Quote:
Originally posted by Replaced_Texan
Also, you're confusing medicine with public health. Public health is about treating populations and finding out what causes disease so it can be avoided. Epidemeology, the field of study that you've ranted the most against, is a public health discipline. It's the reason we drink clean water. It's the reason we pinpointed the HIV virus as a sexually transmitted disease. It's the way we track Avian flu.
Medicine is about treating individuals. It is completely anecdotal in nature, and it depends almost entirely on the individual patient. If you flip through a medical journal, say JAMA or the New England Journal, you'll find a lot of case studies and randomized trials. (This week, it's all HIV all the time, because of the AIDS conference.) If you show up at grand rounds in any teaching hosptial, usually the presentations are on various individual cases. Drug and other interventional trails are also based on randomized reports of individual cases. When the results of an intervention start to a) be beneficial and b) generate the same results in different patients with the same disease, the intervention is adopted as the standard treatment.
In some respects, public health is an attempt to avoid having to resort to medicine. The goal of public health is to keep the population healthy so that medicine is not needed. Once you get sick, the public health part is irrelevant (except, of course, you're now a data point for future public health research) and the medicine part kicks in. Your doctor isn't worried about what got you there; they're worried about how to fix you. He or she is going to tell you about what's going on with you personally and he or she is going to make treatment and diagnosis decisions based on your individual history (including family history, social history, lifestyle and your physical condition (height, weight, blood tests, x-rays, CT scans, and any other diagostic tools that he or she uses in his or her practice)).
So your rant is against public health, not medicine. I, for one, am a fan of John Snow, and I vaguely subscribe to the germ theory of disease. Your milage may differ.
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My rant is against the misrepresentation of any fact to the public for any purpose, even keeping people healthy. If the public can't understand epidemiological data (which it obviously can't, since even the press, and an assumed educated sector of the public, seems incapable of understanding it), then it should be offered with caveats, such as:
"NOTE: MOST PEOPLE WHO [INSERT VICE OR UNHEALTHY BEHAVIOR] DO NOT GET DISEASE. THIS IS EPIDEMIOLOGICAL DATA, WHICH MEANS THAT WHEN WE SAY YOUR 'RISK' INCREASES TWOFOLD, WE MEAN IT INCREASES FROM 1 IN 100,000 TO 2 IN 100,000."
If people must read this kind of data, why would it be a bad thing for them to understand it? Couldn't it save us a good deal of hysteria about diseases? A person I worked with wore sunscreen every day, even in the winter, because she read somewhere that accumulated sunlight over a lifetime could give you cancer. The article, of course, failed to note that it was physically impossible to get a skin cancer from 300 years worth of two minute jaunts from the subway to her office building (which was about the extent of her daily exposure to the sun's rays). That's probably the press's fault, but I think the medical community has an obligation to make sure the press explains a story in full, instead of writing it in a manner to scare people. But no one does that, because they figure the hyper-vigilance of the deluded is good for the deluded's health. Seems like lying by ommission to me.
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