10 replies to this topic

[maineman]

Mark, well said. What you or I do for ourselves is very different from someone "claiming" a result for someone else. One of my favorite expressions in the office is this: a patient asks, "What do you think of macrobiotics (or vitamins, or yoga....etc.). I look at them and smile and reply, "As your doctor I'm going to tell you what is known, what is not known, the risks, the benefits, the research. But, outside the office, if you'd like to go for a beer I can tell you what I believe, or what I do at home....but in the office you are asking me to put on my Medical Hat and synthesize important data for you"... What I try to defend here (and at work) is the ethical and academic INTENT of science and medicine. The sad truth is there are a lot of lousy doctors out there, and a bunch of crummy drugs, excessive tests, treatments, etc. But at least we have a system in place that strives to be better. We have peer reviewed research. We hold our scientists to an ever higher standard. Licensing and monitoring of doctors and hospitals is intense and getting more intense all the time. Love it or hate it, we have malpractice and accountability. Etc. Have you ever had the pleasure of seeing a full retraction of a research paper with accompanying editorial in the NEJM, for instance, after realizing a statistical error? Or a drug pulled off the market because unexpected side effects showed up? How about the recent removal of estrogen replacement therapy? This was "standard of care" for half a century until an intensive review discovered a few, just a few, unexpected cases of uterine cancer and this was felt by the medical community to be unacceptable, even though it was just a few. Overnight, hundreds of thousands of doctors changed the way they approached estrogen therapy. Unlike so-called "alternative" stuff, which is unmonitored, based on testimonials, preys on the fears and hopes of the innocent and is also very, very expensive. Granted, some of it is harmless (caveat emptor) but some of it is pretty dangerorus. And dishonest and unethical. And that chaps my fanny. mm