It's getting scary.

Medical research is largely or more and more being funded by drug companies - DCs.
The universities and their professors are becoming largely dependent upon DCs.
So are medical journals.
DCs are not primarily interested in the potential for harm.
They have been known to with hold information.
DCs have no interest in unprofitable treatments.
They have a duty to their shareholders not to patients.
They do what's expected of them.
Their influence is everywhere.
They need new drugs which can be patented.
Lifestyle drugs is the name of the game.
It's in their interest to have as many people as possible taking pills.
They have done great things for us but they should not control research to the extent that they do.


Guidelines are becoming a standard to judge performance and determine pay.
More and more of our top medical scientist are being helped financially by the DCs.
Too many sit on guideline committees while being paid by DCs whose products are under consideration.
Too many of our guideline producers have career conflicts of interest too.
Too many do not see these conflicts of interest as a problem.
Their mistakes and prejudices are becoming enforced on the workforce under the guise of evidence based medicine.
Tops scientists for instance should not be the ones to decide on the validity of research in their field of interest. Do the research have others crunch the numbers.
We need independent critical appraisers arguing the pros and cons of research.
Anyone being paid by a drug company should be excluded from having any a seat on anyy guidelines committee.

Evidence based medicine is a great boon and a potential trap
What is true today may not be tomorrow.
Findings may be plain wrong.
Things can be fudged.
DOEMs become more important than POEMs (disease as opposed to patient orientated evidence)
(what matters is not your cholesterol level for instance but where you have an MI stroke etc or not)
Statistical tricks can be played.
Very few doctors have the ability to sort wheat from chaff.
Critical appraisers with no conflicts of interest are a rare breed.
Once something becomes a truth it's very hard to change

Doctors are losing power to the politicians and managers.
Their livelihoods more and more dependent upon, not patients, but those that pay them and control their right to practice.
Controllers love guidelines - so would I if I was one - they simplify.
It's not their job to determine whether guideline are the truth or not.
Doing so would complicate their lives.
They tell us guidelines are only guidelines yet demand explanation if one steps out of line.
The professional and government bodies are part of this system too. They too use guidelines.
Doctors are controlled beings. If not they will be.
They are becoming less and less able to act out of their own knowledge or even the knowledge of experts that disagree with guidelines.
They are destined to become obedient souls - soldiers - unless things change.

Doctoring is becoming more and more a business rather than a profession. The yard stick - when your doctor is with you are they putting your interest before their own? Are they interested in you or more interested in their computer's requests - thats' where the money is? Ask them what's the evidence? Whats the countering evidence? What's the number needed to treat and harm? Who funded the research? Does he or she know the interaction of all those drugs she or he is offering? If you ask me, you'd get a lot of don't knows! Are you prepared for the discomfort of there being no certainty - only possibilities and probabilities

It's getting scary out there. Not too bad just yet maybe but the future looks grim to me.

Here's some of my stuff on these issues

Tight control of sugar levels in type 2 diabetes. Take a look at this for an example of differences in interpretation of evidence. As good as no benefit over less tight control

Things are not black and white. The more one knows the more Grey they become. Managers and controllers can not handle grey. Individual doctors and patients can but that's too anarchistic for the piper payers. The two people that matter in the moment are being taken bit by bit out of the game. But even for the doctors and their patients the whole business is too time consuming - better just to rely on those guidelines. Mostly they are pretty good but ......

Paranoid - yup.