Of course we do not need fools who think they know more than their doctors, but we need to understand the limits to what doctors know and what the current state of medicine is.
It has been commonplace for many years to seek a second opinion when one feels uncomfortable with what oneâs doctor tell us. Many lives have been saved because the patient or their caregiver sought a second opinion.
The first opinion might not have been based on any science, but based on the common interpretation of science, or common practice among physicians in that region of the country,.
Medicine is practiced differently in different parts of the US. Some areas may use treatments which do more harm than alternatives.
Educated to be a researcher in biomedical science, I know more than most doctors as to what the science is behind much of what they do.
One of my business failures, because I did not do due diligence, was as a distributor of the American Medical Associationâs online network, MiNet.
The benefits of the service were unappreciated by most doctors. It had extensive drug databases. As one doctor who was a friend told me, most doctors use half a dozen drugs to treat all of their patients. If they are treating a condition they do not have a drug in their personal arsenal to treat, they ask a specialist what to prescribe.
Many of us have changed doctors, and the doctors changed our medications for the same conditions, to a set of drugs which were in their arsenal.
As part of our marketing efforts for MiNet we became involved with the Boston Computer Societyâs medical group. These doctors where fascinated with the PC and were would be scientific researchers.
I listed to dozens of âpapersâ based on their âresearchâ. None of them was accepted for publication because none of them was science. None met the requirements for a scientific study.
This is not to say that they did not provide anecdotal evidence which might point a researcher to design a study but none reached a conclusion which had any science to support it.
These Doctors did not know what science was. These doctors were experienced clinicians, with degrees from prestigious schools but still failed to know what one had to do to provide âscientific truthâ.
Experts are asked for their opinions. Opinion is not science. The hypocracy of Dr. Fauciâs post-pandemic statements was based on the fact he admited to having provided his opinion. But his statements when he had offered his opinion implied he was stating the science.
We pay doctors to provide the best care that the available science offers, but many doctors do not know the alternatives to what they do. And this does not mean that any treatment other than what they normally choose is shamanism.
In NYC a patient is more likely when visiting a doctor for a sore throat to leave the office with a prescription for an antibiotic. In Boston, the patient will have a throat culture taken, and when the results are in be given a prescription for an antibiotic for the specific bacterium which caused the infection or no prescription.
Both are commonly accepted practices, but the regional practitioners will each defend their mode of operation.
Antibiotic resistance among bacteria is more likely in NYC where antibiotic use is higher, based on scientific studies. But patient pressure to have an antibiotic prescribed is higher in NYC and many doctors act to please their patients.
The government decided to protect the public from unsafe drugs in around 1906 when the Pure Food and Drug Act was passed.
It created the FDA, and was a result of a tragic series of deaths of children caused by an oral sulfonamide elixir. It used a solvent which was a component of antifreeze and highly toxic.
In 1968, the FDAâs mandate was expanded to include drug effectiveness. A result of pressure to do something after the thalidamide tragedy, it had nothing to do with the thalidamide tragedy. It did not help to avoid future tragedies because no drug is tested on pregnant patients. Just about every drug approved post-1968 has a warning against giving it to pregnant women. A warning which is sometimes ignored.
And those regulations permit physicians to make off label uses of drugs, I am currently taking two drugs for off label conditions. They are prescribed by my doctors because they work. The dosages and side effects are identical to when they are used for FDA approved purposes.
The Covid debate about the use of Cloroquinine for covid was not about good and professional medical practice. It was about control.
There is no argument that it was other than another off label treatment for a disease.
There are many conditions which do not lend themselves to controlled scientific studies. Physician discretion as to whether to use approved drugs for other purposes is legal. The use of other substances may not be. But there is no justification for using substances which can be tested which are not tested because the proponents are ignorant.
The FDA has made it so expensive to get a drug tested and approved that only Big Pharma can afford it.
Vivek made a lot of money buying the rights to drugs which Big Pharma decided were not worth the investment. He invested a little more and when he got some encouraging data, he sold them to a buyer with more money to invest.
Like so many things, the results are dependent on how much money you are willing to risk.
As for the doctor with the hip replacement, it is not a requirement that he know what metal they are, but it would help if he knew what was done to make sure it was safe. And he definitely should know what the signs are if it was unsafe for some patient.. Unfortunately, they are installed by surgeons, who would like to think their involvement begins and ends in the OR.
