Believing In Medical Treatments That Don't Work

Hugh Pickens writes "David H. Newman, M.D. has an interesting article in the NY Times where he discusses common medical treatments that aren't supported by the best available evidence. For example, doctors have administered 'beta-blockers' for decades to heart attack victims, although studies show that the early administration of beta-blockers does not save lives; patients with ear infections are more likely to be harmed by antibiotics than helped — the infections typically recede within days regardless of treatment and the same is true for bronchitis, sinusitis, and sore throats; no cough remedies have ever been proven better than a placebo. Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment, and knee surgery is no better than sham knee surgery where surgeons 'pretend' to do surgery while the patient is under light anesthesia. Newman says that treatment based on ideology is alluring, 'but the uncomfortable truth is that many expensive, invasive interventions are of little or no benefit and cause potentially uncomfortable, costly, and dangerous side effects and complications.' The Obama administration's plan for reform includes identifying health care measures that work and those that don't, and there are signs of hope for evidence-based medicine: earlier this year hospital administrators were informed by the Centers for Medicare and Medicaid Services that beta-blocker treatment will be retired as a government indicator of quality care, beginning April 1, 2009. 'After years of advocacy that cemented immediate beta-blockers in the treatment protocols of virtually every hospital in the country,' writes Newman, 'the agency has demonstrated that minds can be changed.'"

Comments

And next up

[m0s3m8n]

Just wait. Next up will be treatment based on life expectancy and quality. I see this becoming an issue based on my experience working for a group of Eye docs (retinal specialists). I often see very elderly (and often demented) patients receiving very expensive treatment of eye conditions. do they need the treatment - sure, to preserve their sight. Does the treatment improve their quality of life - maybe. So who decides, the patient or family, or BIG government?

Goes to show.

[palegray.net]

The human body is pretty darn good at healing itself. There is absolutely no replacement for a decent diet, moderate exercise, and a positive attitude. The last factor alone has been repeatedly shown to boost immune system health over a variety of drug-based treatments.

Sinusitis

[jonpublic]

My experience with sinusitis definitely confirms this. Every 3 months or so I would come down with another sinus infection. Each time I would goto the doctor and get a prescription for antibiotics. I wasn't asking for antibiotics. I was looking for a solution to the problem. One time the doctor wanted me to switch to a much more expensive antibiotic. Sure enough I ended up getting some nerve damage from the antibiotic. Nothing permanent, but the numbness lingered for over a year.

What the kicker here is that if the doctor had looked at my chart and said, maybe we should take another approach after the 5 or 6th time, the whole situation would have been avoided.

I got a neti pot and I haven't had a sinus infection since, I just use the neti pot whenever I feel my head getting clogged up. $20 dollar solution.

Idiotic.

[DrYak]

Every 3 months or so I would come down with another sinus infection. Each time I would goto the doctor and get a prescription for antibiotics.

This is indeed idiotic. You should shot your doctor. There's plenty of evidence that chronic sinusitis aren't caused by bacteria (the only thing killed by antibiotics).

If the doctor really wanted to try something, he should have made a try with an anti-fungic (some studies tend to show that part of recurring sinusitis might be due to bugs more of the fungi persuasion).

I got a neti pot and I haven't had a sinus infection since, I just use the neti pot whenever I feel my head getting clogged up. $20 dollar solution.

Brilliant. Washing the nasal cavity is a method which also works for viruses which you most likely had like most of the adult population (and against which antibiotics are no use).
It's part of what we prescribe here around (although as I said in another post, I now work in research).

For extra, you can also buy sprays containing carbocisteine (an agent helping making the mucus more fluid), but you should use sprays containing beta-mimetics more than 1-2 weeks.

But the basic "clean the cavity with water" $20 solution works too.