An article to the Open Page of the Hindu
My previous post about Dr.V.Mohan (Chairman of Mohan Diabetes Centre) certifying Sai Baba’s “miracles”, reminded me of an earlier piece in the Hindu by one Prof.B.N.Hegde. In that he criticised modern medicine heavily without any kind of logic. To that, Lakshmi, a friend, who is also a doctor, and I had written a response (in Dec 2010). It was not published. So, I thought I can post it here. But before that read the original article, to which we responded.
FLAWED LOGIC + POOR MEDICAL ADVICE: A DANGEROUS COMBINATION
This is in response to Prof.B.M.Hegde’s article in the Open Page of the Hindu edition dated 5th Dec 2010. In his opening line, the professor declares that “The foundation of modern medical science is shaky“. To support this statement he refers to articles and books where he says he has written about the unscientific basis of randomized controlled trials (RCTs). He also says that these methods do not meet the standards of NASA-TRL or Modern Systems Engineering. The definition of TRL from Wikipedia says “Technology Readiness Level (TRL) is a measure used by some United States government agencies and many of the world’s major companies (and agencies) to assess the maturity of evolving technologies (materials, components, devices, etc.) prior to incorporating that technology into a system or subsystem“.
TRLs are meant for materials and devices, not human bodies. Materials and devices can be fully understood; their behaviour is deterministic and predictable. In comparison, human bodies are vastly complicated and we do not understand them fully. Thus we have to rely on statistical methods. If statistical methods tell us that a therapy is effective, say, 90% of the time, that is a very strong indicator that it works. This will obviously not meet the standards of TRLs. Expecting human bodies to be as predictable as the machines we make is unrealistic. Moreover, though the professor insists that the foundation of RCTs is shaky, he does not suggest an alternative method to assess effectiveness of therapies.
Further in the article, he says “Many of the present expensive anticancer chemicals have not even gone through the inadequate RCT test!” He talks about how Pharmaceutical industry “could go to any extent to fool even the governments” and cites a recent example. That companies do indulge in such practices is common knowledge. Citing the malpractices of the pharmaceutical industry as the rationale for dismissing modern medicine is illogical.
He also states that “the industry is keen only on imaginary diseases (the so-called silent killers) that need lifelong drug therapy.Blood pressure, sugar and cholesterol are the three biggest milch cows“. While claiming rightly that companies do try to exploit consumers, he takes a scientifically invalid stand that diseases like diabetes do not exist. As a respected physician, does Prof. Hegde realize the impact of his words? If the diagnoses of hypertension and diabetes are delayed or missed, people could end up with strokes, nerve, eye and kidney damage. For those individuals, waiting for the ‘first symptom’ to go to the doctor may be too late. Moreover, a timely check-up can actually serve as a warning regarding one’s weight or cholesterol or BP, help make lifestyle changes, and possibly avoid medications.
The final statement to which we wish to respond is “The tall talk of evidence-based medicine is as hollow as are many of our claims to superiority to all other modalities of treatment such as Ayurveda and Homoeopathy. In fact, most of them have a better scientific base than our modern medicine“. To this we would like to point out to the readers and Prof.Hegde that the British House of Commons Select Committee on Science and Technology has issued a report on homeopathy, saying “systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos” and concludes that “The funding of homeopathic hospitals – hospitals that specialise in the administration of placebos – should not continue”. The report can be seen at http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf.
The professor who earlier in the article tries to equate modern medicine with placebo by stating that “Most modalities of treatment, using both drugs and surgery, have no scientific base, although many of them seem to work through a very powerful placebo effect” goes on to say that Homeopathy, which is actually a placebo, has a better evidence base than modern medicine.
The real problem (that Professor Hegde repeatedly alludes to in his article) is regulation of the Pharmaceutical industry. But he is barking up the wrong tree by saying all modern medicine is wrong and that homeopathy and Ayurveda have more evidence. The professor, with his flawed logic and poor medical advice, is actually doing more harm than good.