‘Useless’ Surgery Is Still Popular

Not all treatments your doctor offers are actually therapeutic. In fact there’s an astounding quantity of sanctioned quackery available to individuals who are willing to purchase “non-therapies.”

There are few requirements that your doctor tell you that your surgery may not be helpful. Most states expect basic disclosure. Basic medical ethics and informed consent generally will require that your doctor explain risks of the procedure.

But your doctor may not know anything about the effectiveness of the procedure (beyond the personal enrichment associated with performing the procedure). You should question every procedure extensively. You should be comfortable that there is genuine possibility of improvement.

After all, you’re the patient. The procedure should be performed for your benefit not for the financial enrichment of your doctor.









Real medicine is better

By now everyone knows that I have a fairly low opinion of doctors and most modern medicine. But, I have to note that there are worse things- the alternative “therapies” that are, in fact, entirely non-therapeutic. These “therapies” rely on you, the general public, to be gullible enough or desperate enough to hand over money in exchange for, well, nothing.

One of the best documented cases is an Australian woman named Carissa Gleeson. Gleeson had a cancer, sarcoma actually, a fairly nasty tumor. Initially she embarked on some seriously foolish naturopathic treatments. Eventually she came around to the realization that chemo and living might be a better idea than dying broke from a potentially curable cancer.

But naturopathic quackery is not the only type for gullible patient. Another of my favorites is Anthony William  who calls himself the Medical Medium. The breadth of his quackery- and outright fabrications seems endless. Some of his advice is quasi-useful. He encourages consumption of fruits and vegetables- hardly a bad idea. But he encourages it because:

Because they grow from the earth and are showered by the sun and sky, enduring out in the elements day after day as they form, they are intimately connected to the holy forces of nature. They don’t just contain the building-block nutrients we need to function. They contain intelligence from the Earthly Mother and the heavens that we desperately need about how to adapt.

Perhaps the best reason to accept William as a full-fledged quack is that Gwyneth Paltrow likes him! Yes, that Paltrow- the purveyor and peddler of unscientific, potentially lethal items and devices and other gunk (ironically sold at goop.com). It’s not terribly dissimilar different from two Klansmen  endorsing each other.

Others that make my “favorites” list:

Geoffrey Ames whose license was appropriately revoked after he was finally found responsible for the death of a patient. But theWashington Department of Health Medical Quality Assurance Commission. Ames initially came to attention because of his use of something called The Life Information System Tens, or LISTEN. The device allegedly tested the patient’s muscle resistance using low-voltage electricity. Eventually Ames abandoned the device because he could obtain the same information “simply by touching the patient.” This form of hoax electrodiagnostics is fairly common.

Clare O’Nan an acupuncturist in Mississippi. Her website claims:

Clare’s focus is primarily on pain and ophthalmologic conditions, including macular degeneration, retinitis pigmentosa, dry eyes, and more. She is the only licensed acupuncturist in Mississippi who specializes in vision treatment and one of a few in the country.

She has a new website now. Her claim to be able to “treat” macular degeneration caught the eye of the Mississippi State Board of Medical Licensure (MSBML), which licenses acupuncturists. O’Nan noted that she doesn’t treat macular degeneration (for which there is no recognized effective, scientifically valid treatment). She treats the “symptoms.” MSBML took no action.

State medical boards will not reliably protect you from bad care or quacks. You must take an active role in your care and be cautious. Unscrupulous “practitioners” will gladly separate you from your money.




The decline and fall of informed consent

Over at KevinMD there’s a great post by Richard Gunderman (Chancellor’s Professor, Indiana University) and James Lynch (Dean of Admissions, University of Florida College of Medicine). In the post they authors bemoan the fact that informed consent documents have become impenetrable aggregations of legalese in comprehensible to almost everyone.

However, the authors only hint at the most important point. Informed consent is the mutual understanding arrived at between two entities. Informed consent may be guided by the massive document to which the authors refer. The document may be used to memorialize the agreement. But, the document is not the agreement.

The authors refer to a 30+ page “informed consent” document for a cancer study. The average person would find the document entirely incomprehensible. But, the average person might actually sign the document because (s)he believes  that the study might offer improved opportunity for survival. The belief is frequently without merit.

Patient have a right to question the care they receive. In particular they should question experimental care. The most important thing any patient should realize-

The purpose of research is NOT to improve your health. The purpose of research is to advance medical knowledge and possibly the career of your physician.

Medical researchers have an irremediable conflict of interest and this conflict of interest will not be in the “informed consent” document. But this conflict of interest may well compromise your health and safety.