Here's why *real* medicine is different than woo: [View all]

[MannyGoldstein]

In *real* medicine, roughly 10% of what's done is based on evidence. 10%. That's it. 90% is based on... guesses? Happy thoughts? How much money some constituency can make off of it?

For woo... hard to tell how much is evidence based. Lots of woo things are actually evidence-based, but they're considered "woo" because neither docs, hospitals, nor drug companies can make a buck off of them. Nobody's made a study of it, to my knowledge, but the percentage of evidence-based woo's probably no worse than the percentage in "real" medicine. Can't be much worse. My personal woo habits are probably a lot more evidence-based than typical "real" medicine practiced by the vast bulk of doctors - Pubmed is my friend.

Now let's look at the other side of the coin - damage.

According to the FDA, Vioxx alone probably killed between 40,000 and 60,000 people. That's what, between 13 and 20 September 11th attacks? It's somewhat of a different thing, but still... it's tens of thousands of dead people. And Vioxx was approved by the FDA after big serious studies by big serious doctors at big serious hospitals. Turns out that the research sucked. Oh well.

Here's the kicker: there was zero evidence that Vioxx was safer or more effective than ibuprofen (which it was supposed to replace) during the time it was killing lots of people. Zero. But it made a lot of money for a lot of people, so there's that, I guess. If those now-corpses had taken ibuprofen instead of Vioxx, they would have gotten better pain relief. But Ibuprofen isn't a big earner these days. Sorry folks!

There's plenty more people killed or grievously injured by "real" medicine - PSA tests, all manner of drug prescribing and dosing fuck ups, excessive use of coronary angioplasty, orthopedic surgeries that are known to be pointless, a bunch of others. It's amazing what people will do if someone in a white coat tells them they should. And it's amazing what people in white coats will tell people to do if it'll make them a few more bucks.

Few men have virtue to withstand the highest bidder.
- George Washington

Once in a while, a few people get killed by woo. But tens of thousands? If anyone knows of even a hundred killed in a woo-tastrophe, I'd love to hear about it.

All in all, sadly, we're mostly on our own when it comes to either "real" medicine or woo. Not much evidence for either. At least woo is a lot less effective at mayhem. There is lots of evidence in the literature about stuff that really helps, but it gets ignored because nobody can make a buck off of it.

Grumpily yours,

First-Way Manny