Science-based Longevity Medicine

Much nonsense has been written in the guise of longevity medicine. In Fantastic Voyage, Ray Kurzweil explains why he takes 250 pills every day and spends one day a week at a clinic getting IV vitamins, chelation, and acupuncture. He is convinced this regimen will keep him alive long enough for science to figure out

Playing by the Rules

It is useless for skeptics to argue with someone who doesn’t play by the rules of science and reason. If no amount of evidence will change your opponent’s mind, you are wasting your breath. I recently read Flock of Dodos (no relation to the movie of the same name). It’s a hilarious no-holds-barred send-up of

Polypharmacy – Is It Evidence-Based?

Polypharmacy essentially means taking too many pills. It’s a real problem, especially in the elderly. A family doctor gives an elderly patient one pill for diabetes, another for high blood pressure, and another to lower cholesterol. The patient sees a rheumatologist for his arthritis and gets arthritis pills. Then he sees a psychiatrist for depression

Are Cardiologists Ordering Too Many CT Angiograms?

A really snazzy new invention allows doctors to see inside their patients’ hearts as never before: the CT angiogram. It produces gorgeous 3-D video images of the beating heart in action. It allows us to see the blood flow through the heart’s chambers and it shows any plaque in the coronary arteries. Cardiologists are understandably

Death By Medicine

Critics of “conventional” medicine delight in pointing out how much harm it causes. Carolyn Dean, Gary Null, and others have written extensively about “death by medicine.” A typical statement (from Mercola.com) says: A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than

Not Treating – A Neglected Option

One of the criticisms of modern medicine is that doctors prescribe too many pills. That’s true. Patients and doctors sometimes get caught up in a mutual misunderstanding. The patient assumes that he needs a prescription, and the doctor assumes that the patient wants a prescription. But sometimes patients don’t either need or want a prescription.

The “Art” of Clinical Decision-Making

Much nonsense has been written about the “art” of medicine. All too often, it amounts to a rationalization for doctors doing what they want to do instead of following the evidence. Medicine is not an art like painting. Neither is it a science like physics. It’s an applied science. Since patients are not all identical,

Science and Chiropractic

In the comments to a previous blog entry, a chiropractor made the following statements: 1. Chiropractic is a science.2. Chiropractic is based on neurology, anatomy and physiology.3. Chiropractors are doctors of the nervous system.4. Chiropractic improves health and quality of life. I offered to write a blog entry on the “science” of chiropractic, and I

Antibiotics for Sinusitis

You’re a patient. That cold just isn’t getting better and you have purulent drainage from your nose, and your face hurts and your teeth hurt. You probably have sinusitis, right? You go to a doctor to get an antibiotic. You’re a doctor. Deep down, you know there’s a good chance the patient has a self-resolving condition.  You’d rather