Medical Myths:

The Art of Skepticism

Article Two

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Tina Steele, MA

Tina Steele is a Science and Medical correspondent who will help you to understand the roles of conventional and alternative, or complimentary, medicine in creating and maintaining health and wellness.
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Medical Myths: The Art of Skepticism

When 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.

You 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 it seems.

Just 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 really happened.

The 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 or consequences.

Of 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.

When 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.

Please don't get me wrong, there ARE excellent doctors practicing medicine, but they are increasingly in the minority—the 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.

Doctors 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.
 

Medications:

1. Why do I need this medication?
2. What are the side effects—could 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 medication?
6. What about alternative/complimentary therapies?
7. Can I expect to be on this medication for any length of time—if 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?

Procedures:

1. How many of these particular procedures have you performed?
2. May I contact some of the patients on whom you have conducted this procedure?
3. What are the risks, and what are the possible outcomes—positive AND negative?
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 time?
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 procedure?

Another 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.

Conversely, 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.

With 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.

The 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 for you.

If you are confused, or have questions, you can always contact me, and so I wish you well.

Tina Steele, MA

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Here are some useful websites worth visiting:

Medication:

The Federal Drug Evaluation and Research Medical Errors site:
http://www.fda.gov/cder/drug/MedErrors/default.htm

The National Coordinating Council for Medication Error Reporting and Prevention:
http://www.nccmerp.org/

Institute for Safe Medication Practices:
http://www.ismp.org/

MedError.com—Bridge Medical:
http://www.mederrors.com/

Patient Advocacy:

Patient Advocate Foundation:
http://www.patientadvocate.org/

Patient Advocacy Coalition:
http://www.patientadvocacy.net/

Find a Doctor, or Check Your Physician's Credentials and Malpractice Information (some sites charge a fee for service):

Questionable Doctors.com:
http://www.questionabledoctors.org/

Medical Malpractice Referral Network (has some useful info):
http://www.medical-malpractice-lawyers-attorneys.com/investigate_doctor.html
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Editors note:

We are honored to have Tina Steele's participation and contributions to Pathfinders and look forward to learning of the ways our readers have benefited from her articles and guidance on healthcare.
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