When doc don’t know

By John Pickering 04/02/2012

I had my 13th general anaesthetic yesterday for the same thing!  It was, yet another, 50/50 call by the surgeon as to whether this new procedure would work.  50/50 calls are not unusual in medicine – to the contrary they are probably the norm.  Most of us have had the experience of having a doctor state they were not sure of the diagnosis (eg. viral or bacterial?) or of the best treatment option.  In the past they may not have told us, just applied their own prejudice and made a decision for us.   Nowadays, we are given the option and expected to make the decision ourselves…daunting!  One wonders why they are paid the big bucks sometimes!  The reality is that very few of us are well prepared to make the decision ourselves.  Few read the research and even fewer have the skills to understand what the numbers mean (a failing of our school system which places more emphasis on algebra than statistics).  So, is there anything we can do?

The number one thing we can do is insist that we become part of a trial.  Two reasons for this, if we are part of a trial then we are more likely to have better health outcomes (there is research to show this, in the meantime, you will just need to believe me).  Second, only by there being trials will answers be found as to which treatment or diagnosis is better/correct. It is a no-brainer really!

Unfortunaetly there are many barriers to trials – labourious ethics proposals (not all bad, just time consuming), lack of willingness in the medical profession (no time, no financial reward), and too few people engaged in analysing the results (my job). This could change if the politicians insisted that all medical professionals be engaged in research because it is a fundamental right of patients to receive the best health care possible!

To summarise:

Being  in a trial is a right.

Being in a trial means better health outcomes

The vision is for all patients, all of the time, to be enrolled in a trial.

As for me,  I read the research (poorly done), I made a decision based on a balance between no op and certain future multiple operations or having the op and if it were not successful more ops with possible additional problems .  I chose hope rather than the status quo.  I suggested a trial but there was no time to get ethics sorted…I may just write a trial protocol for the surgeons and if I can perrsuade them to do better.

Tagged: Clinical trials, Research, Surgery