Medical Myths and Misconceptions

Why do so many unproven recommendations get incorporated into common practice including 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 recommendations as true in the absence of 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 is been roundly debunked. Dislodging these myths takes effort and time.  When I was a younger doctor, antibiotics were routinely prescribed for sore throats and presumed bacterial 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 did take a few decades.

Following a tradition doesn’t mean that the practice is sound.  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. 

What if your doctor counseled no popcorn forever!

As a gastroenterologist, I have seen many patients who have suffered diverticulitis.  In this disease, there are outpouchings in the large intestine and one of them has become infected or inflamed.  Many of these patients have been strongly advised by their physicians or others to avoid nuts and seeds from fear that one of them might land in a pouch and stir up another diverticulitis attack.  I have patients who haven’t had a peanut or popcorn in decades.  Of course, if these patients have remained well they will credit their dietary restrictions with this good fortune.  However, there is not a shred of medical evidence that one’s diet has a role in preventing this disease.  Why would physicians advise and patients accept advice that has no supportive evidence?  

Look, my hands aren’t entirely clean either.  For instance, I’ve recommended therapeutics of dietary advice 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 practiced the 'art of medicine' also when the science isn't there.   In a perfect world, we would be guided by high quality randomized controlled trials for every issue.  We're not quite there yet.

And while having evidence is optimal, the absence of evidence doesn’t mean that the treatment is not effective.  How many things do we do in life that 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?'