Too Good To Be True

It’s interesting to see how a seemingly good idea, scantily studied, that seems too good (easy) to be true is adopted with such enthusiasm. Or perhaps it is just mis-implemented. Never the less, it’s a phenomenon I have seen too much in medicine as well. So, I guess it’s good to see that we are not alone. The real question is how do we stop this phenomenon, the “bandwagon” as it has been called, from occurring over and over, as it has.

It seems the “broken windows” philosophy of policing has suffered the same plight.

Similar events in medicine that come to mind include the “sepsis bundle,” or should I say the “sepsis blunder,” steroids in spinal cord injury, and bicarb in cardiac arrest. Really practically everything in cardiac arrest, in my career, bicarb has allegedly both killed and saved lives in cardiac arrest, most of the rest have either been life savers, or, suddenly done nothing, after all that fretting that you didn’t get the drug in until 6 minutes after the last dose. There is a long cast of characters, bretylium, lidocaine, epinephrine, vasopressin, and the list will surely go on. Another favorite is that oxycontin is not addicting.

Where is the critical thinking? It seems a simple question is in order, “this seems too good to be true, could it be untrue?” Followed by an honest answer.  It may be that the honest answer is those three words that seem so difficult to say, I don’t know.  Even, or maybe especially, if the answer is yes, at the very least, explore more.

When I have these questions, as I often have, I am often treated like a heretic. I feel pretty powerless to speak, which is unusual for me! We must not be afraid. We need to encourage, and at times demand; critical thinking, questioning, collaborative discussion and problem solving.

As healthcare consumers, we need to ask the same question. Does this seem too good to be true? If so, it probably is.

Check back for future editions healthcare by the proverbs.