If you ask a conventional doctor, they'll tell you that double blind placebo controlled studies with large numbers of patients are how they decide on treatments. They'll tell you that these kinds of studies get peer reviewed and written up in reputable and recognized journals. Anything that doesn't have big enough patient numbers, or isn't in a journal that they already trust, is pretty much ignored.
The problems with this are many. First of all, those "peers" who review the articles have been shown to be painfully accepting of total nonsense when it is written in a style that suggests medical knowledge. And second, who pays for double blind placebo controlled clinical trials? Pharmaceutical corporations, who are looking to cook up the next blockbuster drug. They aren't studying these drugs out of the goodness of their hearts. The bottom line is mega profits. If they do the right study, and get the right results, they can get FDA approval and patents and voila! They're in the money.
Just the other day I was studying up on diverticulosis and diverticulitis, and listened to a top physician giving a clinical update about treatment for these conditions. Basically he was reporting on two studies that showed that antibiotic treatments for diverticulitis were no more effective than IV water. He also mentioned a great many other possible treatments, including fiber for which he said the evidence was very "weak", and probiotics, which he encouraged us to use but didn't review any studies about it, again saying the evidence was weak. Is it really weak? The studies I've seen show it as an excellent treatment option and especially good for preventing recurrences. What's "weak" about these studies is they weren't printed in the journals he reads. They were smaller sample sizes because they actually looked at people in the hospital with active diverticulitis. Anyway, the point is that the evidence surrounding "alternative" approaches like fiber and probiotics was considered less conclusive.
Finding studies about natural treatments for anything is hard. This is because nobody is going to make any money studying how much water it takes to ease constipation. They won't sell drugs that way. They won't even get patient visits. People would just learn to drink the right amount of water and not get so constipated.
In my practice I use the best evidence I can find, and if I can't find anything that is directly about what I'm curious about, I look at similar or related evidence. I look at how a system in the body is optimally supposed to function, and what we know about its needs and outputs when it is functioning right. I study up on all the reasons it goes wrong, and everything that is "correlated" with something about it, even if there is no evidence of causality. I try to actually understand.
I know I overstretch. It is only because I have such a light patient load that I can engage in deep study about each case. A busy practice would prevent this, and this is really what I live for. I WANT to understand.
There is a lot of noise about Evidence Based Medicine (EBM), and people who claim that only conventional physicians use it. This is hooey. The evidence is available to all of us, we just have to get educated enough to understand it and put it together. This is what science education is all about. If you don't study science, you can't understand the evidence, and you will have no idea how to apply it except by following someone else's practice guidelines. Which is what most doctors do.
Me, I am writing practice guidelines. For the future. Because medicine is not static. What we used yesterday will be tossed out tomorrow and replaced with something else. If we can give people the tools to be healthy and not go to the doctor ever, that is the ultimate success.
The problems with this are many. First of all, those "peers" who review the articles have been shown to be painfully accepting of total nonsense when it is written in a style that suggests medical knowledge. And second, who pays for double blind placebo controlled clinical trials? Pharmaceutical corporations, who are looking to cook up the next blockbuster drug. They aren't studying these drugs out of the goodness of their hearts. The bottom line is mega profits. If they do the right study, and get the right results, they can get FDA approval and patents and voila! They're in the money.
Just the other day I was studying up on diverticulosis and diverticulitis, and listened to a top physician giving a clinical update about treatment for these conditions. Basically he was reporting on two studies that showed that antibiotic treatments for diverticulitis were no more effective than IV water. He also mentioned a great many other possible treatments, including fiber for which he said the evidence was very "weak", and probiotics, which he encouraged us to use but didn't review any studies about it, again saying the evidence was weak. Is it really weak? The studies I've seen show it as an excellent treatment option and especially good for preventing recurrences. What's "weak" about these studies is they weren't printed in the journals he reads. They were smaller sample sizes because they actually looked at people in the hospital with active diverticulitis. Anyway, the point is that the evidence surrounding "alternative" approaches like fiber and probiotics was considered less conclusive.
Finding studies about natural treatments for anything is hard. This is because nobody is going to make any money studying how much water it takes to ease constipation. They won't sell drugs that way. They won't even get patient visits. People would just learn to drink the right amount of water and not get so constipated.
In my practice I use the best evidence I can find, and if I can't find anything that is directly about what I'm curious about, I look at similar or related evidence. I look at how a system in the body is optimally supposed to function, and what we know about its needs and outputs when it is functioning right. I study up on all the reasons it goes wrong, and everything that is "correlated" with something about it, even if there is no evidence of causality. I try to actually understand.
I know I overstretch. It is only because I have such a light patient load that I can engage in deep study about each case. A busy practice would prevent this, and this is really what I live for. I WANT to understand.
There is a lot of noise about Evidence Based Medicine (EBM), and people who claim that only conventional physicians use it. This is hooey. The evidence is available to all of us, we just have to get educated enough to understand it and put it together. This is what science education is all about. If you don't study science, you can't understand the evidence, and you will have no idea how to apply it except by following someone else's practice guidelines. Which is what most doctors do.
Me, I am writing practice guidelines. For the future. Because medicine is not static. What we used yesterday will be tossed out tomorrow and replaced with something else. If we can give people the tools to be healthy and not go to the doctor ever, that is the ultimate success.
RSS Feed