What would the Doctor do?

[DanaC]

Interesting little piece in the Guardian:

What doctors won't do

From steroids to sleeping tablets, IVF to the flu jab – doctors reveal the treatments they would avoid

Some of it's pretty bland and expected (don't drink when pregnant) but some of the responses are interesting:

… have a full health check

I would never take up the regularly advertised offers by private medical companies to go for a full health check. Why? Well, if you have symptoms, you go to your GP and leave it to them to listen to your history, examine you, request investigations and reach a decision. This process is known as diagnosis. A full health check when you feel totally well is not diagnosis. The procedure is known as "screening". There are few "screening" tests where the advantages of diagnosis and treatment outweigh the disadvantages, and it is likely that your doctor has already checked for these when you first signed on with the practice, or subsequently: for example, in women, a smear test, in middle years a mammography, and for both sexes a blood pressure reading.

One of the samples taken in full screening tests is a blood test for prostate cancer. If you have prostate symptoms, it can be a life‑saving help to diagnosis. If you don't and the screening test shows a high score, it could lead you to have potentially harmful investigations, or indeed cancer treatment, that you may not have needed.

One hears anecdotes about the advantages of health checks. One hears anecdotes about people who have fallen out of sixth-floor windows and lived, but I wouldn't try it myself.
Mike Smith, GP

… have a prostate cancer test
PSA is a "simple" blood test to check for prostate cancer. Know what it stands for? Prostate Specific Antigen. Or rather, as many doctors will tell you, Persistent Stress and Anxiety.

Prostate cancer is far more common – and, usually, less serious – than most people realise. In elderly men, it's virtually a state of normality. Most of these prostate cancers lie dormant and harmless, and are something men die with, not of. So having a PSA may end up giving you information you would have been better off not knowing. That's if you can trust the result: it's notorious for inaccuracies, with false positives, false negatives and an inability to distinguish between harmless pussycat prostate cancers and the less common aggressive tigers.

Which is why, when men ask for the test, they're potentially opening Pandora's box. We try to guide them through the maze of ifs, buts and maybes. Sure, in theory it could save your life. But in practice it could well lead to worry, unpleasant biopsies and unnecessary, traumatic surgery.
Tony Copperfield, GP and author of Sick Notes

… follow a low-carb diet

I would never go on a low-carbohydrate, high-protein diet like Atkins, Dukan or Cambridge. Why? Because although you will probably lose weight, they may kill you. Don't take my word for it – read about the 43,396 Swedish women followed for an average of 15 years. Those who stuck to low carbs and high protein had a rising risk of dying from heart attacks and strokes, depending on how strict they were and for how long they endured them. There was a staggering 62% higher risk of such illnesses among the women eating the strictest diet over those who ate normally. Eating is for enjoyment; these diets turn food into medication, and it's patently the wrong medicine – it is often lethal.
Tom Smith, GP

… dismiss alternative medicine

I would never dismiss an alternative therapy without first understanding how it works. It's taken me years of medical experience to realise that just because a therapy doesn't have evidence behind it doesn't mean it can't help some people. As doctors, we are trained, rightly, to seek scientific evidence of the effectiveness and safety of a given therapy. But conventional modern medicine can't help everyone. Despite a lack of research funding, there is a slowly growing body of evidence of the effectiveness of a range of alternative therapies. A recent example was that yoga can help reduce pain and increase mobility in people with osteoarthritis. Modern medicine remains my own area of expertise, but I now realise other forms of therapy, such as chiropractic and hypnotherapy, can help.
Ian W Campbell, GP

… use homeopathy

I would never use homeopathic medicines. They are based on an 18th-century practice of diluting particular compounds in water or alcohol to the point where the solution is so weak as to contain no trace of the original compound at all. Homeopaths believe that water has a "memory" of the curative substance that then has a beneficial effect. For me, the key word is "believe". Adherents of homeopathy believe in the efficacy of homeopathic medicines in the same way as they may believe in a particular religion. Homeopathy is a faith-based medical system that, in the minds of its faithful, does not require any scientific evidence of effectiveness to be beneficial. If homeopathy is effective, then most of what we have learned in the fields of medicine, chemistry and physics since the 18th century must be incorrect. I find that implausible, so prefer to squander my money in other ways.
Eddie Chaloner, vascular surgeon

Read the rest here:

http://www.guardian.co.uk/lifeandsty...octors-wont-do