Medicine as a pseudoscience

I’ve mentioned before that Western medicine was, on the whole, useless for more than two thousand years after Hippocrates. A malignant pseudoscience, really, worse then useless. I’ve seen some suggest that I must be wrong, that medicine can’t have been that bad – but it was. Name your syndrome – the odds are very high that they couldn’t do anything for it. Worse yet, they’d try anyhow. It wasn’t just knowing nothing: they knew things that weren’t so. Sheesh, I didn’t think Harvard went that far back….

The idea that venesection was a good thing, or at least not so bad, on the grounds that one in a few hundred people have hemochromatosis (in Northern Europe) reminds me of the people who don’t wear a seatbelt, since it would keep them from being thrown out of their convertible into a waiting haystack, complete with nubile farmer’s daughter. Daughters. It could happen. But it’s not the way to bet.

Back in the good old days, Charles II, age 53, had a fit one Sunday evening, while fondling two of his mistresses.

Monday they bled him (cupping and scarifying) of eight ounces of blood. Followed by an antimony emetic, vitriol in peony water, purgative pills, and a clyster. Followed by another clyster after two hours. Then syrup of blackthorn, more antimony, and rock salt. Next, more laxatives, white hellebore root up the nostrils. Powdered cowslip flowers. More purgatives. Then Spanish Fly. They shaved his head and stuck blistering plasters all over it, plastered the soles of his feet with tar and pigeon-dung, then said good-night.

Tuesday. ten more ounces of blood, a gargle of elm in syrup of mallow, and a julep of black cherry, peony, crushed pearls, and white sugar candy.

Wednesday. Things looked good:: only senna pods infused in spring water, along with white wine and nutmeg.

Thursday. More fits. They gave him a spirituous draft made from the skull of a man who had died a violent death. Peruvian bark, repeatedly, interspersed with more human skull. Didn’t work.

Friday. The king was worse. He tells them not to let poor Nelly starve. They try the Oriental Bezoar Stone, and more bleeding. Dies at noon.

Most people didn’t suffer this kind of problem with doctors, since they never saw one. Charles had six. Now Bach and Handel saw the same eye surgeon, John Taylor – who blinded both of them. Not everyone can put that on his resume!

You may wonder how medicine continued to exist, if it had a negative effect, on the whole. There’s always the placebo effect – at least there would be, if it existed. Any real placebo effect is very small: I’d guess exactly zero. But there is regression to the mean. You see the doctor when you’re feeling worse than average – and afterwards, if he doesn’t kill you outright, you’re likely to feel better. Which would have happened whether you’d seen him or not, but they didn’t often do RCTs back in the day – I think James Lind was the first (1747).

Back in the late 19th century, Christian Scientists did better than others when sick, because they didn’t believe in medicine. For reasons I think mistaken, because Mary Baker Eddy rejected the reality of the entire material world, but hey, it worked. Parenthetically, what triggered all that New Age nonsense in 19th century New England? Hash?

This did not change until fairly recently. Sometime in the early 20th medicine, clinical medicine, what doctors do, hit break-even. Now we can’t do without it. I wonder if there are, or will be, other examples of such a pile of crap turning (mostly) into a real science.

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68 Responses to Medicine as a pseudoscience

  1. I think that Dr. Anthony Daniels (Theodore Dalrymple) once wrote that the ill did not improve their chances by consulting a physician until the 1930s — can’t state the reference. Don’t think he wrote that the ill usually worsened their chances, though. Recommend “The Madness of King George” — an amusing flick.

  2. Polynices says:

    I’ve long been astounded that medicine could be so damn useless for so damn long and still get paid any attention to. I think the surgeon/dentist/barber types managed a few helpful actions but they were scorned by the physicians as inferiors. Funny, that.

    • r321 says:

      Medicine is valued as a medium of care, a way of demonstrating love, and thus making people feel better emotionally. That’s why homeopathy is paid attention to today (and psychotherapy etc). Calculating physiological efficacy just doesn’t come into it, and in practice (nearly) all of us still take medical science on trust.

      • peppermint says:

        (also, it’s useful to kill people quickly when they have in incurable illness rather than let them waste away for years becoming increasingly useless, especially if they have crucial duties to attend to like being king)

  3. dearieme says:

    I suspect your question might be whether Social Science will ever become a branch of Science. It’s not the way to bet. As usual, “Social” is an adjective that means “anti”.

  4. I think Mary Baker rejected medicine for the more mundane reason that she’d been chronically ill as a kid, her mother kept subjecting her to doctors aka quacks, and eventually she figured out that she felt better when the doctors weren’t around than when they were.

  5. Great post, and suitable for an entire film. I think medicine lasted because their stories were so good: the skull of a man who had died a violent death; plant roots that looked like body parts; things dug up by moonlight….. Medicine was the first Hollywood. Social science a poor second.

  6. Wency says:

    Is it possible that home remedies, of the sort applied by a peasant grandmother, were net beneficial, even if the remedies of “experts” were not?

    It is often remarked that people have long known of the antimicrobial properties of honey and moldy bread (poor man’s penicillin). As well as various herbs that might have some slight positive effect. Likewise, you don’t hear about these same peasant grandmothers bleeding people (“hemochromatosis” — good word). It would seem to be a basic human (or animal) intuition that losing blood is bad, the kind of intuition that only a certain level of “education” could override, and I might think that peasants would be less susceptible to it unless persuaded convincingly by a man of letters.

    But maybe the peasants also had a range of counterproductive remedies that we just don’t hear about. Maybe they applied everything in the kitchen pantry to an infected wound, and sometimes, by sheer luck, this happened to be honey or moldy bread, and that’s the remarkable part that is written about.

  7. Greying Wanderer says:

    “The idea that venesection was a good thing, or at least not so bad, on the grounds that one in a few hundred people have hemochromatosis (in Northern Europe) reminds me..”

    I was thinking more that may have been a way it caught on (seems too old in the wrong region though). Some guy with an illness connected to hemochromatosis gets wounded in a battle, loses blood and ends up cured of the ailment when healed up, someone notices and makes the connection.

  8. Anonymous says:

    A few surgical methods were probably more useful than doing nothing. There were some ailments (such as infected tissue or tumours) that were easy for somebody to cut out and then sew up without killing the person for the most part. To be honest though if I was feeling dodgy back in the middle ages I’d place more trust in a peasants herbal soup mixture than a doctor. The traditional medicines (for the most part anyways) were largely harmless or weak, probably because the peasantry preferred stuff that didn’t kill them.

  9. Anonymous says:

    Alchemy turned into a real science but not astrology. The post-modern aspects of philosophy make Medieval Scholastics seem quite rational in ccomparison. At this point I suspect that stuff like sociology has still a while to go before reaching peak lunacy.

  10. Anonymous says:

    “nubile farmer’s daughter”. Is it the farmer or his daughter who are nubile? Makes a difference.

  11. Joseph says:

    Medicine still has incredibly positive propoganda, despite constant iatrogenesis-including my mother. If you have ever been to a doctor with a malady that isn’t textbook, you get an interesting picture as to how the system works. Still it is improving on the whole. Mainly by helping the elderly live longer.

  12. Jerome says:

    “This did not change until fairly recently. Sometime in the early 20th medicine, clinical medicine, what doctors do, hit break-even.”

    You think so? Take away the antibiotics and I’m not so sure.

    The sad reality is, that there are always things that cannot be fixed, that we would like to have fixed. And there are always people who claim they can fix them. And there are always people who believe them. Often they believe themselves.

    Think psychiatry. Astrologers with a prescription blank.

    • Tom Bri says:

      Take away antibiotics and a lot of what we do could no longer be done. Many surgeries, obviously, but also the whole concept of the giant hospital where you concentrate every acutely sick person in the city. I’d like to see people with infectious diseases separated from other patients.
      But your point, that other than antibiotics there hasn’t been much improvement, is I believe false. Given that antibiotics still work, there are lots of surgeries, cancer cures, heart treatments that do work well.

      • Douglas Knight says:

        Cancer and heart disease are terrible examples. There are cures for a few specific cancers, but most treatments are probably net negative. The death rates (per population, not per diagnosis!) for most cancers hasn’t changed in a century. Heart disease is a less clear example. It has plummeted over the past half century. But how much of that is due to medicine? There are so many causes vying for credit. I think that nutrition and pollution explain the bulk. Smoking, some. Blood pressure drugs and statins probably do something, but small in historical terms. When a disease abruptly disappears, you can be pretty sure about what worked. Lewis Thomas talks about this. Of course, most of his examples are antibiotics (but that really is plural, not just penicillin). Other examples: micronutrients, hormones, vaccination. Dearieme’s examples are great.

    • dearieme says:

      Insulin and steroids have proved great boons. James LeFanu’s book “The Rise And Fall Of Modern Medicine” is by far the best discussion of this that I’ve ever seen.

    • albatross says:

      Asthma and anaphylaxis treatments work pretty well. Insulin and blood sugar testing does, too. Joint replacements. Modern dentistry works. Vaccines work. And so on.

      • Alice says:

        Works at what?

        I see a dentist once every seven years and nothing is wrong with my teeth on those occasions..

        Children have peanut allergies at unheard of rates, quite possibly because the idiotic obstetricians told their mothers not to eat peanut butter while gestating.

        Children have ADHD at unheard of rates, too, seemingly because the school system hates boys. But hey, they’re medicated, and that’s what’s good, right?

        We test blood sugar now, yes, but we have no idea what causes diabetes and apparently have instead created an entire medical system to browbeat people for being overweight on the utterly unsubstantiated belief the arrow of causation is from their giving into a desire for sweets to the disease. Newsflash: it more than likely goes the other way. And infections in the pancreas might cause the disease in the first place. Antibiotics wiping out diabetes? No modern drug company sells that, so docs don’t investigate.

        The norovirus and rotavuris vaccine are true improvements. But the rest are self induced problems with “cures” that require more medical systems. Make work.

        • Vesi says:

          If you have perfect teeth, good for you. Some of us are not as lucky.
          100 years ago, if I had a caries, I would have to wait till it progresses and remove the tooth.
          A progress of medicine is manifested by the fact, that once the child mortality was near 50%, and now it has definitely dropped. The mothers now have better chances of surviving, too.
          Rh disease is almost forgotten and blood transfusion is relatively safe.

  13. Leonard says:

    There’s always the placebo effect – at least there would be, if it existed.

    The placebo effect does exist. Or, at least that’s what modern medicine has found. Sure, it’s not gonna set a bone or cure cancer — it’s all in your brain. But tricking your brain into releasing extra opiates is nice when you’re hurting.

    This is not to say that pre-modern medicine was any good; as you say, it was surprisingly awful. But I think that the reality of placebo effects is a significant part of the explanation of how it got to be so bad.

  14. Dale says:

    Some device for simulating action, when action is impossible, is indispensable in a sound and functioning democracy. — John Kenneth Galbraith “The Great Crash of 1929”

    I read somewhere “What patients want, as demonstrated by a thousand surveys, is to be treated with respect and deference.” The Boston hospital market shows the power of brands — the big-name hospitals charge considerably more and give no better results than the local hospitals. The local paper makes it clear that there’s a strong desire for “hope”, that the doctors can apply some “Hail Mary” experimental treatment so that you don’t have to face up to the certainty of your imminent demise. In malpractice law, it’s well-known that the penalties for a doctor acting and having it turn out badly are less than the penalties for not acting and having it turn out badly.

    So I’d say that what doctors have provided historically has little to do with actually improving health, but has nonetheless been desired by the market.

  15. Karl says:

    Didn’t the Romans have some reasonable treatment for wounds, like setting broken bones and bandaging wounds? If medicine was actually a help for the wounded, that would explain why people consulted physicians in the case of disease as well.

    • Boris Bartlog says:

      Charles II must have had a fairly strong constitution just to make it as far as Friday. President Garfield held out longer but his doctors eventually did him in, too.

      The net-negative effect of medical treatment up through the 1930s or so should be taken as a symptom of a poor decision-making process, though, rather than as evidence of a complete lack of effective treatments. Some surgeries worked or could work, we had a few opiates and anesthetics and topical disinfectants. It’s just that we didn’t have the wisdom to apply only those (conservatively) and dispense with all the other nonsense.

      • Jim says:

        Anesthetics and anti-septics started in the mid 19th century. That allowed some operations like removing gallstones to be done with some degree of success. Also knowledge of germs reduced the death rate from childbirth.

    • jamesd127 says:

      Jesus was a faith healer, but seems to have focused on casting out demons, faith healing mental illness, an area where we know faith is highly effective. His prescription for wounds resulting from violence was wine, oil, and bandages. Wine is antiseptic, and oil and bandages protect the wounds from further sepsis.

      Clearly considerably better than nineteenth century medicine, or for that matter early twentieth century medicine.

  16. Very few history books give you a feel for just how radically different life was not that very long ago. It is too big a topic. Pre 1900 cities around the world were population sinks that would have shrunk to nothing except they were constantly repopulated by the landless and unemployed people from the surrounding countryside.

    How did this alter human evolution? Obviously evolution gave top priority to any genetic advantage to disease resistance under these circumstances. But what about higher intelligence? The book A Farewell to Alms by Gregory Clark certainly leads you to believe that was the case. Cities were hell holes before the industrial revolution took full effect. Being poor and eking out a living on a near starvation diet didn’t kill you but these were the very people that died by getting sick while their middle class counterparts pulled through because of better care. Better care simply being a warm bed and food being brought to them until they felt better. This by itself could and would drive evolution but then we add to this push that 50% of the children died before age ten with a far higher percentage of poor kids dying than children of well to do parents. And so with enough centuries the urban population of countries like England were transformed from landless rubes forced to live in the city into a nation of shopkeepers.

    Or so a few folks argue. But by and large they are told to shut up because if you believe in recent human evolution then you must also believe in some form of scientific racism. Obviously if populations changed recently then they can be different.

    But all the talk is simply talk until a device is created which allows scientific confirmation one way or the other. Old bones hold their DNA for quite some time and the genetic architecture of human intelligence will be decoded certainly this century and probably within decades, maybe sooner. This will allow us to look directly at how populations changed through time and are different today.

  17. Patrick Boyle says:

    You forgot when enumerating all those horrors to mention that Charles II was called the ‘Merry Monarch’. Not so merry in his last days. Didn’t we have a similar discussion here about George Washington’s death by doctor. Wealth and position were a deadly combination it seems.

    Are these morbid musings of yours related to your recent medical problems? I’m sure you are a very bad patient. There should be a study. I’ll bet ‘bad patients’ live longer that those who are completely accepting of all medical advice.

    The days when the best doctors available gave out bad advice are hardly over. My doctor is a smart fellow but I find it necessary to deceive him on certain matters. I stopped arguing with him about certain drugs. Now If I don’t want to take a certain pill I just let them ship it to me and I toss it in the toilet. Deceiving your doctor may be good for your physical health or not, but it certainly does wonders for your morale.

  18. Xenophon Hendrix says:

    I’d really like to hear more about why you believe the placebo effect doesn’t exist.

    • gcochran9 says:

      “Statistical regression to the mean predicts that patients selected for abnormalcy will, on the average, tend to improve. We argue that most improvements attributed to the placebo effect are actually instances of statistical regression. First, whereas older clinical trials susceptible to regression resulted in a marked improvement in placebo-treated patients, in a modern series of clinical trials whose design tended to protect against regression, we found no significant improvement (median change 0.3 per cent, p greater than 0.05) in placebo-treated patients. Secondly, regression can yield sizeable improvements, even among biochemical tests. Among a series of 15 biochemical tests, theoretical estimates of the improvement due to regression by selection of patients as high abnormals (i.e. 3 standard deviations above the mean) ranged from 2.5 per cent for serum sodium to 26 per cent for serum lactate dehydrogenase (median 10 per cent); empirical estimates ranged from 3.8 per cent for serum chloride to 37.3 per cent for serum phosphorus (median 9.5 per cent). Thus, we urge caution in interpreting patient improvements as causal effects of our actions and should avoid the conceit of assuming that our personal presence has strong healing powers.”

      • Which is why a slick bullshitter who is nothing more than glib witch doctor was rewarded more often with high status rather than to join the patients he had just ushered to an early grave.

      • Leonard says:

        No doubt that regression is part of the explanation. However, a lot of placebo research has happened since 1983. Even back then, they knew that the placebo effect was partially blocked by an opioid antagonist. (I.e., “real”.) Today researchers have seen placebo effects in brain MRIs.

        Not to mention millions of believers spending money on acupuncture and other such snake oil “alternative medicine”. They’re getting something from that exchange, and they will tell you it’s pain relief. Occam’s razor suggests that it is. You can believe that while at the same time thinking “qi” is ludicrous.

      • Xenophon Hendrix says:

        OK, I suspect we are thinking about two different things. Placebo apparently doesn’t help a person get better any faster, but the perception of receiving treatment along with its accompanying psychological suggestion perhaps helps people [i]feel[/i] better while they are waiting to regress to the mean.

  19. Ursiform says:

    Rasputin gained favor with Tsaritsa Alexandra by chasing away the doctors who were killing the Tsesarevich Alexis. History was, perhaps, changed.

    • Jim says:

      He also tried to use his influence to urge the Tsar to avoid getting into a war with Germany and Austria. He did this out of self-interest because he knew that a war would weaken his influence and cut off his lucrative influence peddling. But it was still probably one of the best pieces of advice any ruler ever received, even thousgh Rasputin was a total scoundrel.

      • ursiform says:

        Yes, but Rasputin gained much of the influence he had by keeping the Tsesarevich’s many doctors from killing him. I don’t think anyone beyond Alexandra and some other women he seduced believed he was doing anything good.

  20. Bob says:

    What about hypnosis?

  21. Greying Wanderer says:

    An interesting aspect of these posts slagging medicine is they show how a lot of ppl (including me) want it to be effective.

    • gcochran9 says:

      I would like medicine to be effective now, and more so in the future, but there’s not much point in wanting it to have been effective in the past if it wasn’t.

  22. Henk says:

    Hastening the demise of ailing rulers may have been a feature, not a bug, of pre-modern “medicine.”

    Hierarchy is a nice organizational principle, but the man at the top is also a critical single point of failure. He should be either at the top of his game, or out of the game.

    Subjecting to the ministrations of “doctors” might slot in besides traditions such as getting challenged to a fight over the top spot (before “doctors”), or mandatory retirement age (after “doctors” ceased to be useful… for this purpose.)

  23. dearieme says:

    I was once given a bracelet by a friend of my wife’s. I had understood that it was meant to help with arthritis in the hand. “Bollocks” I thought. But I wore it a few times and began to suspect that it might be helping.

    Only afterwards did I discover that it wasn’t meant to help with arthritis at all, but to impart some beneficial oriental woo.

    So even sceptics are suggestible. A bit.

  24. Anonymous says:

    Romans/Egyptians has some clever medical practices/disease prevention. Halachic rules kept some of this going. The question is why did the Byzantines let it all go? Presumably Classical Era medical advances were lost in some purge or just vanished, like Greek Fire.

  25. Antipsychotic medications can be dramatically effective very quickly. The side effects can be a problem. They don’t do nearly as well if the brain has been injured. Other psychiatric medications, such as mood stabilisers, can be nearly as dramatic. ECT’s even more for mood disorders – though significantly, that was discovered by accident, as many treatments are. Antidepressants are a mixed bag – work well for some, not for others, work best in conjunction with other treatments. Ditto anti-anxiety agents.

  26. silberstreak says:

    Too bad for Charles he lived before Obamacare, which appears to cover the kinds of treatment he received.

  27. Anchises says:

    “You may wonder how medicine continued to exist, if it had a negative effect, on the whole.”

    The extreme pain associated with heroic medicine convinced patients that the treatment must be having some kind of effect- “It really hurts! That clearly mean’s it’s working!” After all, why would any sane doctor subject someone to an agonizing procedure if it weren’t known to be highly effective? It’s a bit like the way cults and political movements inspire intense devotion by demanding long hours and self-sacrifice from devotees. President Andrew Jackson was particularly fond of heroic medicine- the more excruciating, the better, as far as he was concerned.

    “Parenthetically, what triggered all that New Age nonsense in 19th century New England? Hash?”

    The intellectual decay and institutional break-down of Calvinism. New England was founded on intense religious passions wedded to a very particular all-encompassing doctrine. When that doctrine ceased to be widely believed, all that religious passion ran around wildly looking for a new set of beliefs to which it could be attached. For a while it looked like Unitarianism would prove a serviceable replacement, but that really just paved the way for further wackiness.

  28. CL says:

    Here’s a paper describing the death of George Washington:

    Click to access time.pdf

    And here’s a summary of the medical attention that preceeded his death:

    “The exact quantity of blood removed from the ailing President can be derived at as follows:

    12-14 ounces Mr Albin Rawlins
    20 ounces Dr James Craik
    20 ounces Dr James Craik
    40 ounces Dr James Craik
    32 ounces Dr Elisha Cullen Dick

    The total quantity of blood taken amounted to 124- 126 ounces or 3.75 liters, drawn over a period of nine to ten hours on Saturday, December 14, 1799.

    General Washington was a physically impressive man measuring 6 feet 3 inches in height and weighing 230 pounds. Because adult blood volume is 70 ml/kg, one can estimate the blood volume of President Washington at seven liters. The extraction of more than half of his blood volume within a short period of time inevitably led to preterminal anemia, hypovolemia, and hypotension. The fact that General Washington stopped struggling and appeared physically calm shortly before his death may have been due to profound hypotension and shock.”

  29. Cloudswrest says:

    As to “ancient” medical practices that DIDN’T work, how about “low fat diet.” LOL.

  30. Rico says:

    The assumption that medicine really started to become effective in the 1930s or so is, as they say, “problematic.”

    It’s largely the same old medicine, and it works the same as it always did. Not too well.

    A few other things have changed, though.

    1) People stopped drinking so much sewage water
    2) Hygiene improved
    3) Nutrition improved

    Therefore, child mortality declined and longevity increased.

    Attributing these benefits to “medicine” is pretty unscientific.

    In addition, modern medicine is one of the great killers. Roughly 250,000 people per year die from a combination of hospital accidents, hospital infections, and pharma toxicity (overdoses, bad drug combinations, etc.) 250,000 people per year is HUGE. The entire Vietnam War killed 50,000 American soldiers over 10 years. So we absolutely cannot take it as a given that “medicine finally works well in spite of a poor track record in its first 5 centuries.”

    We should also be mindful of the fact that modern medicine is a huge RACKET in the U.S. Americans pay on average 4 or 5 times higher prices for medical treatment than citizens of other developed countries. Health expenses are 20% of GDP in the U.S. vs. 4-5% in all other advanced democracies.

    (The incorrect conventional wisdom is that this is due to “impressive” U.S. medical technology. Not so. U.S. medical technology is deployed globally, they just charge less for it everywhere but here. The high U.S. costs are the result of successful lobbying by the health care industry (docs, big pharma, HMOs, insurance, etc) to exempt health care from anti-trust law. So they can charge whatever they want, charge different prices to different people, restrict competition, etc. etc. And the results are clear. The cost of, say, putting a cast on a broken arm has increased in the US 10X more than inflation with no change in the technology or the procedure.)

    The point of the above paragraph is that medicine became a HUGE moneymaker over the last 80 years in a way that it had not been before. And lo and behold, suddenly we were GIVEN the impression that medicine finally worked! Amazingly well!

    What else has changed since the 1930s?

    1) Public relations, marketing, and propaganda have become increasingly sophisticated, increasingly effective, and increasingly USED by the health care industry and the government.

    2) The government has gotten much bigger and more powerful. 110 years ago, there were no income taxes and the government was tiny. Today it is huge, all-powerful, and dominates the economy, especially in areas like health care. And this huge, powerful government is easily influenced by lobbyists. To the benefit of the health care “industry” and to the detriment of the American people who have to pay 5X more than the Brits, French, Germans, Japanese, Canadians, etc. for the identical medical care, drugs, etc.

    We have been SOLD the idea that modern medicine is now, finally, really really effective! But:
    – many of its claims are untested. (How effective is chemotherapy? How do psychiatric drugs cure “chemical imbalances” and why can’t these “chemical imbalances” be found? Etc.)
    – And 250,000 of its patients per year end up dead due to hospital infections, mistakes, and drugs.
    – And many of its improvements are not improvements vs. the state of nature, but slightly reduced HARM from the medical industry itself. (For example, death during childbirth dropped when the doctors learned to wash their hands between autopsies and births. But that’s not evidence of the OB/GYN specialty improving on midwifery or ancient childbirth practices, that’s evidence of the OB/GYN specialty itself being less destructive than it used to be.)

    The belief that modern medicine is effective is just that, a belief. Billions of dollars have been spent, and sophisticated persuasion techniques have been deployed, to GIVE us that belief.

    And by the way, it’s not necessarily some big conspiracy. A lot of this is just individuals working in their own self interest. Businesspeople and medical people marketing services. Politicians raising money and doling out favors to industry.

    When 1 in every 5 dollars in the entire economy is spent on health care, you can be sure that it PAYS for the industry to influence our beliefs about it. We think we are rational, we think what we know about health care comes from impartial scientific studies. But a lot of what we think we know…just ain’t so.

    We laugh now at “bleeding the patient” but someday we’ll look back at putting patients on 10 different drugs simultaneously and see it as similarly out of touch with real healing.

    What do you think?

    • gcochran9 says:

      I think your numbers are shit. Medical expenses are about 17.1% of GDP in the US, 10.9% in Canada, 9.1% in the UK, 10.9% in France. In no advanced country are they 4-5%.

      Your iatrogenic numbers are also wrong, by a favor of two or somewhat more.

      We have real problems with a spectacularly inefficient medical system in the US, and with medical mistakes – but starting the discussion with a flurry of falsehoods does not help.

      Go away.

      • Douglas Knight says:

        Singapore only crossed 4% in 2012. Though that might reflect the age structure.

      • Rico says:

        Sorry for using bad numbers. I should have checked them more carefully before posting. I overstated U.S. spending and I significantly understated spending in Canada, UK, France, etc. Anyway, I apologize for introducing bad numbers. I agree that it is unhelpful.

        I would still be curious about one question, though. (And then I promise to go away.)

        How do we know that modern medicine has flipped from a net negative to a net positive? “Now we can’t do without it. …a pile of crap turn[ed] (mostly) into a real science.”

        Isn’t it possible that this perception of ours is influenced by effective (and well-funded) marketing and by comparisons to the incredibly low bar of modern medicine 150 years ago instead of to a real control group?

        And isn’t it possible that each generation felt the same way we do: “Medicine used to be destructive but now it’s finally good.” If each generation felt that way, it would explain how this pile of crap kept lasting even back when it was (to our eyes) much more obviously destructive.

        I would be grateful for any thoughts you might have on this. I promise I won’t respond–no more annoying posts from me! 🙂

  31. John Galt says:

    Funny thing. In the 1920s, as doctors stopped inflicting medical “cures” that had almost never worked, politicians developed a following for government “cures” that had almost never worked (and ended up killing far more people than doctors ever did).

  32. Cloudswrest says:

    From Twitter:

    Andrew Sabisky ‏@AndrewSabisky 50m50 minutes ago
    Israeli funeral directors report decreased mortality during medical strikes cc @roreiy @declamare … #toomuchhealthcare

    Andrew Sabisky @AndrewSabisky … via @Mangan150, more evidence that doctors’s strikes are beneficial for public health

    • Father Jacques says:

      Troubling that gcochran didn’t address the commenters’ points that maybe Westen Medicine is STILL notso hotso. Drug toxicity is a thing. Chemo. AZT. HPV vaccines. Doctors would rather perform bariatric surgery than recommend a diet lower in processed carbs. Why no answers to Cloudswrest, Galt, Rico, Doug Knight, and others? It’s Cochran’s blog and he can do what he wants, obvi, but the posters suggest an answer to his question….how did a destructive practice become amazing from its initial destructive foundations? Um, maybe it didn’t?

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  35. dlr says:

    Surgery — setting bones, removing cataracts, etc– were effective techniques long before the 20th century.

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