If it doesn't work, stop it: Small question with big answers

BMJ 2004;328:1015 (24 April), doi:10.1136/bmj.328.7446.1015-b

Letter

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

EDITOR—Why do doctors use treatments that do not work?¹A simple question with many answers.

Doctors are paid to do this.
Doctors are taught to "practisemedicine" not to "help the patient."When these do not overlapdoctors are guided by adherence toprofessionally accepted theoriesas much as by evidence of benefit.
Diffusion and uptake ofknowledge have limits. Doctors are overloadedwith irrelevantinformation but have little access to informationon thingsthat they have been doing for years but do not work.
Thereis a tension between short term relief and long term attemptsto "help the patient." Some things provide instant relief butlittle long term benefit (or even harm).
Effort must be justified.If people take a lot of effort toachieve something they tendto justify their efforts by attachingvalue to what they haveachieved. Doctors spend years learningto offer . . . [Full text of this article]