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Why you should think twice when your doctor is so certain what you should do.

Updated: Jan 16

There’s quite a rift in the medical profession between those who wear blinders and those who don’t. OK, maybe those are fighting words and certainly one could say that about many other professions.

What prompts me to make this observation of my profession? I have never accepted the status quo as necessarily the best or right thing for my patients, my family, or myself. In medicine, the benchmark for the “right” or proper care is what falls within generally accepted standards of medical care in the community. Why should one question these standards? After all, doesn’t the medical community look out for the best interests of patients by making sure the care they get has passed the test of time or passed the scientific tests in the laboratory?

Well, it’s not quite that simple. I like to get to the root of all human interaction—the individual. And all of us possess a primitive, automatic brain (AB), which mostly unknowingly runs most of our behavior. This brain looks to protect us as individuals, and later as we become groups of individuals and still later as we become whole communities. The AB always looks for ways to make us fight or flee danger, so we seek the comfort of a group, a community. This is an entirely human trait, and doctors are no different.

We doctors like to think of ourselves as scientists. Scientists like to propose theories and then prove them. Then, as practitioners, we feel comforted that we’re practicing “evidence-based medicine” supported by the data we’ve developed. But how comfortable should we really be? The data, after all, came from studies conducted by individuals—every one of whom has an AB. Take the hypothetical Dr. Jones, a world-renowned researcher from Harvard. Because of Jones’s and Harvard’s reputations, having their names attached to a study would bestow enormous credibility. For that reason, the hypothetical drug manufacturer MegaPharm wants Dr. Jones to study its new hypothetical drug Zpill. Dr. Jones is reluctant to take direct payment from MegaPharm, so, instead, the pharmaceutical giant makes grants to Harvard for their research labs. Harvard sees that Dr. Jones can bring money into the university, thus pretty much guaranteeing him a job and increasing income as long as he wants to stay. With a family to support and a mortgage to pay, Dr. Jones is going to think twice before reaching negative conclusions in his MegaPharm-financed research facilities. The good doctor’s AB, probably unconsciously, will work hard to get him to fight or flee the potential danger to his family’s well-being represented by a negative finding for Zpill. The AB rears its ugly head elsewhere in medical research as well. Researchers must publish to maintain their jobs, their stature in a university, and their very livelihoods. If they have a choice between publishing generally accepted ideas and ideas that fly in the face of the scientific community, which way will their AB steer them? Some will march to a different drummer, but many will take the safe route—the route that is surer to be published. So the body of accepted medical thought becomes based, in part, on researchers’ aversion to risk. Do I question science altogether? Absolutely not. I am a big fan. What I question are the individuals behind the science, and their unconscious AB-driven motives. Sounds a bit harsh, but we all have this pesky brain. As I say, though, some doctors are willing to follow the path their consciences dictate, albeit at great risk. In 1628, William Harvey wrote that blood was pumped from the heart and moved around the body through arteries. He was ridiculed, but is now regarded as a pioneer. In the Nineteenth Century, Ignaz Semmelweis suggested that surgeons were killing large numbers of new mothers by assisting with births after working on other patients’ festering wounds, without even washing their hands. But the concept was too radical for the medical community to accept, so he was ignored. His suggestion to disinfect hands by simple hand washing prior to obstetrical or surgical procedures was ridiculed. Semmelweis ended up in a mental hospital, and his ideas, later vindicated by Louis Pasteur, caught on only after his death. The skeptics will say that such ridicule of new thinking could not happen today. But consider that though a cure for cancer may actually be right before our eyes, we’re blinded by a collective AB that shuns some innovative researchers and thinkers. And while I predict that autologous (from our own body) adult stem cell therapies will replace most orthopedic joint replacements within the next five years, that theory would not get much traction in the present-day medical community. So what do you do if your doctor suggests something that doesn’t sit quite right with you? Go with your gut. It is likely that the doctor is recommending what is the standard of care in the community. It might be right for some, but maybe not for you. At the very least, have a discussion with your doctor. If he or she isn’t willing to do that, then find a doctor who is. A lot of medicine is worthwhile and effective. But the one-size-fits-all approach might not be what’s right for you. © Dr. Charles F. Glassman, CoachMD

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