Man, the Unknown
I very much liked your present editorial, coupled with the blog by Richard in the same issue. Put together, they echo the sentiments that
I have been trying to sell to the world for the last four decades. In many
of my responses in the BMJ I have touched upon this topic. My book, What doctors Don't
Get to Study in Medical School, goes into this in great detail.
I would like to make a couple of points about your editorial choices.
It is not only the prediabetics and prehypertensives that suffer from our
efforts at disease mongering. Even the mild diabetics that are
asymptomatic and mild-moderate hypertensives suffer much more. Studies
have shown the futility of drugging these hapless people without educating
them about healthy life style changes first. Lifelong drug administration
has no scientific evidence in the so called evidence based medicine that
we claim to practice. None, I am repeating that word, none of the drugs
that we use are safe in the long run and they could themselves result in
misery for the patient. A good friend of mine was suggesting to me a good
analysis of the word pharmaceuticals, thus: The first letter
stands for profit. Take that
away and you are left with the true colour of the drugs that we use--Harmaceuticals.
We do not have any study of anti-hypertensives against placebo in our
evidence base. One drug is shown to be better than the other but we do not
know if that drug is worse than the placebo, which today is known to
produce very powerful natural chemicals from the forebrain to bring the
patient back to good health. Large studies like the Australasian Study
have shown that just observation alone would bring about 40%
blood pressures to normal levels! In the first place what is the normal
blood pressure for a given patient, I do not know. I only know the
statistical so called normal for cohorts but not for individuals. One size
fits all is wrong philosophy in science of man. Do we have a correct
science of man? I am afraid not. I am writing a book on that topic at the
moment. The last one I know is the book by Alexis Carrel-Man, the Unknown.
Even in those with diseases like hypertension, diabetes and
hypercholesterolaemia, the absolute risk reductions (ARR) with drugs is
negligible while the adverse drug reactions could be fatal.
We need to rethink our future strategy whole sale. No changes in
parts would do. We need a new medicine which comes after modern medicine;
I call that Meta medicine.
Competing interests: No competing interests