Leeches and Cocaine

No one uses leeches or cocaine as therapeutics anymore—but they used to.

• Cough remedies do no better than placebo for children or adults
• Angioplasties and stents do nothing to prevent subsequent heart attacks in 95% of patients receiving either of those procedures.
• Patients undergoing coronary bypass operations have prolonged life as a result only 3% of the time.

What is particularly interesting is that Medicare and healthcare insurers pay for these procedures. How much? Well in 2006 1.3 million angioplasties were performed at an average cost of $48,399 each and 448,000 bypasses at $99,743 per procedure.

Doing the math, that comes to $104 Billion. That’s $104 Billion (with a B) for procedures that are “…usually dangerous, invasive, expensive, and largely ineffective.” So while it would seem that syrups and stents are the clinical way to go, the evidence may not really be there to support it. If clinicians don’t know that, they are doomed to blindly and expensively continue on.

One of the pioneers of evidence-based medicine is quoted to have once said that “Half of what you'll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half -- so the most important thing to learn is how to learn on your own.”

-- Dr. Chris E. Stout

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