Medical Reversals – When medical advice goes wrong

medical background

Should you take Hormone Replacement Therapy? Avoid eating peanuts while pregnant to lower the risk of peanut allergy in your child? Take a daily dose of Statins to lower your cholesterol? The answers are often by no means clear despite published medical studies. To complicate the issues, according to a recent New Scientist report, a significant number of medical U-Turns have recently taken place. Advice that was once confidently given was later shown as dead wrong. A recent paper published in Mayo-Clinic proceedings found that out of 980 medical practices published over the past ten years, there were 146 medical reversals. Many other practices were shown to be ineffective.

Why is this so common? Adam Cifu, who wrote the book, Ending Medical Reversals, suggested that a great deal of medical advice is based on theory and not on data. He said,

We spend so much time training people first and foremost in how the body works and how it breaks. So we get why things should work, and then we tend to adopt things because they should work before we know if they actually doThe problem is when that new technology or treatment or surgery has actually gotten out and is being given to millions of people before it’s found to not work.

In addition, there is a fair bit of inertia among doctors who for years have been recommending certain standard practices, even though studies often show them to be no better than a placebo. Ted Kapchuk who studies the Placebo effect said,

“Once a treatment has been dubbed ‘standard of care’ it tends to persist. The practitioners who perform vertebroplasty want to help people and probably continue to believe they are doing so.”

What is a patient to do? The advice given to a patient investigating Complementary and Alternative treatment for a medical condition should also extend to traditional treatment: to ask a lot of questions, especially about known side effects and about the effectiveness of the treatment? Is it based on studies or theories?  What are the alternatives?

Cifu says that patients must push their doctors for answers, The real questions are, how is this actually going to help me? Will this actually decrease my risk of having a heart attack?