Modern Medical Practices We Need To Stop

Summary

The script challenges common medical practices, emphasizing the importance of evidence-based medicine. It discusses the misconceptions around fever reduction, the benefits of early allergen introduction for allergy prevention, the overuse of surgeries for meniscus tears, unnecessary pelvic exams for birth control, and the ineffectiveness of rest for back pain recovery. It also addresses the myths about magnesium for leg cramps, the proper diagnosis of pink eye, the overprescription of insoles for flat feet, the redundancy of preoperative clearances for low-risk surgeries, and the futility of identifying common cold viruses. The message is to question medical advice and seek evidence-based treatments.

Takeaways

• 🧬 Modern medicine is evidence-based but sometimes slow to discard ineffective treatments due to medical inertia.
• 🤒 The common practice of reducing fevers may not always be beneficial, as fevers can boost the immune system and inhibit infection replication.
• 👶 The previous advice to delay introducing allergenic foods to children has been debunked; early introduction can actually reduce allergy development.
• 🦴 Contrary to common belief, not all torn meniscus injuries require surgery, with physical therapy often providing similar improvement.
• 🚫 Requiring a pelvic exam before prescribing birth control is not evidence-based and goes against CDC guidelines.
• 🛌 Resting for extended periods after a strain or sprain can prolong recovery and increase symptoms; movement is key to healing.
• 🦵 The belief that magnesium supplements alleviate nocturnal leg cramps is unfounded, as clinical trials show no effect.
• 👁️ Most cases of pink eye (conjunctivitis) are viral and do not require antibiotics, which can be harmful if not needed.
• 👣 Flat feet do not necessarily require insoles or orthotics, especially if there is no pain or rigidity involved.
• 🏥 Preoperative clearances are important for high-risk patients or procedures, but unnecessary tests for low-risk surgeries can be a waste of resources.
• 🤧 Identifying the specific virus causing a common cold is usually unnecessary as most colds are treated with the same conservative measures.

Q & A

Why does the speaker suggest that reducing fever might not always be beneficial?

The speaker suggests that reducing fever might not always be beneficial because the body raises its core temperature to enhance the immune system's ability to fight off infections, and the infection is less likely to replicate at higher body temperatures.

What was the American Academy of Pediatrics' recommendation regarding peanut products for children until the year 2000?

Until the year 2000, the American Academy of Pediatrics recommended that parents not feed children peanut-based products until the age of three to prevent the development of peanut allergies later in life.

What did the medical community learn about the introduction of allergenic foods to children?

The medical community learned that the early introduction of allergenic foods, such as eggs and peanut products, when done safely, can actually decrease the rates of future development of allergies to these foods.

Why might the common advice to rest after a knee injury not be the best approach for recovery?

The common advice to rest after a knee injury might not be the best approach because prolonged rest can lead to a longer recovery time and more symptoms. Gentle movement and physical therapy are often more beneficial for recovery.

According to the script, why should a pelvic exam not be required before prescribing birth control?

A pelvic exam should not be required before prescribing birth control because the CDC explicitly states that it is not necessary. Requiring such exams goes against evidence-based medicine and can negatively impact health outcomes and the doctor-patient relationship.

What is the speaker's stance on the use of magnesium supplements for nocturnal leg cramps?

The speaker's stance is that magnesium supplements have no proven effect on leg cramps, as evidenced by randomized clinical trials. Therefore, finding and treating the real cause of the cramps is recommended over spending money on ineffective supplements.

Why is it important to see a medical professional for a diagnosis of pink eye?

It is important to see a medical professional for a diagnosis of pink eye because conjunctivitis can have various causes, and a proper diagnosis is needed to rule out more serious conditions. Additionally, not all cases of pink eye require antibiotics.

What is the role of custom orthotics in the treatment of flexible flat feet?

For flexible flat feet that are not painful or symptomatic, custom orthotics are not necessary and may not provide additional benefits. The use of such insoles is part of the Choosing Wisely campaign to avoid overprescribing costly treatments without evidence of their effectiveness.

Why might preoperative clearances be considered 'CYA medicine' in some cases?

Preoperative clearances might be considered 'CYA medicine' when they are ordered excessively or without clear medical necessity, potentially creating unnecessary costs and complications for patients without improving outcomes.

What is the speaker's view on testing for the specific virus causing a common cold?

The speaker believes that testing for the specific virus causing a common cold is generally not worthwhile because the management of the condition will not change, and there are no specific treatments for the average cold.

What advice does the speaker give regarding the treatment of sprained ankles?

The speaker advises against complete rest and instead recommends starting movement as soon as possible, even if it's just small circles with the foot or drawing with the big toe, to promote circulation and healing.