I’m Pete Lipson, and often go by “PAL” (my initials, and base for my internet pseudonym, PalMD). I’m a doctor of internal medicine practicing in the Midwest and I’m full of pithy analysis and opinion that you need. I started blogging anonymously about six years ago, calling my blog White Coat Underground with the idea of giving people an insider’s look at medicine and health care. As the blog evolved, I dropped the anonymity for pseudonymity, and finally decided to use my real name (some of my earlier blogging was a bit…harsh, immature, etc. I wasn’t fond of the idea of having it pop up on google searches).
Much of my writing initially focused on the infiltration of quackery into American healthcare, but has broadened significantly. I’ll let you explore my “musings on the intersection of science, medicine, and culture” rather than tell you what to think.
Speaking of Dr. Oz, why should you be concerned about the infiltration of non-scientific medicine into our culture? A well-respected surgeon has become “America’s Doctor” encourages all sorts of new ways of thinking about medicine. He even brings faith-healers into the operating room. Master communicators and marketers sell all sorts of magic pills, and American’s love this stuff. We spend $20-$30 billion dollars yearly on dietary supplements alone. America’s Doctor loves it, Americans love it, so it sounds like a wrap.
Of course, popular opinion and reality don’t always intersect. There are two types of medicine: the stuff that works, and everything else. While medical practice has operated on a platform of traditional beliefs, over the last thirty years medicine has come to rely on scientific evidence and plausibility. Knowledge transmitted for our medical elders is no longer accepted without question. On rounds these days a trainee is more likely to ask, “where’s the data?” than to take anything I say on faith (and a good teaching physician will answer, “Why don’t you look that up and give us a presentation tomorrow at 9 am?).
Good science requires clear thinking, careful reasoning, and keeping in mind what is plausible. If a patient were to tell me that their blood pressure medication made them impotent, I would take the idea seriously, even if that effect hadn’t been reported before, because it’s biologically plausible. If they told me their medication made them invulnerable to crossbow bolts, I’d be more concerned about their physical and mental well-being than the medication. Plausibility is the keystone to understanding quackery and pseudoscience. A little skepticism doesn’t hurt either. When Dr. Oz tells us that raspberry ketone is the new miracle weight loss drug, why should we believe him? Well, first, because he’s a damned smart guy, and a heart surgeon. That gets him in the door, but as is, as it turns out, irrelevant. It’s known as “argument from authority”, where the fact that someone is good at one thing is used to make us think they are good at another. What’s more important is the plausibility of the claim and the data. The data, it turns out, are nearly absent. There is a small amount of scientific plausibility but not enough to even convince me that “more study is needed”.
More important, it’s implausible from the PT Barnum perspective. If it raspberry ketone or any other weight loss miracle really worked, we would all be thin. People spend billions on these things, yet our waistlines continue to grow. There is no reason to believe the next miracle announced (I think it’s green coffee beans or something) should work any better, and it will be forgotten just as quickly as every other patent medicine we’ve seen through the centuries.
I did get to speak to Dr. Oz about his work, albeit briefly. I told him I was especially concerned about the messages my patients bring me about the latest miracles they hear about on his program. I have patients who eschew real medicine for these medicine show potions and suffer as a result. His response was that he, “doesn’t endorse any products. If people use my name improperly we get them to stop.”
That is terribly disingenuous. If “Americas Doctor” talks it up on TV, every supplement maker with a half-brained marketing department will say, “As seen on Dr. Oz!” If he really doesn’t want his name used to endorse quacky products, I have a simple suggestion: stop promoting them as miracles.
Well, I didn’t really plan on an opening post attacking America’s Doctor. I really wanted to get you fired up about gun control, but I guess that will have to wait.
Article source: http://www.forbes.com/sites/peterlipson/2013/01/31/why-you-should-read-the-white-coat-underground/