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Why do doctors use treatments that do not work? Doust & Del Mar, 2005

Discussion in 'Other health news and research' started by ME/CFS Skeptic, Sep 18, 2020.

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  1. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

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    Thought this was an interesting editorial. It's from 2004 but is still relevant.
    Source: http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC351829&blobtype=pdf
     
    ME/CFS Skeptic, Sep 18, 2020
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  2. alktipping

    alktipping Senior Member (Voting Rights)

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    the same answer as always profit people have forgotten that medicine was built on fraud charlatans selling hope and not much else being payed regardless of patient outcomes allows the medical profession to ignore its mistakes .
     
    alktipping, Sep 18, 2020
    #2
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  3. James Morris-Lent

    James Morris-Lent Senior Member (Voting Rights)

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    The authors' answer:
    I would agree with @alktipping that the the authors have neglected to include pure greed. The opioid crisis is a fine example.

    More banal is the special interests forming around job security incentives. Of course we see this with heavy promotion and deployment of psychotherapies with unreliable evidence bases.

    Lastly none of their categories adequately encompass the personal political and economic risks of questioning dogma backed by authority, eminence, and/or pure political influence.

    i don't disagree with their bullet points but I must say they are insufficiently cynical.
     
    James Morris-Lent, Sep 18, 2020
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  4. shak8

    shak8 Senior Member (Voting Rights)

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    Beware the surgeon who gets an MBA in his spare time.

    I wouldn't say most, but some to many docs go into medicine to make money. And if they feel they don't make enough (I'm talking USA docs) well, buyer beware.
     
    shak8, Sep 19, 2020
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  5. Hutan

    Hutan Moderator Staff Member

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    Yes.
    An individual doctor takes enormous risks to 'ask the question', that is to question the established practice. Also, someone may actually ask the question, but, if they don't have a medical degree, and especially if they are a patient, they may be ignored.

    I think we have to ensure institutions are asking the questions with competence and rigour - institutions like Cochrane, and the offices of the public health services that compare health outcomes by regions and review treatment efficacy research. The WHO should also be doing this at the global level. We, or at least patient advocacy organisations, can hold these institutions to account.

    This is something we can work on too. Patient advocacy organisations need to be well-informed and ask the questions. They need to provide good information (including statements about the absence of treatments where necessary) so that patients don't accept their doctor recommending, for example, gargling as a treatment for ME/CFS.
     
    Hutan, Sep 19, 2020
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  6. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I have many examples, but I'll stick to just one.

    Doctors use unjustified assumptions about the cause(s) of a problem, particularly if that problem is common, so of course any treatment they offer (if any) may turn out to be wrong. One example which affected me for nearly thirty years was a diagnosis I got repeatedly - that I had IBS. I did get given some quite unpleasant tests in order to "prove" that there was nothing wrong with me (and none of these tests are likely to be offered to anyone today because IBS is considered to be strictly a mental health issue).

    The bowel is a tube, with an inside and an outside. All the testing assumed that if any real problem existed it must be as a result of something going wrong inside the tube. It turned out that the problem I had was caused by something going on outside the tube. The surgeon who reduced my problem by about 95% didn't even realise that he had achieved that because he was looking for something else which he didn't find, so my post-op follow-up was "interesting".
     
    Arnie Pye, Sep 20, 2020
    #6
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