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Views & Reviews From the Frontline

Bad medicine: rheumatoid arthritis

BMJ 2011; 343 doi: (Published 05 October 2011) Cite this as: BMJ 2011;343:d6357

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Re:Re: Emotive Responses

I referred to Bad Medicine "Rheumatoid Arthritis" not Rheumatology.
You might like also to read, Bad Medicine "General Practice", there are
plenty of issues in GP.

Also I think you are misquoting me. I suggest that medicines
dependence on self reporting and supposed validated questionnaires is
"intellectually bankrupt" , not rheumatology. As for a non specialist
trampling on specialist turf , hey, try being a non specialist, we get
dragged across the ground by thoughtless pass remarkable specialist
opinion all the time. GPs are always told they "just need better
education" but education is a two way street.

I don't accept the comparison with meningitis. Being on my own in the
dark of a Glasgow flat , injecting 1.2g iv of Penicillin into the arm of a
semi conscious teenager with meningococcal septicemia . Does not equate to
the calm decision to initiate potentially life long medication in someone
with normal inflammatory indices, normal x-ray , negative RF and with
variable self reported symptoms. There has been much talk of stopping
treatments after starting, but this has never been my clinical experience.

It seems clear that there is overdiagnisis and over treatment, the
point of my article. What to do about it? Openly acknowledging it would be
a start. Study these problems second. Sort out some decent epidemiology
for the UK ,third.

Competing interests: No competing interests

16 October 2011
Des Spence
General Practice