Sorry in advance for piggybacking on your post, @ladykaymd. But I have this feeling every day of my life! That I guess is where the advantage of growing up with a hippie mother with a lot of healthcare skepticism comes in.
Medicine lies just like any other giant, homogenous group of people does – it’s made up of a lot of people who don’t know everything, and don’t question authority quite enough.
This is the danger of scientism and dogma. Thinking that knowledge must be correct or true because it comes from a place of authority is the definition of dogma, and the institution of medicine is just another opportunity to be dogmatic. Except this time with a lot of social clout, and people’s lives in your hands.
Most of the time it’s no big deal. e.g. Doctors are NOT trying to kill you when they give vaccines. e.g. We DO need to treat your diabetes even though you don’t have any bothersome symptoms right now.
But there are many many times when doctors trusting their med school education, or a biased set of evidence, or what their mentor told them to do, hurts patients. Like when we told women not to breastfeed, or that C-sections are just as safe as vaginal births. When we told families that there was no risk in prescribing antidepressants to adolescents. When we bolstered the idea that “the more tests the better”, and weren’t thoughtful about when to test and when not to. And this is not to mention the more clear-cut, and historic (widely publicized), examples, like Tuskegee, lobotomies, and Henrietta Lacks.
The point is, medicine is susceptible to dogma just like anything else and I think it’s our responsibility as doctors to do the math (like ladykay did) and keep our ears pricked for times when institutionalized bias, obscure motivations, and misinterpreted numbers are misleading us.
It’s also why I hate the distinction between “traditional” and “alternative” medicine – because it encourages us to dismiss on the whole an entire set of practices as ineffective, or non-evidence-based, when the distinction between these practices and the ones we use are more or less arbitrary. There are practices within traditional medicine that are dangerous or ineffective, and ones which are safe or effective. There are practices within alternative medicine that are dangerous or ineffective, and ones which are safe or effective. In both cases, we should use our brains to figure out which is which rather than somebody else’s labels.
This whole conversation is also why I really want all doctors and future doctors to read The Structure of Scientific Revolutions by Thomas Kuhn. It’s a philosophy of science book that discusses the formation of new ideas within the scientific world, and how the whole process is based on certain dogmas he calls normal science, and that progress depends on someone paying attention to when anomalies build up so that a paradigm shift can occur. I think this whole concept is so important for doctors because being the dinosaur that holds onto old ideas just because “that’s how it’s always been done” means hurting patients.
Okay, y’all. I think I’m finished with my rambling rant. Just…question everything, medblr bbs. Please?
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