Why trusting your doctor could kill you

Whether you consider taking a herbal supplement, use your nasal spray while driving or change your diet – recommendation is to always consult your doctor. Pregnancy is not a sickness, yet women in most countries go to see doctors when expecting a baby. It is as if you are under no circumstances at any point should be in charge of what’s arguably most important to you – your health. Thanks to better economic conditions and improved prosperity, longevity has increased worldwide, as have our needs for medical services.  It seems however that we have gradually outsourced all the decision making regarding our well-being to the medical community. It’s not so strange why it happened though – research has shown that human brain tends to choose path of least resistance. It is indeed liberating to shrug off responsibility of having to think of what’s best for you – your doctor’s prescription says it all. Provided that it does it is.

This is not in any way to belittle the medical community. Physicians belong to one of the most hard-working occupational groups there is, and they spend years and years acquiring colossal amount of information and perfecting their skills to save lives under oath. What baffles me though is patients’ behavior I’ve witnessed time and again. Doctor’s order seems to be sacred. We tend to follow it without giving it a second thought. There are definitely cases (hopefully, majority of them) when a procedure or a drug prescribed by a doctor is your best shot especially when it comes to critical care. But then there are cases when it’s not. Why? Because even when lives are at stake, doctors can be and are wrong. As Dr Druin Burch, specialist in geriatric medicine, noted during his medical training: “If someone senior and wise believed that something worked, it was not necessarily true. Even though sincere and educated and intelligent people thought a treatment was helpful, it could still be toxic”(Druin Burch “Taking the Medicine. A Short History of Medicine’s Beautiful Idea, and Our Difficulty Swallowing It”(2010), p.9). He further concludes that: “Doctors, for most of human history, have killed their patients far more often than they have saved them. Their drugs and their advice have been poisonous. They have been sincere, well-meaning and murderous”(Ibid, p.3).

Let’s take a tiny detour in history: “The Egyptians considered their doctors and their medicines as being potent and effective. Records of their practises show something different. These papyri,

the oldest proper medical instructions of our species, contained potions and salves and drugs whose effectiveness was a fantasy. Traditional knowledge of healing was not reliable. The first doctors in the world were frauds. This was a remarkable beginning for any profession, even more so for one that has always delighted in special trust. For the next three and a half thousand years, little changed” ( Ibid, p.13).

As acclaimed surgeon Atul Gawande pointed out, there was not much known about how to prevent or treat heart attacks even as recently as the 1950s. Doctors were not aware about the danger of high blood pressure or the role of cholesterol, genetics, smoking or diabetes (Atul Gawande “Checklist Manifesto”(2011), p.9). Moreover, only a small proportion of medical knowledge that did exist was actually correct because up until around mid-twentieth century recommendations that doctors made or drugs that they prescribed for the most part lacked basis in any reliable trials. Or simply put: “the “majority of medical beliefs were guesses”(“Taking the Medicine”, p.216).

Despite the fact that medicine has made mindboggling progress during the past half a century or so, it is worth knowing that even today “making the right treatment choice among the many options for a heart attack patient can be difficult, even for experienced clinicians […]. Careful studies have shown, for example, that heart attack patients undergoing cardiac balloon therapy should have it done within ninety minutes of arrival at a hospital. […] What is the likelihood that all [required procedures] will actually occur within ninety minutes in an average hospital? In 2006, it was less than 50 percent. […]”(“Checklist Manifesto”, p.10). This is unfortunately not an unusual example. These kinds of failures occur far more often than you would think is acceptable when you in good faith turn yourself into the hands of healthcare practitioners. “Studies have found that at least 30 percent of patients with stroke receive incomplete or inappropriate care from their doctors, as do 45 percent of patients with asthma and 60 percent of patients with pneumonia. 40 percent of pneumonia patients do not get the antibiotics on time. When they do get the antibiotics, 20 percent of patients get the wrong kind (Ibid). Shockingly, about 30% of healthcare overall is either of no benefit for patients or actively harmful. In other words, it’s being wasted – on unnecessary procedures and services as well asneedless costs. 

Gawande also offers insights as to why errors and inefficiencies occur in healthcare: 

[…] we have been fooled about what we can expect from medicine […]. Medicine has become the art of extreme complexity – and a test of whether such a complexity can, in fact, be humanly mastered. [There are] more than thirteen thousand different diseases, syndromes, and types of injury – more than thirteen thousand different ways in other words, a body could fail. […] Clinicians now have at their disposal some six thousand drugs and four thousand medical and surgical procedures, each with different requirements, risks, and considerations. It is a lot to get right”(“Checklist Manifesto”, p.19).

Although a certain procedure is most often successful, risk of complication after a surgery is within the range of 3-17%. To put this into perspective, “[w]orldwide, at least seven million people a year are left disabled and at least one million dead –  a level of harm that approaches that of malaria, tuberculosis, and other traditional public health concerns”(“Checklist Manifesto”, p.87). With these odds at hand, you might want to reconsider your approach to medical care, especially if it’s been a passive one. Read here how you can do it.