I just watched a video from Healthcare Triage, a YouTube series created by Aaron Carroll, MD. Dr. Carroll is both a pediatrician and a healthcare researcher; his goal is to educate patients about how the healthcare system works (or doesn’t) and answer questions about common health topics.
This video focuses on an unfortunate reality in our healthcare system—roughly half of common treatments aren’t based on good research.
As Dr. Carroll states in the video
A whopping 50% [of medical treatments] are of unknown effectiveness. We just haven’t done the studies.
Benefits are assumed, harms ignored.
Protect yourself from too much medicine
I’ve posted many times about one of the current crises in our healthcare system—too much medicine is killing us.
Doctors prescribe medical treatments—screening tests, diagnostic tests, surgeries, and drugs—that may have little or no benefit. Worse, they may cause harm.
And they all cost money. Insurance companies pay for lots of medical treatments that aren’t evidence based. Why? Because many of these treatments have become common, and are considered standard care.
Actually, the better your insurance, the more likely you are to be overtreated!
The way our healthcare system is designed rewards overtreatment. Physicians aren’t paid much to do nothing; the big dollars are in procedures: tests and surgeries. And drugs.
It’s called perverse incentive.
Doctors and hospitals are also afraid of getting sued. They order more tests to protect themselves.
As the patient, or the family member of a patient, it’s in your best health and financial interests to ask lots of questions before consenting to a treatment, especially one of unknown effectiveness.
Dr. Carroll also points out in the video
When there is no known cure for a fatal or severely debilitating health condition, trying something uncertain is a reasonable approach, provided the patient is informed and consents. [my emphasis]
How can you protect yourself from unproven treatments?
- Do your own research. I’ve listed my favorite resources below.
- Ask questions. Lots of questions. Check out my post 5 questions you should ask your doctor.
- Get a second opinion. If you don’t feel the physician is being straight with you, don’t hesitate to get a second opinion. I can think of a couple instances in my family where I wish we had gotten one!
Use these resources for evidence-based medicine
Be an informed patient. These are some of my go-to resources when I have questions about the safety or effectiveness of medical treatments.
- Choosing Wisely. An initiative set up by the American Board of Internal Medicine, Choosing Wisely helps both physicians and patients choose medical treatments that are “evidence based, free from harm, and absolutely necessary.” Medical specialty groups submit lists of tests or procedures they think are harmful or ineffective.
- The United States Preventive Services Task Force (USPSTF). This independent panel of experts reviews the evidence for preventive tests or treatments, and then creates a recommendation for or against based on the quality of that research.
- The Cochrane Library. Cochrane Reviews has been a leader in evidence-based medicine for decades. Physicians and researchers on Cochrane’s panel of experts evaluate studies for results and quality, and then publish their reviews online for anyone to look at.
- Evidently Cochrane. Evidently Cochrane is a more patient-friendly version of the Cochrane Library, and shares articles on a wide range of health topics.
- Science-Based Medicine. SBM is an evidence-based medicine blog that features posts from scientists, physicians, pharmacists, and nutritionists. Topics covered include the value of screening exams, drugs, supplements, nutrition, vaccination, health fads, and more. My favorite science blog!
- Healthcare Triage. A YouTube health channel, Healthcare Triage is a quality source of information on many common health topics.
- ConsumerLab.com. ConsumerLab is an independent testing laboratory that reviews the research on supplements, herbal remedies, and other over-the-counter treatments. They then test the products for quality, and publish their recommendations. It’s like Consumer Reports, but for supplements [subscription required for some content].
I also recommend reading these books: