Show 1135: Who Do You Believe–the Experts or the Evidence?

Doctors have been advocating evidence-based medicine for a few decades, but a surprising amount of medical practice is based on tradition. How can you sort out the value of evidence-based medicine from eminence-based medicine? (That is, what the most influential experts recommend, based on their own experience or beliefs.)

The Fate of Medical Mythbusters:

Collecting medical evidence may uncover practices that are not optimal. Are medical mythbusters hailed as heroes, or are they more often pilloried like Dr. Ignaz Semmelweis? (He advocated doctors washing their hands between autopsies and patients.)

Is Evidence Overwhelmed by Conflicts of Interest?

Prominent physicians are often paid handsomely by drug or device makers on the hope that they will prove to be opinion leaders. Such conflicts of interest may go undetected for years, as they did with Dr. José Baselga. Until Sept. 13, 2018, he was chief medical officer of Memorial Sloan Kettering. He stepped down when his supervisors learned that he had not disclosed receiving millions of dollars from health care companies. His case was uncovered by ProPublica and The New York Times, but most doctors don't get that kind of scrutiny. How can we learn about their conflicts of interest? Why do they matter?

The High Cost of Cancer Treatments:

The development of new cancer treatments such as CAR-T is exciting, but at the prices being charged few patients will be able to benefit. Can our medical system survive such sky-high costs? Find out how patients can make the best decisions on their treatments.

This Week’s Guest:

Vinay Prasad, MD, MPH, is a practicing hematologist oncologist and internal medicine physician. He is an associate professor of medicine and public health at Oregon Health and Science University. Dr. Prasad with Adam Cifu is author of Ending Medical Reversal: Improving Outcomes, Saving Lives. His website is http://www.vinayakkprasad.com/