Stories
Slash Boxes
Comments

News for nerds, stuff that matters

Slashdot Log In

Log In

Create Account  |  Retrieve Password

Believing In Medical Treatments That Don't Work

Posted by Soulskill on Sat Apr 04, 2009 07:18 AM
from the take-two-placebos-and-call-me-in-the-morning dept.
Hugh Pickens writes "David H. Newman, M.D. has an interesting article in the NY Times where he discusses common medical treatments that aren't supported by the best available evidence. For example, doctors have administered 'beta-blockers' for decades to heart attack victims, although studies show that the early administration of beta-blockers does not save lives; patients with ear infections are more likely to be harmed by antibiotics than helped — the infections typically recede within days regardless of treatment and the same is true for bronchitis, sinusitis, and sore throats; no cough remedies have ever been proven better than a placebo. Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment, and knee surgery is no better than sham knee surgery where surgeons 'pretend' to do surgery while the patient is under light anesthesia. Newman says that treatment based on ideology is alluring, 'but the uncomfortable truth is that many expensive, invasive interventions are of little or no benefit and cause potentially uncomfortable, costly, and dangerous side effects and complications.' The Obama administration's plan for reform includes identifying health care measures that work and those that don't, and there are signs of hope for evidence-based medicine: earlier this year hospital administrators were informed by the Centers for Medicare and Medicaid Services that beta-blocker treatment will be retired as a government indicator of quality care, beginning April 1, 2009. 'After years of advocacy that cemented immediate beta-blockers in the treatment protocols of virtually every hospital in the country,' writes Newman, 'the agency has demonstrated that minds can be changed.'"
+ -
story

Related Stories

This discussion has been archived. No new comments can be posted.
The Fine Print: The following comments are owned by whoever posted them. We are not responsible for them in any way.
 Full
 Abbreviated
 Hidden
More
Loading... please wait.
  • aprilfools (Score:4, Funny)

    by ShakaUVM (157947) on Saturday April 04 2009, @07:28AM (#27456687) Homepage Journal

    ...will be retired as a government indicator of quality care, beginning April 1, 2009

    April Fools!

    Actually, beta blockers are GREAT for you.

  • And next up (Score:5, Interesting)

    by m0s3m8n (1335861) on Saturday April 04 2009, @07:28AM (#27456691)
    Just wait. Next up will be treatment based on life expectancy and quality. I see this becoming an issue based on my experience working for a group of Eye docs (retinal specialists). I often see very elderly (and often demented) patients receiving very expensive treatment of eye conditions. do they need the treatment - sure, to preserve their sight. Does the treatment improve their quality of life - maybe. So who decides, the patient or family, or BIG government?
    • Re:And next up (Score:5, Insightful)

      by gerf (532474) <edtgerf@gmail.com> on Saturday April 04 2009, @07:36AM (#27456725) Journal

      Isn't it Japan that was looking to fine people for being overweight, since it would cost the government more for health care? And don't they stop treating cancer patients in some European countries if they're too old?

      While the idea of universal free happy healthy health care sounds sugary sweet, there are some dire consequences of handing our individual health to governmental control.

      • Re:And next up (Score:5, Insightful)

        by ZombieWomble (893157) on Saturday April 04 2009, @08:32AM (#27457027)

        And don't they stop treating cancer patients in some European countries if they're too old?

        This is a fairly ubiquitous practice - most cancer treatments are nasty. Invasive surgery, chemotherapy and radiotherapy all potentially have significant negative impact on quality of life. If someone has the option of a certain number of relatively comfortable years, or a few additional years filled with serious complications, many doctors will recommend the latter option, and this is sometimes reflected in treatment options.

        • Re:And next up (Score:4, Informative)

          by iYk6 (1425255) on Saturday April 04 2009, @09:16AM (#27457279)

          Not to mention the risks. Cancer treatments can kill people, and surgery is always dangerous. Elderly people are the most likely to die from such treatments.

        • Re:And next up (Score:4, Insightful)

          by WgT2 (591074) on Saturday April 04 2009, @10:45AM (#27457869) Journal

          You used a subtle, but clear distinction, that affirms the GP:

          many doctors will recommend the latter option

          ...but they cannot require it... nor do our laws.

          I will say that the article's use of "evidence-based medicine" is heartbreaking - implying evidence isn't currently used... which I don't believe.

          • Re:And next up (Score:5, Insightful)

            by onionlee (836083) on Saturday April 04 2009, @11:49AM (#27458327)
            It isn't that evidence isn't used when considering treatments. In fact, there were studies in the 90s that supported the use of beta-blockers. The problem is that when later evidence shows up to prove otherwise - ie that it does not make a difference - the medical community has adopted the usage of such as standard procedure. Hard to change, no matter the evidence.
      • Re:And next up (Score:5, Insightful)

        by cptdondo (59460) on Saturday April 04 2009, @09:19AM (#27457297)

        As opposed to not having health care at all?

        Having universal gov't health care doesn't stop the wealthy from buying more health care than anyone else; it provides health care for the 30% or so of Americans who have none.

        It would also control some of the ridiculous cost spirals. Doctors have no idea how much treatment costs; I've asked how much a certain procedure might cost and I'm always met with a blank stare. All the doctors know is that they get a kickback from the lab/hospital/etc for ordering some test. They don't really care if it's necessary or useful.

        I'm familiar with both Japanese and European health care systems. The Japanese system provides universal care to everyone. It's basic and no-frills, but it covers nearly all.

        The European System (actually Czech Republic) is much the same way. Its focus is on quality of life; they are less likely to provide life-extending care if it means being tethered to a hospital bed. They'll tell you to go home, have some beer, and enjoy what life you have left. They might even send you to a spa or a hot-springs at state expense.

        • Re:And next up (Score:4, Informative)

          by Solandri (704621) on Saturday April 04 2009, @03:24PM (#27459915)

          It would also control some of the ridiculous cost spirals. Doctors have no idea how much treatment costs; I've asked how much a certain procedure might cost and I'm always met with a blank stare. All the doctors know is that they get a kickback from the lab/hospital/etc for ordering some test. They don't really care if it's necessary or useful.

          Actually, the doctors order all the tests because if they don't, and the patient happens to have some disease that would've been detected by that test, they'll get sued for malpractice, and their malpractice insurance rates will go up, and/or they could lose their license to practice. Having universal health insurance wouldn't stop this, it would actually make it worse since the doctors would know the tests would be paid for. (Unless you put some bureaucrat in charge of deciding which tests are necessary, taking that decision out of the hands of the doctor who sees you.)

          The only other ways to stop it are to tighten up the requirements to file a malpractice suit (which would make the lawyers unhappy), or for the government to provided some sort of universal malpractice insurance. But then you'd get the same arguments being raised for/against universal health insurance, but applied to rich doctors instead of poor people (e.g. bad doctors being allowed to continue practice). Personally I think getting people's opinions on both is a great way to detect whether they truly want to fix the health care system, or if they just have an agenda they want to push and have picked health care as their vehicle.

          • Re:And next up (Score:5, Insightful)

            by sjames (1099) on Saturday April 04 2009, @09:58AM (#27457531) Homepage

            O nm, its the same ones who already pay for almost all the amenities to the poor and/or lazy.

            WOW that was a loaded sentence. First you call life saving medical care an amenity then you paint one third of the population as lazy all in one stroke.

          • Re:And next up (Score:5, Informative)

            by cptdondo (59460) on Saturday April 04 2009, @10:09AM (#27457619)

            From your nic, I assume ze jsi cech. I'm not sure where you live, but try the health care here in the US. When my kid broke his arm, my insurance refused to pay for the doctor, as it was "elective surgery", the doctor was not one of our preferred providers, and we did not get prequalified.

            I guess we could have set his arm ourselves, or perhaps let it heal crooked....

            For this we were billed $7,000....

            One of my relatives is a doctor in the CR. As everywhere, there are good doctors, and bad doctors. All in all, the care I've received in the CR and Japan rivals that in the US, at a much lower cost.

          • by spiffmastercow (1001386) on Saturday April 04 2009, @01:02PM (#27458945)
            If my experience of moving from minimum wage to upper-middle class in the span of 3 years has taught me anything, its that the amount you're paid is inversely proportional to how hard you work. I still work, but not nearly as hard as when I was an intern. And when I was an intern, I didn't work nearly as hard as when I was a janitor. Looking up on the pay scale, I see that most of the execs at my company make $300-500k to sit around and talk out thier asses, and come up with ideas that lose the company millions of dollars.
          • Re:And next up (Score:5, Insightful)

            by RobinH (124750) on Saturday April 04 2009, @12:33PM (#27458721) Homepage

            And don't pretend the US isn't a socialist nation. I spent 5 years in the US. You guys have a national program that pays farmers to *not farm* to increase the price that the rest of the farmers get for their produce. You also just gave $700 billion in hand outs to failing corporations. You give national subsidies to the states for building the highway system, but tie social policy to it (the states have to implement a minimum drinking age of 21 to qualify for the funding).

            The US still pays for the poorest people to get free medical care even though middle income people can't afford it. That's much worse than the Canadian system (having used both). In Canada, the people who run the health care system have to eat their own dog food. Their kids use the system that they run. Do you think the people who run the Medicare system in the US use that system?

    • Re:And next up (Score:5, Insightful)

      by bargainsale (1038112) on Saturday April 04 2009, @07:45AM (#27456761)
      This is in fact the way things work now in the UK.

      There is a pretend-independent government committee called NICE (yup) which decides which treatments are to be made available through the free-at-the-point-of-delivery government health service, the NHS.

      They do indeed make heavy use of QALYs, "Quality-Adjusted LifeYears" in much this way.

      Although the way NICE works in specific instances has led to a lot of very justified criticism, there seems to be no realistic alternative to something like this if you have a tax-financed system that the sick don't pay for directly. There just isn't enough money to do everything possible for every patient.

      I don't know the right answer. I work for the NHS (as a retinal specialist too!) and have had endless grief getting funding for some treatments for my patients; on the other hand, I've worked in systems where the first question you have to ask is not "what does this patient need?" but "what can this patient afford?" and I prefer the former despite all its problems and stupidities.
      • Re:And next up (Score:5, Interesting)

        by JohnFluxx (413620) on Saturday April 04 2009, @07:55AM (#27456815)

        The scientist in me likes the ideas of NICE. If an operation neither extends life nor increases quality of life, then what's the point in the operation?

        Of course, it never works perfectly, but I'd be interested in what the critisms against NICE are?

        • by Kupfernigk (1190345) on Saturday April 04 2009, @09:15AM (#27457267)
          There is evidence that drug companies have orchestrated campaigns to get the general public to agitate for their treatments when NICE has identified that they do not work, or do not work well. Many cancer treatments are actually pretty ineffective, but of course dying people clutch at straws - as I may do one day - and if they are told that X treatment is very expensive but may prolong their lives, they will probably demand it. They may not be told that, say, the side effects are awful and they will get six months of life instead of three.

          We need NICE because ethical drug companies are no longer ethical, and that in part reflects our demand for magical cures. The really serious problems we face - like TB and avian flu - are of little interest to drug companies because (in the first case) most people affected are poor and cannot afford expensive medicine and (in the second case) vaccines are usually a one or two off and do not represent a continuing revenue stream paid for by insurance. We cannot rely on insurance companies to control public health because their aim is to balance revenue and cost - they are not interested in controlling the diseases of the poor, and they do not want diseases cured to the extent that their revenue goes down. We as taxpayers need agencies like the NIH in the US and the NICE in the UK to advise and regulate in our interests, not those of shareholders only.

            • by Haeleth (414428) on Saturday April 04 2009, @12:47PM (#27458815) Journal

              realize that NICE denies care to those that could benefit from it greatly.

              Welcome to what we call the "real world". In the real world, resources are limited. There isn't enough money to provide treatment to everyone who could benefit from it -- that means you have to deny some people treatment. Full stop.

              NICE exists to make sure that the limited resources are spent on cost-effective treatments, not wasted on expensive and ineffective treatments.

              Patients should decide when they can AND then with their doctors, what treatments to have. Everyone else needs to stay the f*** out of the decision nexus.

              Fine -- go private, then. Private patients can buy whatever treatments they like, and NICE can't do a thing to stop them.

              NICE decisions only have any effect whatsoever on the treatments that are provided by the NHS. Treatments that are funded by the taxpayer. What the hell makes you think you're entitled to demand that we pay for whatever treatment you want? If you want something that's not on the menu, you can damn well pay for it yourself.

          • Re:And next up (Score:4, Insightful)

            by BarryJacobsen (526926) on Saturday April 04 2009, @09:16AM (#27457273) Homepage

            If an operation neither extends life nor increases quality of life, then what's the point in the operation?

            True, but if there is a choice between an operation that extends life and one that increases quality, which does the provider pay for?

            It depends on if the extended life years are Quality Life Years or just extended life. For example an operation that would keep the patient alive, but in a coma would have a low Quality, so it would be lower in priority than an operation that would give sight to a blind person - which while not changing the length of their life (ignoring any differences in life expectancy between the sighted and the blind) increases quality significantly.

      • Re:And next up (Score:5, Insightful)

        by syntaxglitch (889367) on Saturday April 04 2009, @08:24AM (#27456967)

        Although the way NICE works in specific instances has led to a lot of very justified criticism, there seems to be no realistic alternative to something like this if you have a tax-financed system that the sick don't pay for directly. There just isn't enough money to do everything possible for every patient.

        Who says it has to be tax-financed?

        In the USA, much health care is funded by insurance companies that essentially serve the function of averaging medical expenditure among a group of people. The net result of this is that an individual with insurance has every incentive to spend as much as the insurance while let them, because the costs will distribute to all policy holders. When everyone does this, insurance policy costs keep going up. The insurance companies, trying to get costs back down, have incentive only to pay as little as possible, not prioritize approved treatments by QALYs or any other similar metric.

        Then, due to all that, you end up with people who are uninsured or otherwise unable to afford health care ending up with emergency conditions, receiving expensive treatment, and being forced into bankruptcy. This also drives up cost (as the hospitals are forced to absorb the cost of treatment) and harms society (a financially ruined citizen accomplishes less and pays less tax).

        And thus, we come to this, the worst of all possible worlds.

          • by nine-times (778537) <nine.times@gmail.com> on Saturday April 04 2009, @09:20AM (#27457307) Homepage

            I do not mind universal catastrophic health care, I do mind the idea of paying for every kook who thinks his tummy ache is an emergency.

            Well the two might not be directly connected. It doesn't seem to me like giving universal catastrophic health care would encourage people to use the ER more, and in fact having better access to healthcare on a regular basis might decrease ER costs. Setting aside for a second the people who go to the ER for every tummy ache, what about those who do nothing about potentially serious issues until they actually become serious issues? Early detection can often save money, actually.

            A local hospital in Atlanta (actually more than one) reports many cases of people calling 911 to get a ride downtown where by law they are required to be given a "ticket" to get home.

            Well that's just a problem, and again doesn't really have a direct connection to universal healthcare. You can get in trouble (fines, I believe) for calling 911 unnecessarily. You have to figure there will be some abuse, that sometimes a person will get away with something like that. But if it's really all that rampant (the abuse the the ambulance service that you describe) then I would think they should investigate and arrest or fine people abusing the system.

          • Re:And next up (Score:5, Insightful)

            by anagama (611277) <thepotter@@@yahoo...com> on Saturday April 04 2009, @10:49AM (#27457899) Homepage
            The problem is, any public health care system devised in the US is going to be one that benefits the insurance industry. The only way to cut costs is to CUT OUT the insurance industry from the process. I could be supportive of such a plan, but I have absolutely no expectation that will happen. Universal health care in the US will simply be forced subsidization of the insurance industry.
      • Re: (Score:3, Insightful)

        I work in a health-related field where a lot of practitioners are focused more on the dollars than the patient's best interest. Unfortunately, this is human nature. The only thing you can really do is try to find the ones that aren't just trying to sell you stuff.

        I think government mandated standards can be harmful in some cases. Practitioners must have the flexibility to treat as they see fit, since not everyone fits the same mold and it's not always clear what's going to work. I've seen instances where

    • Re:And next up (Score:5, Insightful)

      by Anonymous Coward on Saturday April 04 2009, @07:55AM (#27456817)

      I often see very elderly (and often demented) patients receiving very expensive treatment of eye conditions. do they need the treatment - sure, to preserve their sight. Does the treatment improve their quality of life - maybe. So who decides, the patient or family, or BIG government?

      This isn't about BIG government telling you you can't take homeopathic remedies, or OTC cough medicine, or sit under a pyramid. This is about government funding research that reveals snake oil as snake oil. If the $8 bottle of robitussin is no more effective than lemon tea, what reasonable consumer would buy the robo? Hooray, I say, for a government that encourages open and honest markets.

    • Re:And next up (Score:5, Informative)

      by similar_name (1164087) on Saturday April 04 2009, @09:09AM (#27457225)

      So who decides, the patient or family, or BIG government?

      Under our current system, insurance companies decide. It seems disingenuous to imply that patients have the choice and that the current system(private insurance companies) pays for every treatment than anyone could ever want/need. There are plenty of people who have been denied claims. I also don't understand why you can't still have private insurance if there is national health care. Did the advent of Blue Cross/Blue Shield make it impossible to get Aetna?

      • Re:And next up (Score:5, Informative)

        by BarryJacobsen (526926) on Saturday April 04 2009, @09:19AM (#27457293) Homepage

        I can testify that knee surgery is sometimes a wonderful cure. I suffered terrible pain for years and two new artificial knees are better than the originals in many ways and they never,ever hurt at all.

        The knee surgery being referred to is the kind where they don't replace anything, just dinkering around in there - I believe. They aren't arguing that artificial knees don't work.

  • Goes to show. (Score:5, Interesting)

    by palegray.net (1195047) <philip DOT paradis AT palegray DOT net> on Saturday April 04 2009, @07:30AM (#27456703) Homepage Journal
    The human body is pretty darn good at healing itself. There is absolutely no replacement for a decent diet, moderate exercise, and a positive attitude. The last factor alone has been repeatedly shown to boost immune system health over a variety of drug-based treatments.
    • Re: (Score:3, Interesting)

      I'd say in fact, especially for us people who like tinkering and tuning complex machines, getting our body to run perfectly should be a pretty easy and fun thing to do.
      The them "species-appropriate" is the key word. What is the perfect food for our machine called body? How do you maintain it? How does the brain work?

      If you look that stuff up, it all becomes so totally obvious. And much simpler to implement.

      About the last factor: What you mean is the placebo effect. There were experiments, where people becam

      • Re:Goes to show. (Score:5, Interesting)

        by lawpoop (604919) on Saturday April 04 2009, @10:08AM (#27457615) Homepage Journal
        I think that the human organism basis some of its healing on its perception of its role in society. We are a social creature. Every culture has some kind of 'theory of medicine' -- that disease has a cause, which can be treated by certain practices, procedures, and bitter plant concoction ( the taste of 'bitter' is the chemical recognition of alkaloids, or drug compounds, in a plant ).

        If we are receiving 'treatment', or attention from the community when we are known to be sick, then our body's healing response will amp up.

        Likewise, people can die basically 'on command' in certain circumstances, when a doctor or sorcerer pronounces them dead. In some tribe somewhere, if a shaman does a certain ritual called a 'bone-pointing', the person who gets cursed will sicken and die in about three days -- shorter than you would die from thirst or hunger. Likewise, back in the 80s when AIDS was first on the scene, people would sometimes die within days of a diagnosis. Doctors didn't find any physical cause; they just kind of willed themself to death, probably because of the severe social stigma and lack of hope that an AIDS diagnosis meant at that point.

        So I think placebo medicine will be a big insight into understanding human health in the future.
    • Re:Goes to show. (Score:5, Insightful)

      by nloop (665733) on Saturday April 04 2009, @08:07AM (#27456877)

      The human body is pretty darn good at healing itself. There is absolutely no replacement for a decent diet, moderate exercise, and a positive attitude. The last factor alone has been repeatedly shown to boost immune system health over a variety of drug-based treatments.

      While I agree that a lot of our respective societies health issues are preventable, I am 26 years old, can run a marathon, and rarely ever touch red meat and I call shenanigans on the idea that diet and exercise are a cure-all! I have 140/85 blood pressure (high) despite doing cardio work 5 days a week and eating right. I have knee problems when it's cold, back problems all the time, and suffer from bronchitis every winter from exercise in the cold. Sometimes I feel like a healthy lifestyle is making me fall apart.

      However, my qualm is more with more with scientologists, and that various left field christian sects that refuse to immunize their kids or see doctors. Modern medicine is useful. Really. It is. There is more than diet, exercise, and positive thinking.

        • Re: (Score:3, Insightful)

          by nloop (665733)
          I utilize periodized training. Weeks on, weeks off, gradual build up to a big race, taking a month of very little exercise to let the body recover. I take my resting heart rate every morning. If it goes up, your body is heading towards a overtrained state, time to take a rest. I'm pretty careful about it. As far as middle aged... take a look at marathon runners. You don't peak until you are in your 30s, people run them competitively long after that. Lance is pushing 40 and is about to race The Tour.
    • Re:Goes to show. (Score:4, Insightful)

      by nine-times (778537) <nine.times@gmail.com> on Saturday April 04 2009, @08:22AM (#27456949) Homepage

      There's merit in what you say, but on the other hand, I'll take antibiotics when I have an infection. I'll go in for any recommended cancer screenings, and if they find something, I'll be glad for the best medical treatment I can get, because I don't want to rely on diet, exercise, and attitude to fix that.

      There is no replacement for diet, exercise, and a positive attitude, but those things also aren't a complete replacement for medical treatment.

      • by the eric conspiracy (20178) on Saturday April 04 2009, @09:04AM (#27457201)

        You do realize I hope that carcinogenic and toxic chemicals are present in great quantities in the natural environment too? For example the human bloodstream naturally contains small amounts of formaldehyde. It is hard to imagine how it would be possible to eliminate exposure to these materials when they are present in every plant or animal through their natural metabolisms.

        Sperm count studies that claim reductions in sperm count over time are very questionable. There have been a number of publications [google.com] in the literature that claim sloppy investigative practices are the reason for this perception. And it definitely has not been world-wide. The data vary greatly by region.

        As far as immune system affects of nuclear testing - there is no evidence of such effects even in areas directly downwind of radiation hotspots like Hanford. The only studies showing such affects are in populations exposed to far greater doses, i.e. Nagasaki survivors or children exposed in the Chernobyl accident.

  • A Nit To Pick (Score:4, Informative)

    by darkmeridian (119044) <william@chuang.gmail@com> on Saturday April 04 2009, @07:50AM (#27456791) Homepage

    Prescription cough syrups may be useful.The linked article regarding cough syrups only covered over-the-counter cough medications. Prescription cough syrups that contain codeine or hydrocodone seem to work really well but are liable to abuse.

    • by DrYak (748999) on Saturday April 04 2009, @08:19AM (#27456937) Homepage

      Cough syrups *do* work. ...BUT...

      They don't combat the infection. They alleviate the symptoms.
      They don't kill the bug which is causing the cough, they only make the patient cough less (and thus sleep better, feel more comfortable).

      So if you count the days spent being sick, a cough syrup won't make any difference. On the other hand if you look which makes happier the patient, one should prescribe the cough syrup anyway. (Same goes for lots of other ailment : most of the treatment prescribed by doctors for common illnesses are only to make the symptoms more bearable, not to kill the bug faster).

      There's a saying here among doctors telling that a "cold" last one week without treatment and 7 days with treatment.

      I am more astonished about the prescription of antibiotics. Here around in Europe, there have been large campaign to make the public aware that most common infections (bronchitis, sinusitis, sore throats, ear infections, etc...) are due to viruses and thus there's no point in insisting until the doctor prescribes antibiotics.
      I would have expected that the same reduction in use of antibiotics would have happened in the US too.

      Disclaimer : Although IAAMD, I happen to work in research for the last few years so other medical /.ers should have better knowledge than me.

  • Inefficiency (Score:5, Interesting)

    by syntaxglitch (889367) on Saturday April 04 2009, @07:58AM (#27456825)

    It's well-established that Americans as a whole pay far too much for health for far too little benefit, compared to other first-world nations.

    Can some of this discrepancy be explained by high availability of essentially useless or even harmful "treatments"?

  • Sinusitis (Score:5, Interesting)

    by jonpublic (676412) on Saturday April 04 2009, @08:02AM (#27456845)

    My experience with sinusitis definitely confirms this. Every 3 months or so I would come down with another sinus infection. Each time I would goto the doctor and get a prescription for antibiotics. I wasn't asking for antibiotics. I was looking for a solution to the problem. One time the doctor wanted me to switch to a much more expensive antibiotic. Sure enough I ended up getting some nerve damage from the antibiotic. Nothing permanent, but the numbness lingered for over a year.

    What the kicker here is that if the doctor had looked at my chart and said, maybe we should take another approach after the 5 or 6th time, the whole situation would have been avoided.

    I got a neti pot and I haven't had a sinus infection since, I just use the neti pot whenever I feel my head getting clogged up. $20 dollar solution.

    • Idiotic. (Score:5, Interesting)

      by DrYak (748999) on Saturday April 04 2009, @08:36AM (#27457051) Homepage

      Every 3 months or so I would come down with another sinus infection. Each time I would goto the doctor and get a prescription for antibiotics.

      This is indeed idiotic. You should shot your doctor. There's plenty of evidence that chronic sinusitis aren't caused by bacteria (the only thing killed by antibiotics).

      If the doctor really wanted to try something, he should have made a try with an anti-fungic (some studies tend to show that part of recurring sinusitis might be due to bugs more of the fungi persuasion).

      I got a neti pot and I haven't had a sinus infection since, I just use the neti pot whenever I feel my head getting clogged up. $20 dollar solution.

      Brilliant. Washing the nasal cavity is a method which also works for viruses which you most likely had like most of the adult population (and against which antibiotics are no use).
      It's part of what we prescribe here around (although as I said in another post, I now work in research).

      For extra, you can also buy sprays containing carbocisteine (an agent helping making the mucus more fluid), but you should use sprays containing beta-mimetics more than 1-2 weeks.

      But the basic "clean the cavity with water" $20 solution works too.

  • by Hogwash McFly (678207) on Saturday April 04 2009, @08:03AM (#27456849)

    As any man knows, if you ignore it for long enough, it will eventually go away. Just like the pain in my tooth and the blood on my toilet paper. I haven't been to the doctor in years, and I am as fit as

  • Beta Blockers (Score:3, Interesting)

    by jamesl (106902) on Saturday April 04 2009, @08:12AM (#27456897)

    On the other hand, generic beta blockers (ie. propranalol) are so cheap as to be almost free. The conclusion in the cited article does not call for an absolute ban on beta-blocker therapy: Consequently, it might generally be prudent to consider starting beta-blocker therapy in hospital only when the haemodynamic condition after MI has stabilised.

    As much as we would like to believe otherwise, medicine is still an inexact science.

  • by misanthrope101 (253915) on Saturday April 04 2009, @08:26AM (#27456979)

    I'm sure doctors are performing some treatments that aren't warranted. However, I assure you that patients want treatment. I work in the medical field, and the psychology of medicine is weird. Parents want antibiotics for their children, and they don't really care about research that says the antibiotics aren't necessary or may even cause harm. Everyone wants a pill for what they have, and they want it now. I've seen people demand x-rays for their pinkie toe, even though the doc told them outright that it wouldn't make a bit of difference. If the doc doesn't order the x-ray (or fork over the pills), the patient is unhappy, and unhappy patients are vastly more likely to sue.

    I've had a woman bring her kid to the ER with an cold and tell me in the triage room "I can't get in to see the pediatrician till Wednesday, and by then she'll get well on her own." I'm not making this up---she was rushing to make sure her kid got seen by a doctor, because she knew the kid would get well if she waited too long. She wasn't a drooling idiot, but part of her mental checklist of being a good parent included "If kid is sick, see doctor." If docs don't hand out antibiotics for every earache and sore throat, the patient will just come back tomorrow or the next day and complain "I'm still sick." If the second doc gives them pills, they'll tell everyone they know about the first doc, who is obviously an idiot who didn't have the intelligence to see how direly ill they were. "I needed antibiotics, and he didn't give me anything!"

    So all told, I don't blame the docs too much. They are working against hypochondriac patients who demand a pill for everything. In a weird way, people want to be sick, or at least they want their routine aches and pains dignified with snazzy medical terms. I've actually had patients get mad at me when I told them that a contusion is just a bruise, and cephalgia is just a headache.

    • by nelsonal (549144) on Saturday April 04 2009, @08:44AM (#27457099) Journal
      In a similar vein, there are some recent studies that suggest that most of the benefit of medicine is the temporary status transfer from a high status individual paying more attention to the patient which perversely causes them to get better. That goes along with the idea that it's important to get your chance to get that status boost.
  • by dachshund (300733) on Saturday April 04 2009, @08:30AM (#27457009)

    "You'll have to pry my Beta Blockers out of my cold, dead hands."

    Point: when the government "retires" beta blockers --- based on strong evidence that they're ineffective --- you can expect objections having to do with 'patient choice' and how the government is telling doctors what to do. Merits be damned: this will be used as an example of why we can't afford government-subsidized health care.

    It's no coincidence that the people who oppose "socialized medicine" are often the same ones who avoid evidence-based medicine in large-scale situations where it might be effective. It's also no coincidence that our health care costs more on average than many other nations, and yet our health outcomes are worse.

  • Corrupt Doctors (Score:4, Interesting)

    by bloobamator (939353) on Saturday April 04 2009, @09:27AM (#27457341)

    The single biggest factor driving health care costs in America is the corruption of doctors. Too many doctors are on the take from Big Pharma.

    I personally know one who makes millions dispensing medicines pushed by the pharmaceutical companies. He owns a big house in the Westchester, a swank apartment on the Upper East Side, 2 BMW's, a Mercedes, pays hefty child support, alimony (which includes a third mortgage on his ex-wife's big house in Westchester), and he parties like a freak.

    He's not even a surgeon. How does he make so much money? By accepting kickbacks from the pharmaceutical companies for the medicines he prescribes and dispenses (his specialty allows him to dispense certain injections to relieve back pain.)

    All this guy does is inject people's backs with something that is clearly ineffective, and then refers them on to his surgeon buddy when the injections don't work. What a scam!

    He bragged to me on several occassions, while drunk, how the Big Pharma companies wined and dined him in super-expensive Manhattan restaurants, and how they paid for ultra-luxurious island vacations. I know there was more he wasn't telling me.

    I met another "doctor" who actually just owned a bunch of clinics in NJ. He was the dumbest son-of-a-bitch I have ever met, and he walked, talked and dressed like a wiseguy. Yet he drove 2 Rolls-Royces and invested heavily in porn sites and strip clubs in FL. He was scary, really scary, yet he was a "leader in quality private health care in the greater NJ region". *shiver*

    It's time we cracked down on medical waste and fraud.

  • by Kral_Blbec (1201285) on Saturday April 04 2009, @09:41AM (#27457425)

    So what about those that dont? When I was a kid, our doctor refused to give me anything based on this reasoning. As a result of chronic untreated ear infections, I developed a speech impediment that i had to have therapy for until i was almost 16 and still lingers today. I attribute a lot of my anti-sociality in my youth (and now) to being embarrassed to talk. Thanks for nothing doc.

  • Rapid CRP (Score:4, Interesting)

    by Aggrajag (716041) on Saturday April 04 2009, @10:30AM (#27457759)
    At least here in Finland it is common practice to take a rapid CRP test from patients when they show symptoms of for example sinusitis. If the result is less than 10 sinusitis is most likely caused by a viral infection so no antibiotics will do the patient any good.
  • by Sj0 (472011) on Saturday April 04 2009, @10:36AM (#27457813) Homepage Journal

    I dated a nurse's aide for about a year, and what always shocked me was how little she knew about the treatments she was suggesting. Every time I got a cold, she demanded we rush to the ER to get some penicillin.

    Now, I'm not one of those assholes who thinks he knows everything, but I know that colds are caused by a virus, and penicillin doesn't work on viruses.

    Since then, I've gone on the philosophy that just because someone who works in a hospital says something, doesn't mean it's gospel. I won't take it as *wrong*, but I'll take it with a grain of salt, like I do medical advice on the Internet.

    • Re:good news (Score:4, Insightful)

      by novakyu (636495) <novakyu@member.fsf.org> on Saturday April 04 2009, @02:27PM (#27459589) Homepage

      And do you know what one of the complaints against Bush's No Child Left Behind was?

      That it required pedagogical methods to be scientifically proven [1].

      Teachers didn't like that because then they couldn't use anecdote-based or other methods that they would prefer than methods that were "scientifically proven".

      Expect similar complaints from the doctors (after all, if they were really scientists, they would've gone into research; there's a reason they chose the career that they chose), and yes, the "O admin" believes in the scientific method just as much as the Bush administration did—it's just the left-wing distortions in the media that made you think somehow Bush stood against scientific progress (remember last year, Bush proposed a relatively generous science budget, but it never got past the Democratic congress).

      [1] From Department of Education website [ed.gov], "It only funds curricula and teaching methods that are scientifically proven to work."