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The Problem with Modern Medicine

It’s been a while since the last post here but I have not been idle. I have been considering the topic of modern medicine and its modalities of healing. This was precipitated by my own recent encounter with the medical behemoth after a severe earache incapacitated me temporarily which led me to the clinic. This experience left me realizing just how vulnerable the patient is in the face of the authority of the doctor who hands down judgment upon the helpless patient desperate for an answer to the ailment that afflicts him/her. The doctor, usually, will give you an answer since that is what you seek. Whether this answer will in fact help your condition is another question entirely and it is in this way that it becomes easy for the doctor to prescribe medicine for conditions that don’t require it. This is all to say that going to the doctor is as much a psychological experience as anything else and that this must be taken into account in order so that the patient is not mislead or taken advantage of in his/her vulnerability. After all, the cures of modern medicine are not without their risks and to be taking a drug or undergoing a procedure simply because the doctor believed that that is what you wanted and without any proof of the efficacy of the drug or procedure is to be gambling with your health as hospitals are not safe places. Mistakes are made and antibiotic resistant infections breed there. No, we must be aware that doctors are people who make mistakes and who are subject to influence. That modern medicine is itself a pseudoscience based upon a lot of conjecture and questionable data and that it is sold like any other product, with lots of spin. I will now outline some of these problems.

Absolute Risk versus Relative Risk

Have you ever heard an advertisement for a drug where it was stated that it reduces the risk of some condition by let’s say 50%. This percentage refers to the rate of reduction as compared to another group, it is relative risk. This means that if there was a trial done with two groups of 1000 people and in group A, 1 person died while in group B 2 persons died then it could be said that the intervention done for group A reduced their risk of death by 50%, quite impressive despite the fact that the risk of dying in group A was 0.1% and the risk of dying in group B was 0.2%. This is one way in which unimpressive data can be made to appear much more impressive than it is in order to sell product. The problem with relative risk is that is meaningless unless you know what the percentages being compared are. If in the example trial above, 250 people died in group A and 500 people died in group B, the relative risk would be the same even though the risk of death in group A would have now been 25% been versus 50% in group B, a much bigger difference. This is but one example of why you should be very skeptical of procedures or drugs that are “proven.” You need to investigate the data yourself and do your own cost/benefit analysis to ensure that it’s not just hype and statistical abuse.

The Authority of Medicine

Modern medicine has been able to occupy a position of power and authority that very few other institutions have and this has given them something of a carte blanche to do what they like. Everyone seems to accept that the doctor knows best or that modern medicine is usually the most effective or most proven. The problem with these conceptions of modern medicine is that they are wrong. There are many obvious and standard procedures in medicine which in fact have nothing to support them. Cardiology is a great example of a pseudoscience as it seems to have the highest prevalence of procedures and medicines that harm people while procuring no benefit. Trials have shown that stents, angioplasty, and coronary artery bypass grafts are essentially worthless not to mention the overprescription of statins which treat a number but not a condition and may increase the prevalence of cancer since really low cholesterol is correlated with higher cancer risk. If these procedures did not have any risks then I suppose using them would not matter but the fact is that people become ill and consent to these procedures which have not been shown to work only to become sicker from complications related to these procedures. It is in this way that going to see the doctor can, paradoxically, make you sicker than if you had stayed at home and done nothing. For instance, ear infections are self limiting conditions that don’t generally need antibiotics, nevertheless, doctors routinely prescribe antibiotics for ear infections and this can lead to diarrhea or constipation as a side effect due to the disruption of gut flora and in trials it has been shown that those who took antibiotics for ear infections have a higher chance of recurrence than those who did not. Nevertheless, doctors do not seem to inform patients that they should take probiotics with their antibiotics or that a shorter course may be just as effective as the longer course or even take the trouble to make sure the infection is bacterial or what sort of bacteria it is so that the narrowest spectrum antibiotic is prescribed.

The Problem of the Screening Test

The screening test has come to appear as a thing that saves lives by detecting life threatening problems way before they actually threaten life. Unfortunately, the screening test doesn’t really save lives as much as it turns perfectly healthy people into patients, patients who become survivors because the problem they had wasn’t a problem in the first place. A screening test in an asymptomatic individual is seldom necessary since many screening tests are unreliable and since most of the types of cancers detected by screening tests are not ones to worry about. There is the tumor that is static, the tumor that grows so slowly as to have no effect on mortality, the tumor that grows slowly and can have an effect on mortality, and the tumor that grows quickly. If you have one of the first two then you’ll be getting medicalized for no reason. If you have the last one then you will become symptomatic rapidly and will not be helped by any screening test. Thus, out of 4 types of cancer, only 2 are worth worrying about and of those 2 only 1 can be detected at a screening test. I personally am not interested in lining the pockets of the medical industry for a problem I may or may not have so I suggest avoiding all medical screening tests unless you actually have symptoms.

Iatrogenicity

All of this is to say that if one is to remain healthy one must avoid doctors, hospitals, drugs, and procedures as much as possible otherwise one risks falling into the trap of endless iatrogenicity and lifelong disease management. The approach of modern medicine is treatment of symptoms and this leads to treatments that mask the problem while allowing it to progress. For instance, GERD is a condition that usually is caused by low stomach acid but is treated in ways that further reduce stomach acid thus helping the disease to progress while only providing minor symptomatic relief. In this way, the individual can become a patient for life who manages his/her chronic illness as opposed to someone who is getting better and will cease being diseased at some point. There are few cases in which one must remain diseased and manage it, certainly many fewer than what modern medicine believes and, in any case, considering how harmful treatment through conventional methods is, it seems prudent to always begin with the least harmful treatments and work up to the more harmful ones. As such, modern medicine should always be a last resort for treatment and be used chiefly for diagnostic purposes. Herbalism, osteopathy, rest, relaxation, psychotherapy, saunas, placebos, probiotics, laughter, nutrition, and vitamins all have healing potential that should be exploited before one runs into the arms of allopathy where the possibility of unintended consequences greatly increases. I will be expanding on some of these topics more later but this serves as a general exposition of my position.

References:

Hadler, Nortin. Worried Sick.

Welch, Gilbert. Overdiagnosed.

Schmidt, Michael. Beyond Antibiotics.

Bremner, Doug. Before You Take that Pill.

Cohen, Elizabeth. The Empowered Patient.

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Filed under: Health, Iatrogenicity, Medicine

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