GOOP

Just when you thought it might be safe to return to the waiting room. It’s not.

GOOP the pure junk science website offers a wide array of not-medically-valid-possibly dangerous pseudo-treatments for non-diseases. It has been widely derided for the sheer magnitude of the absurd claims. Entirely on the defensive. some of the GOOP “doctors” decided to speak out trying to resurrect their credibility. They failed, in my book. They failed for three reasons:

1) Who they are, what they’ve done, and what they’re credentials are is unrelated to their scientific and medical credibility on any given topic. It’s a common logical fallacy know as “appeal to authority.”

2) They have conflated absence of evidence with evidence of absence. Whether such  junk devices and science are actually dangerous takes only a single reported occurrence. Proof of safety is, in contrast, elusive.

3) These sites are cluttered with endless “testimonials.” While these may make entertaining reading it’s important to remember that non-randomized, non-blinded, uncontrolled, combined anecdotal experience is not data, no matter how much of it you get.

Scientifically implausible medical “therapy” needs credible evidence not simply testimonials.

But how does this persist? Basically, mainstream medicine allows it. Even large, well-known institutional providers are getting into the “alternative and complementary medicine” act. This occurs at a time when physicians themselves acknowledge that 20% of “mainstream” healthcare is without meaningful patient benefit. Since this study involves AMA members (members of a protectionist trade guild) one might expect the 20% figure to represent a floor rather than a ceiling on the amount of unnecessary care delivered.

But it’s not just the trade guilds. State medical boards also implicitly promote charlatanry. Looking just at Mississippi (the recognized worst medical board in the country see also here and here) we find such things as “low pressure hyperbaric oxygen” therapy- which despite the testimonials lacks any scientific basis and stem cell “research”– another “therapy” lacking in meaningful scientific basis and foisted on the public as “research.” Yet, in the case of stem cells it lacks any of the traditional characteristics of medical research- no real theory (unless let me have you money is a scientific theory). No real systematic collection of analysis of data. No real selection of patients in a manner that might permit reasonable stratification to determine if anyone actually benefited. In the case of the cited stem cell “clinic” the physician is a non-board certified former surgeon.

The bottom line- you can’t depend on other doctors. You can’t depend on medical boards. You simply need to be diligent, ask questions, and realize that you- the patient- are little more than a revenue center to most doctors.

 

 

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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.