MEDICINE TODAY: Have we improved in the last 200 years?
C. Norman Shealy, M.D., Ph.D.
In 1972 I reviewed the original operative notes, X-Rays and original history and physical exam on over 100 failed back surgery patients and concluded that 80% should never have had surgery, 10% really did have rupture discs and in 10% I could not be certain. An 80% inappropriate surgery! When I presented this at a national orthopedic meeting, a prominent orthopedist commented that he agreed with what I said but resented my mentioning it publicly!!
A recent report which appears in the August issue of Mayo Clinic Proceedings suggests that medical practice in general may be fairly effective in 38% of cases, ineffective or harmful in more than 40% of cases and uncertain in 20% of cases. Flip a coin— less than a 50% CHANCE OF GETTING THE FAIR RESULT!!!
We have really not improved much in at least a couple of hundred years. Ignaz Philpp Semmeweis could not convince physicians to wash their hands after doing autopsies on women who died of puerperal fever, even when they were going to deliver another baby! Hahnemann was rejected for seeking a safe alternative to blood-letting and leeching.
Today statin drugs and many chemotherapeutic approaches carry at best more risks than benefit. As a physician, I remain convinced that 85% of problems do not require drugs or surgery. In the 15% of cases where these can be life-saving, modern medicine is superb. In the other 85%, safe, alternative, holistic approaches are superior and carry no risk. Of course the challenge is in choosing the 15% who do need drugs or surgery!
Barnes Woodhall, the great Duke neurosurgeon, said in the 50’s, “I can teach you all the neurosurgical techniques you need in 6 months. It will take me 5 years to teach you to know when to use them.”
Now, if only someone would teach physicians when to know what and how to use modern technology!!