believing in treatments that don’t work

Exercise as Effective as Surgery for Knee Pain

By | July 21st, 2016|Fitness and Health|

I'm glad to see surgery subjected to meaningful control studies.  That's the standard for Acupuncture research except we also have the additional burden of adding sham acupuncture as a study arm.  Surgical studies, for some reason, don't need add a sham arm. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged [...]

Knee Surgery for Meniscus Repair No Better Than Placebo

By | January 14th, 2014|First Do No Harm: Risks, Follow the Money|

Of course, surgery is one of the most powerful placebos that exist.  But the studies that have actually looked at placebo surgery are vanishingly rare.  So bravo that they looked, and shame on surgeons that they so seldom scrutinize the real value of their procedures. THURSDAY, Dec. 26, 2013 (HealthDay News) -- Improvements in knee [...]

Exercise, Not Surgery, for Back Pain

By | January 14th, 2014|Fitness and Health, uncategorized|

Perhaps surgery is not the greatest idea for back pain???  Those of us who provide alternatives would heartily agree, since we end up seeing many of the post operative patients who are still in pain.  From npr.   Groopman, a Harvard cancer specialist who writes about medicine for The New Yorker, wanted the problem fixed [...]

Sanity on Statins: Part 4? or is it 5?

By | November 14th, 2013|Big Pharma, First Do No Harm: Risks, Fitness and Health, Follow the Money|

Can I really trust these guidelines??? Lots of news about the latest recommendations for patients with high cholesterol vis a vis drug regimens.  At first I thought it was good news, but now, reading the editorial by Rita Redberg, I realize that these recommendations could actually WIDEN the use of statins.  I will [...]

Questioning Steroids for Back Pain

By | October 22nd, 2013|First Do No Harm: Risks, Follow the Money|

So a new study shows that injecting epidural saline is just as good as injecting steroids for low back pain.  I think this should be a rather big deal. This study was painstakingly done reviewing all appropriate studies to date, even taking into account publication bias. The full study here.Epidural_Injections_for_Spinal_Pain__A_Systematic.31 A handy review of what [...]

Recommendation for Otitis Media: Watchful Waiting

By | February 25th, 2013|First Do No Harm: Risks|

New guidelines from the Academy of Pediatrics.  We've discussed the conundrum of antibiotics for otitis media here and here.  Having completed a Pediatric Residency and passed my Boards (granted, this was back in the Dark Ages), this comes as such a 180' turn around, it's sort of difficult to believe. Stricter diagnostic criteria and broader [...]

Acupuncture and Allergy: Editorial from the Annals of Internal Medicine

By | February 21st, 2013|Acupuncture research|

From the Annals of Internal Medicine: To be considered effective, a pharmaceutical intervention genrally needs to be proven more effective than placebo.  Most suregical interventions, however, are not held to this standard.  With some exceptions including vertebral kyphoplasty and knee arthroscopy, surgical interventions have not been subjected to  sham surgery-controlled trials.  Acupuncture, on the other [...]

Black Swan: Sunday Morning Philosophizing

By | February 17th, 2013|Acupuncture research, uncategorized|

Spent the morning reading "Black Swan" by Nassim Taleb, a mathematical trader by profession, but an essayist and "intellectual."  His book outlines how difficult it is to override our innate, evolutionary tendency to make assumptions and draw conclusions that leave us unable to predict highly unusual events.  But in outlining his ideas, he touches on [...]

Dr.Oz: Morning Philosophizing

By | February 3rd, 2013|Fitness and Health, Follow the Money|

From the Feb 4th issue of the New Yorker, a profile of Dr. Mehmet Oz, entitled "The Operator," (he is discussing the presence of a guest "authority" on his show who explicitly rejects the tenets of science) "If I don't talk to him I have abdicated my responsibility, because the currency that I deal in [...]

Clinical Trials Subject to Bias in Reporting.

By | January 14th, 2013|First Do No Harm: Risks|

What to believe? This post is a sort of corollary of the skepticism around acupuncture research.  The flip side is that when the researchers believe in, or want something to work, the reporting becomes skewed. In this case, side effects were significantly under reported in the studies. January 14, 2013 Clinical Trials Flawed [...]

Huffington Post: What Acupuncture Can Teach Us About Science

By | January 8th, 2013|Acupuncture research, First Do No Harm: Risks|

I came across this article from last October from the Huffington Post.  It is referencing the comprehensive article concluding that acupuncture works for pain. Blog discussion here. In the Huffington Post a professor from Saybrook University discusses the quandary of acupuncture and that it has been shown to work in spite of a comprehensive understanding [...]

Mammography: Effectiveness Still Under Scrutiny

By | November 28th, 2012|First Do No Harm: Risks|

First Do No Harm From the recent  New England Journal of Medicine, their conclusion from examining the data "Although it is not certain which women have been affected, the imbalance suggests that there is substantial overdiagnosis, accounting for nearly a third of all newly diagnosed breast cancers, and that screening is having, at [...]

Clostridia Dificile on the Rise

By | November 21st, 2012|First Do No Harm: Risks|

We've been discussing C.Dif (Clostridia Dificile) in the context of encouraging good bacteria.  This is from the most recent Anesthesiology Today. Dramatic Rise in Hospital Visits for C. Difficile by George Ochoa Despite efforts by the U.S. Department of Health and Human Services and antimicrobial stewardship programs to combat Clostridium difficile infections (CDIs), the national [...]

Another Article on Steroid Injection Risk

By | November 19th, 2012|First Do No Harm: Risks, Follow the Money|

For Back Pain: Relax! Or try acupuncture! We've covered the hazards of epidural steroid injections here.  But this article is a good summary of the questionable efficacy, the skyrocketing usage, and the horrors of the fungal meningitis cases.   How Back Pain Turned Deadly ..There are the doctors who overprescribe an invasive back-pain [...]

Antibiotics and Serious Side Effects

By | September 12th, 2012|First Do No Harm: Risks|

A long article about various dangerous side effects of common antibiotics.  Fluoroquinolones are among the most common prescribed with serious side effects, including possible fibromyalgia sequelae.  The best known are Cipro (ciprofloxacin) and Levaquin (lovofloxacin.)  In 2010 Levaquin was the best selling antibiotic.  I have to admit I'm surprised at the number of my patients [...]