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A review by anothermulekickin
Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health by Marty Makary
4.0
I am going to complain at the end. So, first: there is some absolutely great--and new to me-- health and information content in this book. Great examples, some of which I was unaware of, when very important medical misinformation seemed to get placed into practice on the basis of poor evidence, or well-intended, but misguided attempts to balance policy goals, and then was defended by the profession, and these practices persisted and many cost a large number of lives. Some colossal mistakes have been made in my lifetime.
It is a worthwhile reminder that medicine is highly complex and well-intended, but much is driven by best guesses and best current knowledge--which is no perfect and contains many unknowables.
But there is some sensationalism here too--it is easy to project hazard ratios onto populations and come up with some fantastic number of people impacted--at the same time--he loses in the sauce the fact that when it takes an enormous study to find an effect, it means the effect is in explicitly hard to detect!
The cautions and critiques are absolutely right for within the profession, and should be addressed. Within the profession, you should argue, debate, criticize, question everything if you have a legit scientific basis.
But let's not validate the notion that every time anybody has a question about any topic, that means the whole profession cannot be trusted. "Teach controversy" is an explicit strategy. Some see this as "things are perpetually broken in the medical research community, we need an outsider" --that will sell books-- But demagogue solutions seems to be as nuanced, as deciding it makes sense to have "disruption" and get person outside the profession (I don't know, say, a plumber or lawyer) run NIH, "cuz only an outsider can fix it--it's just common sense." We live a society in which "vaccines cause autism" seems to have significant traction.
Very much worth reading.
It is a worthwhile reminder that medicine is highly complex and well-intended, but much is driven by best guesses and best current knowledge--which is no perfect and contains many unknowables.
But there is some sensationalism here too--it is easy to project hazard ratios onto populations and come up with some fantastic number of people impacted--at the same time--he loses in the sauce the fact that when it takes an enormous study to find an effect, it means the effect is in explicitly hard to detect!
The cautions and critiques are absolutely right for within the profession, and should be addressed. Within the profession, you should argue, debate, criticize, question everything if you have a legit scientific basis.
But let's not validate the notion that every time anybody has a question about any topic, that means the whole profession cannot be trusted. "Teach controversy" is an explicit strategy. Some see this as "things are perpetually broken in the medical research community, we need an outsider" --that will sell books-- But demagogue solutions seems to be as nuanced, as deciding it makes sense to have "disruption" and get person outside the profession (I don't know, say, a plumber or lawyer) run NIH, "cuz only an outsider can fix it--it's just common sense." We live a society in which "vaccines cause autism" seems to have significant traction.
Very much worth reading.