Lambert is here: Strangely, I don’t see any mention of Covid. However, the author of the book I reviewed, Marty McCurry, has a track record. It’s very worth a read.
By Laura Butcher, a healthcare business and policy writer based in Portugal. Originally published in Undark.
Like many surgeons, Marty McCurry regularly treated appendicitis by removing a patient’s appendix. The procedure used to be performed nearly 300,000 times a year in the United States, but that all changed about 10 years ago when researchers read that antibiotics could be an effective alternative.
in spite of subsequent research While confirming that appendectomy can be avoided in many cases, McCurry estimates that only about half of surgeons accept the idea. “This means that in America today, whether or not you go under the knife for appendicitis depends on who is on call when you go to the emergency room,” he wrote.Blind spots: When the medicine goes wrong and what it means for our health.”
In a detailed, behind-the-scenes case study, McCurry, a surgeon and public health researcher at Johns Hopkins University, explains how doctors often extol bad science and unsubstantiated opinions at the risk of patients. and clarifies the reason.
Among other things, McCurry argues that the medical establishment created the opioid epidemic and the peanut allergy epidemic. Tens of thousands of women die prematurely due to misinformed data about the risks of hormone replacement therapy. The US government has banned silicone breast implants for 14 years without any evidence they cause harm. Overuse of antibiotics by doctors is likely causing untold suffering. Doctors still tell overweight people to eat low-fat diets, even though low-fat diets are associated with obesity and diabetes.
“Much of what the public is told about health is medical dogma – ideas and practices that have been given incontrovertible authority because someone has decided based on intuition that they are true.” writes McCurry.
Macari’s claims are supported by hundreds of footnotes in each indictment, but that doesn’t mean all doctors and researchers agree. One example: The research team analyzed 13 studies comparing antibiotics and appendectomy and found that nearly one-third of patients initially treated with antibiotics underwent appendectomy within a year. It turned out that there was. The remaining two-thirds did not, but the researchers said the evidence that antibiotics were better was “very uncertain”. So surgeons who choose surgery right away aren’t necessarily doing anything wrong.
McCurry is one of medicine’s most prolific iconoclasts, poking fun at American society. medical system At least since 1998, when I was a medical student. article A call for hospitals, medical schools and health insurance companies to divest their tobacco stocks has been published in the prestigious Journal of the American Medical Association.
Years later, ignoring criticism from colleagues, McCurry created a checklist to improve surgical safety. After safe surgical checklists were proven to reduce surgical errors and deaths, they are now used in most operating rooms around the world. His 2012 book “without accountability;” demanded that the hospital reveal its infection rate and medical errors. A few years later, Medicare began requiring public reporting of these and other indicators of quality of care. His 2019 book “the price we pay,” documented hospital price gouging practices and required all hospitals to post cash prices for certain services (now required by law).
In both cases, Mr. McCurry cannot claim to be solely responsible for influencing these major changes, but he did have one of the biggest megaphones. Both of these books, as well as “Blind Spot,” became New York Times bestsellers.
A thread running through Macari’s statements is that the American health care system is wrong in many ways. “Blindspot” focuses on the failures of “medical institutions.” Although McCurry does not clearly define the term, he mentions it more than 40 times, almost always in a pejorative context.
He accuses medical journals, government agencies, and professional societies of doing harm to those who trust them. He did not call medical institutions nefarious. Rather, he accused them of frequently adopting the theory that stress causes ulcers without evidence, ignoring scientific findings that support that idea, and criticizing those who question their position. There is.
For example, medical journals are a major way for doctors to learn about new scientific knowledge that helps inform the care they provide. Most journals use a peer review process. This means that your paper will only be accepted for publication if a panel of experts determines that it is accurate and of high quality.
McCurry has written more than 250 peer-reviewed articles in medical journals, but he is not a fan of the genre. In his view, editorial boards, the gatekeepers of peer-reviewed publishing, “tend to be made up of like-minded friends.”
“I am shocked that a study so flawed that its results are invalidated can be published in a prestigious medical journal and supported as scientific evidence, but instead only supports a groupthink narrative. I received it,” he wrote.
Are the results invalid? Inconsistent and fraudulent data published in medical journals are commonplace, with more than 10,000 papers being retracted in 2023 alone. Earlier this year, Dana-Farber Cancer Institute retracted seven published papers and revised 31 others due to errors or errors. suspicion of processed image.
The National Institutes of Health, the world’s largest public funder of biomedical research, has also lost some of its luster under Mr. McCurry’s gaze. In particular, he slammed the institution for its 2002 decision to halt a clinical trial on the long-term effects of hormone replacement therapy, citing an increased risk of breast cancer based on bad science. McCurry vigorously defends the therapy’s many benefits, citing estimates that about 140,000 women died prematurely over 20 years because they didn’t take advantage of hormone replacement therapy. “The message that HRT causes breast cancer persists,” he writes. “And that message is believed by most doctors to this day.”
Medical societies that provide guidance to doctors and the public have also criticized Mr. McCurry. For example, the American Heart Association promoted a low-fat diet for 60 years, despite a lack of evidence that fat causes heart disease. The American Academy of Pediatrics’ unsubstantiated recommendation to avoid peanuts in children under 3 has fueled the peanut allergy epidemic in the United States. Consuming peanuts early in life actually reduces the risk of allergies. The American Medical Association supports what McCurry sees as government censorship of health information.
Makary’s criticism of the entire medical establishment is reminiscent of oncologist Vinay Prasad’s criticism of cancer treatment.Malignancy: How bad policy and bad evidence harm cancer patientsThe similarities in the authors’ intuitive approaches are no coincidence. In his acknowledgments, Makari calls Prasad a “great teacher.”
McCurry’s writing style makes it easy for the general reader to understand how he identifies “blind spots”, travels around the country collecting information about its history, and digs into research studies to collect data points. His many digressions and digressions – readers read long and bloody accounts of sailors’ scurvy symptoms, learn that President John Adams defended British soldiers in court, and learn that VIP patients have become a nuisance. Knowing what you’re getting may feel uncomfortable at first. But his enthusiasm for his subject matter is contagious, with the book peppered with surprises and wonders.
That said, because he includes so many calls for action, his primary audience seems to be doctors, especially those who he considers to be part of the medical establishment. In particular, they are demanding an apology from the government agencies and medical societies that gave them inappropriate advice. He would like to see funding for a repeat study to confirm the findings. He wants the American medical education system to stop promoting “outdated groupthink.”
What he most often calls for is a call for civil debate, where questioners can question medical consensus without being dismissed or belittled. Mr. McCurry’s harsh opinions and hyperbolic derision of the medical establishment may antagonize those he seeks to influence, but his track record of promoting change cannot be ignored.
So perhaps readers can expect his vision to look something like this: “Open discussion and discussion of the benefits of data over dogmatism will lead to stronger societies, more civility, and faster medical discoveries.”
