Medical Myths: The Art of Skepticism
I was a graduate student I took several classes in medical school,
one of which was Geographic Medicine. My professor was a medical
doctor: an extremely well-traveled and erudite man, with an acerbic
wit and quick mind. Among the many things I learned from him was
how to be a critical thinker, and I will be eternally grateful
to him for giving me that gift. I am now going to pass on a little
of his wisdom to you, in the hope that it will help you gain a
more powerful role in addressing your healthcare needs.
see, I, like so many of us, was usually quite happy to believe
much of what I read; especially if it was in a medical journal,
or other scientific paper. Blessed with a reasonable level of
intelligence, I thought that I was perfectly equipped to sift
the clinical wheat from the chaff. But, it was only when my professor
pulled me aside, and made me question the research that I had
so readily quoted on a poster presentation I was giving on mercury
poisoning, did I begin to see that not everything is always as
because Dr. So-and So says that you have to take a certain highly
toxic medication, because your blood pressure (or cholesterol/glucose/triglycerides)
is too high, and does not bother to inform you that by taking
this drug you might experience liver or kidney failure, a severe
even fatal allergic reaction, cardiac arrhythmias, or a plethora
of other serious side effects, does not mean you have to blithely
take his word for it! A 1998 meta-analysis of hospital medication
errors revealed that in 1997 more than 100,000 people lost their
lives due to adverse drug reactions. This figure has been repeated
yearly ever since, and these are only the numbers in hospitals,
but what of those at home…unaware that the pill they are about
to take is going to kill them? Autopsies don't always reveal what
same philosophy applies to undergoing surgery, or other invasive
procedure, even a visit to the dentist: no one should be expected
to know exactly what is about to happen to them, but we all have
a right to be informed of any risks, side-effects, possible outcomes
course, it is unrealistic to expect that every Tom, Dick and Harriet
should take it upon themselves to study pharmacology and medicine
in order to self-manage their own healthcare. What, however, is
perfectly acceptable is that as consumers (that is what a patient
really is), we know what questions to ask our doctors and when
to ask them. It is worth remembering that many (far too many to
my mind) doctors make the same mistake that I did; in that they
believe everything that they are told, whether it be in medical
school or in the text books that they are mandated to read. The
problem arises when they fail to question the dogma, and go through
their entire careers without opening their minds and eyes to the
possibilities that their instructors were wrong, or out of touch.
my body became allergic to literally every medication known to
man, and I could not eat because of cross-over reactions, I went
to see an allergist. A specialist, who was supposed to be able
to tell me why my immune system was out of control and what to
do about it. I had done my research, and reached a logical and
scientifically-based conclusion, that I was hoping that she would
at least entertain. Before seeing the allergist I had also run
my theories past a couple of my old professors: one a toxicologist,
the other a pharmacologist, who had both agreed that I was probably
on the right track. However, this woman dismissed my ideas with
a barely disguised snort of derision, and told me that my science
was completely flawed. It wasn't. In fact, she was the one who
had no clue about what she was saying, but instead of admitting
that she did not know, she tried to turn her ignorance into an
attack on me. I was both hurt and horrified, than anyone could
treat another human being the way she treated me, especially when
I was so physically and emotionally vulnerable, because of the
devastating consequences of what had happened to my body.
Unfortunately, there are far too many doctors like her out there,
and you need to be aware of it. Remember, medicine is NOT an exact
science, and most good doctors would admit that they can never
be 100% certain about anything! Time after time I have encountered
cases where doctors have misdiagnosed, over prescribed, misprescribed,
or been just plain negligent, yet their patients have continued
to believe that 'doctor knows best', often to their own detriment,
even to their own demise.
don't get me wrong, there ARE excellent doctors practicing medicine,
but they are increasingly in the minoritythe incompetent doctors
are not necessarily so through any fault of their own; many are
victims of a disinterested educational system that just wants
its money, instructors who long ago lost their love of the profession,
if they ever had it, a cost-cutting Federal mandate, and a voracious
health insurance industry that serves only its shareholders and
not its patients. It is a daunting task to navigate the confusing
and oftentimes broken healthcare systems, but a little information
goes a long way, and there are people (such as myself) to help
you along the way.
are not Gods; they may think they are, but in fact they are as human
as you or I. You need to remember that fact, next time you sit in
his or her office, when they try and prescribe you the latest medication,
for which they may receive a kick-back from the pharmaceutical company,
or a potentially unnecessary surgery for which they will receive
a disproportionately gargantuan payment. Below I am going to give
you some questions that you need to ask, and ask you must. Another
point to remember would be to write down any questions that you
may have about what ails you; too many doctors are under time constraints
and you need to insist that they listen and respond, until you are
satisfied that you have all the answers you need.
Why do I need this medication?
2. What are the side effectscould my personal/professional
life be affected?
3. What drug-drug interactions may occur with this medication?
4. I am taking this drug/supplement, will there be a problem?
5. What else could I do that would enable me to not take this
6. What about alternative/complimentary therapies?
7. Can I expect to be on this medication for any length of timeif
so how long?
8. If I have to take this medication for X amount of time, have
there been any long-term studies done to test the safety of
this drug over an extended period?
9. How much does this medication cost?
10. Is there a generic equivalent?
How many of these particular procedures have you performed?
2. May I contact some of the patients on whom you have conducted
3. What are the risks, and what are the possible outcomespositive
4. Are you Board certified to perform this procedure?
5. When will I get to meet the anesthesiologist (if its right
before the surgery, insist that you meet at least a day before,
to discuss the procedure and the options that you have, e.g. spinal
block vs. general anesthesia for knee surgery)?
6. How long will I be staying in hospital, and is this sufficient
7. What length of time will I require for recovery?
8. What about returning to work?
9. How much does this surgery cost?
10. What, if anything, would be an alternative to this invasive
thing to remember is that when you have an appointment to see
the doctor, you should expect to the doctor; not the nurse, or
the nurse practitioner (NP), or the advance practice nurse (APN).
The doctor. Friends of mine, who attend a prestigious medical
center that specializes in seniors, were informed that “their”
doctor was moving on and they were being assigned to a new one.
However, three appointments later, they had yet to meet their
elusive new medic and kept being shunted in to see the APN, who,
regardless of her skills, has neither the training nor the valuable
critical thinking skills to address the multitude of illnesses
that this elderly couple have between them.
it is sometimes preferable to see the NP, APN or RN, if you doctor
is not receptive to your concerns and you feel more comfortable
with the nursing staff. However, this should only be something
you do while seeking another physician, and not a permanent arrangement.
If you are unhappy with your doctor you have the right to change
him or her, either for another in the same practice, or in another
practice altogether. This applies to all insurances, including
Medicare and Medicaid. Do not let the insurance company try and
bully you into staying with someone who makes you unhappy or uncomfortable.
health insurance costs soaring, it is ever more important to ensure
that you are not getting short-changed, such as being forced into
seeing a nurse instead of your doctor, refused medications or
procedures, denied access to less invasive alternatives, bamboozled
into surgeries or taking drugs with unacceptable side-effects,
or excluded from complimentary or physical therapies, and the
list goes on.
most important thing to remember is that an educated patient is
at a distinct advantage over one who unilaterally surrenders control
to their healthcare professionals; you have the ability to not
only be pro-active in your healthcare, but can assume a managerial
role in it too. To this end, I am giving you some links that I
think will empower you, and I hope that you will decide to avail
yourself of the wealth of knowledge that is waiting out there
you are confused, or have questions, you can always contact me,
and so I wish you well.
are some useful websites worth visiting:
a Doctor, or Check Your Physician's Credentials and
Malpractice Information (some sites charge a fee for service):