Medical Doctors, Unproven Treatments, and Professional Standards

Taking a closer look at how physicans deal with alternative medicine

If there’s one group that you’d expect would take a dim view of physician provision of unproven or ineffective treatments, it’s the regulatory colleges that determine medical standards of practice. And that’s why it’s concerning and surprising the College of Physicians and Surgeons of Ontario (CPSO) has published the following draft policy paper, Non-Allopathic (Non-Conventional) Therapies in Medical Practice. The policy as written is unclear with respect to physician expectations. It also appears to significantly diminish the requirement for physicians to provide medical care and advice based on established scientific standards.

To start, let’s look at the CPSO’s role. From their own description:

Doctors in Ontario have been granted a degree of authority for self-regulation under provincial law. The College of Physicians and Surgeons of Ontario is the body that regulates the practice of medicine to protect and serve the public interest. This system of self-regulation is based on the premise that the College must act first and foremost in the interest of the public. All doctors in Ontario must be members of the College in order to practise medicine.

Now let’s take a look at the policy, and its congruence to the CPSO’s role. There’s already been a strong reaction online. Both The Committee for the Advancement of Scientific Skepticism (CASS), as well as  Dr. David Gorski, at the Science-Based Medicine Blog have posted detailed analyses. Each identifies multiple shortcomings in the policy that put the public interest into question. Here are some additional thoughts on the policy itself [PDF]. Continue reading

Oh yeah? Thalidomide! Where’s your science now?

Online discussions on the merits of alternative medicine can get quite heated. And its proponents, given enough time, will inevitably cite the same drug as “evidence” of the failings of science. Call it Gavura’s Law, with apologies to Mike Godwin:

As an online discussion on the effectiveness of alternative medicine grows longer, the probability that thalidomide will be cited approaches one.

A recent commenter  to this blog, regarding the homeopathic product Traumeel, is typical:

If the scientific method is all that separates an accepted claim, ie Thalidomide, Vioxx, Bextra, Darvon, from mere anecdote, of what benefit is the Science?

As a non-scientist consumer, I’ll take the anecdotes and my own experience. Thank you.

If scientists want to be taken seriously, they must stop selling themselves to the highest bidder becoming corporate whores without a shred of decency. To my mind, that’s how the claims for Thalidomide, Vioxx, Bextra, Darvon were accepted, making the scientific method utterly worthless.

To this commenter, “science has been wrong before.” And that invalidates science, and apparently validates homeopathy. It’s a fallacious argument. But does thalidomide actually represent a failing of science-based medicine? No, not even close. It’s so wrong, it’s not even wrong. Thalidomide is good example of the importance of science-based medicine and why allowing alternative medicine to be sold in the absence of good science is a concern. Continue reading

Tylenol: Safe painkiller, or drug of hepatic destruction?


This is somewhat of an update to a prior post.
What do Tylenol, Excedrin Extra Strength, Nyquil Cold & Flu, Percocet, Vicodin, and Anacin Aspirin Free have in common? They all contain the drug acetaminophen. Taking multiple acetaminophen-containing drugs can be risky: while acetaminophen is safe when used at appropriate doses, at excessive doses, it is highly toxic to the liver. Take enough, and you’ll almost certainly end up hospitalized with liver failure. Acetaminophen poisonings, whether intentional or not, are a considerable public health issue. In the USA, poisonings from this drug alone result in 56,000 emergency room visits, 26,000 hospitalizations, and 458 deaths per year. [PDF] This makes acetaminophen responsible for more overdoses, and overdose deaths [PDF], than any other pharmaceutical product.

Last week, Johnson & Johnson announced that it’s lowering the maximum recommended daily dose for its flagship analgesic, Extra Strength Tylenol, from 8 tablets per day (4000mg) to 6 tablets per day (3000mg). Why? According to the manufacturer,

The change is designed to help encourage appropriate acetaminophen use and reduce the risk of accidental overdose.

Continue reading

Salt: More confirmation bias for your preferred narrative

Death in a bottle? Or harmless food enhancer?

Judging by the recent press reports, the latest Cochrane review reveals that everything we’ve been told about eating salt, and cardiovascular disease, is wrong:

The New York Times: Nostrums: Cutting Salt Has Little Effect on Heart Risk

The Daily Mail: Cutting back on salt ‘does not make you healthier’ (despite nanny state warnings)

Scientific American: It’s Time to End the War on Salt

Sometimes it’s possible to completely miss this point. And that’s what’s happened here.

Continue reading