Usually, going against the general consensus is a huge red flag. Sometimes I will hear of a doctor telling a patient something like this: "Most doctors don't agree with this treatment. That's because they don't understand these problems the way I do. I can tell you from my experience that this treatment really works."
If you hear a statement like this, run, don't walk, to the nearest exit. You see, in medicine, we do not determine truth by looking subjectively at our own experience. We determine what works by prospective, double-blind, randomized, placebo controlled trials. When I try a treatment, I really want it to work, so I will tend to exaggerate the success. And when something does not go so well, I will not want to remember that bad experience, so I will minimize my failure. (Chapter 5 of Navigating the Medical Maze covers this issue in detail.)
If a doctor has a unique treatment that they believe in, they should subject it to proper scientific study, because if they do and prove its effectiveness, everyone will use it. The only reasons not to do proper study would be either that I am greedy, or that I am a charlatan.
The valid reasons for offering a non-consensus treatment would include 1. The uniqueness of your particular problem; 2. Newer treatments that have only limited availability. (Typically these treatments will also have limited evidence of success. However, if you happen to be at a center that specializes in your problem, the new approach may be reasonable.) 3. The lack of effectiveness for you personally of the usual treatments for your condition.
The bottom line is that non-consensus recommendations are usually a good reason to get a second opinion.
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That's a great question.
Usually, going against the general consensus is a huge red flag. Sometimes I will hear of a doctor telling a patient something like this: "Most doctors don't agree with this treatment. That's because they don't understand these problems the way I do. I can tell you from my experience that this treatment really works."
If you hear a statement like this, run, don't walk, to the nearest exit. You see, in medicine, we do not determine truth by looking subjectively at our own experience. We determine what works by prospective, double-blind, randomized, placebo controlled trials. When I try a treatment, I really want it to work, so I will tend to exaggerate the success. And when something does not go so well, I will not want to remember that bad experience, so I will minimize my failure. (Chapter 5 of Navigating the Medical Maze covers this issue in detail.)
If a doctor has a unique treatment that they believe in, they should subject it to proper scientific study, because if they do and prove its effectiveness, everyone will use it. The only reasons not to do proper study would be either that I am greedy, or that I am a charlatan.
The valid reasons for offering a non-consensus treatment would include 1. The uniqueness of your particular problem; 2. Newer treatments that have only limited availability. (Typically these treatments will also have limited evidence of success. However, if you happen to be at a center that specializes in your problem, the new approach may be reasonable.) 3. The lack of effectiveness for you personally of the usual treatments for your condition.
The bottom line is that non-consensus recommendations are usually a good reason to get a second opinion.
Hope this helps!
May 21, 2008 - 5:08pmThis Comment
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