Savvy consumers of health news must be skeptics with common sense

skepticism-image-197x300At one point, medical experts recommended that physicians aggressively treat patients 60 and older so the top number of their blood pressure readings ran as close as possible to 140. Maybe not so, anymore. For a while, physicians were told to treat patients so their “good cholesterol” increased significantly. But maybe this approach doesn’t protect against heart disease after all. Pediatricians once warned parents to protect newborns by not exposing them to certain allergens, especially peanuts. If you haven’t had your head buried in the sand, that counsel, of course, has just changed 180 degrees.

Thanks are due to Aaron E. Carroll, a pediatrician, health research and policy expert, and columnist with the New York Times “Upshot” feature, for reminding — yet again, as repetition is the Mother of Learning — that medical news must be taken in by patient-consumers with a “dose of healthy skepticism.” This he says is especially true about reports on nutrition.

I’ve written about the harms that result from hype and the many, sometimes dramatic reverses in health and medical news. I’ve pointed out that there are accessible resources, such as the excellent, to watchdog coverage of medical science and so-called advances. I’ve suggested that patient-consumers look closely at key elements in research stories, including how the work was done, how long the study ran, whether its data is visible and if it was published in a reputable medical journal. This will help savvy readers look askance, even at pieces in quality news sites — such as recent articles touting turmeric or eating lots of hot peppers.

I’ve discussed the challenges we confront when we heed too much the advocacy, often not based in evidence or research, of celebrities and prominent individuals for therapies, nostrums, and just plain bunk. Really, I can’t make some of the health craziness up, including an actress selling gullible women $66 “jade” eggs that she insists they should aim to retain in their privates — all in the ludicrous claim that this boosts their sex lives and hormonal balance, when, really, it can cause serious infections and other harms that even could be deadly.

Common sense and moderation matter —a ton — when it comes to something as critical as your health. I see in my practice plenty of challenges and harms done by bad doctors. But, c’mon folks, why do you have your M.D. around if you listen more to a 20-something starlet? Your MD likely has been in school studying science and medicine almost as long as that celebrity has been alive.

Doctors, and other experts, are human and prone to misjudgments, too. Let’s be emphatic about that. And the federal Food and Drug Administration has provided fresh evidence, scrutinizing 22 case studies where medications, in the course of long, rigorous testing, had “divergent results” between promising phase three and final phase four in clinical trials. In other words, these drugs, as described by a specialized site that reports on biopharma, belong in a “Hall of Shame.” They didn’t do what they were supposed to. They were more harmful than thought, potentially even lethal.

This is a timely lesson for those who want the federal Food and Drug Administration to race medications and medical devices to markets. President Trump has met with aspirants to lead the FDA who assert that patients should know the risks and should take drugs and use medical devices accordingly, without Uncle Sam, as they contend, nannying and overprotecting them, and possibly hindering the advancement of medical science.

Do Americans really want this?

I’ve also said that progress in rigorous, safe medical science all too often occurs slowly and incrementally. Atul Gawande, a surgeon and health policy expert, has an excellent, long read in the New Yorker, arguing that modern medicine gives excess weight to dramatic, one-off therapies rather than recognizing the heroic powers of incremental care. We lionize brain surgeons when primary care doctors may benefit our health more. We fail to recognize that flashy-seeming therapies like stem cells, a treatment that I have written is being hyped, even dangerously, across the country, may benefit us. But this realistically occurs only after years and years, and with fits and starts in what we know about how they work and where they may be most safe, useful, and affordable. Patience and skepticism pays, and we should always keep this in mind about health care information especially.

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