Doctors Admit Giving Useless Medicine To Patients

I posted a blog yesterday defending Doctors in a case where the Doctor was accused of negligence when a boy died of Anesthesia overdose during Cosmetic Surgery in Bangalore,India.

It is not that I am always on the side of Doctors.

Useless Medicines prescribed.

I have posted a couple of blogs on Doctor’ unethical practices including administering useless medicine to patients.

Now Doctors, in a study conducted on Doctors selected at random, for medical practice, have admitted to giving useless medicine like

like low-dose drugs, vitamins, nutritional supplements or an unnecessary exam.

Story:

The surveyed doctors said they prescribed them to induce a “placebo effect,” to reassure patients or because patients pushed for a treatment.

“For authorities to put their heads in the sand and pretend (placebo treatments) are not being given out is not helpful,” said Jeremy Howick of Oxford University, one of the authors of the study, which was published online Wednesday in the journal PLoS One. “We need to think of ways to maximize the benefits of using placebos,” he said.

Howick and colleagues used a Web-based survey and got 783 responses. The sample was drawn from a list that included 71 percent of all doctors registered with the General Medical Council, the governing body for doctors in the U.K.

The survey asked doctors if they had ever used a true placebo, like a sugar pill or another kind of dummy treatment such as a drug not meant for the patient’s condition or a non-essential examination including blood tests and X-rays. Nearly all of the doctors — 97 percent — reported having used some kind of placebo treatment at least once, while 12 percent reported having used a fake pill.

About 77 percent of doctors said they used some kind of placebo treatment every week; more than 80 percent of them said their use in some circumstances was ethical.

The “placebo effect” treatments included unnecessary physical exams, joint injections, physical therapy, peppermint pills for a sore throat and antibiotics for infections where they would not be effective.

Dr. Tony Calland, chairman of the British Medical Association’s Ethics Committee, said he was disappointed by the findings. “Prescribing something that you know is of no value is not ethical,” he said.

A previous study found about half of U.S. doctors regularly give their patients treatments that probably won’t work without telling them, and the practice has been reported elsewhere, including Canada, Denmark and Switzerland. The American Medical Association says physicians may only use placebos if the patient is aware.

In 2011, the German Medical Association recommended doctors use fake pills and other placebo treatments more often and said patients didn’t necessarily need to be told.

Some small studies have found dummy pills work even when patients are explicitly told what they’re getting and others have documented the fake treatments can spark a biological effect in the body.

“For illnesses where there is no truly effective treatment, a placebo or alternative therapy is a fine thing to do,” said Dr. Walter Brown, a clinical professor of psychiatry at Brown University and author of a recent book on placebos. He was not connected to the new study”

http://www.washingtonpost.com/world/europe/many-uk-doctors-give-patients-useless-drugs-treatments-authorities-say-thats-unethical/2013/03/20/da5f1376-9194-11e2-9173-7f87cda73b49_story.html

Let me add some more practices, at the ground level , indulged by the Doctors in India.

1.Most of the Doctors do not examine the patients at all.

They hear the symptoms and immediately scribble some Tests.

These ‘Tests’ have financial implications for the Doctor and the Corporate Hotels, sorry Corporate Hotels.

A scan , in general costs Rs.2000.

But a patient is charged any where between  6000 -8000!

50 % of this , between 3000- 4000 goes to the Doctor.

He gives a cut to the Hospital whee he is a Consultant.

2.The use two different types of pens or inks to write a prescription.

For a a particular type of pen or ink used, the Labs do not conduct any Tests and give a normal parameter Report.

Of course the patient is charged!

Suggesting useless procedures.

This happens mainly in Appendicitis cases.

Appendicitis procedure involves the removal of the Appendix.

Till date no body knows what function Appendix serves and te side effects of removing them.

The patient is threatened that the bursting of Appendix would poison the syste,.which is true.

But that it might be ruptured is a decision for a Doctor to make.

Removal of Uterus.

On unsuspecting patients, i have seen doctors, suggesting removal of the Uterus even for Urine Infection!

Blood Tests.

Same test is repeated for the same patient in a gap of a day!

Useless Drugs, and at times Procedures .

Physicians recommend against many procedures patients have come to expect, including imaging for low back pain (unless it has lasted more than six weeks) and any cardiac screening, including EKGs, in patients without heart symptoms.

The widely used “DEXA” X-ray screening for osteoporosis landed in rheumatologists’ crosshairs. It should not be done more than once every two years, they advise, because changes in bone density over shorter periods are typically less than the machines’ measurement error, which can cause women to think they’re losing bone mass when they’re not.(life,national post)

“

If you’re having surgery, you may wonder if you need an imaging test of your heart to make sure it is safe for you to have the surgery. But if you are not having heart surgery—and you haven’t had a stroke and don’t have a severe heart condition, diabetes, or kidney disease—the imaging tests usually aren’t helpful. Here’s why:

The tests usually aren’t necessary before low-risk surgery.

Some imaging tests use sound waves to take pictures of the heart. This is called echocardiography. Other tests use a small amount of radioactive material. These can be called either a nuclear or CT scan.

Doing a heart imaging test can show whether you’re at risk of having a heart attack or another serious complication when you have surgery. The test results may lead to special care during or after surgery, delaying surgery until the problem is treated, or changing the kind of surgery.

But the risk of heart complications from minor surgeries, such as a breast biopsy, eye or skin surgery, or any “same-day” surgery, is very low. There really isn’t anything doctors can do to lower the risk further. In other words, heart-imaging tests are not likely to change anything. In fact, even major surgery is safe for most healthy people who feel well and are physically active.

Unless you have heart disease or other risk factors, usually all you need before surgery is a careful medical history and physical exam.

Heart imaging tests can pose risks.

The tests are usually very safe, and some can be done with little or no radiation. But if your risk of having a heart problem is low, the tests can produce a false-positive result that could cause anxiety and lead to more tests and an unneeded delay of surgery.

For example, you might have a follow-up coronary angiography (cardiac catheterization). During this test, a catheter is inserted into the heart through a vein, dye is injected, and x-rays are taken. The risks are low, but exposure to radiation adds up over your lifetime, so it’s best to avoid x-rays whenever you can.

Imaging tests can cost a lot.

An imaging stress test costs between $500 and $2,000, and a cardiac CT scan costs $500 to $600. If abnormal results lead to coronary angiography, that can add about $5,000 to the cost. So the tests should only be used when the results would change the way your surgery is done.

Check this site for more before you take any decision on Tests for you and discuss with your Doctor.

It is your right.

http://www.choosingwisely.org/doctor-patient-lists/heart-imaging-tests-before-surgery/

Please watch this clip on Medical expenses from STAR Vijay.

 

MMR Row Doctor Hits Back At Conduct Claims

What the Doctor has done is not only Professionally wrong but ethically as well.He should not have made children as guinea pigs and he can not complain if he is debarred.
In this case , facts have come to light because of investigative reporting;but there are Doctors who have not touched medical Books/Journals since their qualifying examination about 15/20 years back and treat patients based on out dated or discarded practices.There are Doctors who prescribe unnecessarily and over drug patients;recommend and perform surgery when not warranted;
What of them?
As for MMR being 100% safe no body can assert it as such.hence caution is needed.
Story:
The doctor at the centre of the MMR controversy has said allegations that he failed in his duties as a responsible consultant are “unfounded and unjust”
Speaking outside the General Medical Council (GMC) offices in London and surrounded by supporters, Dr Andrew Wakefield also pledged that “science will continue in earnest”.
The GMC’s disciplinary panel of experts ruled Dr Wakefield showed a “callous disregard” for children’s suffering and abused his position of trust.
His conduct brought the medical profession “into disrepute” after he took blood samples from youngsters at his son’s birthday party in return for payments of £5.
He also acted dishonestly and was misleading and irresponsible in the way he described research later published in The Lancet medical journal, the panel ruled at a hearing.
Dr Wakefield faces being struck off the medical register after the panel decided the allegations against him could amount to serious professional misconduct, which will be decided at a later date.
Parents who believe their children were damaged by the MMR jab heckled the GMC panel as its members delivered their findings.
Dr Wakefield had argued that he had been acting in the children’s best interests
His research on 12 children with bowel disorders and autism was published in The Lancet in 1998.
Although it did not make a proven link with the MMR vaccine, Dr Wakefield subsequently warned parents to have single jabs against measles, mumps and rubella. The claim has been widely discredited.
Sunday Times journalist Brian Deer, whose investigations sparked the inquiry, told Sky News that the GMC had to act.
But Rochelle Poulter, whose son Matthew was involved in the study, said Andrew Wakefield was a compassionate doctor.
Matthew had been soiling himself up to seven times a day, but his symptoms improved after being diagnosed and treated by Dr Wakefield.
“If I did not feel they were acting in his best interests I would not have let them investigate him in the first place,” she said.
“Sometimes you have to be a bit self-sacrificing to improve things, not just your own child, but for other children too.”
The MMR scare led to a sharp drop in the number of children having the jab. Although uptake has risen as safety fears recede, more than 1200 children last year developed measles.
Dr Helen Bedford, lecturer at the Institute of Child Health, said: “Parents should be reassured that there is a large body of good scientific evidence which shows MMR is not linked to autism and bowel disease.”
http://news.sky.com/skynews/Home/UK-News/Doctor-At-Centre-Of-MMR-Controversy-Failed-In-His-Duties-GMC-Rules/Article/201001415537552?DCMP=EMC-news_OBU

When To Say No To Your Doctor-Forbes.

Also read my blog on Health Care Costs under Health.
In Depth: Six Reasons To Say No To Your Doctor
When it comes to economic threats to our country, President Obama says nothing even comes close to spiraling health care costs, expected to hit $2.5 trillion this year. Legislators are struggling to come up with health reform plans that cover millions more people without boosting the deficit.

One obvious place that Congress could look for savings: the waste already embedded in the medical system.
http://www.forbes.com/2009/11/12/health-care-costs-lifestyle-health-spending-tests.html

Health policy researchers furiously debate how much is wasted on treatments that sometimes don’t make people better. There are no sure numbers because much of modern medicine remains unstudied and unproven, but by every indication the figure is colossal. Health spending is projected to hit 17.6% of gross domestic product this year. In 2008 McKinsey found $650 billion in excess medical costs, even after adjusting for the fact that rich nations spend more of their incomes on health.

In Depth: Six Reasons Say No To Your Doctor
Elliott Fisher and his colleagues at Dartmouth Medical School have shown that medical spending fluctuates wildly from town to town and hospital to hospital, with no measurable improvement in health in the pricey places. They calculate that 20% or more of all costs could be eliminated without harming anyone. It might even save some lives by preventing complications from unnecessary treatments and hospital stays. At least 40% of all specialist visits and 25% of hospitals stays are unnecessary, Fisher estimates. (For more, see: Useless Medicine.)

“We don’t have any sort of system to measure the effectiveness of what we are doing,” says Dartmouth-Hitchcock Medical Center orthopedic surgeon James Weinstein. He showed in 2006 that patients with herniated spinal discs often get better on their own, without the need for back surgery. “For all of the money we spend, we are flying blind.”

Tests and treatments Congress could target if it decides to get serious about controlling health care costs:

Another strand of evidence comes from health researcher Robert Brook at UCLA and the Rand Corp. In the 1980s and early 1990s, he and his colleagues looked at rates of unnecessary surgery for numerous elective procedures. “Across the board, a large percentage of surgery was inappropriate or of questionable value,” he says. Sometimes it was 30% or more. Brook says no federal agency has been interested in funding his proposals to develop a broad set of surgical appropriateness criteria. “You’d think the federal government would make this a priority. But it is politically too hot to handle,” he says.

Wasteful medicine can be profitable. “Every time you isolate a place where we are wasting money and there is something we can do about it, it takes money out of someone’s pocket,” says Wendy Everett, who heads New England Healthcare Institute, a nonprofit research outfit.

States With The Most And Least H1N1 Vaccine Per 1,000 Residents
Your chances of getting inoculated against America’s worst pandemic since the 1918 flu improve greatly depending on where you live.
But American consumers share the blame. They often falsely equate fancy tests with high-quality care.

“There is an assumption that more testing is better care,” says Richard Deyo, a back pain expert at Oregon Health & Science University in Portland. People don’t trust their physicians and assume they aren’t doing a good job if they don’t order more tests.”

A Headache That Didn’t Go Away

I have relative of mine,about 50, who had difficulty in vision. Ophthalmologist advised him to wear glasses.By chance he happened to see a GP who informed him his case was not one of vision ,but of eye balls about to pop out and he immediately rushed to Specialty hospital where he was diagnosed with a disorder that has resulted in his eyeballs being held only by 40%.He was immediately operated upon and he is recovering.
Moral-better seek second opinion .Sometimes, though cynical it may sound , it may again be not 100% correct.Sometimes there are as many opinions as there are doctors.What are we to do?
Valerie Novak fervently wished doctors would stop telling her the intense headache she’d endured for several weeks was a migraine. For one thing, neither the Georgetown University senior nor her close relatives had headaches, and migraines are frequently familial. None of the increasingly potent drugs doctors prescribed was doing much good. And the 22-year-old had lost 15 pounds in three weeks from bouts of severe vomiting.

“I was so frustrated and upset,” recalled Novak of her ordeal last summer, which involved consultations with half a dozen doctors, several trips to area emergency rooms and two hospitalizations. Novak, who had always been healthy, said she feared the unrelenting pain in her left temple and associated symptoms were something “I’d have to live with for the rest of my life.”

Her mother, Kathy Novak, a nurse practitioner in Bowie, was similarly skeptical of the diagnosis but grateful that doctors had ruled out more ominous possibilities, such as a brain tumor. When her middle daughter began complaining about double vision, Kathy took her to an ophthalmologist. His judgment led to an accurate diagnosis that had nothing to do with migraines but was instead a rare complication of a common item listed on Novak’s medical records. Left untreated, it might have killed her……………….

Back home with her parents, unable to go to class, Novak recalled that her “eyesight was getting wonky, with really, really weird double vision.” Alarmed, her mother made an appointment with an ophthalmologist, hoping he might have an explanation that didn’t involve migraines.

After dilating Novak’s eyes, the eye specialist immediately spotted something alarming: Her optic nerves were dangerously swollen. “This is not a migraine,” he told Novak. “You have increased intracranial pressure.”

The unrelenting headache as well as the numbness, tingling and vomiting were caused by a rise in pressure in the brain. The condition, which can result from a head injury or meningitis, is considered a medical emergency; increased pressure caused by a buildup of fluid can permanently damage the central nervous system by restricting blood flow to vessels that supply the brain. In Novak’s case, the double vision was caused by pressure on her cranial nerve.

The ophthalmologist’s first thought, given Novak’s age and history, was pseudotumor cerebri, a rare condition sometimes called a false brain tumor, that affects women between ages 20 and 45. Valerie’s illness had nearly all the hallmarks but lacked one critical variable: She was not overweight or obese, as are most of those with the condition.

The ophthalmologist immediately sent Novak to Greenbelt neurologist Roger Whicker. She immediately began taking a drug to reduce the pressure and underwent another MRI and other testing, which revealed the actual cause of the illness and changed the diagnosis to sagittal sinus thrombosis, or SST, caused by a blood clot in her brain.

http://www.washingtonpost.com/wp-dyn/content/article/2009/02/02/AR2009020202209_2.html

Orgasm Patient Withdraws Case Against Gynaecologist

In any rape or attempt to molest case, woman’s word is taken.Unless Providence intervenes, Man is doomed.Tricky to define rape.Detailed blog follows.
Consensual sex may also be denied by the woman later.
In this case, the woman need to be awarded exemplary punishment.

A Brit women who accused a gynaecologist of sexually assaulting her has withdrawn the case and paid the doctor 30,000 pounds as legal costs.

Bibi Giles, 50, had claimed that Angus Thomson, 40, exploited her sexually and gave her two “leg buckling orgasms” while checking her after a surgery.

She also alleged that Thompson pressed her into having a fling with him.

Giles had come to Thomson, a consultant gynaecologist from Droitwich Spa, Worcs, after a 16-year history of medical problems.

However, it was revealed that Giles had sent explicit messages to the gynaecologist, including one where she asked him to christen her with his “Angus beef sausage”.

The case completely turned in favour of Thompson when Giles’ former GP, Dr William Dowley, revealed medical notes taken when he was treating her from 2002-2004.

During the hearing, Christina Lambert QC, Thomson’s lawyer called Dr Dowley “in respect of invites and conversations between him and Mrs Giles”.

She said the evidence showed that Giles had wanted a relationship with Dr Dowley.

“Mrs Giles had reported to him that there had been a previous relationship above and beyond a doctor patient relationship,” the Telegraph quoted Lambert, as saying.

Judge Daniel Pearce-Higgins told the court that Giles had decided to withdraw the case.

He said: “Life would have been much easier if Mrs Giles had admitted this incident at the start of the case. She has got form. She has pestered a doctor in the past.
http://www.medindia.net/news/Orgasm-Patient-Withdraws-Case-Against-Gynaecologist-62543-1.htm