Renegades

Renegades

I came across Could a 'renegade' doctor save your life?

Short answer: nope. 

It is a curious article out of the UK, with a sympathetic look at maverick doctors who

... help patients other doctors have given up on, often by prescribing drugs and treatments the medical establishment won’t touch.

Some observations.

They focus on a physician, Gordon Skinner, who was evidently quite prolific in his treatment of hypothyroidism in people with normal thyroid function tests and as a result

hounded by the General Medical Council (GMC) for “reckless prescribing”.

Hounded.

Thyroid is not benign. Just look up the complications of hyperthyroidism.

It was not that he was giving potentially dangerous medications to people who did not need them based on his unsubstantiated belief that if patients had the symptoms of hypothyroidism (many nonspecific), then they had hypothyroidism despite normal tests.  Nope.  Renegades, by virtue of, well, being a renegade, are correct in their belief,  despite the lack of pesky data to support them and renegades never cause harm, only unadulterated good.

Dr Sarah Myhill also has the same belief and

has been the subject of 30 different cases brought by the GMC, most of them, like Gordon Skinner’s, to do with the prescribing of thyroid treatments for people whose bloods are “normal”. She also has legions of supporters and a campaign has been launched to save her from what her fans perceive as a “witch-hunt”.

Witch-hunt.

Probably these same patients, if they had been seen by a "Lyme literate" physician, would have been declared as chronic Lyme despite negative tests. Or Chronic Candida. I say this with the caveate that 1) I am no endocrinologist and 2) I am not a fan of somatoform disorder, often credited to patients with fatigue states. Whether there is actually an issue with the diagnosis of hypothyroidism, I am not knowledgeable enough to comment. It is more how the issues are framed and justified.

Proponents of science-based medicine get accused of arrogance when we have standards and physicians who pull unsupported diagnosis out of, let us say, thin air are the mavericks.  I find the hubris of renegades enviable.

Then they contrast these renegades with physicians who actually took the time and proved their hypothesis:

The Australian physician Barry Marshall was so frustrated in his attempts to convince the medical profession that stomach ulcers were caused by the bacterium H. pylori that in 1984 he produced ulcers on demand by drinking a batch of it. Prof Stanley Prusiner endured derision for two decades before winning the Nobel Prize in 1997 for identifying the cause of BSE.

The Galileo Gambit, beloved by all cranks.

They note

Is it possible, however, that another unexpected side effect from the Wakefield scandal is that the medical profession is less prepared to take account of dissenting voices?

Nope. But you have to more than a loud voice and the opinion that the man is oppressing you at the behest of Big Pharma. You have to have, hm, lets see, proof?  You know, Data  Like  Marshall and Prusiner.

Somehow it never occurs to proponents of renegade therapies that they are opposed because they do not have the data to back up their assertions, that what they are doing is not totally benign and that doctors care that their patients get the right care. It matters since

Doctors making up their own rules are a danger to patient safety.

Renegades need to put up or shut up. Instead, they put up clinics.

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