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Unscientific Medicine: What’s The Harm?

Any promoter of science-based medicine often faces the question: “What’s the harm?” What is the harm if people try treatment modalities that are not based upon good science, that are anecdotal, or provide only a placebo benefit? There are generally two premises to this question. The first is that most “alternative” placebo interventions are directly harmless. The second is that direct harm is the only type worth considering. Both of these premises are wrong.

The pages of Science Based Medicine (SBM) are filled with accounts of direct harm from unscientific treatments: Argyria from colloidal silver, death from chelation therapy, infection or other complications from acupuncture, burns from ear candleing, stroke from chiropractic neck manipulation — the list goes on. You can read anecdotal accounts of such harm on the website, whatstheharm.net.

Of course, as we often point out, harm and risk is only one end of the equation — one must also consider benefit. It is the risk-benefit ratio of an intervention that is important. But generally we are talking about interventions that lack any evidence for benefit, and therefore any risk of harm is arguably unacceptable. Read more »

*This blog post was originally published at Science-Based Medicine*

Who Should Get A Flu Shot? You Should

It’s that time of year again. Children back at school. Football season is underway and baseball playoffs to start soon. The television networks are rolling out their new shows.

And it’s also time to think about getting flu shots. I just got mine today as I have done annually since going to medical school.

Compared to last year, there isn’t as much news about the flu or the flu vaccine. This year the Centers for Disease Control and Prevention (CDC) gives clear guidelines that everyone aged 6 months and older should get the influenza vaccine. 

This month the American Academy of Pediatrics recommends that all healthcare providers should be required to get the influenza vaccine.

And one fact that hasn’t gotten much attention is whether the 2009 H1N1 virus is included in the 2010-2011 vaccine: Is it? Yes, it is. This year’s vaccine will be as safe as vaccines in past years as the production process is unchanged. Inclusion of the 2009 H1N1 virus will not be a problem. Read more »

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

WHO And H1N1: Conflict Of Interest?

On June 11, 2009, Dr. Margaret Chan, the director general of the World Health Organization (WHO), declared that the H1N1 flu that was then spreading around the world was an official pandemic. This triggered a series of built-in responses in many countries, including stockpiling anti-viral medications and preparing for a mass H1N1 vaccination program.

At the time the flu was still in its “first wave” and the fear was that subsequent waves, as the virus swept around the world, would become more virulent and/or contagious –- similar to what happened in the 1918 pandemic. This did not happen. At least our worst fears were not realized. The H1N1 pandemic, while serious, simmered through the winter of 2009-2010, producing a less than average flu season, although with some worrisome difference. Read more »

*This blog post was originally published at Science-Based Medicine*

Audio: ACP President: Not Enough Americans Have Been Vaccinated Against H1N1 Flu

stubbsOver 10,000 Americans (mostly young) have already died of H1N1 flu, and yet we’ve only vaccinated 10-20% of those who need protection. January 10-16 is National Influenza Awareness Week, and the American College of Physicians is doing its part to raise awareness of the ongoing need to protect Americans from the next wave of influenza.

I interviewed ACP President, Dr. Joseph Stubbs, about the current influenza season and Americans’ vulnerabilities to the virus. Please enjoy the audio of our conversation or read the transcript below.

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Flu Vaccine, Dystonia, Cheerleaders, And The Truth

In my efforts to have a rational discussion about the H1N1 flu shot I have been increasingly confronted with the following fear, expressed most commonly by concerned mothers and teenagers:

Did you see that video on Youtube about the cheerleader who got the flu shot? Something called dystonia? She can’t walk unless she goes backwards. I don’t want to risk ending up like that.

Apparently Inside Edition broadcast a story featuring a woman who claims to have a movement disorder she attributes to an adverse effect of the seasonal flu shot. I had to take a look at this video along with the millions of other viewers. Here it is: Read more »

*This blog post was originally published at The Examining Room of Dr. Charles*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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