we have to assume the treatment will work

Health Care Myth Busters: Is There a High Degree of Scientific Certainty in Modern Medicine?

"Yeah, yeah - but we have the best healthcare in the world. Be happy. Stop questioning your doctors - what do you know?"

Complaining, talking about the importance of data, using the word "evidence-based" gets people (me) into all sorts of trouble. My own doctors take a jaundiced view of my interest in the evidence behind their recommendations. My friends' eyes glaze over when I ask them if they have researched their own diagnosis or gone for a second opinion. But the problem isn't the tyranny of data, it's the willful ignoring of it. And here is an excellent explanation of why we do:

"...physicians frequently base their decisions on shortcuts, such as the actions of the average practitioner ("if everyone is doing it, the intervention must be appropriate"); the commonness of the disease ("if the disease is common, we have no choice but to use whatever treatment is available"); the seriousness of the outcome ("if the outcome without treatment is very bad, we have to assume the treatment will work"); the need to do something ("this intervention is all we have"); and the novelty or technical appeal of the intervention ("if the machine takes a pretty picture, it must have some use").

Every single of the bolded items above apply to eating disorder care. I wish everyone who is puzzled by my droning on about "evidence-based" will read that article to understand why.


  1. The anecdotes (on pg 4 of the article) about orthopedic surgeons' opposition to evidence about lower back pain treatment is very similar to some ED professionals' reactions to new evidence. It seems that our popular faith - our belief that health care is science-based and all of our providers keep up with, welcome and use the latest findings is just that - faith.

    It took decades for the 19th-centruy medical community to accept the evidence that hand-washing limits the spread of disease. Seems we haven't evolved very much since then. In the end, doctors are human animals after all, and like so many other people - individuals and groups - when threatened they have the urge to keep heads in the sand, circle the wagons, and attack the messengers.

    So, to you Laura and to the practitioners who keep their eyes open about EDs- THANK YOU. Keep up the good work of supporting and disseminating important information. What you are doing makes all the difference.

  2. The only thing I don't understand is why people are puzzled by your emphasis on evidence-based treatments. It seems like best practice and plain old common sense to me - the treatment with the best outcomes, as proven by as many studies as possible - should be the treatment of choice. Why the heck are people so weird about that? Well, I can actually think of many reasons why a professional might be resistant to changing their practices...but none of them are good reasons.

    Thank you for continuing to puzzle people :) more Lauras, fewer antiquated mental health professionals please!

  3. That's a pretty amazing, eye-opening article Laura. Everyone should read it. Thanks for sharing it.

  4. Having it laid out in front of you like this puts so much into perspective for me. Doctors are human beings, with many faults, just like all of us. I would like to think that the medical profession would force itself to a higher standard, though, because they have our health and lives in their hands. Thanks, Laura.


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