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The Mythology Of Science-Based Medicine 7 years 7 months ago #48259

  • John
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The Mythology Of Science-Based Medicine

www.huffingtonpost.com/dr-larry-dossey/the-mythology-of-science_b_412475.html

The current healthcare debate has brought up basic questions about how medicine should work. On one hand we have the medical establishment with its enormous cadre of M.D.s, medical schools, big pharma, and incredibly expensive hospital care. On the other we have the semi-condoned field of alternative medicine that attracts millions of patients a year and embraces literally thousands of treatment modalities not taught in medical school.

One side, mainstream medicine, promotes the notion that it alone should be considered "real" medicine, but more and more this claim is being exposed as an officially sanctioned myth. When scientific minds turn to tackling the complex business of healing the sick, they simultaneously warn us that it's dangerous and foolish to look at integrative medicine, complementary and alternative medicine, or God forbid, indigenous medicine for answers. Because these other modalities are enormously popular, mainstream medicine has made a few grudging concessions to the placebo effect, natural herbal remedies, and acupuncture over the years. But M.D.s are still taught that other approaches are risky and inferior to their own training; they insist, year after year, that all we need are science-based procedures and the huge spectrum of drugs upon which modern medicine depends.

If a pill or surgery won't do the trick, most patients are sent home to await their fate. There is an implied faith here that if a new drug manufacturer has paid for the research for FDA approval, then it is scientifically proven to be effective. As it turns out, this belief is by no means fully justified.

The British Medical Journal recently undertook an general analysis of common medical treatments to determine which are supported by sufficient reliable evidence. They evaluated around 2,500 treatments, and the results were as follows:

13 percent were found to be beneficial
23 percent were likely to be beneficial
Eight percent were as likely to be harmful as beneficial
Six percent were unlikely to be beneficial
Four percent were likely to be harmful or ineffective.
This left the largest category, 46 percent, as unknown in their effectiveness. In other words, when you take your sick child to the hospital or clinic, there is only a 36 percent chance that he will receive a treatment that has been scientifically demonstrated to be either beneficial or likely to be beneficial. This is remarkably similar to the results Dr. Brian Berman found in his analysis of completed Cochrane reviews of conventional medical practices. There, 38 percent of treatments were positive and 62 percent were negative or showed "no evidence of effect."

For those who have been paying attention, this is not news. Back in the late 70's the Congressional Office of Technology Assessment determined that a mere 10 to 20 percent of the practices and treatment used by physicians are scientifically validated. It's sobering to compare this number to the chances that a patient will receive benefit due to the placebo effect, which is between 30 percent and 50 percent, according to various studies.

We all marvel at the technological advances in materials and techniques that allow doctors to perform quadruple bypass surgeries and angioplasties without marveling that recent studies indicate that coronary bypass surgery will extend life expectancy in only about three percent of cases. For angioplasty that figure sinks to zero percent. Those numbers might be close to what you could expect from a witch doctor, one difference being that witch doctors don't submit bills in the tens of thousands of dollars.

It would be one thing if any of these unproven conventional medical treatments were cheap , but they are not. Angioplasty and coronary artery bypass grafting (CABG) alone cost $100 billion annually. As quoted by President Obama in his drive to bring down medical costs, $700 billion is spent annually on unnecessary tests and procedures in America. As part of this excess, it is estimated that 2.5 million unnecessary surgeries are performed each year.

Then there is the myth that this vast expenditure results in excellent health care, usually touted as the best in the world (most recently by Rush Limbaugh as he emerged from a hospital in Hawaii after suffering chest pain). But this myth has been completely undermined. In 2000 Dr. Barbara Starfield, writing in the Journal of the American Medical Association, estimated that between 230,000 and 284,000 deaths occur each year in the US due to iatrogenic causes, or physician error, making this number three in the leading causes of death for all Americans.

In 2005 the Centers for Disease Control and Prevention reported that out of the 2.4 billion prescriptions written by doctors annually, 118 million were for antidepressants. It is the number one prescribed medication, whose use has doubled in the last ten years. You would think, therefore, that a remarkable endorsement is being offered for the efficacy of antidepressants. The theory behind standard antidepression medication is that the disease is caused by low levels of key brain chemicals like serotonin, dopamine, and norepinephrine, and thus by manipulating those imbalanced neurotransmitters, a patient's depression will be reversed or at least alleviated.

This turns out to be another myth. Prof. Eva Redei of Northwestern University, a leading depression researcher, has discovered that depressed individuals have no depletion of the genes that produce these key neurotransmitters compared to people who are not depressed. This would help explain why an estimated 50 percent of patients don't respond to antidepressants, and why Dr. Irving Kirsch's meta-analysis of antidepressants in England showed no significant difference in effectiveness between them and placebos.

You have a right to be shocked by these findings and by the overall picture of a system that benefits far fewer patients than it claims. The sad fact is that a disturbing percentage of the medicine we subject ourselves to isn't based on hard science, and another percentage is risky or outright harmful. Obviously, every patient deserves medical care that is evidence-based, not just based on an illusory reputation that is promoted in contrast to alternative medicine.

We are not suggesting that Americans adopt any and all alternative practices simply because they are alternative. These, too, must demonstrate their effectiveness through objective testing. But alternative modalities should not be dismissed out of hand in favor of expensive and unnecessary procedures that have been shown to benefit no one absolutely except corporate stockholders.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48267

  • tamar
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And here's a slightly different view that I just stumbled upon:

www.theatlantic.com/health/archive/2015/04/dr-oz-and-the-pathology-of-open-mindedness/391370/
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The Mythology Of Science-Based Medicine 7 years 7 months ago #48269

  • EmilyK
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I think there is a place and a use for all types of therapies and treatments. Chinese herbs and homeopathy have been around a very long time and have served many more people than allopathic medicine. Feeling better from energy therapy and acupuncture helps the mind feel more relaxed which I believe helps the body heal. I do not think there is a right or wrong belief or perspective on this. We each need to find what works for our mind, body and spirit.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48270

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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Like Emily, I believe that some non-traditional treatments can help the overall well-being of a person, such as acupuncture and meditation. I also believe that some lifestyle diet changes can be helpful.

The problem with non-traditional and holistic treatments is that there are too many people who try to make a profit and prey on desperate, ill people. They sell junk-filled capsules and claim that it's 'natural' and will cure anything. Patients can pay $80 for a bottle of nothing. To make matters even worse, you don't know if anything in those capsules is harmful and it very well could be. There is no regulation and you cannot rely on testimonials or anecdotal claims. That is what gives holistic and so called 'natural' remedies a bad name. You basically put your life in the hands of someone who could be offering fraudulent guidance and that can cause more than just monetary loss.

I am all for avoiding traditional treatment whenever possible. I agree that many medications can cause more harm than the illness you started with. I agree that medications are over-priced and over-used, especially anti-depressants. But I cannot consciously condone the random use of most of those products and services when they either make no logical sense or come with no legitimate certainty.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48278

  • tamar
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It just reeeaaaaalllly bugs me that the pot calls the kettle black in many articles that I read that endorse alternative treatments. They can't seem to do it without dissing science-based medicine.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48310

  • John
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Really? :whistle:

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48311

  • tamar
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Really? :whistle:


Yep, but I concede I should stay out of this sub-forum. I was upset yesterday after visiting an inlaw in ICU who would've died without emergency surgery. So I was annoyed by the generic attack on science-based medical treatment, which saved his life.

Of course others are entitled to their opinions. Sorry!

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48313

  • John
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Tamar,
I'm an engineer. I've spent a few academic years studying science. I prefer the balanced view and common sense, and I won't be taken for a fool. We should all recognize that doctors and nurses are there to save lives. But there is a lot grey out there on what falls outside of Western medicine. I've learned a lot about alternative approaches to helping manage my ITP in the last 4 years. And that success you could say came from within, because no hematologist or GP helped me get there.
cheers,
john

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48317

  • Ann
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I think part of the problem is that many non-medical people start off by assuming that doctors know everything and when they realise they don't, they get totally disillusioned and reject it all completely. If they could only realise earlier on that doctors don't know everything and simply do their best with the knowledge they have at the time, and doctors do know that themselves, people would do better. They would then understand what informed consent means.. it means understanding what is known and what is not, understanding what the known risks are and that there maybe unknown risks too, weighing up the pros and cons and deciding what to do.
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The Mythology Of Science-Based Medicine 7 years 7 months ago #48321

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Hi Ann,

Modern (or Western) medicine as taught in medical schools does not have all the answers. Most readily assume so but that is not that case. That is the point of the article. As long as you are armed with that fact, you are going in with your eyes wide open.

It took me more than 20 years of having ITP to realize that there are natural approaches to improving your ITP condition, none of which seem to be formally documented or promoted much (anywhere). The internet, this website, and Joan Young's experience altered my outlook and inspired me to change and try everything available - diet, gluten-free, probiotics, allergen management eg. chlorine, dust, etc., reiki, and last but not least homeopathy. What can these drug-free approaches do? Downregulate (medical term ~ calming) your immune system. Its not rocket science. Just a common sense approach that any non-medical person would appreciate. And yes, all of these things help in the long run. Natural methods take a lot of time to have a lasting impact and that's the problem for many (ie. it is hard to see) in our ITP community.

cheers,

john

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48325

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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John:

I agree that some of those things can be helpful. The problem is that the word 'natural' is over-used, abused, misleading and misunderstood. It is used to describe things that are not natural or are tainted with harmful substances. Many people don't know the difference and all they see is that word and think it's good for them.

Marijuana is natural too and is now being used for medicinal purposes. However, if you buy it from the wrong source, you have no idea what might be added to it. People are naive and desperate and honestly, I have little trust for the supplement world because I have no idea who is credible.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48334

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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I'm in a situation where I am going to attempt a 'natural' route for a problem. I've been in the middle of menopause for about six years. I started a bit early, probably because of Lupus. Anyway, the hot flashes are horrible and show no sign of stopping. I get them all day long and just pour sweat. It affects everything I try to do. Every year I tell my GYN about it and end up telling them that soy and HRT are contraindicated with Lupus, so I'm stuck. She recommended Black Cohosh and Primrose Oil. I ordered them and will give it a try.

I am not against it enough to never try anything. The reviews seem credible so it's worth a shot. I'm hoping I can stick to a routine of fitting more pills into my day. I can barely keep up with what i have now.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48349

  • Aoi
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A related point regarding the effectiveness of medical treatment is that physicians and other health care practitioners make mistakes. The error rate rises if you have a rare disorder or an unusual presentation of any disorder. According to the CMS, the error rate in the US may be as high as one in three diagnoses. This greatly complicates judging the effectiveness of treatments, and makes life difficult for people with a wide variety of disorders. Unfortunately, it seems to go unrecognized and unmentioned in commentary about health care.

@Sandi: several women I know have reduced their PMS hot flashes with evening primrose oil, and two endocrinologists I've met have used it in their practice for many years. I hope it helps you.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48353

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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That's encouraging. Thanks. I've been temperature sensitive since I was diagnosed with Lupus and having menopause on top of it has been twice as bad. I sometimes use my air conditioning in the winter and haven't worn anything but short sleeves for years.

I agree about the misdiagnoses and have been there myself. It has led to a mistrust of doctors. I listen to what they say and then check things out for myself. Of course I won't stop seeing them because of that, but I do realize the limitations and failures of the medical community.

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48357

  • John
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Sandi,

The word "natural" can mean many things and yes it is an abused term.

I'm not a big fan of supplements, nor am I big on "pills" or meds. If I have a bad cold or flu, I no longer take ibuprofen or cold medications. Just go to bed and crash for a couple of days (or longer). The only med I take is a beta-blocker and I am trying hard to not add to that. I take a potent probiotic daily which I do not consider a "pill" and an occasional cod liver oil capsule. But that's it. I hope to get all my vitamins etc. I need from eating real food.

And although I have been introduced to Maryjane in my younger years, there is no doubt that I would use her one day for pain managed if need be. B)

Take care. cheers, john

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The Mythology Of Science-Based Medicine 7 years 7 months ago #48368

  • Sandi
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  • Sandi Forum Moderator Diagnosed in 1998, currently in remission. Diagnosed with Lupus in 2006. Last Count - 344k - 6-9-18
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I consider any vitamin or supplement to be a pill only because it's something more that I have to swallow and time around all of my other meds. Many of the things I take cannot be taken around the same time, so I end up taking something every two hours or so. It's hard to keep up with when I have things going on in my day. I am constantly getting thrown off schedule because of things that come up.

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