Is Evidence-Based Medicine Only an Illusion?

Posted On Tuesday, 19 March 2013
Is Evidence-Based Medicine Only an Illusion?
Throughout my career, I have heard the snickers of my medical doctor colleagues as they lay claim to practicing the only legitimate type of medicine.

I would ask a medical doctor why they would not recommend CoQ 10 or magnesium oratate for cardiovascular issues, and they would answer, "where is the research?" So, I would show them the research, and their answer would usually be that the research was not good enough to meet their standard.

Mark Twain said that there are three types of lies: a lie, a damn lie, and a statistic.

The truth is that research is in the eye of the beholder.

Last year I received a letter from the head of McGuff, a medical supply company, saying that they where stopping the production of Vitamin C in an injectable form, due to the FDA’s claim that there was a lack of research for any medical application.

The background on vitamin C is that sailors who lacked it developed a disease called scurvy, which upon taking in vitamin C would be reversed. The FDA says that the use of vitamin C for scurvy was not proven, even though it had been used successfully in various forms for scurvy for over 100 years.

It's their right, but I disagree with it.

I, however, look at all evidence including historical use and safety, and then decide whether it will benefit my patients.

Recently though, there is mounting evidence that medical doctors are not even practicing the type of evidence-based medicine that they think they are.  According to Ben Goldacre in the book Big Pharma, doctors (medical) are merely "imagining that there practicing evidence-based medicine".

Goldacre is among the most vocal critics of the pharmaceutical industry and government agencies who refuse to hand over all the clinical trial data, making it impossible for doctors and patients to get the full picture on most of the medicines widely used today. Basically he is accusing Big Pharma of selectively showing physicians the positive research and suppressing the negative.

This allegation is nothing new, but now it is coming into national discussion.

What is a patient to do if the physician is being lied to about the drugs she or he is prescribing? How is a patient to know?

As a physician, I have only one piece of advice: Think!

Before taking anything, drug or natural, hear the argument from the qualified practitioner, and make the best decision you can. Also, know the risk/benefit for each substance you are considering.

For example, vitamin C, due to it’s historical use, may be more likely to help someone than an experimental antiviral that has only been on the market for a few years. One last thing is to avoid, if possible, are new or non-generic medications. It seams that the “rest” of the evidence on medications tends to come out after the financial incentive is gone.

Funny though, it seems that after 15 years of practicing, medical doctors and Naturopaths have something in common, we have to use our best judgement on anything before prescribing it to our patients.

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