I find it amusing when I am accused of practicing bad medicine because I don’t follow evidence-based medicine. When I am confronted with this argument, I always ask, “What evidenced-based medicine are you talking about? Is it the ghost-written articles? Or is it the industry-sponsored articles that provide the evidence-based medicine that you make your decisions with?”
I have written about the problems with ghost-written medical articles. What this means is that the article was written by an unidentified person. Instead of listing the person that truly wrote the article, the medical article will be titled under someone else’s name—usually a prominent doctor. Of course, this doctor was paid to have his/her name on the article, which gives the report more credibility. Ghostwriting was brought to light when Big Pharma founding member Wyeth Pharmaceuticals was caught ghostwriting 26 papers promoting conventional hormone replacement therapy in different scientific journals. Since then, it is estimated that at least 10% of all medical articles may be ghost-written. I would bet money that the number is much higher for industry-sponsored research.
What about industry-sponsored articles? Do you think these articles are created without bias? The Cochrane Collaboration sought to answer this question of whether industry-sponsored articles are more likely to be biased when compared to non-industry-sponsored reports. (1) I don’t think it takes much brain function to guess what the researchers found here.
In the Cochrane Review titled, Impact of Industry Sponsorship on Research Outcomes, the authors stated, “Because industry-funded research has the potential to change practice guidelines, mechanisms to reduce bias have been instituted. Yet, industry-sponsored research still may have bias…”
The authors examined 48 papers for evidence of bias. The outcomes studied compare the favorable results and favorable conclusions in industry- vs. non-industry- sponsored studies. The researchers found that industry-sponsored studies had a 24% chance of having a more favorable effectiveness result when compared to non-industry-sponsored studies. Furthermore, out of 561 studies analyzed, industry sponsored studies had an 87% chance of having a more favorable harm results when compared with non-industry based studies.
The bias gets worse when looking at the effectiveness of drug trials when the test was sponsored by the manufacturer of the drug vs. those sponsored by a manufacturer of a competitive treatment. The Cochrane researchers found that, as compared to a competitor’s drug study, a trial sponsored by the manufacturer of the drug were 464% more likely to favor their treatment. There was other evidence of industry-sponsored bias in the remainder of the article.
What can you do? Number one, don’t get caught up in the peer-reviewed literature. There is too much bias, ghost writing, and outright fraud. Here’s how I explain it to medical students: When choosing any treatment program, you need to ask yourself, “Does this therapy support or enhance the body’s biochemistry? Or, does it block, poison or inhibit the body’s biochemical pathways. If the latter is true, then you should have a sound reason to use it and the therapy should probably be used for the shortest time period possible. Unfortunately, most drugs–at least 95%–work by blocking, poisoning, or inhibiting the body’s biochemical pathways.
If you don’t have a biochemical background, it is best to find a health care provider who does, or at least one who understands how important biochemistry is. He/she can help you decide if the particular drug or therapy is right for you. More information about this approach can be found in my book, Drugs That Don’t Work and Natural Therapies That Do.
(1) American Family Physician. Vol. 88. N. 11. Dec. 1, 2013
As an independent Patient Advocate/Health Care Consultant, one of my primary duties is to protect my patient from the system, primarily hospitals and doctors. That is to say, make sure no medication/treatment/procedure or other course of action harms them, and intervene with advice/suggestions when necessary.
Though admittedly a small sample, after 3 years the need for intervention is running 100%. And some of the interventions undoubtedly prevented serious harm. The scary thing is, had the harm in every case occurred, it wouldn’t as much as caused a blip in the system. There would have been no reaction at all.
Patients today are helpless, on the whole, completely at the mercy of the system described above. And that’s not a good place to be. So we can be grateful that the integrative/complimentary/alternative community is beginning to flourish. More and more patients are, in a number of ways, becoming empowered with the knowledge and skill required to take control of their own health care.
And that’s a good place to be.
~~~
Jake,
You are right. Patient’s do need an advocate in today’s world. I can’t agree with you enough; patients need to become empowered. This can only occur with acquiring knowledge. That is what prompts me to keep writing.
DrB
The “Virtues of the FDA” is that not an oxymoron statement?
I totally concur with your message. But, it will never change. Thanks to your willingness to do the research and be smitten by your colleagues but still tell the truth.
Thank you, Dr Brownstein
Evidence based – such buzz words. There is a plethora of phrases within the medical field that push to substantiate trials, results, medical information, tests, etc……As an RN for decades, I’ve seen it all. Sadly so.
I went to an endocrinologists office due to recently diagnosed Hashimoto’s and hypothyroidism. At one of my early visits, the PA was extolling the virtues of the FDA and how they are doing an amazing job. I just sat there dumbfounded and with jaw dropped. I was speechless. Needless to say, I only went there a couple more times – lack of trust in care provided by said PA.
Vicki,
The “virtues of the FDA”? How could anyone say that!!
DrB
When I see comments online abut FDA approved, I cringe. Those are some of the same people who wind up working at pharmaceutical companies later, maybe even putting their names on those reports that get published.
The FDA attempts to eliminate supplements while actually allowing toxins like fluoride and bromine in our food and drink, not to mention mercury in our mouths (still).
Then there is the fraud of statin drugs when only a small percentage will actually benefit and many will suffer from side effects like muscle death, brain fuzziness, amnesia and dementia, possibly increasing diabetes and ALS risks.
Firstly, let me say that I really appreciate Dr. Brownstein’s strong voice in getting the truth out. Though an Ophthalmologist for more than 30 years, I have long been an Alt Med kind of doctor. Recent events forced a move into a part-time academic position and I rapidly found out that recommending even simple things like diet, vitamins, and nutritional supplements is not permitted in Ivory Tower Land because only “evidence-based” medicine is permitted. As Dr. B points out, the “evidence” so beloved by Academia is largely produced by Big Pharm related labs and journals, Big Government and Big Insurance shills… In short, by the Medical-Industrial complex that so dominates the fascist country in which we live. Obamacare, of course, seeks to futher enforce this paradigm. Hopefully, it is not sustainable. We shall see.
When the local dietitians filed a complaint against me for telling people to eat butter instead of margarine, I presented the AND with a paper going through the research on saturated fat and cholesterol explaining why our fear of fat and cholesterol is unfounded. I had 99 references and told them that I would change my views if they could show me where I was wrong in my assessment of the science. They wouldn’t even address the science and instead their “experts” attacked me personally claiming I had presented a hodge-podge of papers and I liked to think outside the realm of evidence. When it comes to research, the truth is irrelevant. What matters is what advice will bring in the most dollars. (I did win the case though)
I tell people to take a historical look because we can’t trust the science. We didn’t have chronic disease and obesity when we ate real food. Our health went downhill with the introduction of processed foods, particularly vegetable oils, and our increased sugar intake that came with our fear of fat.
OmbamaCare will require physicians to follow research-based protocol with their treatments or they won’t get paid. Thus your conventional doc won’t have any incentive to think outside the box.
The audacity of these Big Pharma buttheads is amazing.