Where the prescription looks like the laundry list!
Posted by Admin on December 9, 2010
PROF. B. M. HEGDE
“All good is hard. All evil is easy. Dying, losing, cheating, and mediocrity is easy. Stay away from easy.” — Scott Alexander
The foundation of modern medical science is shaky. The gold standard of medical science is only statistical, randomised controlled trials (RCTs) used to test drugs and instruments. In short, if there is a science (I have shown elsewhere that there is no science of man), it is just statistical science and does not meet the strict standards of either science or technology as defined by the National Aeronautics and Space Administration‘s Technology Readiness Levels (NASA-TRL) or modern systems engineering (MSE). I have extensively written about the unscientific base of the RCTs in both my books and articles over the past four decades.
Even the President of NICE, which is the highest body to oversee drug research in the U.K., Sir Michael Rawlins, in his Harveian Oration at the Royal College, had this to say about RCTs: “That randomised controlled trials (RCTs), long regarded as the ‘gold standard’ of evidence, have been put on an undeserved pedestal.” Sir Michael outlines their limitations in several key areas, arguing that a diversity of approaches should be used to analyse the whole evidence base. (Rawlins M. The Harveian Oration of 2008, De Testimonio. On the evidence for decisions about the use of therapeutic interventions. Royal College of Physicians, 2008). This is bad news for the conventional thinkers, coming as it does from the highest level in their own backyard.
Using this kind of science, industry tries to exploit the public to make money with all kinds of chemicals passed off as effective drugs! History tells us that Nujol, the useless byproduct of petroleum extraction, was the first anti-cancer drug; and chlorpromazine, (Largactil), used extensively in psychiatry, is a byproduct of rocket fuel extraction! Many of the present expensive anticancer chemicals have not even gone through the inadequate RCT test! Now my friends who hate me for writing that a routine check of healthy individuals is dangerous will understand why I wrote what I wrote. Check-up means labelling, which is followed by drugging or intervening by other means. Most modalities of treatment, using both drugs and surgery, have no scientific base, although many of them seem to work through a very powerful placebo effect. Corrective surgery is an exception.
Most body parameters do change as there is need for them to do so for reasons unknown to us at the moment. Sugar, cholesterol and blood pressures belong to that category. The surest way to get them back to what we think should be the normal is to change our unhealthy lifestyle. Interventions with drugs have a dubious reputation in this field. Lifestyle change is something that is universally useful. Instead of going for a check-up when one is healthy, it is safer to change one’s lifestyle and try to live as close to nature as is possible, keeping one’s mind filled with universal love, devoid of hatred, greed, jealously and anger.
Heavy smokers and alcoholics need check-ups as their body warning signals of diseases fail anyway. The rest of us could make do with seeing doctors only at the first symptom of any change in our body. Symptoms denote the failure of our inbuilt repair mechanism, the immune guard. This also is due to the wrong lifestyle these days.
The pharma industry could go to any extent to fool even the governments to sell its wares. A recent revelation in the Guardian, London, exposed one such heinous act that could have endangered and/or extinguished many lives already. (http://www.guardian.co.uk/society/2010/nov/17/drugs-companies-exorbitant-profits- nhs). The European Union has defined some diseases as ‘orphan diseases,’ where the drug companies are not interested in finding a cure since the financial return might not be attractive. Companies finding out newer treatments for ‘orphan diseases’ would get special incentives from the governments. Please note that the industry is keen only on imaginary diseases (the so-called silent killers) that need lifelong drug therapy; the latter are their cash cows. Blood pressure, sugar and cholesterol are the three biggest milch cows.
It is now discovered that some companies have repackaged some of the old drugs in a new format and called them new cure for ‘orphan diseases’ and have milked the National Health Service of millions of pounds! The Guardian article gives graphic descriptions of the fraud going on. These so-called new drugscould easily pass the RCT test to qualify them as having evidence base. The tall talk of evidence-based medicine is as hollow as are many of our claims to superiority to all other modalities of treatment such as Ayurveda and homoeopathy. In fact, most of them have a better scientific base than our modern medicine. While U.S. medical schools teach for six months, out of their four-year MD course, the basis of other complementary systems, in India, the cradle of the best medical wisdom, Ayurveda, we seem to be averse to teaching anything other than the unscientific modern medicine.
The result is that most of our graduates become good technicians mastering a couple of interventions to make money. The rest of them become researchers, doing RCTs for western drug companies, making tonnes of money in the bargain through the new CROs. One has only to see one of the prescriptions which reads like a laundry list with one beta blocker, one ACE inhibitor, one blood thinner, one sugar lowering drug, of course, one cholesterol lowering drug and many others for every patient.
There is NO science base for this kind of poly-pharmacy, not even the imperfect RCT to back such practices. Recent studies show that patient compliance with such poly-pharmacy is less than 23 per cent. Seventy seven per cent of the recipients are, therefore, safe as they forget to take those tablets! God alone can save mankind from human greed, which has invaded every sphere of human activity ranging from 2G spectrum to patient care. “Do not make money in the sick room,” wrote Hippocrates. We take our oath in his name when we graduate only to become hypocrites in later life! “It is double pleasure to deceive the deceiver.” — Niccolo Machiavelli
(The writer is a former professor of cardiology, Middlesex Hospital Medical School, University of London, and former Vice-Chancellor, Manipal University. email: email@example.com)
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