Posts Tagged ‘Alternative Medicine’

Your Physician Should Be Your Advocate

Saturday, August 25th, 2012

Doctor and PatientA patient goes to a doctor’s office with the belief that the doctor knows something, or has the ability to do something, that will help the patient. It is the doctor’s obligation to have knowledge, or have access to knowledge, relevant to the patient’s situation, or the training to perform a procedure to evaluate or treat the patient.

It is therefore important for the doctor to be educated in what he purports to know, to offer recommendations based on a satisfactory knowledge base. It is also important that the basis of a physician’s recommendation is the well-being of the patient, not the physician’s self-interest.

These conditions are by no means straightforward. Many types of approaches are available for most conditions, while other conditions have few proven therapies. Still, patients will always look for answers, for some kind of help, because it is not in man’s make-up to sit and do nothing in the face of adversity.

The doctor must keep in mind that a given treatment may not help the patient, or may cause complications and make the patient worse, or that the real diagnosis lies elsewhere. The age, physical and mental status of the patient must also be considered in choosing a therapy. Cardiac bypass surgery may be a proper choice for a 50 year-old, hard-driving businessman, but excessively dangerous for an 85 year-old woman with severe arthritis and emphysema. Determining the best therapy may more involve the art than the science of medicine.

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Disproven Medical Practices Are Still the “Standard of Care”

Tuesday, March 27th, 2012

An editorial in JAMA, Jan 4, 2012, deplores the persistent promotion of outmoded medical practices, in the guise of being valid.  (Reversals of Established Medical Practices, pp37-38)

Modern medicine presents itself as being “evidence-based,” meaning that its tests and therapies are proven by research to be valid.  Unfortunately for patients, that is patently not the case.  Many standards of care have never been tested in trials, or worse, have been tested and shown to be wanting in efficacy.  In a recent evaluation of 35 trials of established medical practices, 46% reported results consistent with the current practice, but an additional 46% offered results contradicting current practice, and another 8% were inconclusive.  In other words, more than half of the practices were lacking or had dubious validity.

Among the invalid therapies are vertebroplasty for spinal fractures, demonstrated in two studies to lack effectiveness, but nevertheless now utilized as much or more than before the studies were published.  Another invalidated procedure is the use of coronary artery stents in the treatment of stable angina.  Stents provide no advantage in survival, although they do reduce exertional chest pain, but so do medications, and with much less risk.

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