“impressive science”???? and what percentage of the treatments doctor prescribe/perform is, in fact, evidence-based??? Skepticism about doctors’ claims is quite rational.

With so much stuff that doctors claimed was evidence-based yesterday that turned out not true today, why are you wondering some people don’t trust you? By the way – I do believe in science, don’t take supplements and don’t go to the doctor for the self-limiting viral illnesses. And don’t take antibiotics unless they are really needed.
Let’s see
1. eat low-fat diet; carbs are great for you, it is not potatoes or spaghetti it is what you put on it… Limit all fat, even if it is from olive oil or avocados or fish.
2. Don’t eat eggs yolks (to my mom) – oops, they have most digestible lutein which is shown now to retard macular degenaration which my mom now has. Maybe if she hadn’t followed this advice she kept her vision just a little longer? Maybe not – but we would never know. Would you care to show a single study that people who eat egg yolks have more heart attacks? That dietary cholesterol has a huge effect? Oh well, at least local stray cats benefited as we used to leave it out for them – they enjoyed it.

2. take a multi-vitamin (a doctor told me some years back when I told him I am not taking any supplements but eat lots of fruit and vegetables…)

3. “most women your age are on HRT” – to my aunt (who was over 65 at the time, had no symptoms of menopause, no osteoporosis, active, healthy and slim). She thought about it and said, no thanks.
4. HRT is good for you; HRT is bad for you, oh well, maybe it is good for some people and bad for others…

I could probably come up with more examples but don’t have time.

when you go to the doctor they have to tell you something to justify the visit…why did you go to the doctor for all those visits in the first place? Probably some BS complaint…
Once upon a time, we were told we are supposed to go for annual physicals. It’s only recently that I found out that they are useless. Actually I resisted for a long time before I went for the first one… then I got HMO that asked me to choose a pcp. I guess my aunt thought she needs one too.

This is where this advice was mostly happened for me and my aunt – at annual physicals. My mom has a high blood pressure controlled by medication, so she has to go to refill her prescription. Is it a BS complaint?

Nobody in my family enjoys going to the doctor. We are more likely not to go when we need to than to go for a BS complaint.

There are plenty of reasons people go to the doctor. Not all of them are BS reasons.

He says he doesn’t go to the doctor for BS reasons but in the post prior to that he says that he only takes antibiotics if they are really needed…I’m sure that’s code for viral uri…what a joke…

“Once upon a time, we were told we are supposed to go for annual physicals. It’s only recently that I found out that they are useless”
They are totally useless. You need to wait till you’re really sick and show up at the ER on a MOnday at 3 pm with the rest of the masses and sit out in the waiting room for 12 hours while yousuffer. Enjoy the wait. Thanks for the job security.
This is a great example of how doctors always preach evidence-based medicine… NOT. There is not a shred of evidence to show that annual physicals do any good -as mentioned multiple times on this blog (with references to USPSTF). Yet this doctor attacks and ridicules the poster who simply cites what he read here.

Please correct me if I am wrong but beyond non-smoking and staying in shape most preventive measures have very limited effect. OK, maybe statins for middle-aged men may prevent some heart attacks, but how many people exactly do you need to treat for how many years to prevent one heart attack? What about to prevent one death? Would you care to show some evidence for primary prevention in women? Please cite some evidence, we are talking about EBM after all.

Here is a novel thought. Maybe if you always tell people the truth of what is currently known or not known, people would believe you more?
P.S. I do believe in science. What I don’t believe is that doctors always practice EBM. For whatever valid reasons.

When a patient comes in for an annual physical the doc has to do whatever it takes to prevent future liability…so any symptoms generate a specialist referral or more tests…its an endless cycle…its better to try and find something wrong than be blindsided by a subpoena 2 years later…
This is exactly what I was trying to say – a healthy symptomless person will do better not doing physicals, but that I hadn’t known it until recently because this was what doctors recommended. So we hadn’t known that our going to annual physicals was “a BS reason” as somebody pointed out. We were just doing what you guys had been recommending us for years. On TV, radio, by our insurance companies and employers.

Then this arrogant know-it-all ER doctor seemed to imply that if we don’t go to annual physicals we will end up in his ER. So I started to wonder if he had some great “evidence” for this claim. Apparently not – he just thinks that everything a patient says is an ignorant BS. Even if this patient is quoting Kevin’s summary of USPSTF view.

11:06 You ASSume too much I think.

I think this ER doc is saying that physical exams are useless, which for the most part they are. I don’t think he is saying they prevent you from coming to the ER. When you are really sick you will end up in the ER with all the other people who are really sick (or not sick), the illegal aliens needing routine medical care, worried well getting CYA tests done, etc………. There will not be enough ER beds and nurses to take care of everyone and not enough beds in the hospital so you will end up boarding in the ER overnight.

Why is it that when a Dr. states a driective it comes from “science” and yet when he or she makes a mistake they say , “Well, mediciene is art, not science”.
Their code of silence makes the cops look like first graders. I have witnessed damage done to patients and the attending Dr. joins forces with the damaging Dr. to sweep it under the carpet. This means that golf buddies and people who might cover for them in the future are more important than the patient. I have reported this many times over the time I worked, on paper! Administration response = thank you very much we will look into it. All the doctors response – one step lower on the pu line, BUT with fear in their heart that they make a mistake when I was around, they paid a little more attention to those details that make good medicine.
Did you know that a nurse can loose her license for telling her patient that she needs to get another doctor – no matter how bad it is? Me? A hospstal R.N. for twenty seven years and five specialities.

Oh, great. Another all-knowing nurse with another gross oversimplified villifying caricature of doctors as a species.

Medicine is not an art. It’s more of a crap shoot. Medicine lurches slowly forward by cruching numbers. Lots of numbers.

The results of which tell Doctors that best likelihood of a good outcome for this particular patient with these risk factors and this medical history is treament plan X. So that’s what they implement.

It doesn’t always work. Are patients sometimes worse off after receiving some form of therapy? Sure. Surgical wounds get infected or become ischemic despite best efforts. Patients have unexpected reactions to medication. Sometimes therapy is initially more painful than the disease. Does this display some negligence or malfeasance on the part of the medical team? Not necessarily.

So, put your retrospectoscope away.