Comments on: Throwing in the towel on lifestyle changes http://www.kevinmd.com/blog/2006/10/throwing-in-towel-on-lifestyle-changes.html Tue, 14 Feb 2012 22:04:00 +0000 hourly 1 By: drncchttp://www.kevinmd.com/blog/2006/10/throwing-in-towel-on-lifestyle-changes.html#comment-67907 drncc Wed, 18 Oct 2006 03:28:00 +0000 http://clients.emmense.com/kevinmd/2006/10/throwing-in-the-towel-on-lifestyle-changes.html#comment-67907 Heya Kevin,<br/><br/>I tend to cave early to meds on top of lifestyle.<br/><br/>Strokes are bad.<br/><br/>--drncc-- Heya Kevin,

I tend to cave early to meds on top of lifestyle.

Strokes are bad.

–drncc–

]]> By: anonymoushttp://www.kevinmd.com/blog/2006/10/throwing-in-towel-on-lifestyle-changes.html#comment-67897 anonymous Wed, 18 Oct 2006 01:27:00 +0000 http://clients.emmense.com/kevinmd/2006/10/throwing-in-the-towel-on-lifestyle-changes.html#comment-67897 "If you want to get all politically correct and feign offense, go ahead, but he has the truth on his side."<br/><br/>The truth is that this is the downside of "evidence based medicine" and the antithesis of medicine as an art. Highly patronizing; I would expect better out of Mass. General. “If you want to get all politically correct and feign offense, go ahead, but he has the truth on his side.”

The truth is that this is the downside of “evidence based medicine” and the antithesis of medicine as an art. Highly patronizing; I would expect better out of Mass. General.

]]> By: Gasmanhttp://www.kevinmd.com/blog/2006/10/throwing-in-towel-on-lifestyle-changes.html#comment-67892 Gasman Tue, 17 Oct 2006 23:39:00 +0000 http://clients.emmense.com/kevinmd/2006/10/throwing-in-the-towel-on-lifestyle-changes.html#comment-67892 But throwing in the towel on right living just seems a pitty. Drugs have external costs (insurer, employer, taxes or whoever does the paying) and have side effects, sometimes debilitating (again, more external costs). <br/><br/>Good clean living according to the biologic needs of our bodies has no external cost, but does require some effort from the patient. There are no side effects and many secondary benefits to be had. <br/><br/>So even if the efficacy sucks like jackiemd suggests for the 80%, why not start by providing the best intervention for the motivated 20%, whom you can only identify after treating all to lifestyle change. The cost of failure, i.e. identifying the 80% is minimal and then drug treatment can be targeted to this group. To drug those who can or will adopt a lifestyle consistent with their body's needs is irresponsible. But throwing in the towel on right living just seems a pitty. Drugs have external costs (insurer, employer, taxes or whoever does the paying) and have side effects, sometimes debilitating (again, more external costs).

Good clean living according to the biologic needs of our bodies has no external cost, but does require some effort from the patient. There are no side effects and many secondary benefits to be had.

So even if the efficacy sucks like jackiemd suggests for the 80%, why not start by providing the best intervention for the motivated 20%, whom you can only identify after treating all to lifestyle change. The cost of failure, i.e. identifying the 80% is minimal and then drug treatment can be targeted to this group. To drug those who can or will adopt a lifestyle consistent with their body’s needs is irresponsible.

]]> By: JackieMDhttp://www.kevinmd.com/blog/2006/10/throwing-in-towel-on-lifestyle-changes.html#comment-67891 JackieMD Tue, 17 Oct 2006 23:24:00 +0000 http://clients.emmense.com/kevinmd/2006/10/throwing-in-the-towel-on-lifestyle-changes.html#comment-67891 If a cheap first-line antibiotic had, say, an 80% failure rate in curing an infection then you wouldn't find a doctor in the world who would advocate completing the full course first, and prescribing something more effective and expensive only after it fails.<br/><br/>This guy isn't predicting a failure rate for lifestyle changed based upon his own prejudice against the individual patient; this is an outcome which has already been observed scientifically for years. If you want to get all politically correct and feign offense, go ahead, but he has the truth on his side. If a cheap first-line antibiotic had, say, an 80% failure rate in curing an infection then you wouldn’t find a doctor in the world who would advocate completing the full course first, and prescribing something more effective and expensive only after it fails.

This guy isn’t predicting a failure rate for lifestyle changed based upon his own prejudice against the individual patient; this is an outcome which has already been observed scientifically for years. If you want to get all politically correct and feign offense, go ahead, but he has the truth on his side.

]]> By: anonymoushttp://www.kevinmd.com/blog/2006/10/throwing-in-towel-on-lifestyle-changes.html#comment-67881 anonymous Tue, 17 Oct 2006 18:19:00 +0000 http://clients.emmense.com/kevinmd/2006/10/throwing-in-the-towel-on-lifestyle-changes.html#comment-67881 How arrogantly judgmental of the individual patient. Cookbook medicine and treating patients as cattle; not the doctor I would see. How arrogantly judgmental of the individual patient. Cookbook medicine and treating patients as cattle; not the doctor I would see.

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