when evidence says no but doctors say yes


A long read on why sometimes your doctor is wrong, she knows it but still goes on to prescribe a procedure or a drug and why you should ask questions.

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About makagutu

As Onyango Makagutu I am Kenyan, as far as I am a man, I am a citizen of the world

33 thoughts on “when evidence says no but doctors say yes

  1. I appreciate you acknowledging doctors are occasionally women, but in this context it suggests women doctors are also incompetent.
    Anyway. Don’t start me on medics. Ten years of working with them is more than enough for total disillusionment. Steer well away if possible. If not, ask for their clinical audit reports to show their performance. Not that you’ll get anything, because, doctors are basically unaccountable. Like politicians. And lawyers.

    Liked by 3 people

    • makagutu says:

      I think I should have become a medic. You bury all your mistakes and with the help of a good lawyer, you can get away from most cases of professional negligence.
      Good afternoon

      Liked by 1 person

      • Good afternoon to you too. Nobody ever criticises clinical performance, people are too too grateful to get any sort of health care. In the UK you don’t need a lawyer, you just join the BMA, medic’s trade union.

        Like

  2. Violet says:

    On a similar theme: I used to work as an infection control nurse at a world famous hospital. The truth is all hospitals have massive amounts of hospital-acquired infections, which the hospitals could hide until a law was made that they had to publish their infection results (this happened somewhere around 2006). Typical of lawmakers though, they didn’t require hospitals to release the study methods used to arrive at these results.

    I was the first nurse ever hired to do a scientifically-sound measure of whether or not this hospital was using proper infection control procedures, and what our infection rates were. After 1.5 years, I came back with the information that there was only 5% compliance with infection control procedures, and our hospital-acquired infection rates were off the charts (as are most hospitals). The administrators were furious with me and told me to do it over and come back with different results. I redid all the work and came back with the same numbers.

    They fired me. They then “changed the parameters” of the study (did not tell anyone how they changed them) and published that hospital was in 100% compliance with infection control procedures and had the lowest hospital-acquired infection rate in the nation. They’ve released this same information every year, and no one questions it, even though the methods of their study have never been released. Of course all other hospitals in the nation released that they had over 97% compliance and had low infection rates too. This is nothing than utter bullshit on an epic scale.

    Bottom line: hospitals are businesses, and until the financial incentive for all of them is removed, corruption and lies will always occur. After that experience I totally lost faith in medicine. Your article shows the same problem…medical practitioners have to follow the SCIENCE. There is no other option if we want to improve. Lying to ourselves about what is real will not help us in the end!

    Liked by 6 people

    • makagutu says:

      This is so informative Violet.
      So one goes to hospital to be treated only to get other infections. That’s what I call double tragedy

      Liked by 2 people

      • Violet says:

        If people knew the super high rates of hospital-acquired infections they would be terrified to go there. It’s worse now with “super bugs” (antibiotic resistant bacteria like MRSA and C. Diff)…if you get one of these in the hospital, which is quite likely, your chances of death go WAY up. There has been some news coverage about the dangers of acquiring these super bugs but the reports never fail to mention how the most common way of getting them is from hospitals. You can bet hospitals do everything possible to keep that shit out of the news, by falsely reporting they have low rates of infection. Basically they just lie their asses off.

        Those couple years I worked as an infection control nurse were very, very eye opening.

        Liked by 1 person

        • makagutu says:

          I think i should be inviting the doc to treat me from home

          Liked by 1 person

          • Violet says:

            Home treatment is an excellent option to reduce infections, and the US healthcare system seems to finally be recognizing and doing this in our part of the country….but only for the frail elderly. I’d like to see us go the route of Britain where a home doctor visit is available to everyone. Keeping everyone is is not critically ill OUT of the hospital is the best way to slow rates of infection.

            Like

  3. >>> “For all the truly wondrous developments of modern medicine — imaging technologies that enable precision surgery, routine organ transplants, care that transforms premature infants into perfectly healthy kids, and remarkable chemotherapy treatments, to name a few — it is distressingly ordinary for patients to get treatments that research has shown are ineffective or even dangerous. Sometimes doctors simply haven’t kept up with the science. Other times doctors know the state of play perfectly well but continue to deliver these treatments because it’s profitable — or even because they’re popular and patients demand them. Some procedures are implemented based on studies that did not prove whether they really worked in the first place. Others were initially supported by evidence but then were contradicted by better evidence, and yet these procedures have remained the standards of care for years, or decades.”

    Like Violet said, the profit motive is the worst problem. It creates a parallel and competing set of priorities and pressures which medical professionals simply cannot ignore. Health care should adhere to: 1) treating medical conditions in the most effective and least invasive manner; 2) be based on objective, unbiased, and best-available science; 3) serve as many people as possible regardless of their circumstances or financial status.

    Liked by 4 people

  4. renudepride says:

    My primary care doctor once told me: “A patient is the best resource for an attentive physician.” Thank you for sharing this, my Kenyan brother. Excellent. Naked hugs!

    Like

  5. shelldigger says:

    Wow, very entertaining and informative read. Thanks Mak.

    I know now, never get a stent if you are stable and stay the hell away from doctors unless it is an emergency or a sickness that likely will require antibiotics to get better. Which for the most part is how I have been treating the situation anyway.

    Hospitals are a great place to get sick, and a great place to acquire an infection as per Violets contribution.

    My wife is an LPN and has worked in a few nursing homes, the horror stories I could tell you, suffice to say you are better off dead. She could write a book on nursing homes. She will never work in a nursing home again, she has empathy and respect for patients, both traits that corporate entities won’t tolerate for long, and she could not tolerate the way they expected nurses to get things done… She got into the home health field treating mostly kids and hasn’t looked back.

    I knew a guy who had mesothelioma for years he was pushing 85 or so. He got along pretty good for a guy who should have been dead already. He had to get a simple operation for some reason I forget now, but he sustained an after operation infection that did indeed kill him.

    Liked by 3 people

    • makagutu says:

      As Bob said, as long as the bottom line or rather lining one’s pocket is the sole motivation for opening and running a hospital, we are fucked. Go there only when necessary and question the procedures your doctor wants you to take.

      Liked by 1 person

  6. Arkenaten says:

    In one of Pratchett’s novels one of the characters was expressing concern about visiting someone in hospital.

    (paraphrase) After all, Johnny thought, most of those he visited never expected to come out of hospital and no matter how hard they try, hospitals are not cheerful places.

    Like

    • makagutu says:

      Hospitals are not cheerful places. Most are painted in dull colours. In the wards you get a mix of the very sick and not so sick. And then top it with the smell of drugs and you will be happy to come out alive

      Like

      • Violet says:

        Well, Mak, clearly you’ve never been a world famous hospital in the US. They’re rich as shit and every corner oozes money. They hire the best architects in the world, and have world famous artists exhibiting on walls all over the place. There’s stained glass windows everywhere and the floors are marble. They have famous guess speakers every week, like the Dahli Lama, the pope, and Elie Wiesel. Famous classical musicians entertain the rich visitors in the common areas at times. Of course they only treat the most wealthy patients in the world…may the nonexistent god help you if you’re just a regular person with a regular job, or god forbid, a sick person unable to work. In that case, you’re fucked.

        Liked by 1 person

  7. NeuroNotes says:

    An informative article, Mak, thank you, although I’m not the least bit surprised. This stood out:

    “We have a culture where we reward discovery; we don’t reward replication,”

    I agree with Violet and Bob that for-profit is the biggest problem. My multiple misdiagnoses of cancer last year cost approximately $150,000.00. I consider myself fortunate to have survived that nightmare.

    Reading the discussion here about people dying from infections they got while in the hospital — that was my greatest concerned. I was lucky. My brother, who had back surgery at the beginning of December (last year) wasn’t so lucky. He ended up getting the most deadly kind of staph infection, which kept him in the hospital for the whole month of December.

    You are probably aware of this, but I’ll mention it anyway for those who may not know. Medical errors are the 3rd leading cause of death in the U.S.

    Liked by 2 people

    • Violet says:

      I was totally thinking of you when I read Mak’s article, Victoria. Your case is pretty classic of how things can go badly, and unfortunately your story is quite common.

      Medicine is pretty good if you follow the SCIENCE, but medical staff are required to keep *themselves* constantly updated…currently this done by requiring a piddly number of education hours for license renewal. More extensive education does not happen because staff has to do it on their off time, and when you’re working 60 hours a week with very little vacation (in this country), it doesn’t get done. The hospitals need to help educate medical staff but they don’t like to pay for it, and they don’t want to pay staff for “not working” (ie: taking days off to get educated). Basically they don’t want to invest in anything other than their bottom line, and we know that’s a fast slope downhill.

      Liked by 2 people

      • NeuroNotes says:

        Well said. It’s sad that a patient has to be their own advocate, and spend hours doing research so that they can inform the medical professionals on the latest findings.

        Liked by 1 person

        • Violet says:

          We definitely have to advocate for ourselves. But of course physicians have their egos to consider and will then tell you “googling doesn’t make you a doctor.” Well shit, if the doctor’s education is more than 2 years old, they’re outdated!

          Liked by 1 person

          • NeuroNotes says:

            “googling doesn’t make you a doctor”

            No, but we can read. They seem to forget about open access (peer-review) journals available (abundantly), online, to the public.

            Liked by 1 person

          • Violet says:

            The internet has been a great thing for patient empowerment…too bad it’s also a great thing to fuel health anxiety. I believe the benefits far outweigh the negatives though.

            Like

      • makagutu says:

        I think the slope is no longer there, you are downhill already and something needs to be done to go uphill.

        Liked by 1 person

    • makagutu says:

      And who covers for the misdiagnosis?
      I have heard of deaths or complications arising from such cases here and I don’t know who bears that burden

      Liked by 1 person

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