Posted by Dr. Bob on January 31, 2003, at 0:58:22
[Posted by Alan on January 29, 2003, at 18:52:25
In reply to http://www.dr-bob.org/babble/20030125/msgs/138197.html]
> All drugs entail a tradeoff between potential benefit and risk of harm. Let's use them wisely. Openly & honestly discussing the pros & cons here (on Psycho-Babble) contributes to that wisdom.
> >
> > - Bob
> >
> ============================================
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> I suppose that a very large part of using them wisely goes back to the original point of the discussion nerer the beginning of this thread. Do we receive the information that we need openly and honestly from the co. that manufactured Neurontin? The doctors? If not, why not?
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> Discussions on PBabble after the fact brings no comfort to those that have been the victim of blatant commercialism and unethical behaivor displayed by the co's basically underregulated by the FDA.
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> The problem with the rush to "evidence-based medicine", which is analogous to all the business fads that come and go on a faster cycle than medical fads, is the quality of the evidence. The majority of it is coming from drug companies and doesn't seem very reproducible independently. One only has to read about all the cheating GSK perpetrated in and after its first 83 Paxil trials (in a majority of which placebo performed better than Paxil, by the way) and then talk to doctors who don't have a clue about any of that, to see exactly who is behind the push toward "evidence-based medicine" and who intends to control the evidence.
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> The idea of evidence-based medicine is a good idea if not taken to an extreme (but then we take most of our ideas in the US to unhealthy extremes, both the good ideas and the bad ones) but it's being exploited in the same old cynical fashion we've gotten used to.
>
> Here's the fundamental flaw: In the US, we practice mass medicine, assembly-line medicine. We delude ourselves that we are treating a population when in fact we are treating individuals. Only if you believe you are treating a population can you ignore what works (or doesn't) for the individual in favor of what is supposedly proven by all the evidence to be the optimal treatment for a population.
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> When you're standardizing on one treatment that provides the "greatest good for the greatest number," you're guaranteed to be mistreating fairly wide "wings" of people at the edges of a normal distribution of response. (All the more so if the evidence is crooked.) In fact, you may be doing them great harm. Yet in an assembly-line context, there's often a belief that the fault in those cases lies with the patient and not the treatment. THAT's mass medicine.
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> REAL medicine is about healing each individual patient. The rest is self-aggrandizement.
>
>
poster:Dr. Bob
thread:35970
URL: http://www.dr-bob.org/babble/social/20030120/msgs/35970.html