Month: July 2008

A Guide for Confronting Patients

I sometimes lecture on science-based medicine to my colleagues and one of the most common questions I get is how to deal with a patient who expresses belief in unscientific treatments. The dilemma for the physician is that professionalism requires that we do not confront patients regarding their personal beliefs. We are there to inform and advise, not preach. And yet proper...

/ July 16, 2008

Should I Take a Multivitamin?

I’ll start with a confession. I used to do something irrational. I used to take a daily multivitamin, not because I thought there was good scientific evidence to support the practice, but for psychotherapy. I tried to eat a healthy diet and worried about it. By taking a pill, I could stop worrying. Then I found out that higher intake of vitamin...

/ July 15, 2008

When “investigative reporting” becomes anti-vaccine propaganda

Introduction: The following is the text of a letter that I mailed to Bob Sliva, General Manager of WXYZ-TV in Detroit in response to arguably the most biased and incompetent “investigative report” about mercury, vaccines, or autism that I have ever seen. I sent the letter by snail mail, because I was always taught that that gets a station manager’s attention far...

/ July 14, 2008

Science, Reason, Ethics, and Modern Medicine Part 1: Tu Quoque and History

Several weeks ago I argued here that a physician’s primary ethical obligation is to science and truth. In retrospect I probably should have put it a slightly different way: a physician’s primary ethical obligation is the same as everyone else’s. It is to honesty and integrity. For physicians, however, that means being true to real medical knowledge, among other things, and real medical...

/ July 11, 2008

Cavalcade of Quackery: A Pantomine Horse

Last week I received the news release below that Steve Zeitzew, an orthopedic surgeon at VA Hospital Los Angeles and UCLA, sent to the Healthfraud list. It was sent to me by our colleague Liz Woeckner, President of the nonprofit research protection advocacy organization Citizens for Responsible Care in Research (CIRCARE) http://www.circare.org/ Ms. Woeckner sent it on with a cryptic comment, wondering...

/ July 10, 2008

Should We Study Chelation for Autism?

The National Institute of Mental Health (NIMH) supports doing a study on the effects of oral chelation therapy in autism. The proposal is highly controversial, is drawing criticism from many scientists, but has popular support among parents who believe this type of therapy might help their children with autism. The proposal raises many questions about the ethics of biomedical research. Chelation and...

/ July 9, 2008

Are Cardiologists Ordering Too Many CT Angiograms?

A really snazzy new invention allows doctors to see inside their patients’ hearts as never before: the CT angiogram. It produces gorgeous 3-D video images of the beating heart in action. It allows us to see the blood flow through the heart’s chambers and it shows any plaque in the coronary arteries. Cardiologists are understandably excited about this new tool. Too excited....

/ July 8, 2008

Death by “alternative” medicine: Who’s to blame?

One of the more annoying duties I used to have several years ago at our cancer center was to “show the flag” at our various affiliates by attending their tumor boards. I say “annoying” not so much because the tumor boards themselves were onerous or even uninteresting but rather because traveling to them used to cut into my already limited time for...

/ July 7, 2008

Another State Promotes the Pseudoscientific Cult that is “Naturopathic Medicine.” Part 4

The “Science” and Ethics of “Natural Medicines” (and Nutrition) cont. This is the continuation of a discussion concerning the explicit claim of “naturopathic physicians”* to being experts in the use of “natural medicines,” defined as “medicines of mineral, animal and botanical origin.” Last week’s post established that the cult has chosen to profit from the “retail selling of medications,” as evidenced by the relevant...

/ July 4, 2008
Quoth the Black Knight in "Monty Python and the Holy Grail": "None shall pass."

The Placebo Myth

King Arthur: Now stand aside, worthy adversary. Black Knight: ‘Tis but a scratch. King Arthur: A scratch? Your arm’s off. Black Knight: No it isn’t. King Arthur: What’s that, then? Black Knight: [after a pause] I’ve had worse. King Arthur: You liar. Black Knight: Come on ya pansy.King Arthur: [after Arthur’s cut off both of the Black Knight’s arms] Look, you stupid...

/ July 3, 2008