Editorials

Why do doctors use treatments that do not work?

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7438.474 (Published 26 February 2004) Cite this as: BMJ 2004;328:474

This article has a correction. Please see:

  1. Jenny Doust (j.doust@sph.uq.edu.au), senior research fellow, general practice,
  2. Chris Del Mar, professor of general practice
  1. Centre for General Practice, University of Queensland, Medical School, Herston, Queensland 4006, Australia
  2. Centre for General Practice, University of Queensland, Medical School, Herston, Queensland 4006, Australia

    For many reasons—including their inability to stand idle and do nothing

    One of the surprising things about James Lind's celebrated trial of citrus fruit for scurvy was not just that he ignored the evidence from his own trial but that in clinical practice he continued to advocate treatments that he himself had found ineffective, including those containing sulphuric acid.w1 The history of medicine is replete with examples of treatments once common practice but now known not to work—or worse, cause harm. Only because the French surgeon Paré ran out of boiling oil did he discover that not cauterising gun shot wounds with it created much less pain and suffering.w2 Leeches and blood letting were used for thousands of years for almost everything. Attempts to show that they were ineffective were resisted with great passion by the medical profession.w3 More recently, we have had treatment with insulin for schizophrenia and vitamin K for myocardial infarction.1 2 In case we are all feeling too smug …

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