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Sunday, August 10, 2014

Sanjay Gupta's Friday Feedback: Is Today's Standard Care Tomorrow's Horror?

A new cable TV show "The Knick," premiering this week, dramatizes cutting-edge medicine circa 1900, with a recurring theme that treatments standard at the time were actually ineffective or even harmful. (Other reviews by the New Yorker and The New York Times.)
We reached out to a diverse group of physicians via email and asked:
Do you think there are standard-of-care treatments today that future generations will look back on in horror, and which ones will they be?
The participants this week:
Cherie C. Binns, RN, an independent multiple sclerosis-certified nurse based in Wakefield, R.I.
John P. Higgins MD, MBA , MPHIL, associate professor of cardiology, the University of Texas Health Science Center at Houston (UTHealth)
Murali Doraiswamy, MD, professor of psychiatry and medicine, Translational Neuroscience Division, Duke University School of Medicine
Michael Rinaldi, MD, interventional cardiologist and director of clinical research at Carolinas HealthCare System's Sanger Heart and Vascular Institute
Jack Shapiro, MD, member, Michigan State Medical Society-Physicians Review Organization of Michigan, and a board-certified internist recently retired after practicing for over 50 years
Tanzid Shams, MD, sports concussion specialist and pediatric neurologist in Boston
Shotguns and Carpet Bombs
Murali Doraiswamy, MD: "Ninety-nine percent of treatments today will be viewed as harmful or unethical in the future; for example, most psychiatric treatments given to children or most back surgeries."
John P. Higgins MD, MBA , MPHIL: "Many of our medications that we use today will be considered primitive 'shotgun style' approaches in the future. We currently use medications in a 'one size fits all' manner, and they are absorbed into our bodies and affect many systems in addition to the one they are intended for and may cause damage to healthy systems. An analogy would be spraying a whole rose bush with chemicals to treat one leaf that has a black spot fungus. Examples include most commonly used medications such as beta-blockers, statins, antibiotics, and NSAIDs."
Cherie C. Binns, RN: "Talk of limiting care for geriatric patients or the multiply handicapped child (especially at birth) and limiting access to resources for those with chronic health conditions that utilize a majority of services and healthcare dollars available are certainly, if they become standards of care, something that will be mocked, misunderstood, maligned in another generation."


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