Here’s some new info for you…
The Orthomolecular Society is publishing a paper on what they deem the downside to Evidence Based Medicine (EBM), which is the medical model our healthcare system has adopted over the last couple of decades.
The Orthomolecular Society is a group of medical doctors who study the use of natural substances like vitamins and herbs in the treatment and prevention of diseases. They believe that natural substances, at the right doses and for the right conditions, work as well or better than medications in most cases, and with fewer side effects.
WHAT IS EVIDENCE BASED MEDICINE?- The idea behind evidence based medicine is to run experiments in a very scientific manner (double blind, controlled, etc) and see what, on average, works the best. Once that is known, then the treatment that worked best for the average person in the study is made into a “cookbook” or “recipe” to be used for anyone with that problem.
WHAT ARE THE BENEFITS TO EVIDENCE BASED MEDICINE?- In the past, it may have made a tremendous difference which doctor you went to see. A doctor in Georgia may have figured out a very effective treatment for stomach ulcers. But you may live in Tennessee and have never heard of that doctor nor his treatment. Your doctor may have not heard of the successful treatment either, and may not get good results with stomach ulcers.
By using Evidence Based Medicine, experiments are run using different “recipes” for treating diseases like stomach ulcers. Whichever treatment works the best – in this case maybe it was the treatment used by the doctor in Georgia – becomes the “recipe” for treating ulcers nationwide, and all doctors and hospitals in the country are alerted to the successful treating method.
WHAT IS WRONG WITH EVIDENCE BASED MEDICINE?- There are several problems with evidence based medicine:
(1) Pharmaceutical companies are notoriously good at getting their hands in the cookie jar. They are able to use their influence to get into these studies and sway the outcomes in their favor. In this way, the results are not necessarily the best treatment available, but the treatment that most supports the involved Pharmaceutical Company’s bottom line.
(2) When a study is run and a treatment is found to positively benefit lets say 60% of the population, that particular treatment is found to be the most effective and is the one made into a “recipe” to be used by all medics for that particular condition. The problem is that if 60% responded favorably, that means that 40% did not in varying degrees.
(3) The recipes from Evidence Based Medicine studies become law in the medical community. In the past, a medical doctor was a detective, bent on figuring out your problem and how best to treat it. Now medics are being told to be simple technicians. They are not supposed to do the detective work themselves, they are to leave that to the pharmaceutical groups doing the studies. The doctors are simply to get a diagnoses and use the proper recipe as told to them by the Pharmaceutical Groups running the studies. If you happen to be one of the 40% that do not respond well or respond badly to the “recipe” used, you are out of luck.
(4) Because these “recipes” born of research are law, if you do not respond well to the treatment you are in trouble. The medics are not taught to think for themselves anymore, and are not really allowed to. If they go to court and treated you with anything different from the standard “recipe” they get in trouble. So if you do badly with a medicine or even have side effects, their hands are tied, and often will not even admit that the “recipe” could be causing you problems.
SOLUTION?- Like anything else, Evidence Based Medicine has its strengths and weaknesses. It has been a large improvement to modern medicine, in our opinions, despite its drawbacks, but there are areas for improvement.
First, we need to get the pharmaceutical companies and special interest groups out of the research arena. If we want the best treatments possible we need real unadulterated studies.
Second, the results of the tests need to be guidelines not laws. If a patient does not respond to that particular treatment, or has side-effects with it, the doctor should be allowed to go past the “recipe” and use his or her detective skills to figure out the next best course of action. We see so many patients who go try one doctor for their problem, do not get results, so go to another and yet another and keep getting the same treatments. They are getting the “recipe” each time, for their doctors seem to be either convinced it is the best treatments and if the patient doesn’t respond there is simply something wrong with the patient, or they are too afraid to buck the system and go a different route.
Third, the research needs to not just say what does best on average, but needs to indicate what the people who did best on average had in common, as well as what the ones who did not do well had in common. For instance, maybe the patients with stomach ulcers who did best on the “ulcer recipe” were Caucasions, female African Americans and Americanized Asians for some reason. Those that didn’t respond may have been male African Americans. And those that had bad side effects, maybe they were Hispanics. By doing it this way, we don’t treat everyone the exact same way, we find out what works best for different groups. This would not benefit the pharmaceutical companies as much, they want as many people as possible on their most popular medications, but it would help the people much more. And isn’t that the point?
Hope this helps,
Dr Matt and Dr Robin
http://barneschiropractic.wordpress.com (newsletter archives)
This weeks bit of Useless Information: Mice, whales, elephants, giraffes, and humans all have seven neck vertebrae.