When Evidence Says No, but Doctors Say Yes

[AnonEMouse]

Not sure if this has been posted, but thought it relevant.

https://getpocket.com/explore/item/when-evidence-says-no-but-doctors-say-yes

Basically, beware of medical procedures recommended by doctors and do your own research. US regulations have also been loosened, so do your research on medicines, medical procedures, etc. too. I.e., be a wise consumer of medical care.

Probably nothing new to the people here. I was, however, surprised at the scope and breadth of procedures and medicines that were useless or even harmful.

And lastly, a relevant quote for this forum:

"In 2012, he co-authored a paper showing that pretty much everything in your fridge has been found to both cause and prevent cancer—except bacon, which apparently only causes cancer."

 

[6miths]

Good article. I was going to post but figured I had recently posted a two year old article from The Atlantic so that was my limit for the month. The age of articles like this aren't really that relevant. The content continues to be very current.

 

[unclemick]

BACON!

heh heh heh - I leave it to the old timers on this forum to comment.

 

[sengsational]

Users of the sick-care system probably would be mostly fine most of the time, but they'd be wise to double check, like the guy in the opening vignette of the article. Being an informed patient is probably appreciated by the best doctors. I know my PCP is never put-off by my relating information I've gathered through my own research. In fact, he seems energized by it.



I'm kind of a statistics hobbyist...one of the few engineers in my undergrad class that took more statistics than I "needed". I like NNT, and was pleased to see that the article mentioned that.

Graham Walker, an emergency physician in San Francisco, co-runs a website staffed by doctor volunteers called The NNT that helps doctors and patients understand how impactful drugs are—and often are not. “NNT” is an abbreviation for “number needed to treat,” as in: How many patients need to be treated with a drug or procedure for one patient to get the hoped-for benefit?

 

[copyright1997reloaded]

I prefer the studies where wine, beer, and coffee protects against cancer.

 

[Tekward]

Thank you for sharing. Really well written and sobering.

 

[HI Bill]

Yes, doctors want to treat symptoms. They rarely ask the patient to change diet or behavior or lose weight. I once had high cholesterol, and my physician wanted to put me on cholesterol meds. I asked him if I should instead change my diet, lose weight, and exercise more. He seemed surprised, but said yes, I should try it! I did, and my cholesterol was lowered to the normal range. All without the side effects of meds!

 

[Which Roger]

Yes, doctors want to treat symptoms. They rarely ask the patient to change diet or behavior or lose weight. I once had high cholesterol, and my physician wanted to put me on cholesterol meds. I asked him if I should instead change my diet, lose weight, and exercise more. He seemed surprised, but said yes, I should try it! I did, and my cholesterol was lowered to the normal range. All without the side effects of meds!

I think doctors want to treat symptoms because most of their patients would rather have a magic pill than do the hard work to treat the underlying causes. Patients like you who want to do the hard work are an exception, thus the doctor's surprise.

 

[swakyaby]

I think doctors want to treat symptoms because most of their patients would rather have a magic pill than do the hard work to treat the underlying causes. Patients like you who want to do the hard work are an exception, thus the doctor's surprise.

+1

 

[walkinwood]

I think doctors want to treat symptoms because most of their patients would rather have a magic pill than do the hard work to treat the underlying causes. Patients like you who want to do the hard work are an exception, thus the doctor's surprise.

I've heard that line of argument & its a cop-out. They have assumed a responsibility and should uphold it. They're being paid well enough for that - both financially & in social standing.

OP - Thanks for sharing. I've read snippets of this before, but this is a well-rounded article. I'm a big believer in public health initiatives. Thanks to the publicity around the ills of tobacco & the accompanying laws that made it difficult & expensive to smoke, I quit 23 years ago.

 

[joeea]

Basically, beware of medical procedures recommended by doctors and do your own research.

Do your own research?

That's all well and good. But for most people "do your own research" means a few Google searches until you find a source that confirms whatever it is you wanted to do anyway.

I see nothing in the article that suggests folks should do their own research.

 

[joeea]

Yes, doctors want to treat symptoms. They rarely ask the patient to change diet or behavior or lose weight.

I guess my doctor must be in the minority...

 

[Amethyst]

On the flip side, my cholesterol has been creeping up for several years and is now a bit high, but that includes high HDL, a BMI of 20.5 and a habit of regular exercise. So far, my internist has not seen fit to prescribe statins. I hope whichever doctor I end up with in Florida sees things the same way.

Yes, doctors want to treat symptoms. They rarely ask the patient to change diet or behavior or lose weight. I once had high cholesterol, and my physician wanted to put me on cholesterol meds. I asked him if I should instead change my diet, lose weight, and exercise more. He seemed surprised, but said yes, I should try it! I did, and my cholesterol was lowered to the normal range. All without the side effects of meds!

 

[Amethyst]

Feeding off the article, I wonder how many people go on anti-depressants, which all have side effects, simply because the current mantra is "You don't have to suffer! These drugs can help!" And then stay on these drugs forever, afraid to come off.

 

[audreyh1]

On the flip side, my cholesterol has been creeping up for several years and is now a bit high, but that includes high HDL, a BMI of 20.5 and a habit of regular exercise. So far, my internist has not seen fit to prescribe statins. I hope whichever doctor I end up with in Florida sees things the same way.

Personally I’m going to focus on keeping my HDL high, and my triglycerides (and fasting insulin) low, and not worry too much about LDL and total cholesterol. From what I’ve read, the research saying using statins to lower LDL means longer lives in women without cardiac events is pretty spotty - much says not, or the numbers needed to treat to benefit are so high they don’t make up for the side effect risks. There are many doctors who do not agree that lowering cholesterol protects against heart disease for patients who are otherwise healthy, and in over 65 women high cholesterol is associated with longevity.

 

[audreyh1]

Very long article. I don’t think it even mentioned the way excessive number of hysterectomies performed in the US. When the first doctor I saw immediately recommended a hysterectomy for my not that large fibroids, I was shocked and explored alternate treatments. Researching further, I was became even more shocked at the system.

It’s tough, but you really do have to try to evaluate alternatives and often you are on your own.

 

[ugeauxgirl]

Great article. Thanks for posting

 

[Amethyst]

Especially in post-menopausal women, since we're no longer baby machines. "Hey, you won't even miss it, right?" Well, from what I've read, that's bogus and women do "miss it."

Very long article. I don’t think it even mentioned the way excessive number of hysterectomies performed in the US. n.

 

[audreyh1]

Especially in post-menopausal women, since we're no longer baby machines. "Hey, you won't even miss it, right?" Well, from what I've read, that's bogus and women do "miss it."

Of course.

I was around 40, still more than 10 years away from average age of cycles stopping, and the female doctor was already talking total hysterectomy and saying you can take hormones, no big deal. I’m just thinking WHAT?!?

 

[homestead]

I was referred to a surgeon for a TMJ problem with my jaw being locked up. He said he could look at fixing the problem with surgery but he said when you are a hammer every problem looks like a nail. He ended up prescribing me vallium.

 

[misshathaway]

I think doctors want to treat symptoms because most of their patients would rather have a magic pill than do the hard work to treat the underlying causes. Patients like you who want to do the hard work are an exception, thus the doctor's surprise.

Well, how many of us have obese PCP's? I'm willing to bet that my last one, loved his care anyway, and my present one, are both on statins.

 

[AnonEMouse]

I prefer the studies where wine, beer, and coffee protects against cancer.

But where's the bacon?

 

[AnonEMouse]

Do your own research?

That's all well and good. But for most people "do your own research" means a few Google searches until you find a source that confirms whatever it is you wanted to do anyway.

I see nothing in the article that suggests folks should do their own research.

Well, I think it's implied even if the author didn't flat out say it. The two vignettes at the very beginning of the article kinda made it explicit. The executive who did his research (googling on his phone in the ER) lived while the other who blindly followed his doctors' recommendations sadly didn't.

 

[MichaelB]

It’s tough, but you really do have to try to evaluate alternatives and often you are on your own.

I agree, but this is easier said than done. Just recalling the recent thread discussion in statins as an example. Health care professionals tend to be very dismissive of diagnoses and treatments other than the ones they prescribe.

 

[audreyh1]

I agree, but this is easier said than done. Just recalling the recent thread discussion in statins as an example. Health care professionals tend to be very dismissive of diagnoses and treatments other than the ones they prescribe.

Oh, it’s very difficult. And usually very time consuming too! The information out there can be extremely conflicting. And many doctors disagree on what is the best approach.

When a doctor is quickly dismissive of your concerns or your wishes to review alternatives, and has a “just do as I say” attitude, it’s time to talk to another doctor or two before taking a big step. You are the one who has to live with the outcome.