3 ms·

I don't think that's really true. https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no-but-doctors-say-yes/517368/ https://www.theatlantic.

by Dove 8y ago

I don't think that's really true. https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no-but-doctors-say-yes/517368/ https://www.theatlantic.com/health/archive/2017/02/when-evid...

simonh 8y ago
You do not think that established medical treatments generally improve outcomes? What do you do if you think you have a medical problem? Where do you go for help? Obviously there are mistakes made and some unnecessary or counterproductive treatments are given in some cases. We’re talking about a massive endeavour involving millions of practitioners across the world. But claiming that in general this activity is not beneficial seems a big claim to make based on a single article on an issue with seemingly specific scope.
- nickodell 8y ago
  >You do not think that established medical treatments generally improve outcomes? That's not what the linked article claims. The linked article claims that there are specific procedures that do not help in specific situations, yet these procedures continue to be done in those situations. This is totally compatible with the claim that medical care improves outcomes on average.
  - simonh 8y ago
    I'm not quite clear what it is that you "don't think is really true", then.
    - nickodell 8y ago
      I'm not the parent commenter. Ask him. If you want to justify the claim, "future generations will look at modern medical procedure X and remark at how primitive and pointless X is," you don't need to show that all medical procedures are bunk. Indeed, in Washington's time, not all medical procedures were bunk. Doctors helped people, sometimes. If doctors in Washinton's time never helped people, the average person would notice that, and stop calling for a doctor. Were some of those procedures harmful to patients? Sure, but not obviously so.
- Dove 8y ago
  I was disagreeing with the idea that established treatments today are known to improve outcomes. It is very mixed, and really depends on what problem you are trying to solve. There has been a lot of progress in some areas, but there is also a lot of bad science out there, together with institutional, legal, and regulatory corruption, on top of plenty of plain old incomplete understanding of complex hard problems and the associated necessary accidental causing of harm in ignorance while doing the best we can. We do a lot of good. We have made some miraculous advances. But we also still treat some very common problems with methods known to cause harm. The way we treat type 2 diabetes, heart disease prevention, chronic high blood pressure and mental health are particularly suspect, and these are very common and widespread problems. And I don't call those out because I have read an article or done a survey of medicine - I call them out because as problems I have personally had, I have taken the time to learn about them and found the standard approaches to be shockingly poorly evidence based. I do not know enough to make a claim about the average case, but I do know that the reliability of the medical system in dealing with the particular problems I've had in the last decade or so has been surprisingly bad and dangerous. I've come through it okay, but I've also been given way more useless or harmful advice than I would have expected, and dodged way more bullets than I would have believed were out there. The article I posted is the tip of the iceberg. A commonly recommended, unnecessary procedure, which kills or seriously injures one in fifty is a horrible scandal. Hundreds of thousands of deaths a year from errors in hospitals, a risk one avoids by staying home, is an awful scandal. Drugs prescribed long term to improve mental health issues based on short trials, now suspected to make them worse and induce dependence, are a terrifying prospect. Diabetes treatment protocols now absolutely known to kill people, in use for decades and probably still in use in plenty of cases. Suppression of dissent. Suppression of competition. Corrupt and motivated research. I'm not saying don't go to the doctor. You should for a lot of things. I certainly do. I'm not saying doctors don't help - for a new issue I know nothing about, I'd generally expect them to be able to. But it is certainly true that if you exercise blind faith in the system, it is perfectly capable of cheerfully killing you. The best advice I have, and it is not very good advice, is to read absolutely everything. Review the basic science yourself for and serious condition you are dealing with, commit to no serious and life changing treatments without plenty of research and multiple opinions, DON'T TRUST THE STANDARD RECOMMENDATIONS TO BE SOLUD WITHOUT REVIEWING THE BASIC SCIENCE, and avoid unnecessary hospital trips and medication as much as possible. It is easy to scoff at the doctors of Washington's day - look at all the unnecessary and harmful crap they did! At least things are better now! Well... yes, a lot of things are better now, but we still do plenty of unnecessary and harmful crap.

by Dove 8y ago

I don't think that's really true. https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no-but-doctors-say-yes/517368/ https://www.theatlantic.com/health/archive/2017/02/when-evid...

simonh 8y ago

You do not think that established medical treatments generally improve outcomes? What do you do if you think you have a medical problem? Where do you go for help? Obviously there are mistakes made and some unnecessary or counterproductive treatments are given in some cases. We’re talking about a massive endeavour involving millions of practitioners across the world. But claiming that in general this activity is not beneficial seems a big claim to make based on a single article on an issue with seemingly specific scope.

nickodell 8y ago
>You do not think that established medical treatments generally improve outcomes? That's not what the linked article claims. The linked article claims that there are specific procedures that do not help in specific situations, yet these procedures continue to be done in those situations. This is totally compatible with the claim that medical care improves outcomes on average.
- simonh 8y ago
  I'm not quite clear what it is that you "don't think is really true", then.
  - nickodell 8y ago
    I'm not the parent commenter. Ask him. If you want to justify the claim, "future generations will look at modern medical procedure X and remark at how primitive and pointless X is," you don't need to show that all medical procedures are bunk. Indeed, in Washington's time, not all medical procedures were bunk. Doctors helped people, sometimes. If doctors in Washinton's time never helped people, the average person would notice that, and stop calling for a doctor. Were some of those procedures harmful to patients? Sure, but not obviously so.
Dove 8y ago
I was disagreeing with the idea that established treatments today are known to improve outcomes. It is very mixed, and really depends on what problem you are trying to solve. There has been a lot of progress in some areas, but there is also a lot of bad science out there, together with institutional, legal, and regulatory corruption, on top of plenty of plain old incomplete understanding of complex hard problems and the associated necessary accidental causing of harm in ignorance while doing the best we can. We do a lot of good. We have made some miraculous advances. But we also still treat some very common problems with methods known to cause harm. The way we treat type 2 diabetes, heart disease prevention, chronic high blood pressure and mental health are particularly suspect, and these are very common and widespread problems. And I don't call those out because I have read an article or done a survey of medicine - I call them out because as problems I have personally had, I have taken the time to learn about them and found the standard approaches to be shockingly poorly evidence based. I do not know enough to make a claim about the average case, but I do know that the reliability of the medical system in dealing with the particular problems I've had in the last decade or so has been surprisingly bad and dangerous. I've come through it okay, but I've also been given way more useless or harmful advice than I would have expected, and dodged way more bullets than I would have believed were out there. The article I posted is the tip of the iceberg. A commonly recommended, unnecessary procedure, which kills or seriously injures one in fifty is a horrible scandal. Hundreds of thousands of deaths a year from errors in hospitals, a risk one avoids by staying home, is an awful scandal. Drugs prescribed long term to improve mental health issues based on short trials, now suspected to make them worse and induce dependence, are a terrifying prospect. Diabetes treatment protocols now absolutely known to kill people, in use for decades and probably still in use in plenty of cases. Suppression of dissent. Suppression of competition. Corrupt and motivated research. I'm not saying don't go to the doctor. You should for a lot of things. I certainly do. I'm not saying doctors don't help - for a new issue I know nothing about, I'd generally expect them to be able to. But it is certainly true that if you exercise blind faith in the system, it is perfectly capable of cheerfully killing you. The best advice I have, and it is not very good advice, is to read absolutely everything. Review the basic science yourself for and serious condition you are dealing with, commit to no serious and life changing treatments without plenty of research and multiple opinions, DON'T TRUST THE STANDARD RECOMMENDATIONS TO BE SOLUD WITHOUT REVIEWING THE BASIC SCIENCE, and avoid unnecessary hospital trips and medication as much as possible. It is easy to scoff at the doctors of Washington's day - look at all the unnecessary and harmful crap they did! At least things are better now! Well... yes, a lot of things are better now, but we still do plenty of unnecessary and harmful crap.