Medical Quality: Myth or Science?
On the morning that I began this post, I read in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects.
No, I don’t think that creationism is science and it should not be disguised as such. Global warming, or climate change, however, is more nuanced. While it is inarguable that temperatures have been rising, it is not certain and to what extent human activities are responsible for this. Clearly, this issue has been contaminated by politically correct warriors and those who have an agenda against fossil fuel use. Science, like all scholarship, should be a pursuit of the truth, without a destination in sight. Believing or wanting to believe that man is turning the world’s heat up may sound plausible, but it may not be true.
Just because something sounds true and logical, doesn’t make it so. In addition, repeating an opinion like a mantra isn’t sufficient to confer legitimacy on a view. Zealots and partisans gainsay these inconvenient truths.
In the medical universe, much is presented as true, which may be either false or unproved. Consider how many established medical procedures and practices have no underlying science to buttress them. Consider the following examples and decide if you agree that each is a good idea that makes sense. Do they sound right or are they truly sound?
- Patients should have regular physical examinations as an integral part of preventive medicine.
- Patients should undergo a CAT scan of the chest and abdomen at age 50 in order to detect any silent lesions that may be present, before they have an opportunity to grow and threaten the patient.
- Medical care is superior in large medical centers because physicians there have access to the best minds and technology.
- If you have fever and a cough, it’s best to begin antibiotics early before pneumonia can develop.
- Everyone should restrict their salt intake.
- Probiotics facilitate good digestion and should be part of a healthful diet.
- Placing stents in narrowed arteries helps patients live longer by allowing for increased blood flow.
- Cardiologists are more skilled at managing high blood pressure than general internists because of additional training and experience.
- A back x-ray is important to evaluate new back pain to exclude a fracture or other serious condition.
- Everyone should receive medication to lower their cholesterol levels, even if the levels are ‘normal’, as this will reduce risks of developing heart disease.
- Alternative and complementary medicine are safe and effective and should be incorporated into mainstream medical practice.
- Colonoscopy is a fun and exciting event that everyone should enjoy often.
- Medical bloggers who spew forth sarcasm need to be chastised and publicly humiliated.
So, let’s not label the backwoods Tennessee folks as backwards too quickly. Medicine and climate change have common elements. Both are suffused with politics, to their detriment. Remember Mammogate? Proponents of both make spirited claims without scientific basis, and attack principled dissenters as outlying heretics. Count me as one of them. Someone has to blow the whistle here.
I have something in common with climate change myself. When I read about myth masquerading as fact, I find that my own temperature starts rising.
I am a full time practicing physician and writer. I write about the joys and challenges of medical practice including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When I'm not writing, I'm performing colonoscopies.