Should you Trust your Doctor?

Should you Trust your Doctor?

Medicine, like other professions, has some outstanding practitioners, some incompetents, and a large number of mediocre performers. It’s especially hard to assess physicians, however, because their judgments have an air of authority and scientific certainty.

Unfortunately, many laypeople are inclined to trust their doctors implicitly, and that can be a mistake, often with serious consequences.

For one thing, it is hard for doctors to keep up with scientific data. Scientists once thought eggs, potatoes, avocadoes, canned and frozen vegetables, and shrimp are unhealthy but now have reversed their position. They also once approved frozen yogurt, trail mix, granola, and many health drinks but now question their healthfulness. If your doctor is not aware of the new data, he or she will surely give you bad advice.

For another, many doctors are overly influenced by pharmaceutical companies. Like the rest of us, they focus on the often-inflated claims for a drug and pay little or no attention to its side effects. Here are a few examples of how numerous, and sometimes dangerous, those side effects can be:

Consumer Reports notes that the erectile dysfunction drugs Cialis and Viagra can “increase the chance of heart attack and stroke, and can cause other serious side effects, such as vision and hearing loss.” Also, that the fibromyalgia drug Lyrica “can cause blurred vision, confusion, dizziness, liver and kidney problems, suicidal thoughts, and dangerous swelling of the face, mouth, and throat.” And that the anti-depression drug Abilify can “increase the risk of side effects, including heart attack and stroke . . .” as well as “type 2 diabetes, and involuntary movements of the tongue, lips, face, trunk, arms, or legs, which may be permanent.“

The psoriasis drug Humira has 39 mild to moderate side effects and over 130 for which immediate medical attention is recommended.

The anti-smoking drug Chantix has over 80 side effects ranging from less severe to more severe:

Statin drugs such as Crestor, Lipitor, and Zocor are among the most prescribed drugs in this country and perhaps the world. If your ratio of good to bad cholesterol is judged to be unacceptable, chances are your doctor will reach for the prescription pad. Yet despite the hundreds of millions of advertising dollars spent promoting those drugs, research has shown them to have significant and potentially serious side effects, including “memory loss, mental confusion, high blood sugar, and type 2 diabetes.” To make matters worse, many doctors are still ordering older, imprecise cholesterol tests, rather than the newer and more precise VAP (Vertical Auto Profile) test.

Medical specialists tend to be biased in favor of their specialties. For example, an orthopedic surgeon will be inclined to recommend surgery on an arthritic knee whereas a rheumatologist would first consider a non-surgical treatment such as injections of the joint-lubricant hyaluronan to replace the joint’s natural lubrication. Over twenty years ago an orthopedic surgeon recommended I have both knees replaced. (Another surgeon said that was not necessary but that if pain persisted I might consider partial replacements.) Later, a rheumatologist injected hyaluronan, which helped considerably. Ultimately, I got the greatest relief from a physical therapist who taught me a combined regimen of “active isolated stretching” and “active isolated strengthening.”

Even conscientious physicians can occasionally fail to think through their recommendations before making them. Many years ago my elderly mother was put on a diuretic to flush out excessive salt from her body (and lower her blood pressure). Yet the same doctor recommended she take a popular liquid nutritional supplement. I checked the supplement’s label and learned it was loaded with salt, thus exacerbating the problem the diuretic was intended to solve.

A few years ago, I contracted a fungal infection on the sole of one foot. My dermatologist prescribed a strong anti-fungal cream. When that didn’t work, he prescribed another, which also didn’t work. He then recommended an oral fungicide. Having heard that such drugs can cause liver damage, I asked him, “Would you take this oral drug yourself?” He paused and then said he would not. I said I wouldn’t either. After doing a little research of my own, I found that vinegar often clears up fungal infections. So I soaked my foot in undiluted white vinegar three times a day. The fungal infection went away in a couple of weeks.

The next time I visited the dermatologist, I remarked that vinegar had solved the problem. He said “Hmmmn, that makes sense because fungi hate acid.” Had he thought the problem through more critically in the first place, he would have not have recommended a drug that could easily have done me grave harm. (I can’t help wondering how many dermatology patients have followed such common but ill-considered advice over the years, to their detriment.)

The more important point, however, is that only by questioning his advice was I able to do my own research and find a safe protocol.

To sum up, my approach in dealing with doctors is (to borrow a phrase Ronald Reagan used in a different context) to “trust but verify.” In doing so I am in no way insulting the doctors or questioning their professionalism. I am merely recognizing that no matter how educated and well-meaning they may be, they are human and therefore fallible. Also, that my life is too precious to treat carelessly.

Copyright © 2015 by Vincent Ryan Ruggiero. All rights reserved

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Vincent Ryan Ruggiero