Failures of Medical Professional to Follow the Science

Pamela Paul has written an excellent opinion piece for the New York Times entitled, “The Medical Establishment Closes Ranks, and Patients Feel the Effects”. She expertly dissects the medical mistakes of the past, among them- advice on peanut allergies, the rejection of a recommendation to restrict blood donations from people at high risk for AIDS, and limiting the use of hormone replacement theory for menopausal women. The guidance on all these was later proven to be incorrect.

To this list I would add smoking, lobotomies, and of course, gender affirming care.

In the example of peanut allergies, Paul describes how parents had conscientiously followed the advice of medical authorities to avoid early exposure to peanuts, only to learn later that doing so actually harmed their children. Too often, parents learned, dissenting voices in the medical community had provided evidence contrary to the prevailing opinion, only to be shouted down and ostracized. Paul refers to it as “avoidable tragedy”. She writes: “Rather than remaining open to dissent, the medical profession frequently closes ranks, leaning toward established practice, consensus and groupthink.”

Paul’s piece is basically a review of a new book, “Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health” by Marty Makary, a surgeon and professor at Johns Hopkins School of Medicine.

If you are a reader of PITT you know where I am going with this.

I wish I had spoken to Paul before she published her article. I’d like to have shared the justification the Head of Student Healthcare sent to my husband and me when we asked why they were prescribing testosterone to our 18 year old daughter after just two visits with her:

“If I were responding to a general inquiry as to how we developed our services, I can tell you that these were developed with great care in following the guidelines that are described by the Center of Excellence for Transgender Health at UCSF: http://transhealth.ucsf.edu/trans?page=guidelines-home   Our practices are also rooted in the scientific evidence-base, which is well established and reflected in the policy statements from several professional organizations, most recently by the American Academy of Pediatrics: http://pediatrics.aappublications.org/content/early/2018/09/13/peds.2018-2162

The American Academy of Pediatrics refuses to acknowledge the CASS Review. Paul could have added gender affirming care to her list. Makary could have cited it in his book. Perhaps it’s too soon. But the truth will come out. Probably when the lawsuits start.