Gettysburg Medical News
 The Clinical View
 by P.E. Hoffsten, MD
19 October 2005

RELIABLE MEDICAL SOURCES

            Last week’s column was devoted to the concept of medical literacy.  While literacy has to do with the ability to read and understand language, the concept of medical literacy takes on an additional consideration.  Specifically, after one has read or heard information, how does one evaluate whether the information is valid and applies to their own situation?  Is one drug or another drug really better?  Do the side effects of a medication warrant the benefits of the medication?  What are the critical factors in one individuals health considerations?

            One of the major American industries is advertising.  As we have all learned, sometimes through bitter experience, advertising is designed to benefit the seller.  Sometimes, it benefits the buyer also.  But in today’s world, the statement, “Let the buyer beware” is truer than it has ever been.  We are constantly deluged with information and offers on television, the internet, newspapers, radio, and direct mailing advertising.  How does a person know what to believe?

            The medical professional today continues to evolve toward “evidence based medicine”.  By evidence based medicine, is meant that a medication or treatment has been tried in a group of people and either no treatment or older treatment tried in a similar group of people.  Then a comparison is made between the two treatments to see which one works better.  Which one has the fewest side effects?  Which one is the most cost effective? These results are then published in so called “peer review journals” that healthcare professionals subscribe to.  Peer reviewed means that when a doctor or a scientist does a research study and draws a conclusion, his analysis and conclusions are analyzed and criticized by another scientist or physician with similar training who thoroughly understands the problems.  The issues are often so complex that when an article is published in a medical journal, an editorial is written by one of the editors expressing yet another opinion and analysis of the scientific work.  By this method, results are carefully screened, analyzed and evaluated before a medication or a treatment is offered to the public.  Finally, there are professional societies devoted to many medical specialties such as diabetes, heart disease, and hypertension.  These societies have advisory boards that consider the best treatments for their various missions.  These advisory boards analyze multiple publications about many different treatments and then make recommendations to healthcare professionals on how to treat various conditions.  These professional society recommendations are perhaps the most reliable medical sources.

            The information described above is available through your local clinics.  There are various reliable medical publications available to healthcare professionals to help advise you.

            What are the unreliable, shaky sources that a consumer should be careful of?  You first have to realize that television, newspapers and radio stay alive by attracting readers and listeners.  They attract readers and listeners by getting your attention.  They get your attention by scaring you with the latest medical disaster, the most terrible side effects, or the exposé of some healthcare professional or clinic.  The reader and the listener should recognize that the reliability of this type of information is very low.

            Secondly, the advertisements on late night TV on non-mainstream television channels are really suspect.  Vitamins that decrease aging, various preparations to grow hair, and various preparations to treat your sexual concerns have little, if any, validity.  It has always been strange to me that these advertisements ever work but they must because they stay on TV.  Now there are a host of advertisements for Medicare funded diabetic supplies and diabetic shoes.  The shoe business is a horrible fraud.  Diabetic shoes should be fitted by a person who examines your feet and should not be prescribed by getting you to step on a mold, mailing that into the company and getting back a pair of shoes based on that mold.  That is dangerous.  The advertisements for diabetic supplies are slanted to make money from Medicare; but unless the results are interrupted with a healthcare professional and adjustment in medications made, usefulness of these supplies is negligible.

            The value of all the nutritional supplements, vitamins and “natural products” available over the counter is very suspect.  Those nutrition supplements are not standardized in regard to their potency or their purity.  Note that prescription medications are pure and standardized.  It serves one well to keep in mind that an endorsement or beneficial claim for a medicine is much more credible if made by someone who is not selling the medicine.  Glucosimine, folic acid supplements, fish oil, and flax seed oil all have believable benefits as supplements.  Vitamin E supplements appear to actually be dangerous.

            Lastly, we come to a source that is highly impactful and may even be useful.  This is, “A friend told me ….”  Sometimes, this is very good advice and sometimes not so good.  When people have similar problems and someone has already used something that worked, there is a strong tendency to believe what your friend had to say.  The conditions are not all the same no matter how similar they may seem.  Checking with your healthcare professionals is a warranted step.

            In the final analysis, the most reliable source is the healthcare professional at your local clinic that takes the time to listen to your story, analyzes your situation, and then advises based upon your individual needs.  There is nothing more personal in your life than your specific medical needs and each of us are individuals requiring individual consideration.  The healthcare professionals at your local clinics are aware of this and are your most reliable medical source.