“When you visit a doctor, you probably assume the treatment you receive is backed by evidence from medical research. Surely, the drug you’re prescribed or the surgery you’ll undergo wouldn’t be so common if it didn’t work, right?
“LOL” is what The Atlantic writer David Epstein and ProPublica might have preferred to have written after this paragraph in their column about the gap between health research and “evidence-based” medicine. They share what happens to patients who receive unnecessary procedures, and crack open the system behind the mess.
It turns out that some prescription and treatment protocols are not evidence-based, even when they could be. Medics prioritize tradition rather than effectiveness, and the regulatory system doesn’t help them change.
A few weeks ago, I read a line from Roman Catholic essayist G.K. Chesterton: “Tradition,” he wrote, “is only democracy extended through time… It means giving votes to the most obscure of all classes, our ancestors. It is the democracy of the dead. Tradition refuses to submit to the small and arrogant oligarchy of those who merely happen to be walking about.”
Like religious people who shape a common tradition by passing stories, practices, and lenses across generations, scientists come to share a consensus of interpretations and inferences through the disciplines of repeating and confirming previous experiments and peer-reviewing the findings. This is a kind of tradition: as Epstein demonstrates, it’s the ideal medical researchers sometimes fall short of.
Like Chesterton, I can see tradition as admirable. Thanks to the ideals of science and the kind of journalism that calls it out, I’ve also learned to require that traditions be beneficial as well as long-lasting.
That’s the expectation the writers of the Atlantic/Pro-Publica article have about contemporary medicine. Read the article and share your thoughts about it with me on Twitter.