Last month, Dr. John wrote an excellent blog about medical wisdom. I’d urge everyone to read it. I took that post one step further and read Ending Medical Reversal, which was recommended in the article. If you want to make better life decisions then you need to make time to read and consider the book. At a minimum, ensure that the book is read by a leader within your family, firm or practice.
Aside from the specific examples, which are fascinating, I hope you take the following away from the book.
HUMILITY – medicine is a global field where we have tens of thousands of our brightest humans spending trillions of dollars. The book makes are strong case that 30 to 40% of that expenditure provides no net benefit to humanity.
The authors lay out numerous examples where billions are blown for no net benefit. It is a wonderful reminder of our shared capacity for irrationality and misjudgment.
PARACHUTES – one of my favorite parts of the book is when they explain that there aren’t a whole lot of parachutes left in medicine.
What does this mean?
If all of humanity has to jump out of an airplane then nearly all of us are all going to do dramatically better if we’re giving a parachute.
A parachute is an intervention with big positive outcomes for a large slice of the population.
What are parachutes that you can apply in your life?
They probably include items like: exercise, germ theory, antibiotics, vaccines, not smoking and seat belts. In a capitalistic society, there’s a clear role for government to play in keeping society focused on the big ticket items.
EXPECTATIONS – let’s say you do your part and follow the “parachutes,” what’s a reasonable expectation from modern medicine?
Keeping in mind that 30-40% of modern interventions are bunk, I was left with an expectation that most procedures will usually make most people a little better.
If we have the courage to consider:
- widespread error
- limited number of high-value options
- realistic expectations
then we might find that there are new resources to focus on parachutes in other areas of our society. The cost of the status quo is often hidden from view.
There are plenty of good ideas: universal basic health services, early-childhood programs, pre-K, drug treatment, parent coaching and financial literacy training (see Kristof at the NYT). Other authors prefer infrastructure projects.
Whatever your preference, it’s clear that uninformed choices can waste valuable resources.
A final note about change.
Even clearly harmful treatments can take a decade to exit the system (plenty of examples in the book). Strangely, I took this as a message of hope.
You might not be able to reform the healthcare system but you can certainly make better decisions within your own life.
Keep at it.
Ultimately, the truth wins.