Medical Idolatry And Healthcare Outcomes

Coach is Right ^ | 11/17/15 | Michael D. Shaw

[Oldpuppymax]

Many articles have appeared in this column questioning the conventional wisdom on matters ranging from infection control practices; to the validity of established (yet oft-changing) guidelines on diet, and “healthy” blood titers for a host of substances; to suitable blood pressure numbers. The implication is that such wisdom is subject to influence by sundry commercial and political forces.

While most people are familiar with the CDC, FDA, and NIH, in many cases, so-called non-governmental organizations (NGOs) are involved. These can be trade associations such as the American Heart Association and American Medical Association, as well as consensus standard groups such as the Association for the Advancement of Medical Instrumentation. And then, there are the certification bodies, such as the American Board of Internal Medicine (ABIM).

In a sense, the prestige and very existence of these institutions is a form of idolatry, which—like it or not—is part of human nature. Less dramatically, we restless humans are searching for answers, and some sort of higher authority to assure us. However, we ignore the factors that may tempt such authority at our peril.

It isn’t revolutionary to point out the unseemly alliance between those bodies that set “healthy” blood values, and the very pharmaceutical companies that sell products to adjust these values. In one of many examples that could be cited, there is essentially no hard science behind the draconian reductions in the blood glucose level defining type 2 diabetes—from 160 mg/dL, to 140 mg/dL, to 125 mg/dL (8.9, 7.8, 6.9 mmol/L). Nonetheless, there are plenty of hard sales numbers for all the drugs thus prescribed.

As to ABIM—according to its website—it is one of 24 medical specialty boards that make up the American Board of Medical Specialties. The associated boards work together to establish common standards for physicians to achieve and maintain...

[Uncle Miltie]

My ex worships at the feet of the Medical G-ds, one of the key reasons she’s my ex. They ruined her with opiates.

[pieceofthepuzzle]

Medicine is not controlled, generally, by your physician. There are so many levels of input, and so many people at the trough, that it would make your head hurt to even try to sort it out.

In the meantime, one of the general principles that this article is addressing is the flaws in the growing trend toward ‘standardization’ (e.g. Certification by specific Boards and societies, standardized guidelines for treatment, standardized measures of outcome etc.). With this I agree entirely. Yes, there need to be guidelines, and measures of outcome, and verification of credentials - but it needs to be kept in mind that these are always limited in their value, and they don’t guarantee the best, or even effective treatment.

[Madame Dufarge]

I always get the feeling that my doctor is practicing Paint by Number medicine. She just ticks off items from a menu.

And her being a 34-year old Muslim from Turkey (complete with head scarf) doesn't help instill any confidence.

[TBP]

There are usually alternatives.

Think healthy.