Thanks Rogue Medic – What are EMS’s “Fad Diagnoses”?

Our friend Rogue Medic has a shiny new site up there on the Interwebs. It rocks. Rogue Medic is one of the many, many bloggers, non-bloggers, and/or random people who are much, much smarter than I am. I read his site a lot and I am very pleased to throw a link to his new site. He’s part of a new blog network with the URL Http://www.EMSblogs.com. Rogue has been joined by our other friends David Konig and Too Old To Work, Too Young to Retire.

That URL again for Rogue Medic is: Http://www.RogueMedic.com

Too Old to Work’s new digs are at: Http://www.ToOldToWork.com (yes, I know the “To” should be a “Too” and it just bugs the hell out of me as well)

And you can find everyone on their network on Http://www.EMSblogs.com 

Anyways, since this is my blog and you’ll come back here eventually. Rogue Medic pointed me to a site that I’m quite surprised I hadn’t found before Http://www.QuackWatch.com It’s provided me with some hours of entertainment tonight and since I’m a nerd and I admit it, that’s ok for me.

On QuackWatch, I read an interesting article on “Fad Diagnoses” with a handy checklist at the end that tells one how to create a bona-fide fad disease. (The article is here, with a lot of handy links: http://www.quackwatch.com/01QuackeryRelatedTopics/fadindex.html)

 The checklist, which is just entertaining as hell, is below:

 Recipe for a New Fad Disease

  • Pick any symptoms—the more common the better.
  • Pick any disease—real or invented. (Real diseases have more potential for confusion because their existence can’t be denied.)
  • Assign lots of symptoms to the disease.
  • Say that millions of undiagnosed people suffer from it.
  • Pick a few treatments. Including supplements will enable health food stores and chiropractors to get in on the action.
  • Promote your theories through books and talk shows.
  • Don’t compete with other fad diseases. Say that yours predisposes people to the rest or vice versa.
  • Claim that the medical establishment, the drug companies, and the chemical industry are against you.
  • State that the medical profession is afraid of your competition or trying to protect its turf.
  • If challenged to prove your claims, say that you lack the money for research, that you are too busy getting sick people well, and that your clinical results speak for themselves.

 

This checklist got me to thinking about what “fad diseases” we may be treating as Paramedics and EMTs in the prehospital setting. While logically, I can think that we must be treating diagnoses that are more en-vogue than others, I can’t really seem to think of one off hand. I blame it on a mixture of my long day and my ADD. I would guess that our contemporary collective attention to STEMI care could be one. While ST-Segment Elevation Myocardial Infarction’s are quite serious and require immediate intervention, haven’t you noticed that we never call anything a “heart attack” anymore and now everything’s a STEMI? Do we emphasize the diagnosis of the STEMI at the expense of other conditions, such as Thoracic Aneurism or a Pulmonary Embolism? What about non-STEMIs?

Since I’m drawing a blank on something where I believe that logically, I should be able to think of something, I’m asking for your opinions:

What are the “Fad Diagnoses” of contemporary EMS? Feel free to add your own in the comments section below. I’m sure this could get wildly entertaining.

(Oh, and I’m not making any clams as to the existence or non-existence of any of the “Fad Diagnoses” posted here or on the other site. If you think they’re real, then heck… why not?)

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  • http://twitter.com/MattTheMedic Matt Wright

    As I said last night I believe SIDS could fit the criteria for this category. Although certainly no one is profiting off of SIDS, it does have a wide range of potential causes (From low birth weight to high birth weight and low Vitamin C to high Vitamin C). There is no way to test for it. It can happen to any family no matter race or socioeconomics. And generally infants show no signs or symptoms prior to the event. Treatments (really prevention) run the gambit from making sure your little bundle of joy sleeps on his back to making sure there is a fan in the room circulating air. There is certainly no lack of literature about SIDS, even though no one seems to know exactly what the Hell they are talking about. And it does play into the “don’t compete” clause listed above. If anything it loves company…as long as the company doesn’t take too much of the credit in the end result.

    I’m not suggesting there is some great SIDS Illuminati that prevents it’s actual cause from being found, I’m just saying SIDS fits a surprising number of the rules as they are laid out above.

    Also…there is absolutely no way to make SIDS funny. I’ve been sitting here for 5 minutes trying. Can’t be done.

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  • http://thehappymedic.com the Happy Medic

    It can be done, just not tastefully. I agree with Matt on SIDS, it was a name assigned to help parents cope with the fact that their child is just dead. I heard on a news show years ago SIDS was on the decline since less parents were smoking in the home, but found that difficult to believe. It is indeed just a gathering point for “We don’t know why your seemingly healthy child died suddenly.”
    My favorite fad diagnosis is erectile dysfunction. No, really. A bunch of middle aged guys who are used to watching 18 year old girls on the internet do things their less than healthy wives would never consider suddenly have trouble becoming aroused? And we’re surprised? “ED” is a simple way to say “Watching too much porn? We can help make your reproductive organs work without your involvement while at home with the wife.”
    What a joke.

  • http://510medic.wordpress.com 510medic

    It seems to me that “Fad Diagnoses” in EMS are directly proportional to whatever new medication/procedure/toy we were just given. For instance, Zofran is indicated in my county for “Severe Nausea”. In the months following the protocol change it was amazing how many patients suddenly presented with “severe” nausea. The same is true for most of the other new procedures (standing orders for chemical restraint especially).

    As far as fads in medicine in general, ADHD seems to have been replaced by bipolar disorder in kids. I was always under the impression that it could be diagnosed until adolescence, but I’ve been seeing huge numbers of pre-teens on anti-psychotics for it, so there ya go.

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  • Totwtytr

    It’s efficiency! TooOldToWork didn’t work well, since in English there are no words with three letters repeated.

    Thanks for the link, though.

    I think about the only fad diagnosis is Asthma. It seems that a lot of doctors are making that Dx based on scanty clinical evidence. That’s just me, though.

  • Nritchey84

    Fibro myalgia is a complete crock and too general to describe any do you notice the people who say they have it have another treasure trove of health problems and it just strikes to you this person is a seeker of some kind or another

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.

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  • Comments
    mr618
    Welcome to the Club
    Well said, Chris. We can't save everybody, but the ones we don't save tend to stick around a lot longer than the ones we do save.
    2014-10-18 14:40:00
    Steel City Medic
    Welcome to the Club
    Particularly appropriate for me this week. Thanks.
    2014-09-23 21:46:00
    DiverMedic
    Welcome to the Club
    Very well done, Chris.
    2014-09-17 22:15:00
    DiverMedic
    My Blogroll
    One of these days you'll figure out where my blog is... :)
    2014-09-17 22:11:00
    emtterri123
    Six Tricks You Can Use Today to Improve Your EMS Narrative Report
    The first and best way to get people reading you to think that you are an idiot is to pepper your writing with spelling and grammatical errors. It makes you look dumb. - Me thinks this should have been restructured as it does not flow and caused me to reread it several times. lol :)
    2014-09-17 08:27:00

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