Bad Medicine: Doctors Doing Harm since Hippocrates
David Wootton argues, from the fifth century BC until the 1930s, doctors actually did more harm than good.
"For 2,400 years patients have believed that doctors were doing them good; for 2,300 years they were wrong." The unsparingly pessimistic view of the overwhelming failures of doctors is that of David Wootton, a professor of history who has written "Bad Medicine: Doctors Doing Harm Since Hippocrates"
For a couple of thousand years, medicine was based on Hippocrates and his successors, especially Galen, whose theories dealt with balancing bodily fluids, and to help nature along, doctors would induce vomiting or diarrhea, apply hot irons to the body, or drain off some blood. There was no physiological benefit in such treatments, which could do nothing but make things worse. Yet such treatments were the staple of medical practice until the middle of the nineteenth century.
Why did physicians and scientists, and even patients, believe in the theories of Hippocrates and Galen, which were wrong from start to finish? According to Hippocrates, for example, the arteries carry air. No one made a connection between the pulse, which could be felt in the wrist, and the beating of the heart.
The first microscope was invented in 1575, and a hundred years later, Antony van Leeuwenhoek built hundreds of them. But no one thought of using them to continue studying the tiny particles that Leeuwenhoek saw under his microscope and illustrated.
The truth is, I never paid attention to the fact that there was such a large time gap between the invention of the microscope and its clinical use, or the fact that patients suffered such intolerable pain during operations performed without anesthesia when the substances that allowed pain relief were already known. Only when the use of ether was demonstrated in 1846, and amazingly, not by surgeons who saw the suffering they caused, but by a quack dentist who thought it was a good way to get rich, did doctors begin to administer ether to dull pain during surgical procedures.
http://www.amazon.com/Bad-Medicine-Doctors...s/dp/0192803557
http://www.haaretz.com/weekend/week-s-end/...gnosis-1.216267
Full Version: Doctors Doing Harm since Hippocrates
Lies, Damned Lies, and Medical Science
Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.
That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.
It didn’t turn out that way. In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views
Indeed, nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest.
Medical research is not especially plagued with wrongness. Other meta-research experts have confirmed that similar issues distort research in all fields of science, from physics to economics (where the highly regarded economists J. Bradford DeLong and Kevin Lang once showed how a remarkably consistent paucity of strong evidence in published economics studies made it unlikely that any of them were right).
http://www.theatlantic.com/magazine/archiv...l-science/8269/
Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.
That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.
It didn’t turn out that way. In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views
Indeed, nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest.
Medical research is not especially plagued with wrongness. Other meta-research experts have confirmed that similar issues distort research in all fields of science, from physics to economics (where the highly regarded economists J. Bradford DeLong and Kevin Lang once showed how a remarkably consistent paucity of strong evidence in published economics studies made it unlikely that any of them were right).
http://www.theatlantic.com/magazine/archiv...l-science/8269/
Stocks, what is the root cause of your years long habit of posting this trash on this site. You may have had close contact with a bad apple and every profession has bad apples, but why do you have to be so one sided.
You post flies in the face of so many things that it is ludicrous. Like
The ever growing life expectancy...
The control of pandemic and epidemic type infections like smallpox that wiped out 20% of populations, sweeping through the continents and killing 300-500,000 people, more than all the world wars put together, and 1/3 of the surviving left blind...
Heart attack mortality going steadily down with the advent of emergency angioplasy and STEMI protocols...
Heart failure mortality going steadily down with many improvements in medicine...
Reduced sudden cardiac death through appropriate screening and inplantable defibrillators...
Decrease in the ravages of hypertension with the advent of good medicines to control it...
Improved survival of certain types of cancers through surgical removal, chemotherapy and radiation...
Survival of end stage kidney failure with dialysis
Survival of various types of organ failure including heart, lung, kidney, and liver to name a few with transplants...
Anyway, I doubt I, or anyone, will ever get through to you, as you have you blinders on, reading and posting every conspiracy theory medical bash you can get your hands on. Just accept the fact that there are bad apples in every profession, medicine is not immue to it, and leave it at that.
Realize that every single patient that a doctor encounters is a father, or mother, or brother, or sister, child of someone, etc and the vast majority of doctors use their years of training skills and knowledge to HELP people in a caring and compassionate way, hopefully as they would treat their own loved ones, rather then see dollar signs in the eyes of their patients.
The final proof that this is the norm is that nearly every single doctor out there treats their own parents or children or siblings, indeed themselves, with the same cutting edge medical care that they use on everyone else, whether it is heart disease, cancer, infectious disease, etc.
Enough said. Give it a break, Stocks!!!
Doc
You post flies in the face of so many things that it is ludicrous. Like
The ever growing life expectancy...
The control of pandemic and epidemic type infections like smallpox that wiped out 20% of populations, sweeping through the continents and killing 300-500,000 people, more than all the world wars put together, and 1/3 of the surviving left blind...
Heart attack mortality going steadily down with the advent of emergency angioplasy and STEMI protocols...
Heart failure mortality going steadily down with many improvements in medicine...
Reduced sudden cardiac death through appropriate screening and inplantable defibrillators...
Decrease in the ravages of hypertension with the advent of good medicines to control it...
Improved survival of certain types of cancers through surgical removal, chemotherapy and radiation...
Survival of end stage kidney failure with dialysis
Survival of various types of organ failure including heart, lung, kidney, and liver to name a few with transplants...
Anyway, I doubt I, or anyone, will ever get through to you, as you have you blinders on, reading and posting every conspiracy theory medical bash you can get your hands on. Just accept the fact that there are bad apples in every profession, medicine is not immue to it, and leave it at that.
Realize that every single patient that a doctor encounters is a father, or mother, or brother, or sister, child of someone, etc and the vast majority of doctors use their years of training skills and knowledge to HELP people in a caring and compassionate way, hopefully as they would treat their own loved ones, rather then see dollar signs in the eyes of their patients.
The final proof that this is the norm is that nearly every single doctor out there treats their own parents or children or siblings, indeed themselves, with the same cutting edge medical care that they use on everyone else, whether it is heart disease, cancer, infectious disease, etc.
Enough said. Give it a break, Stocks!!!
Doc
I have several docs as clients.
They mostly seem to be humans, and nice ones at that, unlike lawyers.
They mostly seem to be humans, and nice ones at that, unlike lawyers.
QUOTE (Echo @ Oct 24 2010, 12:07 PM) 
posting every conspiracy theory medical bash you can get your hands on.
Ridiculous.
All defensive emotion.
My posts have links, make a list of the authors and assess the credibility
All distinguished professionals.
I will continue to inform people about the sad state of the medical profession with links to
credible sources and hard reasoning.
Not defensive emotion. Pure logic and facts.
When doctors get sick, we go to colleagues we know and trust that practice cutting edge medicine as practiced on all other patients as well. We get the same medicines and treatments given to all others.
WE DON'T LOOK UP THE DISTINGUISHED PROFESSIONALS QUOTED IN YOUR LINKS FOR ALTERNATIVE MEDICINE TREATMENTS!
Doc
When doctors get sick, we go to colleagues we know and trust that practice cutting edge medicine as practiced on all other patients as well. We get the same medicines and treatments given to all others.
WE DON'T LOOK UP THE DISTINGUISHED PROFESSIONALS QUOTED IN YOUR LINKS FOR ALTERNATIVE MEDICINE TREATMENTS!
Doc
What does this remind you of?
Hint: It starts with global and ends with warming.
THOUGH SCIENTISTS AND science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it. Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.” What’s more, the peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs—as with the exciting-sounding gene linkages (autism genes identified!) and nutritional findings (olive oil lowers blood pressure!) that are really just dubious and conflicting variations on a theme.
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
Ioannidis found that even when a research error is outed, it typically persists for years or even decades
http://www.theatlantic.com/magazine/archiv...ience/8269/2/at
Hint: It starts with global and ends with warming.
THOUGH SCIENTISTS AND science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it. Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.” What’s more, the peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs—as with the exciting-sounding gene linkages (autism genes identified!) and nutritional findings (olive oil lowers blood pressure!) that are really just dubious and conflicting variations on a theme.
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
Ioannidis found that even when a research error is outed, it typically persists for years or even decades
http://www.theatlantic.com/magazine/archiv...ience/8269/2/at
QUOTE (stocks @ Oct 6 2010, 07:46 PM)
Bad Medicine: Doctors Doing Harm since Hippocrates
David Wootton argues, from the fifth century BC until the 1930s, doctors actually did more harm than good.
"For 2,400 years patients have believed that doctors were doing them good; for 2,300 years they were wrong." The unsparingly pessimistic view of the overwhelming failures of doctors is that of David Wootton, a professor of history who has written "Bad Medicine: Doctors Doing Harm Since Hippocrates"
David Wootton argues, from the fifth century BC until the 1930s, doctors actually did more harm than good.
"For 2,400 years patients have believed that doctors were doing them good; for 2,300 years they were wrong." The unsparingly pessimistic view of the overwhelming failures of doctors is that of David Wootton, a professor of history who has written "Bad Medicine: Doctors Doing Harm Since Hippocrates"
at the age of 67, President George Washington died in 1799.
It is said that Washington spent five hours out in freezing rain, then returned home and dined with guests in his wet clothes because he did not want to keep them waiting. The next day he complained of a sore throat and was hoarse, but otherwise appeared well. The following night he awakened Martha to tell her that he felt a severe pain in his throat, and was having trouble breathing
The next day his personal physician, Dr. James Craik, was summoned. Craik diagnosed the condition as life threatening, and hastily assembled a team of doctors for aggressive treatment. They bled him of five pints of blood, burned his neck, and gave him calomel, a mercury compound used as a purgative but which probably did little more than induce mercury poisoning. Finally, after several days of this torture, Washington displayed the judgment that made him a great president and told them to stop. According to Ellis: “Eventually Washington ordered his doctors to cease their barbarisms and let him go in peace.
In any case, it is entirely possible that his physician's may have contributed to his death... blood-letting of 3.75 liters... Gosh... a human adult has about 5 liters of blood. As far as I'm concerned... that's medical malpractice and one could argue first degree murder. Add mercury poisoning as well.
http://fauquierent.blogspot.com/2010/07/ep...ent-george.html
Greatest Medical Discoveries And Breakthroughs
5) X-ray
The discovery of the X-ray is one of the greatest diagnostic discoveries of all time. It allows us to see inside the human body, without having to perform dangerous surgeries. As well as seeing anomalies in the human body, x-rays have helped hugely in dentistry, allowing a dentist to spot cavities before they turn in to painful abscesses.
With the use of the x-ray in medicine, scientists have been able to find the cause of many diseases, and how to treat them.
4) Anesthetics
Anesthetics are easily one of the most important medical advances in surgical operations. By preventing pain during surgery, surgeons were given the ability to work in completely new ways with the human body, with a lower chance from complications such as shock.
With anesthetics, pain no longer became such a huge factor in operations. Not only did this reduce the risk of shock, but it also allowed for more complex and intricate surgical procedures.
3) Germ Theory
Germ theory allowed our scientist to find the major causes behind disease, and created a whole new understanding on why cleanliness was important, as opposed to the old practice of surrounding oneself with bad smells to ward off bad influences.
The discovery of germ theory helped bring about the knowledge of the importance of sanitation, and is one of the biggest factors in extending human life by prevention of disease.
Germ theory was actually discovered by a haberdasher named Anton Leeuwenhoek, who was also a janitor in his spare time. In the end, the discovery was made his examination of a raindrop under a microscope, in which he could see a myriad of tiny animals swimming around.
2) Penicillin
Germ theory might have been the discovery of bacteria, but the discovery of penicillin was the moment that the medical profession finally had a way to fight back against infections that would have once cost people their lives.
Penicillin became the starting point for a whole string of antibiotics, both broad and narrow spectrum. This new way of treatment meant that amputations were significantly reduced, gum infections could be treated, and infections of the blood were no longer fatal.
1) Vaccination
Edward Jenner faced great adversity when he announced his discovery of vaccination. However, the discovery of vaccination has helped to greatly reduce some of the world’s deadliest epidemics and diseases, from cholera, influenza and measles, to the bubonic plague.
Thanks to vaccination, we no longer have to deal with some of the world’s deadliest and most infectious diseases, which have plagued humankind for millennia.
Top 5 medical
5) X-ray
The discovery of the X-ray is one of the greatest diagnostic discoveries of all time. It allows us to see inside the human body, without having to perform dangerous surgeries. As well as seeing anomalies in the human body, x-rays have helped hugely in dentistry, allowing a dentist to spot cavities before they turn in to painful abscesses.
With the use of the x-ray in medicine, scientists have been able to find the cause of many diseases, and how to treat them.
4) Anesthetics
Anesthetics are easily one of the most important medical advances in surgical operations. By preventing pain during surgery, surgeons were given the ability to work in completely new ways with the human body, with a lower chance from complications such as shock.
With anesthetics, pain no longer became such a huge factor in operations. Not only did this reduce the risk of shock, but it also allowed for more complex and intricate surgical procedures.
3) Germ Theory
Germ theory allowed our scientist to find the major causes behind disease, and created a whole new understanding on why cleanliness was important, as opposed to the old practice of surrounding oneself with bad smells to ward off bad influences.
The discovery of germ theory helped bring about the knowledge of the importance of sanitation, and is one of the biggest factors in extending human life by prevention of disease.
Germ theory was actually discovered by a haberdasher named Anton Leeuwenhoek, who was also a janitor in his spare time. In the end, the discovery was made his examination of a raindrop under a microscope, in which he could see a myriad of tiny animals swimming around.
2) Penicillin
Germ theory might have been the discovery of bacteria, but the discovery of penicillin was the moment that the medical profession finally had a way to fight back against infections that would have once cost people their lives.
Penicillin became the starting point for a whole string of antibiotics, both broad and narrow spectrum. This new way of treatment meant that amputations were significantly reduced, gum infections could be treated, and infections of the blood were no longer fatal.
1) Vaccination
Edward Jenner faced great adversity when he announced his discovery of vaccination. However, the discovery of vaccination has helped to greatly reduce some of the world’s deadliest epidemics and diseases, from cholera, influenza and measles, to the bubonic plague.
Thanks to vaccination, we no longer have to deal with some of the world’s deadliest and most infectious diseases, which have plagued humankind for millennia.
Top 5 medical
QUOTE (stocks @ Oct 6 2010, 06:46 PM)
For a couple of thousand years, medicine was based on Hippocrates and his successors, especially Galen, whose theories dealt with balancing bodily fluids, and to help nature along, doctors would induce vomiting or diarrhea, apply hot irons to the body, or drain off some blood. There was no physiological benefit in such treatments, which could do nothing but make things worse. Yet such treatments were the staple of medical practice until the middle of the nineteenth century.
Antique bloodletting devices
Through the Middle Ages and into the 18th and 19th century there were many strides in medical knowledge with regards to disease states, and anatomy. However, there was not much that could be done in terms of treatment. There were no antibiotics and surgery was in its infancy (in large part due to the lack of quality anesthesia). One of the only therapeutic modalities was to get out the old lancet and let some blood. It can safely be said that this almost never benefited the patient. Perhaps the biggest benefit was to the physician and family, who felt that at least they were doing something, and if the patient died anyway, it was meant to be.
I will look at some of the artifacts that help to demonstrate how phlebotomy was carried out, both on humans and animals. Some of these items are still readily available on the antique market. Others are harder to find but do turn up from time to time. Most of these items are from the 18th and 19th centuries.
THE LANCET
The earliest bloodletters probably used sharpened pieces of wood and stone to "breath a vein." There are many steel lancets with flat ebony or ivory handles that exist today.
THE SCARIFICATOR
Why bleed with one spring-loaded blade when you could have 4, 12, or even 20?! As long ago as the 17th century there were multi-bladed bleeders called scarificators
Bloodletting
Publication Bias
... the tendency of scientists and scientific journals to prefer positive data over null results, which is what happens when no effect is found. The bias was first identified by the statistician Theodore Sterling, in 1959, after he noticed that ninety-seven per cent of all published psychological studies with statistically significant data found the effect they were looking for.
Sterling saw that if ninety-seven per cent of psychology studies were proving their hypotheses, either psychologists were extraordinarily lucky or they published only the outcomes of successful experiments. In recent years, publication bias has mostly been seen as a problem for clinical trials, since pharmaceutical companies are less interested in publishing results that aren’t favorable. But it’s becoming increasingly clear that publication bias also produces major distortions in fields without large corporate incentives, such as psychology and ecology.
Selective Reporting
... an equally significant issue is the selective reporting of results—the data that scientists choose to document in the first place. Palmer’s most convincing evidence relies on a statistical tool known as a funnel graph. When a large number of studies have been done on a single subject, the data should follow a pattern: studies with a large sample size should all cluster around a common value—the true result—whereas those with a smaller sample size should exhibit a random scattering, since they’re subject to greater sampling error. This pattern gives the graph its name, since the distribution resembles a funnel.
The funnel graph visually captures the distortions of selective reporting. For instance, after Palmer plotted every study of fluctuating asymmetry, he noticed that the distribution of results with smaller sample sizes wasn’t random at all but instead skewed heavily toward positive results. Palmer has since documented a similar problem in several other contested subject areas. “Once I realized that selective reporting is everywhere in science, I got quite depressed,” Palmer told me.
Acupuncture
One of the classic examples of selective reporting concerns the testing of acupuncture in different countries. While acupuncture is widely accepted as a medical treatment in various Asian countries, its use is much more contested in the West. These cultural differences have profoundly influenced the results of clinical trials. Between 1966 and 1995, there were forty-seven studies of acupuncture in China, Taiwan, and Japan, and every single trial concluded that acupuncture was an effective treatment. During the same period, there were ninety-four clinical trials of acupuncture in the United States, Sweden, and the U.K., and only fifty-six per cent of these studies found any therapeutic benefits. As Palmer notes, this wide discrepancy suggests that scientists find ways to confirm their preferred hypothesis, disregarding what they don’t want to see
The problem of selective reporting is rooted in a fundamental cognitive flaw, which is that we like proving ourselves right and hate being wrong. “It feels good to validate a hypothesis,” Ioannidis said. “It feels even better when you’ve got a financial interest in the idea or your career depends upon it. And that’s why, even after a claim has been systematically disproven”—he cites, for instance, the early work on hormone replacement therapy, or claims involving various vitamins—“you still see some stubborn researchers citing the first few studies that show a strong effect.
Bias science
... the tendency of scientists and scientific journals to prefer positive data over null results, which is what happens when no effect is found. The bias was first identified by the statistician Theodore Sterling, in 1959, after he noticed that ninety-seven per cent of all published psychological studies with statistically significant data found the effect they were looking for.
Sterling saw that if ninety-seven per cent of psychology studies were proving their hypotheses, either psychologists were extraordinarily lucky or they published only the outcomes of successful experiments. In recent years, publication bias has mostly been seen as a problem for clinical trials, since pharmaceutical companies are less interested in publishing results that aren’t favorable. But it’s becoming increasingly clear that publication bias also produces major distortions in fields without large corporate incentives, such as psychology and ecology.
Selective Reporting
... an equally significant issue is the selective reporting of results—the data that scientists choose to document in the first place. Palmer’s most convincing evidence relies on a statistical tool known as a funnel graph. When a large number of studies have been done on a single subject, the data should follow a pattern: studies with a large sample size should all cluster around a common value—the true result—whereas those with a smaller sample size should exhibit a random scattering, since they’re subject to greater sampling error. This pattern gives the graph its name, since the distribution resembles a funnel.
The funnel graph visually captures the distortions of selective reporting. For instance, after Palmer plotted every study of fluctuating asymmetry, he noticed that the distribution of results with smaller sample sizes wasn’t random at all but instead skewed heavily toward positive results. Palmer has since documented a similar problem in several other contested subject areas. “Once I realized that selective reporting is everywhere in science, I got quite depressed,” Palmer told me.
Acupuncture
One of the classic examples of selective reporting concerns the testing of acupuncture in different countries. While acupuncture is widely accepted as a medical treatment in various Asian countries, its use is much more contested in the West. These cultural differences have profoundly influenced the results of clinical trials. Between 1966 and 1995, there were forty-seven studies of acupuncture in China, Taiwan, and Japan, and every single trial concluded that acupuncture was an effective treatment. During the same period, there were ninety-four clinical trials of acupuncture in the United States, Sweden, and the U.K., and only fifty-six per cent of these studies found any therapeutic benefits. As Palmer notes, this wide discrepancy suggests that scientists find ways to confirm their preferred hypothesis, disregarding what they don’t want to see
The problem of selective reporting is rooted in a fundamental cognitive flaw, which is that we like proving ourselves right and hate being wrong. “It feels good to validate a hypothesis,” Ioannidis said. “It feels even better when you’ve got a financial interest in the idea or your career depends upon it. And that’s why, even after a claim has been systematically disproven”—he cites, for instance, the early work on hormone replacement therapy, or claims involving various vitamins—“you still see some stubborn researchers citing the first few studies that show a strong effect.
Bias science
Well since we are piling on doctors (I respect most of the ones I know):
Little Canada-based St. Jude allegedly paid participating doctors a fee that ranged up to $2,000 per patient as a way of encouraging use of the company's pacemakers and defibrillators.
St. Jude Medical to pay $16 million to settle charges that it paid kickbacks to doctors - Star Tribune http://bit.ly/gc3CmN
Little Canada-based St. Jude allegedly paid participating doctors a fee that ranged up to $2,000 per patient as a way of encouraging use of the company's pacemakers and defibrillators.
St. Jude Medical to pay $16 million to settle charges that it paid kickbacks to doctors - Star Tribune http://bit.ly/gc3CmN
Analysis cautions against wider use of statins
http://www.msnbc.msn.com/id/41143397/ns/health/#
There is not enough evidence to recommend the widespread use of statins like Pfizer's Lipitor or AstraZeneca's Crestor in people with no previous history of heart disease, scientists said on Wednesday.
In a systematic review published in The Cochrane Library journal, researchers said the cholesterol-lowering drugs -- already among the world's the biggest selling medicines -- should be prescribed "with caution" for those at low risk of cardiovascular disease (CVD).
In a review of 14 trials involving 34,272 patients, they also found that all but one trial were industry-sponsored, a finding they said meant the overall results could be "limited by unclear, selective and potentially biased reporting".
"We know that industry-sponsored trials are more likely to report favourable results for drugs versus placebos, so we have to be cautious about interpreting these results," she added.
Commenting on the Cochrane review, Amy Thompson of the British Heart Foundation charity said that in part it confirmed what experts already know -- "that statins have huge benefits for people with heart and circulatory disease, or those who are high risk (smoking, diabetes and obesity are included in high risk factors,) as they help to reduce the risk of heart disease including heart attacks."
But she added there was little to suggest that statins should be prescribed for people without heart and circulatory disease and who are at low risk of developing it. (Reporting by Kate Kelland; Editing by Greg Mahlich)
http://www.msnbc.msn.com/id/41143397/ns/health/#
There is not enough evidence to recommend the widespread use of statins like Pfizer's Lipitor or AstraZeneca's Crestor in people with no previous history of heart disease, scientists said on Wednesday.
In a systematic review published in The Cochrane Library journal, researchers said the cholesterol-lowering drugs -- already among the world's the biggest selling medicines -- should be prescribed "with caution" for those at low risk of cardiovascular disease (CVD).
In a review of 14 trials involving 34,272 patients, they also found that all but one trial were industry-sponsored, a finding they said meant the overall results could be "limited by unclear, selective and potentially biased reporting".
"We know that industry-sponsored trials are more likely to report favourable results for drugs versus placebos, so we have to be cautious about interpreting these results," she added.
Commenting on the Cochrane review, Amy Thompson of the British Heart Foundation charity said that in part it confirmed what experts already know -- "that statins have huge benefits for people with heart and circulatory disease, or those who are high risk (smoking, diabetes and obesity are included in high risk factors,) as they help to reduce the risk of heart disease including heart attacks."
But she added there was little to suggest that statins should be prescribed for people without heart and circulatory disease and who are at low risk of developing it. (Reporting by Kate Kelland; Editing by Greg Mahlich)
Why Almost Everything You Hear About Medicine Is Wrong
“People are being hurt and even dying” because of false medical claims, he says: not quackery, but errors in medical research.
It’s a disturbing view, with huge implications for doctors, policymakers, and health-conscious consumers. And one of its foremost advocates, Dr. John P.A. Ioannidis, has just ascended to a new, prominent platform after years of crusading against the baseless health and medical claims.
A major study concluded there’s no good evidence that statins (drugs like Lipitor and Crestor) help people with no history of heart disease. The study, by the Cochrane Collaboration, a global consortium of biomedical experts, was based on an evaluation of 14 individual trials with 34,272 patients. Cost of statins: more than $20 billion per year, of which half may be unnecessary.
Even a cursory glance at medical journals shows that once heralded studies keep falling by the wayside. Two 1993 studies concluded that vitamin E prevents cardiovascular disease; that claim was overturned by more rigorous experiments, in 1996 and 2000. A 1996 study concluding that estrogen therapy reduces older women’s risk of Alzheimer’s was overturned in 2004. Numerous studies concluding that popular antidepressants work by altering brain chemistry have now been contradicted (the drugs help with mild and moderate depression, when they work at all, through a placebo effect), as has research claiming that early cancer detection (through, say, PSA tests) invariably saves lives. The list goes on.
Surgical practices, for instance, have not been tested to nearly the extent that medications have. “I wouldn’t be surprised if a large proportion of surgical practice is based on thin air, and [claims for effectiveness] would evaporate if we studied them closely,” Ioannidis says.
Medicine Newsweek
“People are being hurt and even dying” because of false medical claims, he says: not quackery, but errors in medical research.
It’s a disturbing view, with huge implications for doctors, policymakers, and health-conscious consumers. And one of its foremost advocates, Dr. John P.A. Ioannidis, has just ascended to a new, prominent platform after years of crusading against the baseless health and medical claims.
A major study concluded there’s no good evidence that statins (drugs like Lipitor and Crestor) help people with no history of heart disease. The study, by the Cochrane Collaboration, a global consortium of biomedical experts, was based on an evaluation of 14 individual trials with 34,272 patients. Cost of statins: more than $20 billion per year, of which half may be unnecessary.
Even a cursory glance at medical journals shows that once heralded studies keep falling by the wayside. Two 1993 studies concluded that vitamin E prevents cardiovascular disease; that claim was overturned by more rigorous experiments, in 1996 and 2000. A 1996 study concluding that estrogen therapy reduces older women’s risk of Alzheimer’s was overturned in 2004. Numerous studies concluding that popular antidepressants work by altering brain chemistry have now been contradicted (the drugs help with mild and moderate depression, when they work at all, through a placebo effect), as has research claiming that early cancer detection (through, say, PSA tests) invariably saves lives. The list goes on.
Surgical practices, for instance, have not been tested to nearly the extent that medications have. “I wouldn’t be surprised if a large proportion of surgical practice is based on thin air, and [claims for effectiveness] would evaporate if we studied them closely,” Ioannidis says.
Medicine Newsweek
From the files of Ben Dover, MD:
Bend over, MD. Get it?
REPORT: Medical students conducted genital, rectal, breast exams on unconscious patients...
* "Examinations performed without consent"
* Students face ethical dilemma - study
* "Most people would not be pleased"
AUSTRALIAN medical students are carrying out intrusive procedures on unconscious and anaesthetised patients without gaining the patient's consent.
The unauthorised examinations include genital, rectal and breast exams, and raise serious questions about the ethics of up-and-coming doctors, Madison reports.
The research, soon to be published in international medical journal, Medical Education, describes - among others - a student with "no qualms" about performing an anal examination on a female patient because she didn't think the woman's consent was relevant.
Read more: http://www.news.com.au/national/medical-st...1#ixzz1CRciYKfk
Bend over, MD. Get it?
REPORT: Medical students conducted genital, rectal, breast exams on unconscious patients...
* "Examinations performed without consent"
* Students face ethical dilemma - study
* "Most people would not be pleased"
AUSTRALIAN medical students are carrying out intrusive procedures on unconscious and anaesthetised patients without gaining the patient's consent.
The unauthorised examinations include genital, rectal and breast exams, and raise serious questions about the ethics of up-and-coming doctors, Madison reports.
The research, soon to be published in international medical journal, Medical Education, describes - among others - a student with "no qualms" about performing an anal examination on a female patient because she didn't think the woman's consent was relevant.
Read more: http://www.news.com.au/national/medical-st...1#ixzz1CRciYKfk
QUOTE (Rogerdodger @ Oct 24 2010, 01:36 PM)
I have several docs as clients.
They mostly seem to be humans, and nice ones at that, unlike lawyers.
They mostly seem to be humans, and nice ones at that, unlike lawyers.
95% of lawyers give the rest of lawyers a bad name.
Practice makes perfect!
“Dr. Midei said my heart was 90 percent blocked, a review showed it was 10 percent”
World-Renowned Heart Surgeon's License Revoked For Performing Hundreds Of Unnecessary Surgeries...
The 88 page report from the Maryland Board of Physicians blasts Dr. Marc Midei for violations they call repeated, serious and indefensible. So severe–they revoked Midei’s medical license.
“What I did is what I would have wanted for myself for anybody in my family, my mother, my father,” Dr. Midei said in October of 2010.
But the State Board of Physicians found in 4 of the 5 patients cases they reviewed, Midei willfully fabricated information about the severity of blockages.
Marrs is one of 585 people who received a letter from St. Joseph Medical Center saying Midei may have unnecessarily given her a stent–a tiny device designed to open up blocked arteries. A charge Midei has vehemently denied.
Marrs says Midei lied about how blocked her arteries were too.
“Dr. Midei said it was 90 percent and after they reviewed everything it was 10 percent,” Marrs said.
“Dr. Midei said my heart was 90 percent blocked, a review showed it was 10 percent”
World-Renowned Heart Surgeon's License Revoked For Performing Hundreds Of Unnecessary Surgeries...
The 88 page report from the Maryland Board of Physicians blasts Dr. Marc Midei for violations they call repeated, serious and indefensible. So severe–they revoked Midei’s medical license.
“What I did is what I would have wanted for myself for anybody in my family, my mother, my father,” Dr. Midei said in October of 2010.
But the State Board of Physicians found in 4 of the 5 patients cases they reviewed, Midei willfully fabricated information about the severity of blockages.
Marrs is one of 585 people who received a letter from St. Joseph Medical Center saying Midei may have unnecessarily given her a stent–a tiny device designed to open up blocked arteries. A charge Midei has vehemently denied.
Marrs says Midei lied about how blocked her arteries were too.
“Dr. Midei said it was 90 percent and after they reviewed everything it was 10 percent,” Marrs said.
Retractions Of Scientific Studies Are Surging
The apparent rise in scientific fraud “is a scar on the moral body of science.”
Over the past decade, the number of medical journals that have issued retractions has climbed precipitously. Since 2001, the overall number of papers that were published in research journals increased 44 percent, but at the same time, the number of papers that were retracted climbed more than 15-fold, according to The Wall Street Journal, citing data from Thomson Reuters.
Meanwhile, retractions related to fraud rose more than sevenfold between 2004 and 2009, exceeding a twofold rise traced to mistakes, according to an analysis published in the Journal of Medical Ethics. After studying 742 papers that were withdrawn from 2000 to 2010, the analysis found that 73.5 percent were retracted simply for error, but 26.6 percent were retracted for fraud. Ominously, 31.8 percent of retracted papers were not noted as retracted
And why is there more fraud? As the Wall Street Journal notes, there is a lot to be gained - by both researchers and journal editors - to publish influential papers. “The stakes are so high,” The Lancet editor Richard Horton tells the Journal. “A single paper in Lancet and you get your chair and you get your money. It’s your passport to success.”
Link
The apparent rise in scientific fraud “is a scar on the moral body of science.”
Over the past decade, the number of medical journals that have issued retractions has climbed precipitously. Since 2001, the overall number of papers that were published in research journals increased 44 percent, but at the same time, the number of papers that were retracted climbed more than 15-fold, according to The Wall Street Journal, citing data from Thomson Reuters.
Meanwhile, retractions related to fraud rose more than sevenfold between 2004 and 2009, exceeding a twofold rise traced to mistakes, according to an analysis published in the Journal of Medical Ethics. After studying 742 papers that were withdrawn from 2000 to 2010, the analysis found that 73.5 percent were retracted simply for error, but 26.6 percent were retracted for fraud. Ominously, 31.8 percent of retracted papers were not noted as retracted
And why is there more fraud? As the Wall Street Journal notes, there is a lot to be gained - by both researchers and journal editors - to publish influential papers. “The stakes are so high,” The Lancet editor Richard Horton tells the Journal. “A single paper in Lancet and you get your chair and you get your money. It’s your passport to success.”
Link
Believing in Treatments That Don’t Work
Emergency room physician Dr. David H. Newman explores how medical ideology often gets in the way of evidence-based medicine.
The practice of medicine contains countless examples of elegant medical theories that belie the best available evidence.
Recent press reports detailing the dangers of cough syrup for children have noted that cough syrup doesn’t work. True: No cough remedies have ever been proven better than a placebo, either for adults or children. Yet their use is common.
Patients with ear infections are more likely to be harmed by antibiotics than helped. While the pills may cause a small decrease in symptoms (for which ear drops work better), the infections typically recede within days regardless of treatment. The same is true for bronchitis, sinusitis, and sore throats. Unnecessary antibiotics are still given to more than one in seven Americans each year for these conditions alone, at a cost of more than $2 billion and tens of thousands of serious adverse medication effects requiring treatment.
Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment. Yet doctors perform 600,000 of these surgeries each year, at a cost of over $20 billion.
More than a half million Americans per year undergo arthroscopic surgery to correct osteoarthritis of the knee, at a cost of $3 billion. Despite this, studies show the surgery to be no better than sham knee surgery, in which surgeons “pretend” to do surgery while the patient is under light anesthesia. It is also no better than much cheaper, and much less invasive, physical therapy.
Treatment based on ideology is alluring. Surgeries to repair the knee should work. A syrup to reduce cough should help. Calming the straining heart should save lives. But the uncomfortable truth is that many expensive, invasive interventions are of little or no benefit and cause potentially uncomfortable, costly, and dangerous side effects and complications.
The critical question that looms for health care reform is whether patients, doctors and experts are prepared to set aside ideology in the face of data. Can we abide by the evidence when it tells us that antibiotics don’t clear ear infections or help strep throats? Can we stop asking for, and writing, these prescriptions? Can we stop performing, and asking for, knee and back surgeries? Can we handle what the evidence reveals? Are we ready for the truth?
Ideology vs Evidence
Dr. Newman is author of “Hippocrates Shadow: Secrets From the House of Medicine.”
(this book is a gem)
Emergency room physician Dr. David H. Newman explores how medical ideology often gets in the way of evidence-based medicine.
The practice of medicine contains countless examples of elegant medical theories that belie the best available evidence.
Recent press reports detailing the dangers of cough syrup for children have noted that cough syrup doesn’t work. True: No cough remedies have ever been proven better than a placebo, either for adults or children. Yet their use is common.
Patients with ear infections are more likely to be harmed by antibiotics than helped. While the pills may cause a small decrease in symptoms (for which ear drops work better), the infections typically recede within days regardless of treatment. The same is true for bronchitis, sinusitis, and sore throats. Unnecessary antibiotics are still given to more than one in seven Americans each year for these conditions alone, at a cost of more than $2 billion and tens of thousands of serious adverse medication effects requiring treatment.
Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment. Yet doctors perform 600,000 of these surgeries each year, at a cost of over $20 billion.
More than a half million Americans per year undergo arthroscopic surgery to correct osteoarthritis of the knee, at a cost of $3 billion. Despite this, studies show the surgery to be no better than sham knee surgery, in which surgeons “pretend” to do surgery while the patient is under light anesthesia. It is also no better than much cheaper, and much less invasive, physical therapy.
Treatment based on ideology is alluring. Surgeries to repair the knee should work. A syrup to reduce cough should help. Calming the straining heart should save lives. But the uncomfortable truth is that many expensive, invasive interventions are of little or no benefit and cause potentially uncomfortable, costly, and dangerous side effects and complications.
The critical question that looms for health care reform is whether patients, doctors and experts are prepared to set aside ideology in the face of data. Can we abide by the evidence when it tells us that antibiotics don’t clear ear infections or help strep throats? Can we stop asking for, and writing, these prescriptions? Can we stop performing, and asking for, knee and back surgeries? Can we handle what the evidence reveals? Are we ready for the truth?
Ideology vs Evidence
Dr. Newman is author of “Hippocrates Shadow: Secrets From the House of Medicine.”
(this book is a gem)
Top 5 Threats To Science In Medicine
#1: Congress
Money is the most powerful gasoline that can be poured on the fire of pseudoscience. And thanks to Senator Tom Harkin, and a few merry enablers, there is now legislation in the Senate healthcare reform bill that would allocate tax dollars to disproven and unproven medical therapies.
#2: Mainstream Media
For some reason, snake oil has captured the imagination of the mainstream media. Thanks to people like Oprah and the major news networks, there is a steady parade of pseudoscientific poppy cock being spoon fed to the public. And because of the lack of critical thinking taught in schools, Americans (on average) have a 6th grade understanding of medicine.
#3: Academic Medical Centers
Often referred to by David Gorski as “Quackademic” Medical Centers – there is a growing trend among these centers to accept endowments for “integrative” approaches to medical care. Because of the economic realities of decreasing healthcare reimbursements – these once proud defenders of science are now accepting money to “study” implausible and often disproven medical treatments because they’re trendy. Scientists at these centers are forced to look the other way while patients (who trust the center’s reputation that took tens of decades to build) are exposed to placebo medicine under the guise of “holistic” healthcare.
#4: NCCAM
Even though we’ve invested $2.5 billion tax payer dollars and 10+ years of time on studying complementary and alternative medicines – we have discovered NO single breakthrough in medical treatment as a result.
#5: New Media
Just as mainstream media is beginning to fade in its influence and popularity, online and “new” media are making exponential leaps in influence. The Huffington Post and Age Of Autism are two strongholds of health misinformation that come to mind. Of course, “user generated content” and unvetted health advice and claims are easily made by anyone anytime. And thanks to the magic of Google, a health claim need only be popular to be promoted
sciencebasedmedicine
#1: Congress
Money is the most powerful gasoline that can be poured on the fire of pseudoscience. And thanks to Senator Tom Harkin, and a few merry enablers, there is now legislation in the Senate healthcare reform bill that would allocate tax dollars to disproven and unproven medical therapies.
#2: Mainstream Media
For some reason, snake oil has captured the imagination of the mainstream media. Thanks to people like Oprah and the major news networks, there is a steady parade of pseudoscientific poppy cock being spoon fed to the public. And because of the lack of critical thinking taught in schools, Americans (on average) have a 6th grade understanding of medicine.
#3: Academic Medical Centers
Often referred to by David Gorski as “Quackademic” Medical Centers – there is a growing trend among these centers to accept endowments for “integrative” approaches to medical care. Because of the economic realities of decreasing healthcare reimbursements – these once proud defenders of science are now accepting money to “study” implausible and often disproven medical treatments because they’re trendy. Scientists at these centers are forced to look the other way while patients (who trust the center’s reputation that took tens of decades to build) are exposed to placebo medicine under the guise of “holistic” healthcare.
#4: NCCAM
Even though we’ve invested $2.5 billion tax payer dollars and 10+ years of time on studying complementary and alternative medicines – we have discovered NO single breakthrough in medical treatment as a result.
#5: New Media
Just as mainstream media is beginning to fade in its influence and popularity, online and “new” media are making exponential leaps in influence. The Huffington Post and Age Of Autism are two strongholds of health misinformation that come to mind. Of course, “user generated content” and unvetted health advice and claims are easily made by anyone anytime. And thanks to the magic of Google, a health claim need only be popular to be promoted
sciencebasedmedicine
How Choose to Doctors Die
It’s Not Like the Rest of Us, But It Should Be
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.”
link
It’s Not Like the Rest of Us, But It Should Be
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.”
link
Do Not Resuscitate -- Do you wish to be resuscitated if your heart stops?
Television has done an excellent job of distorting true medicine, including the resuscitation of dying patients.
Resuscitation isn’t as clean and gentle as they portray on television. The chest must be compressed hard and deep enough to pump the blood out of the heart. This can lead to broken ribs, punctured lungs and possibly an injured heart. Paramedics move beyond the gentle mouth-to-mouth breathing and insert a breathing tube into the patient’s throat. Electrical shocks may have to be delivered to attempt to shock the heart back into a normal rhythm. An intravenous line (IV) would be started, so potent medications could be delivered through it. The patient is transported to the hospital, and if they aren’t already pronounced dead, they may be instantly hooked up to life support machines, without consulting with family.
What are the chances that all of this will work? The statistics, while not highly accurate due to variances in reporting methods, show that survival after resuscitation is 6 to 15% for patients already in a hospital, 1 to 2% for patients in nursing homes and between 4 to 38% for patients who were resuscitated in non-health care settings. The statistics are the worst for patients who have chronic illnesses, cancer or dementia. Since most people who are on palliative care or hospice care have one or more of these conditions, their survival would most closely resemble that of nursing home residents -- 1 to 2%. It’s important to note that the 1 to 2% of patients often have some kind of damage to the brain or heart.
The question now becomes, “Is it worth it to put myself or my loved one through the traumatic process of resuscitation for a 1 to 2% chance of survival?”
link
Television has done an excellent job of distorting true medicine, including the resuscitation of dying patients.
Resuscitation isn’t as clean and gentle as they portray on television. The chest must be compressed hard and deep enough to pump the blood out of the heart. This can lead to broken ribs, punctured lungs and possibly an injured heart. Paramedics move beyond the gentle mouth-to-mouth breathing and insert a breathing tube into the patient’s throat. Electrical shocks may have to be delivered to attempt to shock the heart back into a normal rhythm. An intravenous line (IV) would be started, so potent medications could be delivered through it. The patient is transported to the hospital, and if they aren’t already pronounced dead, they may be instantly hooked up to life support machines, without consulting with family.
What are the chances that all of this will work? The statistics, while not highly accurate due to variances in reporting methods, show that survival after resuscitation is 6 to 15% for patients already in a hospital, 1 to 2% for patients in nursing homes and between 4 to 38% for patients who were resuscitated in non-health care settings. The statistics are the worst for patients who have chronic illnesses, cancer or dementia. Since most people who are on palliative care or hospice care have one or more of these conditions, their survival would most closely resemble that of nursing home residents -- 1 to 2%. It’s important to note that the 1 to 2% of patients often have some kind of damage to the brain or heart.
The question now becomes, “Is it worth it to put myself or my loved one through the traumatic process of resuscitation for a 1 to 2% chance of survival?”
link
The last sixty years have produced a mountain of anti-tonsillectomy evidence that doctors seem to ignore
If you search "tonsillectomy/adverse effects" on PubMed, you will get more than 1000 references:
including polio, weight gain, vomiting (many articles), taste distortion (here, here, here), Hodgkin's disease (here, here, here, here, here, but here is evidence that disputes the association), Creutzfeld-Jacob disease (e.g., here, here), inflammatory bowel disease and Crohn's disease, rheumatoid arthritis, severe spine infection, neck infection (here, here), speech problems (here, here), hearing loss, ear pain, visual loss (here, here), depression, several other serious problems, and immunological abnormalities (e.g., here, here, here).
Also tonsillectomy "is associated with a relatively high risk of postoperative complications" and that "the actual post-tonsillectomy haemorrhage rate is much higher than that recorded in hospital statistics."
Overtreatment -- wasteful and harmful medicine -- is an enormous problem. It is the subject of two recent books (Overtreated and Overdiagnosed) and a Newsweek article. Tonsillectomies are an example.
link
If you search "tonsillectomy/adverse effects" on PubMed, you will get more than 1000 references:
including polio, weight gain, vomiting (many articles), taste distortion (here, here, here), Hodgkin's disease (here, here, here, here, here, but here is evidence that disputes the association), Creutzfeld-Jacob disease (e.g., here, here), inflammatory bowel disease and Crohn's disease, rheumatoid arthritis, severe spine infection, neck infection (here, here), speech problems (here, here), hearing loss, ear pain, visual loss (here, here), depression, several other serious problems, and immunological abnormalities (e.g., here, here, here).
Also tonsillectomy "is associated with a relatively high risk of postoperative complications" and that "the actual post-tonsillectomy haemorrhage rate is much higher than that recorded in hospital statistics."
Overtreatment -- wasteful and harmful medicine -- is an enormous problem. It is the subject of two recent books (Overtreated and Overdiagnosed) and a Newsweek article. Tonsillectomies are an example.
link
Stocks, the message you drive can be offensive to some but true in many ways. I, am grateful to medical science for my mother's survival. Severe pancreatitis with multiple organ failure. I truely believe in the work of nature that the body play the major part in healing itself, but medical science has allowed an environment supporting the process. I for one do not seek any medical attention unless it is totally unbearable or I think i am dying and it's worth a shot. I know there are some doctors here. You are honoured for improving lives without a doubt. But also the misdeeds of medical science cannot be denied. Which includes unethical promotion to public seeking treatment with main objective id to drive medical related product sales. Wild theories practiced over decades and only till date proven it's a mistake, drug companies conveniently ignore. End of the day, we give healthcare workers the due respect as they are the masses option to live better.
Medical abuse might be on the rising trend, along with every other evil due to "globalisation". Can't fight the world, live with it. Don't read too much into everything. You'll just get depressed. It's a far from perfect world.
Medical abuse might be on the rising trend, along with every other evil due to "globalisation". Can't fight the world, live with it. Don't read too much into everything. You'll just get depressed. It's a far from perfect world.
In cancer science, many "discoveries" don't hold up
During a decade as head of global cancer research at Amgen, C. Glenn Begley identified 53 "landmark" publications -- papers in top journals, from reputable labs -- for his team to reproduce. Begley sought to double-check the findings before trying to build on them for drug development.
Result: 47 of the 53 could not be replicated. He described his findings in a commentary piece published on Wednesday in the journal Nature.
Some authors required the Amgen scientists sign a confidentiality agreement barring them from disclosing data at odds with the original findings. "The world will never know" which 47 studies -- many of them highly cited -- are apparently wrong, Begley said.
Part way through his project to reproduce promising studies, Begley met for breakfast at a cancer conference with the lead scientist of one of the problematic studies.
"We went through the paper line by line, figure by figure," said Begley. "I explained that we re-did their experiment 50 times and never got their result. He said they'd done it six times and got this result once, but put it in the paper because it made the best story. It's very disillusioning."
http://www.reuters.com/article/2012/03/28/...E82R12P20120328
During a decade as head of global cancer research at Amgen, C. Glenn Begley identified 53 "landmark" publications -- papers in top journals, from reputable labs -- for his team to reproduce. Begley sought to double-check the findings before trying to build on them for drug development.
Result: 47 of the 53 could not be replicated. He described his findings in a commentary piece published on Wednesday in the journal Nature.
Some authors required the Amgen scientists sign a confidentiality agreement barring them from disclosing data at odds with the original findings. "The world will never know" which 47 studies -- many of them highly cited -- are apparently wrong, Begley said.
Part way through his project to reproduce promising studies, Begley met for breakfast at a cancer conference with the lead scientist of one of the problematic studies.
"We went through the paper line by line, figure by figure," said Begley. "I explained that we re-did their experiment 50 times and never got their result. He said they'd done it six times and got this result once, but put it in the paper because it made the best story. It's very disillusioning."
http://www.reuters.com/article/2012/03/28/...E82R12P20120328
What Causes Disease?
For humans, as large complex animals, invasion and colonisation by infectious parasitic agents is the basic problem in life
For example, it is likely that the mid-twentieth century epidemic of heart disease was caused by some infectious agent - not known;
As well as the damage from micro-organisms and parasites, there are problems with the body's 'immune' reactions to these invaders - and these probably cause another whole set of 'autoimmune' diseases; which may include eczema, asthma, rheumatoid arthritis
What about Diet?
It seems that humans can live a full lifespan on a huge range of diets, so long as the food does not contain too much poisonous or infectious stuff.
The most striking thing about diet is how little dietary components matter to life expectancy, so long as there is enough food.
http://charltonteaching.blogspot.com/2012/...s-of-thing.html
For humans, as large complex animals, invasion and colonisation by infectious parasitic agents is the basic problem in life
For example, it is likely that the mid-twentieth century epidemic of heart disease was caused by some infectious agent - not known;
As well as the damage from micro-organisms and parasites, there are problems with the body's 'immune' reactions to these invaders - and these probably cause another whole set of 'autoimmune' diseases; which may include eczema, asthma, rheumatoid arthritis
What about Diet?
It seems that humans can live a full lifespan on a huge range of diets, so long as the food does not contain too much poisonous or infectious stuff.
The most striking thing about diet is how little dietary components matter to life expectancy, so long as there is enough food.
http://charltonteaching.blogspot.com/2012/...s-of-thing.html
Hospitals, doctors offer cash discounts for medical bills
A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336.
Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054.
Snyder said she went back to work last year at a hair salon in Seal Beach, partly to help pay her insurance premiums of $700 a month.
"It kills me that I'm paying that much in premiums," she said, "and it's better to pay cash out of my own pocket."
(Los Alamitos Medical Center lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.
When The Times called for a cash price, the hospital said it was $250.)
Health-policy experts say the growing awareness of cash prices should accelerate the trend toward increased disclosure of all types of medical costs. But entrenched interests are likely to resist.
"The insiders in the healthcare industry don't want to lose control over this information," Keckley said. "But price transparency is inevitable."
http://www.latimes.com/business/la-fi-medi...2049,full.story
A Long Beach hospital charged Jo Ann Snyder $6,707 for a CT scan of her abdomen and pelvis after colon surgery. But because she had health insurance with Blue Shield of California, her share was much less: $2,336.
Then Snyder tripped across one of the little-known secrets of healthcare: If she hadn't used her insurance, her bill would have been even lower, just $1,054.
Snyder said she went back to work last year at a hair salon in Seal Beach, partly to help pay her insurance premiums of $700 a month.
"It kills me that I'm paying that much in premiums," she said, "and it's better to pay cash out of my own pocket."
(Los Alamitos Medical Center lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.
When The Times called for a cash price, the hospital said it was $250.)
Health-policy experts say the growing awareness of cash prices should accelerate the trend toward increased disclosure of all types of medical costs. But entrenched interests are likely to resist.
"The insiders in the healthcare industry don't want to lose control over this information," Keckley said. "But price transparency is inevitable."
http://www.latimes.com/business/la-fi-medi...2049,full.story
My wife got a self-pay colonoscopy. Price was 1/2 and the doctor was paid immediately WIN-WIN!
But maybe it was a half-@ssed procedure...
But maybe it was a half-@ssed procedure...
QUOTE (stocks @ May 29 2012, 06:39 AM)
Hospitals, doctors offer cash discounts for medical bills
Doctor Explains Shocking and Irresponsible Healthcare Costs
Watch this amazing Video
Forget everything you ever thought you knew about healthcare costs! In this video (as well as the website) I expose many of the deceptions that are occurring in healthcare now.
For example:
-Most generic medication cost less if you don't use your insurance to buy them.
-Most doctors have no idea what they get paid for an office visit.
-Hospitals routinely bill TEN times what they expect to be paid.
-Most diagnostic tests are very inexpensive to run
-Insurance companies deliberately bargain in bad faith when it's your money.
http://www.youtube.com/watch?v=xcLXzWeherI...ture=plpp_video
AARP -- 4 Surgeries to Avoid
1. Stents for Stable Angina
Despite stents' ineffectiveness, close to 500,000 are implanted each year for stable chest pain, says Sanjay Kaul, M.D., a cardiologist at Cedars-Sinai Heart Institute in Los Angeles
2. Complex Spinal Fusion for Stenosis
Deyo recently studied the records of more than 30,000 Medicare patients who underwent surgery for stenosis of the lower back and found that complex fusion procedures (in which surgeons place bone grafts between multiple vertebrae) had increased an astounding 1,400 percent between 2002 and 2007.
The risks are significant: Those who underwent complex fusion were nearly three times more likely to suffer life-threatening complications than those who underwent less invasive surgery. Previous studies have also found that most fusion patients experience no more relief from their chronic back pain than those who had physical and behavioral therapy.
3. Hysterectomy for Uterine Fibroids
Each year approximately 600,000 American women have hysterectomies, or removal of the uterus, and studies show that the vast majority are unnecessary.
4. Knee Arthroscopy for Osteoarthritis
With this procedure a surgeon places a tiny camera in the knee, then inserts small instruments through other incisions to repair torn or aging cartilage. Studies show the operation works well when patients have in fact torn their meniscal tissue, but it is no more successful than noninvasive remedies in treating osteoarthritis of the knee
http://www.aarp.org/health/conditions-trea...to-avoid.1.html
1. Stents for Stable Angina
Despite stents' ineffectiveness, close to 500,000 are implanted each year for stable chest pain, says Sanjay Kaul, M.D., a cardiologist at Cedars-Sinai Heart Institute in Los Angeles
2. Complex Spinal Fusion for Stenosis
Deyo recently studied the records of more than 30,000 Medicare patients who underwent surgery for stenosis of the lower back and found that complex fusion procedures (in which surgeons place bone grafts between multiple vertebrae) had increased an astounding 1,400 percent between 2002 and 2007.
The risks are significant: Those who underwent complex fusion were nearly three times more likely to suffer life-threatening complications than those who underwent less invasive surgery. Previous studies have also found that most fusion patients experience no more relief from their chronic back pain than those who had physical and behavioral therapy.
3. Hysterectomy for Uterine Fibroids
Each year approximately 600,000 American women have hysterectomies, or removal of the uterus, and studies show that the vast majority are unnecessary.
4. Knee Arthroscopy for Osteoarthritis
With this procedure a surgeon places a tiny camera in the knee, then inserts small instruments through other incisions to repair torn or aging cartilage. Studies show the operation works well when patients have in fact torn their meniscal tissue, but it is no more successful than noninvasive remedies in treating osteoarthritis of the knee
http://www.aarp.org/health/conditions-trea...to-avoid.1.html
I can't speak for the last three, but I can for stents. It was difficult to actually read the article as a big ad for some health spa kept popping up, lol. So not exactly a great scientific site.
Any hoo, the argument that stents are ineffective but implanted anyway is grossly misleading. It is true that stents in stable patients have never been shown to save lives. But that is not why they are implanted. They are implanted to relieve chest pain (angina) or ischemia (inadequate blood flow) the latter of which can be without symptoms of chest pain, but nontheless dangerous in increasing the risk of arrhythmias as well as decreasing the quality of life.
Doing the procedure in the same setting as the diagnostic cath is actually preferred by patients who trust their cardiologists to do the right thing. Who would want to go through the same procedure twice if they have a 90% blockage that is causing symptoms or ischemia.
The idea of doing lifestyle changes is advocated in all patients who get stents to prevent further worsening of lesser blockages as nearly all patients who get a stent for a 75% or greater blockage also have numerous smaller blockages in all of the arteries of the heart that could progress without good prevention. But all the good diet and exercise efforts won't change a 90% blockage that is causing chest pain or ischemia anytime soon. An appropriately placed stent relieves the problem instantly, giving the patient time and less risk to do good diet and exercise for future prevention. Do you really want to start a rigorous exercise program with a high grade blockage in the coronary artery, getting active chest pain or ischemic arrhythmias and possible sudden death each time you get up to more than 2.5 mph?
The article is simply misleading. But it does apply to inappropriately placed stents where the blockage is NOT severe and there is no symptom and no abnormality on a nuclear stress test. Unfortunately, that does happen as some doctors make poor decisions. Just like any other profession. There are a few bad apples. Fortunately not a lot. But to give comfort to those reading this and concerned, there is a nationwide movement to require blockages to be at least 70% stenosed or show abnormalities on a stress test in order for stenting to be allowed in the cath labs of hospitals. Those not meeting these requirements are getting reviewed and doctors will have to answer for the outliers.
I'm just curious, stocks, do you ever say anything positive about doctors or the medical profession? It seems to be 100% negative, whistle-blowing, conspiracy theory type stuff. How about a positive post once in awhile! At least try to appear as though you are fair, open-minded, and unbiased, lol.
Doc
Any hoo, the argument that stents are ineffective but implanted anyway is grossly misleading. It is true that stents in stable patients have never been shown to save lives. But that is not why they are implanted. They are implanted to relieve chest pain (angina) or ischemia (inadequate blood flow) the latter of which can be without symptoms of chest pain, but nontheless dangerous in increasing the risk of arrhythmias as well as decreasing the quality of life.
Doing the procedure in the same setting as the diagnostic cath is actually preferred by patients who trust their cardiologists to do the right thing. Who would want to go through the same procedure twice if they have a 90% blockage that is causing symptoms or ischemia.
The idea of doing lifestyle changes is advocated in all patients who get stents to prevent further worsening of lesser blockages as nearly all patients who get a stent for a 75% or greater blockage also have numerous smaller blockages in all of the arteries of the heart that could progress without good prevention. But all the good diet and exercise efforts won't change a 90% blockage that is causing chest pain or ischemia anytime soon. An appropriately placed stent relieves the problem instantly, giving the patient time and less risk to do good diet and exercise for future prevention. Do you really want to start a rigorous exercise program with a high grade blockage in the coronary artery, getting active chest pain or ischemic arrhythmias and possible sudden death each time you get up to more than 2.5 mph?
The article is simply misleading. But it does apply to inappropriately placed stents where the blockage is NOT severe and there is no symptom and no abnormality on a nuclear stress test. Unfortunately, that does happen as some doctors make poor decisions. Just like any other profession. There are a few bad apples. Fortunately not a lot. But to give comfort to those reading this and concerned, there is a nationwide movement to require blockages to be at least 70% stenosed or show abnormalities on a stress test in order for stenting to be allowed in the cath labs of hospitals. Those not meeting these requirements are getting reviewed and doctors will have to answer for the outliers.
I'm just curious, stocks, do you ever say anything positive about doctors or the medical profession? It seems to be 100% negative, whistle-blowing, conspiracy theory type stuff. How about a positive post once in awhile! At least try to appear as though you are fair, open-minded, and unbiased, lol.
Doc
Market-based, low overhead medical care with transparent pricing
The consumer-driven Surgery Center of Oklahoma actually posts transparent pricing and offers deeply-discounted, payable-in-advance, cash-only medical procedures.
To understand how deeply discounted the Surgery Center’s fees are, consider that a nearby local hospital in Oklahoma City, Integris Baptist Medical Center, charges more than $33,000 for a “complex bilateral sinus procedure.” When the same surgeon performs the same surgery at the Surgery Center, the total cost is less than $6,000.
Reasons? The hospital is receiving payment from a third party (insurance company or government), and not the patient, who therefore has no incentive or reason to question or monitor the price. Another reason that the hospital charges 5 times more than the Surgery Center for the same procedure is the huge difference in administrative overhead. Reason explains:
Except for the clerical staff, every employee at the Surgery Center is directly involved in patient care. For example, both human resources and building maintenance are the responsibility of the head nurse. “One reason our prices are so low,” says Smith, “is that we don’t have administrators running around in their four or five thousand dollar suits.”
“In 2010, the top 18 administrative employees at Integris Health received an average of $413,000 in compensation, according to the not-for-profits’ 990 tax form. There are no administrative employees at the Surgery Center.”
http://www.aei-ideas.org/2012/11/markets-i...acare/#comments
The consumer-driven Surgery Center of Oklahoma actually posts transparent pricing and offers deeply-discounted, payable-in-advance, cash-only medical procedures.
To understand how deeply discounted the Surgery Center’s fees are, consider that a nearby local hospital in Oklahoma City, Integris Baptist Medical Center, charges more than $33,000 for a “complex bilateral sinus procedure.” When the same surgeon performs the same surgery at the Surgery Center, the total cost is less than $6,000.
Reasons? The hospital is receiving payment from a third party (insurance company or government), and not the patient, who therefore has no incentive or reason to question or monitor the price. Another reason that the hospital charges 5 times more than the Surgery Center for the same procedure is the huge difference in administrative overhead. Reason explains:
Except for the clerical staff, every employee at the Surgery Center is directly involved in patient care. For example, both human resources and building maintenance are the responsibility of the head nurse. “One reason our prices are so low,” says Smith, “is that we don’t have administrators running around in their four or five thousand dollar suits.”
“In 2010, the top 18 administrative employees at Integris Health received an average of $413,000 in compensation, according to the not-for-profits’ 990 tax form. There are no administrative employees at the Surgery Center.”
http://www.aei-ideas.org/2012/11/markets-i...acare/#comments
Scientists urge ministers: tell truth on 'over-hyped' flu vaccine
The flu vaccine given to millions of people each year in Britain is “over-promoted” and “over-hyped” and the protection it offers against the seasonal illness has been exaggerated, scientists claim.
Professor Osterholm, a US public health adviser whose report “The Compelling need for game changing influenza vaccines” was published last month, said: “Our report is very comprehensive. It took three years, we reviewed 12,000 peer reviewed papers and interviewed 88 experts from around the world. We took no money from the private sector or governments – we had no conflicts of interest.
“The most striking outcome is that we have over-stated the effectiveness of the influenza vaccine. That has had a very dampening effect on the development of new vaccines.”
http://www.independent.co.uk/life-style/he...ne-8336184.html
The flu vaccine given to millions of people each year in Britain is “over-promoted” and “over-hyped” and the protection it offers against the seasonal illness has been exaggerated, scientists claim.
Professor Osterholm, a US public health adviser whose report “The Compelling need for game changing influenza vaccines” was published last month, said: “Our report is very comprehensive. It took three years, we reviewed 12,000 peer reviewed papers and interviewed 88 experts from around the world. We took no money from the private sector or governments – we had no conflicts of interest.
“The most striking outcome is that we have over-stated the effectiveness of the influenza vaccine. That has had a very dampening effect on the development of new vaccines.”
http://www.independent.co.uk/life-style/he...ne-8336184.html
QUOTE (stocks @ Jan 20 2012, 08:36 AM)
How Choose to Doctors Die
It’s Not Like the Rest of Us, But It Should Be
It’s Not Like the Rest of Us, But It Should Be
End-of-Life Medicine: Enormous Lack of Informed Consent
The latest RadioLab podcast (“The Bitter End”) is about the dramatic difference between how doctors want to be treated when they are near death (they want no CPR, no ventilator, no dialysis, no surgery, no chemotherapy, no feeding tube, no antibiotics, nothing except pain medicine) and how the general public wants to be treated (most people want CPR, ventilator, dialysis, surgery, chemotherapy, feeding tube, antibiotics, and so on).
The RadioLab guys were puzzled by the difference. Upon investigation, they learned that the big differences exist because all those medical procedures (except pain medicine) have much worse outcomes than the public is told. The doctors know about the bad outcomes. It is better to die, the doctors decide. Unless doctors have less tolerance for being in a vegetative state, having ribs broken, and so on than the rest of us, it is clear that most people agree to these procedures because of ignorance. They fail to know what actually happens because the people who know — doctors — fail to tell them.
In other words, a huge number of sick people are being treated without having given informed consent. Doctors are doing many things to the sick people that benefit the doctors without telling the sick people how bad those things are. If end-of-life doctors told the truth, they would have a lot less work.
http://blog.sethroberts.net/2013/02/01/end...sent/#more-9058
“The $2.7 Trillion Medical Bill”
The New York Times has started a series called Paying Till It Hurts about high medical costs. The first installment is called “The $2.7 Trillion Medical Bill” and is about the high cost of common procedures, such as colonoscopies, in the United States compared to other countries. (Which I blogged about quite recently.) The most extreme example is that a certain (unspecified) amount of lipitor costs $124 in the United States and $6 in New Zealand. Other treatments that cost much more in the United States include hip replacements and MRI scans.
This series might be a turning point, leading to government regulation of what health care providers can charge, which is how other countries control health care costs. To read the huge number of comments (already > 1000) is to see the suffering caused by these prices. One comment: “An acne medication was over $550 for a small tube of ointment. The [prescribing] Dr. had no idea it was that expensive.”
http://blog.sethroberts.net/2013/06/02/the...-bill/#comments
The New York Times has started a series called Paying Till It Hurts about high medical costs. The first installment is called “The $2.7 Trillion Medical Bill” and is about the high cost of common procedures, such as colonoscopies, in the United States compared to other countries. (Which I blogged about quite recently.) The most extreme example is that a certain (unspecified) amount of lipitor costs $124 in the United States and $6 in New Zealand. Other treatments that cost much more in the United States include hip replacements and MRI scans.
This series might be a turning point, leading to government regulation of what health care providers can charge, which is how other countries control health care costs. To read the huge number of comments (already > 1000) is to see the suffering caused by these prices. One comment: “An acne medication was over $550 for a small tube of ointment. The [prescribing] Dr. had no idea it was that expensive.”
http://blog.sethroberts.net/2013/06/02/the...-bill/#comments
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