Think twice before you accept your doctor's advice

Canadians are often proud of their public Medicare system as compared to the U.S. by citing that the average longevity is higher here than down south. However, I often hold the view that we live longer because we do not get the Medicare our neighbours get due to rationing. So it is like a forced clinical inertia. I had not gone to a clinic for 8 years until last year. The clinical experience of last year was so bad, I will probably forgo another 8 years.

It is good to see that I was not alone. The NYtimes has published an article titled when doing nothing is best medicine. In this article, Doctor Danielle Ofri quoted an essay published in The Journal of the American Medical Association called “Clinical Inertia as a Clinical Safeguard”. The authors postulated that doctors who tend toward inertia might actually benefit their patients by protecting them from overzealous medical intervention.

They focused on three common medical conditions — diabetes, elevated cholesterol and hypertension — for which there are established clinical guidelines for doctors to follow and “quality measures” that evaluate medical care. For all three illnesses, “lower is better” is the dominant mantra.

But while “lower is better” is probably true for large populations, that is not always the case for individual patients. In fact, there are some clinical trials in which aggressively lowered blood sugar or blood pressure has been associated with higher rates of dying.

One of my brothers is a doctor. He says that medicine today is still only 20% science and 80% art. However, most doctors come off as if they think medicine is 100% science. If you have symptom, we must find it and treat it. Of course, every “thing” a doctor does also has side effects.

Unfortunately, every action we do towards health, such as changing diet, choosing exercise programs or deciding whether to take supplements or not, we are all advised to consult our physicians before hand. I guess we should just forgo this advice?