This won’t hurt a bit…

And remember to clean your teeth with sugar

This week the Insights blog will be focusing on health care issues. In this second post, we introduce evidence-based care.

My grandmother believed that tar fumes stopped kids catching colds, so if she saw road menders at work, she’d march me, my sisters and brothers and our friends over to breathe in the vapours.

We’d then have to huddle around a steaming dollop of bitumen, arms flapping to help the lungs pump the goodness into our ventricles, like a flock of baby seagulls stuck in an oil slick.

A woman who thought that pigs could see the wind probably wasn’t the best source of advice on health (or anything else), and a carcinogenic mixture of 10,000 chemicals, half of them unidentified, probably not the best prophylactic around, but the wisdom of the ancients is not the only knowledge that seems bonkers in retrospect. Mainstream medicine has had its share of dubious treatments too.

Not just dubious. The aptly named To Err is Human report from the US Institute of Medicine in 2000 estimated that medical errors killed more people than traffic accidents in the US.

Of course, with millions going to see the doctor every day, even a tiny fraction of mistakes soon adds up to a startling sum, but the problem isn’t just a slip of the scalpel or an illegible prescription. Another report estimated that up to a third of treatments had no real clinical effectiveness.

To the layperson, this is astonishing. How on Earth were the doctors deciding on treatments? Rolling dice? In fact, they were applying what they’d learned at medical school and best practice as it evolved. (more…)