RNZCGP GoodFellow Unit MedCases CPD Sept 2023: Chronic fatigue syndrome/myalgic encephalomyelitis

He seems to be a true believer.

 

I assume it was this, ‘The Lightning Process’ and chronic fatigue syndrome/myalgic encephalomyelitis, 2022, Vallings

 

Fully-trained LP practitioners, uh? Well, if they are fully-trained then how could it be bad? Now that's evidence-based reasoning. You wouldn't want half-trained people, that's for sure.

Anyone notice the implication of "given her age" about LP? Not sure if it means that it's childish and therefore more suited to children, or that children are easier to manipulate. Probably both. The "decides to work with you on CBT" thing is really creepy. As if a child being told stuff like this by a doctor can do that. Holy manipulation, Batman.

Evidence-based medicine really needs to end. This paradigm has only lead the most significant regression in an expert profession, and probably nothing else. It's not even clear if the paradigm actually adds anything at all.

The process itself has become the industry, it is both the means and the ends. It doesn't have or tries to produce any useful outcomes. It merely exists, provides a steady flow of cheap excuses for anything anyone wants, as long as they can push it through a bureaucracy. It's fundamentally antiscience. Not just failing at science but rejecting it entirely. Alternative medicine with all the substance of alternative medicine but the cost and authority of scientific medicine. The absolute worst possible combination.

 

It is a cleverly chosen term. So generic as to be meaningless. Very political, diffuses any criticism of it as essentially invalid, because who indeed is against evidence?

Which is exactly why it is so awful, even dangerous. Like a tinpot dictator making their entire propaganda about justice, and calling any critic to be against justice. Who is against justice? These dangerous radicals, obviously. While I, the ruler, am for justice. It is obvious who is right, here.

Hence why the term is problematic in itself. It's a political statement, not a real descriptor of what is happening. But also probably why it can't be changed, because that would be framed as being against the idea of evidence in medicine. So now pseudoscience and quackery are likely impossible to dislodge at the core of medicine. Likely something that will push the adoption of AI medicine faster than it should be. Because AIs won't care about this junk, they'll care about scientific evidence.

Probably the only diffuser here is non-scientific evidence-based medicine. It may be evidence, but none of it is actually scientific. It is arbitrary and judgmental, no better than what a legislative committee would produce. Change the people, you change the outcome, and the outcome is only as good as the people and the process. No science anywhere in there. It's all about what people want and what they can convince others of.

But this is truly a bind, there is no good way out of this. Like trying to get a political party who keeps winning elections in a system to change to a system where they would win fewer elections. Good luck with that, it almost never happens.

 

Charles Shepherd and ME Association have responded on FB.

https://www.facebook.com/meassociat...AwUWntSiK3fRToFLdZinGX2VpHJbjVERe8gYr5RjCbWal

 

Information on ME/CFS for GPs in New Zealand – Definitely not recommended.
September 21, 2023

Information on ME/CFS for GPs in New Zealand - Definitely not recommended. - The ME Association

 

fyi
M.E. Awareness NZ and ANZMES have connected with our Health and Disability Commission (HDC) over the past year about the risk of harms from the poor quality of clinical information on ME/CFS at GP education events.
HDC have been receptive, have given advice (which has been acted upon) and are actively watching the situation.

This is a summary of some of the action to date...

1. Health & Disability Commissioner
   1. 2023_02_27 Letter to HDC re GPCME stance on MECFS.pdf
   2. Meeting and email discussions with HDC have lead to the following letters being sent from ANZMES and M.E. Awareness NZ and copying them in...
2. 2023_03_31 Medical Council Letter 31032023 ME Awareness ANZMES.pdf
   1. 2023_04_04 Reply re Latest evidence-based guidance on MECFS from Kiri Rikihana MCNZ.pdf
3. 2023_04_24 HQSC letter 240423 MECFS education.pdf
   1. 2023_05_11 HQSC reply to Charlton re ME-CSF education 20230511.pdf
4. 2023_04_24 Medical Deans letter 240423 MECFS education.pdf
   
   
5. 2023_04_23 RNZCGP letter 230423 MECFS education.pdf
   1. Luke Bradford, Medical Director, RNZCGP, wrote that he would attend GPCME South to ensure ‘balanced presentation of evidence’
      2023_05_31 RNZCGP reply Medical Education on ME CFS.pdf
      
      
   2. Fiona replied asking if they will also have someone at GPCME Rotorua for the same reason.
      2023_06_06 ANZMES reply to RNZCGP letter re Medical Education.pdf
6. We understand that HDC and Human Rights Commission (HRC) (edit: not HQSC as I originally wrote) have written to RNZCGP themselves.
   1. As a result, we have been advised that RNZCGP are reviewing their endorsement processes and looking to have key note speakers at their conference in 2024 (GP24, not GPCME).

M.E. Awareness NZ and ANZMES (to be confirmed), with support of the regional NZ organisations, are planning to make a complaint to HDC about the Goodfellow Unit Medcase recently published. Very happy to receive any input into this from this forum.

 

One step forward and three steps backwards sometimes.

I think it is fair to say that the previous advocacy efforts with the NZMA were the direct cause of the plenary session on CFS at GPCME 2023 Rotorua including five 'experts' who support the anti-NICE stance. So a backfire there.

It is progress that the conversation now includes a wider group of players who do have some responsibility (HDC, HQSC and RNZCGP). Whether they step up is yet to be seen. The HDC rely on the medical bodies for clinical guidance, so it is tricky.

 

This may have been answered elsewhere.
The Goodfellow Unit is within Auckland University and has a role in providing education for health professionals. They are endorsed by the RNZCGP to deliver this education and people attending their education can obtain Continuing Medical Education (CME) credits.
Goodfellow and RNZCGP are completely different organisations.

 

Bruce Arroll has a very high reputation within medical circles in NZ.

 

A fantastic letter and tour-de-force.

Minor typos that I happened to notice—

RCNZGP -> RNZCGP
reported -> reported
"no evidence that ME/CFS is in a psychosomatic condition where" -> "no evidence that ME/CFS is a psychosomatic condition where"

"the 2021 NICE Guideline on ME/CFS7 is definitive" (double space)
"biomedical reseearchers"
"any treatments that aim to make people to believe"
"Arrol" -> "Arroll"