they advocate drinking beer while taking a benzodiazepine.
By posting the symbol, caution does not mean that the post is restricted, but that the post could be of the nature of advocating a harmful, or even life-threatening combination. As to knowing if the advice that one has is {good}, could not the symbol make that determination?
Lou
Posted by Phillipa on December 1, 2006, at 21:42:44
In reply to Lou's response to aspects of Jost's post-gdadvic, posted by Lou Pilder on December 1, 2006, at 21:39:43
Gee funny for about 20 some odd years I drank beer nightly and my pdoc knew and took xanax or valium and he said it was okay. There wasn't an internet then. Love Phillipa
Posted by Phillipa on December 1, 2006, at 21:43:27
In reply to Lou's response to aspects of Jost's post-gdadvic, posted by Lou Pilder on December 1, 2006, at 21:39:43
Gee funny for about 20 some odd years I drank beer nightly and my pdoc knew and took xanax or valium and he said it was okay. There wasn't an internet then. Love Phillipa ps I didn't stop breathing or end up in the hospital
Posted by SLS on December 2, 2006, at 6:45:43
In reply to Lou's response to aspects of Jost's post-gdadvic, posted by Lou Pilder on December 1, 2006, at 21:39:43
> It is not my intention to have a system incorperated here that could allow Dr. Hsiung to subject everything to his authorization, but to have him note something that is contrary to the accepted practice.
> This note, in the form of a symbol of a hand raising caution, only alerts a statement to have the potential to be contraindicated according to known parameters. An example could be if someone posted that they advocate drinking beer while taking a benzodiazepine.
> By posting the symbol, caution does not mean that the post is restricted, but that the post could be of the nature of advocating a harmful, or even life-threatening combination. As to knowing if the advice that one has is {good}, could not the symbol make that determination?
That sounds like a noble idea, and has its appeal. Again, the problem arises in that we would be fostering the editing of posts by allowing the commentary that comes in the meaning behind the use of such symbols. And again, I don't think it is reasonable to assume that Dr. Bob, or any other single MD, possesses enough knowledge and understanding to review and certify the safety of all drug combinations in a forum where novel treatment strategies are discussed.
It would be interesting to get some feedback from Dr. Bob on this.
I don't know, Lou. There are a few drug / substance combinations that are indeed dangerous. It would be good to insure safety. Fortunately, the participants on Psycho-Babble are rather vigilent about watching for such things and regularly post appropriate comments.
- Scott
Posted by Lou Pilder on December 2, 2006, at 7:22:18
In reply to Re: Lou's response to aspects of Jost's post-gdadv, posted by SLS on December 2, 2006, at 6:45:43
Scott,
you wrote,[...sounds like a noble idea..problem..editing of posts..I don't think..that.. (DR. Hsiung)..possesses enough knowlege..certify the safety of all drug combinations...{it would be good to insure safety}..participants.. post..comments...]
To edit could mean a lot of things, such as to delete. But it is not my intention to have a deletion to a post, but to have a cautionary symbol placed with the statement in question that could have the potntial cause harm to those who could be catagorized as {the less-likely to question a drug combination} member. I gave the example of the use of alcohol with benzodiazepines. In my suggestion to Dr. Hsiung here, he could post a link to give credibility to his cautionary symbol, in this case such as under the heading in the link,{...Precautions While Using This Medicine...};
www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
I find no fault with posting a link from experts in a field of concern that others could research on their own. Would it not be good for the community as a whole to have the moderator, who is an expert, post a cautionary symbol to perhaps have the potential to save lives? And has not Dr. Hsiung made a rule to accommodate the {less confident} poster, so could it not be reasonable to accommodate the {less-likely to question a drug combination} member?
Lou
Posted by SLS on December 2, 2006, at 8:55:12
In reply to Lou's reply to aspects of Scott's post-nobida, posted by Lou Pilder on December 2, 2006, at 7:22:18
> Scott,
> you wrote,[...sounds like a noble idea..problem..editing of posts..I don't think..that.. (DR. Hsiung)..possesses enough knowlege..certify the safety of all drug combinations...{it would be good to insure safety}..participants.. post..comments...]
> To edit could mean a lot of things, such as to delete. But it is not my intention to have a deletion to a post, but to have a cautionary symbol placed with the statement in question that could have the potntial cause harm to those who could be catagorized as {the less-likely to question a drug combination} member. I gave the example of the use of alcohol with benzodiazepines. In my suggestion to Dr. Hsiung here, he could post a link to give credibility to his cautionary symbol, in this case such as under the heading in the link,{...Precautions While Using This Medicine...};
> www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html
> I find no fault with posting a link from experts in a field of concern that others could research on their own. Would it not be good for the community as a whole to have the moderator, who is an expert, post a cautionary symbol to perhaps have the potential to save lives? And has not Dr. Hsiung made a rule to accommodate the {less confident} poster, so could it not be reasonable to accommodate the {less-likely to question a drug combination} member?
Interesting ideas, Lou. I'm not sure they are practicable, though.I consider adding a symbol a form of editing.
- Scott
Posted by Lou Pilder on December 2, 2006, at 10:29:12
In reply to Re: Lou's reply to aspects of Scott's post-nobida, posted by SLS on December 2, 2006, at 8:55:12
Scott,
You wrote,[...interesting ideas,Lou..practicable?..symbol..a form of editing...]. A symbol to show caution could be implemented here, as a symbol to show that a poster is a new member has a symbol to show that. A red or orange symbol could be used instead of the hand symbol. Other symbols could be used also.
An edit could be of many natures. But the caution symbol is to indicate, not to delete or modify the words in a statement. An administrative note could also be posted, which is another form of editing. But the administrative note,{please be civil} is also an edit. Could not an administrative note that could caution about the dangers of a post's statement be at least just as important and relevant here as the {please be civil} edit?
Lou
Posted by SLS on December 2, 2006, at 11:27:35
In reply to Lou's reply to aspects of Scott's post-intidas » SLS, posted by Lou Pilder on December 2, 2006, at 10:29:12
> Scott,
> You wrote,[...interesting ideas,Lou..practicable?..symbol..a form of editing...]. A symbol to show caution could be implemented here, as a symbol to show that a poster is a new member has a symbol to show that. A red or orange symbol could be used instead of the hand symbol. Other symbols could be used also.
> An edit could be of many natures. But the caution symbol is to indicate, not to delete or modify the words in a statement. An administrative note could also be posted, which is another form of editing. But the administrative note,{please be civil} is also an edit. Could not an administrative note that could caution about the dangers of a post's statement be at least just as important and relevant here as the {please be civil} edit?
I am currently against the idea of "flagging" posts in the manner you suggest. However, I would be interested to know what others think.
- Scott
Posted by Lou Pilder on December 2, 2006, at 11:43:50
In reply to Re: Lou's reply to aspects of Scott's post-intidas, posted by SLS on December 2, 2006, at 11:27:35
Scott,
You wrote,[...against..flagging..(as) you suggest...].
If you are against the symbol,are you also against having the green indicator to show that the poster is a new member? If not, could you list what your differences could be that could have you endorse the one symbol, if you are against the other symbol? If you could, then I could have the opprunity to respond accordingly.
Lou
Posted by Dinah on December 2, 2006, at 12:31:57
In reply to Lou's reply to aspects of Scott's post-agflag » SLS, posted by Lou Pilder on December 2, 2006, at 11:43:50
Lou, what you're suggesting would establish a different sort of relationship with the board than Dr. Bob currently has. And he has been utterly clear that he's not interested in establishing that sort of relationship.
Posted by Lou Pilder on December 2, 2006, at 13:46:32
In reply to Re: Lou's reply to aspects of Scott's post-agflag, posted by Dinah on December 2, 2006, at 12:31:57
Dinah,
You wrote,[...your suggestion could establish a different relationship...he's(Dr. Hsiung) not interested...].
If my suggestion could establish a different relationship, could my suggestion also {not} establish a different relationship?If an edit writes,{please be civil},and if an edit is used to indicate that the poster is a new member, how in your opinion, could an edit that is a symbol that indicates caution about something posted that could have the potential to kill someone or cause harm to someone be a {different} relationship and if so, why would ,in your opinion, you think that DR. Hsiung would be against the use of the edit in relation to the symbol for caution? If you could clarify this, then I could have the opportunity to respond accordingly.
Lou
Posted by Dinah on December 2, 2006, at 14:29:04
In reply to Lou's reply to Dinah- » Dinah, posted by Lou Pilder on December 2, 2006, at 13:46:32
Because the new poster notification is an administrative function, for one, and is done automatically by the computer, for another.
It has nothing to do with what you're proposing.
You're proposing that Dr. Bob establish a relationship with the board where he effectively gives medical advice. He's not going to do that. I wouldn't do that. His role here is strictly administrative. He's made that more than clear.
That's really all I have to say about it. I can't be any more clear than that. I don't know how.
Posted by Lou Pilder on December 2, 2006, at 15:08:09
In reply to Re: Lou's reply to Dinah-, posted by Dinah on December 2, 2006, at 14:29:04
Friends,
Dinah has replied to me with something like that I am proposing that Dr. Hsiung establish a relationship with the board where he gives medical advice.
Let us look at the facts. I am suggesting that DR. Hsiung place a symbol in the thread where statements that offer, let's say for example, drug combinations that could have the potential to harm of even cause the death of a person to be notated in some way that the medical profession does not endorse the combination of drugs advocated. One example could be if a poster advocated drinking alcohol while taking a benzodiazepine. DR. Hsiung could also post an administrative comment with the symbol.
The question here now, is if Dr. Hsiung was going to implement my suggestion on the board, would he be [...giving medical advice...]?
The concept of giving medical advice could be understood in many ways. I think that to notate that taking a combination of drugs that a member posts to take, that could have the potential to cause someone to die, is not IMO giving medical advice , but clarifying that there is danger in the taking of the combination in question.
There are many web sites that list the adverse reactions of combinations of drugs and I do not see any mention that they are giving medical advice. The government offers liturature about the harmfull effects and possible death by taking various combinations of drugs and I have not seen where the government has been accused of giving medical advice.
Teachers of health related subjects tell their students about the potential for death from taking various combinations of drugs.There are other doctors that have web sites that warn their readers about the harmfull effects of some combinations of drugs. I have not seen any claim that they are giving medical advice by republishing the PDR's section on such or posting the manufacturers liturature for such. I think that medical advice is different from posting common knowlege available on the internet.
DR. Hsiung has also posted that he may ask someone here about their feelings if they ask another to please not post to them and has posted that he does not think that he is establishing a psychiatric relationship if he was to do that.
Dr. Hsiung offers expert's opinions about medical issues here. And does he not receive the questions first and then forward them to the expert? If so, is this not establishing a >vicarious< relationship? If not, could anyone here post why not? If you could, then I could have the opportunity to respond accordingly.
Lou
Posted by zazenduckie on December 2, 2006, at 15:18:19
In reply to Re: Lou's reply to Dinah-, posted by Dinah on December 2, 2006, at 14:29:04
.
>His role here is strictly administrative.No not strictly. He has assumed the role of protecting posters by not allowing the posting of sources of drugs that are not permitted by the FDA. He has made the judgement that descriptions of suicide methods or fatal dosages of drugs may not be posted. He has all ready assumed a role as gatekeeper for the posts which are allowed here based on his professional judgement regarding safety and legality.
I believe he should limit posters to describing their own experiences rather than offering diagnosis or treatment suggestions for other posters.
Go forward in thread:
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