Healthy Skepticism

Healthy Skepticism

What if you accepted every ‘diagnosis’ made by an auto mechanic? What if you never read a food label, or totally ignored ratings and reviews on amazon?

Surely you’d be paying for some repairs you don’t need, eating stuff you should avoid, and buying inferior products.

The average person is smarter than that!

Then does it make any sense to accept what a doctor says or recommends or prescribes (or more likely these days, what the paramedical office staffer says) without at least questioning it?

In fact, every healthcare consumer should develop a healthy skepticism.

One of the good things to come out of the pandemic is heightened awareness that as doctors we are just practicing. Really, does any other profession get away with that?

If you’ve been paying attention recently then you know the experts were wrong about CoVID death rates, wrong about CoVID treatment with hydroxychloroquine, and wrong about aggressive use of ventilators for CoVID.

If you’ve not been in the habit of paying attention on a routine basis, here are some more facts from the practice of medicine that you may not know:

Ineffectiveness Of The Frequently Recommended Flu Vaccine

Influenza vaccine has been around since the late 1930s but it has an extremely variable success rate, as low as 5% in some age groups in some years.

A recent study showed that routine flu vaccination at the age of 65 does not even result in fewer hospitalizations or a lower death rate in the elderly.

Dangerous Drugs

In the past 20 years, 20 drugs previously approved by the US FDA as safe and effective were later pulled from the market, averaging one per year:

  • lorcaserin (Belviq) due to cancer;
  • valdecoxib (Bextra) due to heart attack;
  • tagaserod (Zelnorm) due to heart attack, stroke, unstable angina;
  • sparflixacin due to heart electrical abnormalities, light sensitivity;
  • sibutramine (Meridia) due to heart attack and stroke;
  • rimonabant (Acomplia) due to severe depression and suicide;
  • rapacuronium (Raplon) due to fatal spasm of airways;
  • phenylpropanolamine (Dexatrim) due to bleeding in the brain;
  • pergolide (Permax) due to heart valve damage;
  • ozogamicin due to not working, and causing vein clots, death;
  • lumiracoxib (Prexige) due to liver damage;
  • levomethadyl acetate due to abnormal heart rhythm and cardiac arrest;
  • drotrecogin alfa (Xigris) due to the fact it didn’t work;
  • propoxyphene (Darvocet/Darvon) due to heart attacks and stroke;
  • cisapride (Propulsid) due to fatal heart rhythm;
  • cerivastatin (Baycol) due to muscle destruction;
  • alatrofloxacin due to liver damage and death;
  • aprotinin (Trasylol) due to death;
  • ardeparin (Normiflo) was removed for unknown reasons.

Dangerous Medical Devices

The US FDA is not doing its job as the watchdog for patient safety in the realm of medical devices, either. In 2018 the FDA reclassified the machine used to deliver psychiatric electroshock down to Class II – in the same category as condoms, paper surgical gowns and pregnancy test kits.

Deaths From Adverse Events Related To Medical Treatment

Hospital deaths from adverse effects of medical treatment were first broadly admitted in The Institute of Medicine’s 1999 report estimating 98,000 deaths per year, making it the sixth leading cause of death in the U.S.

Subsequent studies saw that number climb, and by 2016, Johns Hopkins researchers estimated 250,000 iatrogenic deaths in hospitalized patients per year. That study was both widely criticized and widely supported.

In 2019 a study from University of Washington estimated a more accurate number was about 123,000 hospitalized patients dying per year in the US from the adverse events related to medical treatment.

Compare that to 38,800 who died in car accidents and 48,344 suicides in the US in 2019.

When a jet crashes, do we shrug our shoulders and say well, you know, the pilot was just practicing…

So what is healthy skepticism?

It is being aware enough to be an advocate for your own or a loved ones’ medical care.

The best framework for this is the process to follow for Informed Consent or Informed Refusal.

For any recommended drug, test or procedure, ask these basic questions, demanding answers in language you can understand:

  • What is the recommended drug/test/procedure?
  • How does it act on the body and mind?
  • What is known and not known about how well this drug/test/procedure works?
  • What is known and not known about the safety and hazards of the drug/test/procedure?
  • What are the viable alternatives to drug/test/procedure? What would happen if you did not take the drug/test/procedure?
  • What are the potential or actual conflicts of interest between the entities recommending and selling the drug/test/procedure?

Tip for the smart health care consumer: Watch this blog for articles to help you cultivate a healthy skepticism, with upcoming topics such as the annual medical exam, disease screening tests, and how to evaluate your local hospital.

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