I’m having a helluva Sunday.  My father-in-law’s in the hospital,  it’s 2 degrees out with a wind chill of 40 below, my clothes all smell like latkes, my daughter is having a melt-down, and I screwed up the .xml file for my podcast. The last part reminds me of something—science is hard, and when we step out of our areas of expertise, it’s easy to make some pretty silly mistakes.

If you don’t understand the basics of a subject, it’s easy to form conclusions that seem logical, but these same conclusions seem silly to those who have a deeper understanding of a subject.

With may damned podcast, I’m writing xml files based on templates—little thinking is involved.  I’m looking at other people’s code and inserting my own details, hoping it works.  If I actually understood the syntax of xml files, I could write a correct one based on a solid understanding of the specifics of the subject.

Medicine is one of those areas in which we all feel we should be experts.  After all, we all have a body, and we figure that our bodies follow a logic that we can plainly see—if you prick us, do we not bleed? If you tickle us, do we not laugh? If you poison us, do we not die? It all seems so logical.

Colons are full of poop. Poop is yucky. Therefore, cleaning out a colon is good.

Except that it’s not true. The human body is rather complex, and the study of the aggregate of all human bodies living together (e.g. public health) is more complex still.

Since the world of cult medicine hasn’t bothered to learn real science,  they often rest on what sounds “right”.  Like poop being yucky, this is often based on a sliver of fact that is horribly misused due to ignorance.

One of the more popular canards propagated by cult medicine leaders and their followers is that modern medical care kills.  Rather than exploring what the data are and what they mean in order to find a problem and correct it, they manufacture a problem out of whole cloth and come up with non sequitor solutions.

This little gem, for example, gets it wrong from the start:

As the use of pharmaceuticals drugs has become a leading cause of death in North America, patients want options. Naturopathic Doctors are the only regulated health professionals who study these medications for four years, write licensing examination upon them and whose scope of practice specifically focuses upon these.

First, the data do not point toward “pharmaceuticals drugs” (sic) as a leading cause of death.  The Institute of Medicine found that medical errors in aggregate are a serious problem.  And  Dr. Atwood very effectively debunked the claim that naturopaths have some special insight into pharmacology, refined or otherwise.

Joe Mercola and Gary Null have very long articles on their websites bemoaning the dangers of medicine versus the safety of their own brands of made-up medicine.  They love to make statements like, “It is now  evident that the American medical system is the leading cause of death and injury in the US.”

When cultists cite their terror statistics they leave out a few important facts.  There is no doubt that medical errors, and even medical therapy without errors, can harm.  No one would argue otherwise.  The flip side is, it also helps—a lot.

The document that has fed this conflagration of idiocy is a landmark study by the Institute of Medicine.  One of its findings was that somewhere between 44,000 and 98,000 deaths yearly in the U.S. may be due to medical errors. That’s a lot.  Of course, the lengthy report is somewhat more complex than a single statistic.  Before and after the IOM report, there has been a great deal of research into medical error.  I’ve written a bit about the topic, and the more I study it, the more complexity I see in the problem.  But it’s not an insurmountable complexity.  The question implied by the alties is, “if modern medicine kills so many, why bother with it at all?  Wouldn’t it be safer to do [insert absurdity here]?”

In a word, no.  No, no, NO!  A thousand times NO!

There is no guarantee that coffee enemas, St. John’s Wort, or reiki are any safer than real medicine (not the least because they may make one avoid real treatment).  There is also a huge ethical problem in using unproven and disproved treatments.

But there is a more important fact that should keep you from being scared away from real medicine.

Advances in the treatment of coronary artery disease, the number one killer of Americans,  reduced the number of deaths by over 340,000 in 2000 alone.  And that’s just one disease.

So, in one year, medical errors may cause a few tens of thousands of deaths (and these are preventable deaths), but real medicine, in one disease alone, saves an order of magnitude more.

Of course there are risks to modern medicine—it’s active treatment, not placebo, so it can be expected to hurt some people.   But it helps far more.  Reducing medical errors is important, and is an active field of research.  As we improve our error rates, we can increase the lives saved by modern medicine by thousands per year. (It is impossible to prevent all deaths due to errors.  It’s just statistically unlikely.  Also, if you fail to treat someone for fear of error, that’s an error too.) Abandoning modern medicine out of fear will not save us from ourselves, it will deny us the chance to increase the benefits we are already getting from science-based medicine.  The solution to medical errors isn’t voodoo, it’s science.  Anyone who tells you different is trying to sell you something.

Posted by Peter Lipson

Peter A. Lipson, MD is a practicing internist and teaching physician in Southeast Michigan.  After graduating from Rush Medical College in Chicago, he completed his Internal Medicine residency at Northwestern Memorial Hospital. He currently maintains a private practice, and serves as a teaching physician at a large community hospital He also maintains appointments as a Clinical Assistant Professor of Medicine at Wayne State University School of Medicine and at Oakland University William Beaumont School of Medicine, the first being a large, established medical school, the latter being a newly-formed medical school which will soon be accepting its first class of students.  He blogs at White Coat Underground at the Scientopia blog network. A primary goal of his writing is to illuminate the differences between science-based medicine and everything else.  His perspective as a primary care physician and his daily interaction with real patients gives him what he hopes is special insight into the current "De-lightenment" in medicine.  As new media evolve, pseudo-scientific, deceptive, and immoral health practices become more and more available to patients, making his job all that much more difficult---and all that much more interesting. Disclaimer: The views in all of of Dr. Lipson's writing are his alone.  They do not represent in any way his practice, hospital, employers, or anyone else. Any medical information is general and should not be applied to specific personal medical decisions.  Any medical questions should be directed to your personal physician.  Dr. Lipson will not answer any specific medical questions, and any emails and comments should be assumed public. Dr. Lipson receives no compensation for his writing. Dr. Lipson's posts for Science-Based Medicine are archived here.