Why do doctors use treatments that do not work?

doi:10.1136/bmj.328.7438.474

BMJ 2004;328:474-475 (28 February), doi:10.1136/bmj.328.7438.474

Editorial

Why do doctors use treatments that do not work?

For many reasons—including their inability to stand idleand do nothing

The first 150 words of the full text of this article appear below.

One of the surprising things about James Lind's celebrated trialof citrus fruit for scurvy was not just that he ignored theevidence from his own trial but that in clinical practice hecontinued to advocate treatments that he himself had found ineffective,including those containing sulphuric acid.^w1 The history ofmedicine is replete with examples of treatments once commonpractice but now known not to work—or worse, cause harm.Only because the French surgeon Paré ran out of boilingoil did he discover that not cauterising gun shot wounds withit created much less pain and suffering.^w2 Leeches and bloodletting were used for thousands of years for almost everything.Attempts to show that they were ineffective were resisted withgreat passion by the medical profession.^w3 More recently, wehave had treatment with insulin for schizophrenia and vitaminK for myocardial infarction.^1
2 In case we are all feeling too. . . [Full text of this article]

Jenny Doust, senior research fellow, general practice

(j.doust@sph.uq.edu.au), Centre for General Practice, University of Queensland, Medical School, Herston, Queensland 4006, Australia

Chris Del Mar, professor of general practice

Centre for General Practice, University of Queensland, Medical School, Herston, Queensland 4006, Australia

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Rapid Responses:

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The use of Time: Campbell Murdoch
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Missing Our Moral Imperative: Lawrence I. Silververg
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