The whole idea of doctor’s “orders” bothers me. After all, it is your health and your choice! A doctor should be an advisor like your lawyer or accountant. Decisions should be made by the patient after the doctor and patient share information. It has been considered routine and acceptable to get a second opinion before taking a major step such as surgery. But, it is apparently no longer smart to simply take her word for what to do about chronic conditions and test results…at least without double checking those recommendations.
The problem is that the average doctor just goes by the “standard of care” guidelines. They are kind of a cookbook created by what is basically a committee. The rules don’t allow much innovative thinking and become stagnant dogma that is perpetuated…even when there is little scientific evidence to support them and even when they are wrong. Too often the rules are also influenced by entrenched economic interests such as those of pharmaceutical companies, big medicine and even insurance companies. Below is some evidence that what is considered “standard” may be far from optimum. (In case you can’t read the caption in the cartoon, it says “Your condition has no symptoms or health risks, but there is a great new pill for it.”)
- This article from Consumer Reports (CR) debunks the myth that the higher our HDL (“good” cholesterol) the better. CR notes that “increasing HDL levels artificially, without behavioral changes, doesn’t reduce risk at all.” Drugs are being prescribed to raise HDL, but the studies show that they do not lower cardiovascular risk. And, more surprisingly, elevated HDL levels might even be a problem.
- This article in the Atlantic tells of a man who wisely pushed back on doctor’s orders to have a stent installed in one his arteries in favor of doing more research. The article notes a contributor’s summary that “nobody [who is] not having a heart attack needs a stent.” Also, “hundreds of thousands of stable patients receive stents annually, and one in 50 will suffer a serious complication or die as a result of the implantation procedure.”
- This article in UK’s Daily Mail points to a lack of science behind a number of hard and fast “rules” we’ve been taught. Examples include: get 30 minutes of exercise 5 times a week; take 10,000 steps a day; eat 5 portions of fruits and vegetables a day; eat oily fish once a week; drink 8 glasses of water a day; and aim for a certain calorie level (2,000 for women / 2,500 for men). Even if there was science to prove these rules, they would be for an arbitrary average person. You are unique.
- This is just some relatively new information, but this list could be very long indeed.
What about patient advocacy groups as a source of information? We’d like to think they are pure of intent, but according to The NY Times, 9 out of 10 have potential conflicts of interest because they take money from big pharma and often have their reps on the charity’s board of directors.
Well then, where should we get a second opinion if most doctors in the insurance network went to similar medical schools and operate out of the same cookbook? (That just gives us the same opinion twice.) Dr. Google is a good place to get questions, but not always reliable answers. (The information in the HBN library gives some reliable sources.)
Ideally, an integrative or functional medicine doctor can give you both the standard answers and the alternative and innovative approaches. He or she can help you decide which avenue makes the most sense for you. (The type of physicians who sponsor our radio show are like that.) If you don’t have access to one of those, you can put together a little team. For example, your brain trust might include a highly-recommended chiropractor, a nutritionist, an acupuncturist and a massage therapist. You might be surprised that a chiropractor can help with a major cause of acid reflux (hiatal hernia) and a nutrition adjustment might solve depression, and so on.