Evidence/Science based medicine

Non-Evidence based Medicine: Part Three

Hilary Butler - Friday, September 03, 2010
Like many of my friends, there was once a time when I trusted the system; was ignorant about the actual lack of “evidence base”; and assumed that what I was told was right. Because of this naivety, I learned the hard way that the system can be wrong. Since then, I’ve done my best to keep myself out of this system, but when neded, I have never hesitated to confront the system  in order to get the best for my family or friends, and protect them from the worst. I’ve only been able to do that, with a backbone honed from years of research into all sorts of diagnostic scenarios, so that I know what is supposedly gold standard treatments, what evidence (or lack of) that’s based on, and the flaws.

Standing up for your family or your friends, comes with a price. The “black mark” for speaking up, has followed me into each next encounter more times than I care to count. Just like the elderly who speak about against elder abuse in rest-homes… if patients or friends in hospital speak out, the next time, depending on the team they get, may not be pretty.

But at the back of my mind are these questions: “What if some idiot drunk driver decided to make me into a broken pretzel? Who will be able to get for me, the best from the system and protect me from the worst of the system, other than God?"

My trust in the people within the medical system is that “rock bottom”. I see very few doctors prepared to stand against their colleagues, and be effective advocates for their patients. The system’s needs dictate doctors’ actions, which is grossly unfair.

It is an utter tragedy to have a state- run medical system founded on self protection, which treats with contempt, people who know and challenge medical practice, or ask for something which the system hypocritically considers isn’t “evidence based”!

The system tries to keep everyone right where they want them. Most of the time they succeed, because most people allow themselves to be walked over. New Zealand is a nation of sheep in more ways than one, so the system has never had to systemically confront the fact that they need to change how they view informed patients (and uninformed patients).

There is a serious shortage of conviction, backbone and activism in this country, and one day the results of this might be that we get UTTERLY screwed, because collectively, the public hears little (if anything) from medical people who know these facts, but don’t forcefully denounce them.

Those of us run over by the system, tend to clam up, and vote with our feet and never confront the system unless we have to. It’s time for us to stop saying, “Oh, but if I speak out, I or my child might be in the firing line the next time.” What if that next time is us? Who will be there for you?

The more people sit back, the happier the system is. It’s time for action.

One question is, “How can the system be changed?” But another more realistic question is, “If the system refuses to be changed, how can I guarantee that if I need serious help, I have people around me, prepared to support me, to get what I want?”

Seriously people, it's time that you find like minded people and work on collective supportive networks, of people with some backbone.  Some say, "Silence is golden".  Yeah, it is for the vested interests protecting their bank balances, but sometimes... silence is simply... yellow (cowardice)!

This morning someone told me they had just come back from doing errands, and were impressed by a bumper sticker on a four wheel drive vehichle which read:

"WHEN INJUSTICE BECOMES LAW - REBELLION BECOMES DUTY"

Maybe it's time for a rebellion.