https:\/\/commons.wikimedia.org\/wiki\/File%3ADoctor_examines_patient_(1).jpg; By Unknown photographer [Public domain], via Wikimedia Commons<\/figcaption><\/figure>Yes, I just finished Marty Makary\u2019s new book, the topic of which is clear from the subtitle, \u201cWhen Medicine Gets It Wrong and What It Means for Our Health,\u201d and the story he tells is grim.\u00a0 It\u2019s a slim book and probably available for checkout at your local library (though I had to wait for it to come off hold) and honestly I don\u2019t understand why his nomination for a cabinet position in the Trump administration was treated as suspicious \u2014 Dr. Makary has been a consistent advocate for a better healthcare system, and is nothing remotely like JFK Jr.\u2019s anti-vax nuttery.\u00a0 The largest part of the book is a set of brief reports on ways in which the groupthink of medical professionals got things wrong, with deadly\/costly consequences.<\/p>\nHere\u2019s a short list:<\/p>\n
Peanut allergies<\/strong>:\u00a0 in 1998, based on a total misinterpretation of a 1996 study, the UK health department recommended \u201cpeanut abstinence\u201d for high-risk young children to avoid peanut allergies.\u00a0 In 2000, the American Academy of Pediatrics (AAP) went even further, and said that no child should be given peanuts before age 3.\u00a0 This caused peanut allergies among children to climb dramatically \u2013 resulting in high costs due to EpiPens and serious medical harm to allergic children when they are exposed, as well as an upheaval as classrooms became \u201cpeanut-free.\u201d\u00a0 It took until 2015 for a researcher to look at the available evidence (including much smaller rates of allergies outside of the US and the UK, even in places such as Israel where a common baby food, Bamba, is made of peanuts), conduct a study (despite heavy criticism) and publish the results \u2014 the discovery that peanut exposure in infancy results in an 86% reduction in peanut allergies compared to following the AAP recommendation.\u00a0 But it took 2 further years for the AAP to reverse its guidance.<\/p>\nHRT<\/strong>:\u00a0 Hormone Replacement Therapy for women suffering from symptoms of menopause was pretty much the norm, until a 2002 study announcing that HRT increased a woman\u2019s risk of breast cancer.\u00a0 Now women are told to take hormones in menopause for the shortest dose and the least time needed to alleviate symptoms such as hot flashes.\u00a0 The truth is actually that the \u201cproof\u201d of breast cancer risk didn\u2019t pass statistical significance tests, and at the same time HRT has been proven, at rates that pass statistical significance tests, to reduce risks for heart disease, Alzheimer\u2019s, and more.\u00a0 But the influence of the first study, and the power of the lead researcher (who, it seems, simply disliked HRT and wanted to find reasons to end the practice), means these positive benefits can\u2019t get traction.<\/p>\nAntibiotics<\/strong>:\u00a0 It\u2019s generally known that antibiotics cause short-term tummy troubles, but it turns out that there are long-term consequences to frequent doses of antibiotics, with associations with higher rates of obesity, learning disabilities, ADHD, asthma,\u00a0 and celiac disease.\u00a0 (It\u2019s not 100% clear whether this is a matter of children whose doctors overprescribed antibiotics, say, for ear infections or viral illnesses, vs. the cause potentially being having illnesses which required more frequent antibiotics, but Makary is so concerned about appropriate statistical analysis that I would be pretty disappointed if he made this mistake.)\u00a0 It\u2019s also the case that Crohn\u2019s disease and ulcerative colitis didn\u2019t really exist before the 1940s, coinciding with the advent of antibiotics.<\/p>\nCholesterol<\/strong>:\u00a0 This chapter was the least surprising because it is now common knowledge, I think, that dietary cholesterol does not cause blood cholesterol, and that fat in one\u2019s diet is not the cause of being fat.<\/p>\nBlood from HIV-infected donors<\/strong>:\u00a0 Yikes!\u00a0 The Red Cross did not begin screening donated blood until 1985, despite the existence of a test years earlier, based on an almost-magical belief that blood was safe.<\/p>\nOvarian Cancer<\/strong>: The norm for the last 70 years has been that women past childbearing age who are having surgery for any other reason, have been encouraged to also have their ovaries removed, as protection against ovarian cancer.\u00a0 Apparently, \u201chundreds of millions\u201d of women have had the procedure.\u00a0 But it turns out that even after menopause, the ovaries still produce hormones, just at a smaller level, and what\u2019s more, ovarian cancer is not what it seems, but it\u2019s really \u201cfallopian tube cancer\u201d which quickly spreads to the ovaries, so that fallopian tube removal, a much less invasive procedure which doesn\u2019t impact women\u2019s health or well-being afterwards.\u00a0 Scientists are now conducting trials as to the impact of this procedure as a purely preventive measure.<\/p>\nSilicon breast implants<\/strong>:\u00a0 Silicone breast implants became very popular, but then came to a screeching halt when, in 1990, news anchor Connie Chung reported on \u201cbreast implant illness.\u201d\u00a0 One thing led to another and in 1995, Dow Corning paid $3.2 billion to 440,000 women to settle claims, leading to the company\u2019s bankruptcy.\u00a0 But it turns out that there was never any evidence and in 1999, an Institute of Medicine report by independent scientists concluded that the claims that these breast implants caused diseases such as autoimmune disease, were false.<\/p>\nWhat\u2019s the cause of these failures?\u00a0 \u201cGroupthink\u201d is a pat answer, but a large part of it is in fact a \u201cdon\u2019t rock the boat\u201d mindset.\u00a0 Getting along with colleagues, playing by the rules of orderly paper submission, maintaining the existing paradigm \u2014 the medical and scientific world simply doesn\u2019t like dissent.<\/p>\n
And Makary concludes with \u201cwhat else are we getting wrong?\u201d \u2014 as potential items to rethink include flouride in drinking water, the supposed harmlessness of marijuana, the use of tylenol for fevers (that is, bringing down low-grade fevers rather than enabling the body to use fever as an infection-fighting mechanism), certain types of early cancer detection, so-called \u201cgender affirming care\u201d for children, and more.<\/p>\n
So what\u2019s to be done?\u00a0 I don\u2019t know. But the book\u2019s overdue at the library and I wanted to write down the key points.<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"
Yes, I just finished Marty Makary\u2019s new book, the topic of which is clear from the subtitle, \u201cWhen Medicine Gets It Wrong and What It Means for Our Health,\u201d and the story he tells is grim.\u00a0 It\u2019s a slim book and probably available for checkout at your local library (though I had to wait for […]<\/p>\n","protected":false},"author":2209,"featured_media":5217,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[207,1523],"class_list":["post-18946","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-health-care","tag-marty-makary"],"yoast_head":"\n
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