Why do so many unproven recommendations get incorporated into the medical arena?
Put a jacket on so you don’t catch cold!
Stress causes stomach ulcers.
Caffeine causes _______.
(Fill in the blank since it’s blamed for everything!)
Sugar makes kids hyper.
Colonic cleansing rids the body of evil toxins.
We accept many medical recommendations as sound in the
absence of supportive data or in some cases, even if data refutes the claim. Many folks, including current governmental public health leaders, still maintain that the measles vaccine causes autism which has been roundly debunked. Dislodging medical myths takes effort, time and open mindedness of the believers. When I was a younger doctor,
antibiotics were routinely prescribed for sore throats and ear
infections.. When these
patients recovered, the antibiotics were credited with the salutary outcome. Doctors were simply following the teachings
and customs of that era. Nowadays,
physicians approach these patients much more conservatively, but this therapeutic retreat took a few decades.
Following a tradition doesn’t mean that the practice is sound. Robust medical evidence should be our professional guidepost. And if there is no underlying supportive scientific
data, then ideally the treatment should be tested to verify efficacy.
My hands aren’t entirely clean either. I am culpable of accepting and perpetuating certain practices that have been passed down but never proven. For instance, I’ve recommended therapeutic or dietary measures to many of my patients with various types of bowel disturbances in the absence of supportive medical evidence. My guess is that your physician has also practiced the 'art of medicine' when the science isn't there. In a perfect world, we would be guided by high quality randomized controlled trials for every medical issue. Reader Alert: The world is imperfect!
And while
having solid evidence is optimal, the absence of evidence doesn’t mean that the
treatment is not effective. How many
actions and decisions in life do we strongly believe are beneficial but haven’t
been tested? But we should look for a
better reason to perpetuate a practice than this is how it has always been done. At some point, let's shake up the system and ask, 'why are we still doing it this way?'
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