Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Are you a medical liberal or a conservative?

Michael Kirsch, MD
Meds
August 9, 2014
43 Shares
Share
Tweet
Share

Our nation is highly polarized today, and often bitterly so.  Democrats rail against the GOP.  Pro-lifers face down pro-choicers.  Fox News disses MSNBC.  Isolationists push back against expansionists.  Traditionalists disdain the politically correct.  Free marketers duel against government advocates.  Carnivores deride the gluten-free crowd.  Martin Bashir trashes Sarah Palin, two proxies in a culture war.

There’s a philosophical divide among physicians also.  Would you prefer a liberal physician or a conservative practitioner?  I’m not referring here to fiscal policy or legalizing recreational marijuana use.  Consider the following hypothetical scenario and the two physicians’ approach from opposite sides of the medical philosophical spectrum. Which physician would you choose?

The patient:  She is a 50-year-old female with chronic fatigue syndrome (CFS).  She is only able to work part time because of her condition.  She has consulted with an internist, an infectious disease specialist and a naturopath, but her fatigue persists.

A new treatment for CFS has just been launched by a reputable herbal supplement company.  Two well-designed studies suggest symptomatic improvement in afflicted patients after 6 months of treatment.  As the product is an herb, there is no formal Food and Drug Administration (FDA) oversight.

Physician #1: “I’m reluctant to recommend this product, despite the optimistic preliminary results from two medical studies.  These studies were funded by the herb company and there may be bias present.  Moreover, it is very typical in medicine for initial results to be favorable, with unforeseen side effects and complications emerging later when after more widespread use of a drug.  I’m concerned that the FDA had no role in validating that the drug is safe and effective for its intended use.  Additionally, there is evidence that the active ingredient in the product disrupts the immune system, which may have serious future consequences that may not become manifest for several years or longer.  While CFS is decreasing your quality of life, your condition has been stable and will never threaten your life.  I recommend holding off until we have an FDA approved medicine for CFS or the herbal supplement has been used long enough that we have a better sense of its safety and efficacy.”

Physician #2: “I recommend that you try this new herbal product.  It is completely natural and showed promising results in two medical studies.  Importantly, no serious side-effects developed in either study.  Of course, we have no long term data on safety, but the vast majority of herbal supplements on the market are safe.  No other treatment thus far has been successful for you, and your condition is adversely affecting your professional and personal lives. The choice is to try something new or to continue suffering as you have been.  Try it for 6 months and then we’ll reassess.”

So, that’s my herb blurb.  This is a common situation in the medical world where medical advice must pass through the prism of risks and benefits.  These analyses are limited when the risks and benefits are unclear or disputed.  Treatment acceptance also depends heavily on the patient’s risk tolerance.  What if the herb referenced above had a 5% risk of cancer?  What if the herb needs to be taken indefinitely? Clearly, when the disease poses a serious medical threat, the patient may be willing to accept greater risk of new or investigational therapies.

So, which of these physicians would you choose for yourself?  Are you a medical liberal or a conservative?

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower. 

Prev

Learning from the lessons of night float

August 9, 2014 Kevin 1
…
Next

Context is crucial when deciding what to do with abnormal test results

August 9, 2014 Kevin 4
…

Tagged as: Medications

Post navigation

< Previous Post
Learning from the lessons of night float
Next Post >
Context is crucial when deciding what to do with abnormal test results

More by Michael Kirsch, MD

  • Drawing the line on unnecessary medical tests

    Michael Kirsch, MD
  • We are suffering from an epidemic of anger

    Michael Kirsch, MD
  • Physicians sometimes need to deviate from established policies

    Michael Kirsch, MD

More in Meds

  • The deadly consequences of a shortage: The Pluvicto crisis leaves metastatic prostate cancer patients in limbo

    Matt Drewes
  • The real story of Xylazine contamination in street fentanyl and how we can manage it

    Julie Craig, MD
  • The cannabis education gap: Why patients are left in the dark

    Timothy Byars
  • Are doctors ready to discuss psychedelic therapies with patients?

    Thaís Salles Araujo, MD
  • The rise and dark side of fungi: Exploring health benefits and pathogenic threats

    Sandra Vamos, EdD and Deanna Lernihan, MPH
  • Advocacy and collaboration lead to major patient safety benefits on sterile pharmaceutical compounding: a review of USP’s revisions to Chapter <797>

    Elizabeth Rebello, MD
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
  • Past 6 Months

    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • Empowering Black nurses for lasting change [PODCAST]

      The Podcast by KevinMD | Podcast
    • Master time management with 7 productivity strategies for optimal results

      Farzana Hoque, MD | Physician
    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 12 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • What Was Tied to Lower Long COVID Risk?
  • Chemo-Free Approach Works in Subset of Patients With HER2+ Early Breast Cancer
  • Two-Drug Combo Wins for Refractory Gout
  • First-in-Class Sjogren's Drug Passes Mid-Stage Test
  • Pricey Drug Combo Boosts PFS in First-Line Advanced Ovarian Cancer

Meeting Coverage

  • Chemo-Free Approach Works in Subset of Patients With HER2+ Early Breast Cancer
  • Two-Drug Combo Wins for Refractory Gout
  • First-in-Class Sjogren's Drug Passes Mid-Stage Test
  • Pricey Drug Combo Boosts PFS in First-Line Advanced Ovarian Cancer
  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
  • Past 6 Months

    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • Empowering Black nurses for lasting change [PODCAST]

      The Podcast by KevinMD | Podcast
    • Master time management with 7 productivity strategies for optimal results

      Farzana Hoque, MD | Physician
    • Proposed USPSTF guideline update: Advocating for earlier breast cancer screening at age 40

      Hoag Memorial Hospital Presbyterian | Conditions
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Are you a medical liberal or a conservative?
12 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...