whygetfat on Nostr: Dr. Madhava Setty: "Thirty years ago, when I was in medical school, there was this ...
Dr. Madhava Setty: "Thirty years ago, when I was in medical school, there was this new thing called evidence-based medicine. That sounds great: we want to make our guidelines and choices based on evidence. It had a couple of bad effects.
"The first, and the biggest deleterious effect of this, was that it came upon our medical institutions to gather large amounts of data. The way they had to do this was that they had to computerize things. You used to go to see your doctor and you would just have a conversation, and they would write a few notes about your medical history, and why you came to see them. Everything was on paper. They would spend their whole time looking at you. Now, as you know, you go to see a doctor and they're on their computer the whole time, because they're inputting data into a vast database that can be accessed and mined for signals.
"What has happened? Well first of all, you've lost that human contact with doctors. Secondly, once you have very large bodies of data, let's say, you can prove almost anything you want to, using whatever biased methodologies you want to show yourself something. What has happened then is that doctors now are second-guessing their own experience, because they're being told that, 'Oh no, the evidence says this, so whatever you're seeing, oh, it's purely anecdotal.'
"But anecdotes is what used to drive medicine. It was the anecdotes, when offered in enough volume, would drive a reflection of the medical system to say, 'Oh my gosh. We must be doing something wrong. There could be something wrong with this medicine we're giving. There must be something wrong with what we're doing, because all of these doctors are reporting that there's been harm.' But now doctors are second-guessing what they're seeing. it's like, 'Oh well, obviously I can't explain what's happened to you, but we know it's not the vaccine.'
"What's very scary is that doctors now are just going with what's being told, as opposed to what they're seeing. And this is a massive problem. Covid is something that is exposing this. We have to be aware of how it works in order to understand that yes, it's not an infallible system. Evidence-based medicine is not an infallible thing; it can actually be very fallible.
"As physicians we've tended to have lost the art of medicine, which is the feeling and seeing. The gumption that was required back then is no longer needed. We have studies we can get. We can get MRIs and echocardiograms. Fifty years ago you didn't have those things, and you would have to do a diligent physical examination, really listen to someone's heart, and make some guesses. The clinical acumen of physicians back then were much greater than they are now."
Dr. Alexis Cowan: "Yeah. Something I think quite a bit about is how we allowed ourselves for having all this innovation in medicine and science, and yet most of our innovation is literally to deal with problems we created through our ignorance and our use of technology and our detachment from nature.
"And I also think the evidence-based label never really sat right with me because, like you said, in a doctor's office, that's an N of one setting. You want the doctor to be able to understand what's wrong with you, not what's wrong with a population, on average. If you're looking at averages in science and translational science, you're losing a lot of information about the individuals within that group, because you're averaging everything together and you're looking at the average response. But the average response may not apply to any one individual within the group. And now we're just sticking that label onto people, or putting them in a bucket that may not actually be for them."
Dr. Madhava Setty with Dr. Alexis Cowan @ 46:33—50:50 https://youtu.be/KzvBjI6fYS8&t=2793
"The first, and the biggest deleterious effect of this, was that it came upon our medical institutions to gather large amounts of data. The way they had to do this was that they had to computerize things. You used to go to see your doctor and you would just have a conversation, and they would write a few notes about your medical history, and why you came to see them. Everything was on paper. They would spend their whole time looking at you. Now, as you know, you go to see a doctor and they're on their computer the whole time, because they're inputting data into a vast database that can be accessed and mined for signals.
"What has happened? Well first of all, you've lost that human contact with doctors. Secondly, once you have very large bodies of data, let's say, you can prove almost anything you want to, using whatever biased methodologies you want to show yourself something. What has happened then is that doctors now are second-guessing their own experience, because they're being told that, 'Oh no, the evidence says this, so whatever you're seeing, oh, it's purely anecdotal.'
"But anecdotes is what used to drive medicine. It was the anecdotes, when offered in enough volume, would drive a reflection of the medical system to say, 'Oh my gosh. We must be doing something wrong. There could be something wrong with this medicine we're giving. There must be something wrong with what we're doing, because all of these doctors are reporting that there's been harm.' But now doctors are second-guessing what they're seeing. it's like, 'Oh well, obviously I can't explain what's happened to you, but we know it's not the vaccine.'
"What's very scary is that doctors now are just going with what's being told, as opposed to what they're seeing. And this is a massive problem. Covid is something that is exposing this. We have to be aware of how it works in order to understand that yes, it's not an infallible system. Evidence-based medicine is not an infallible thing; it can actually be very fallible.
"As physicians we've tended to have lost the art of medicine, which is the feeling and seeing. The gumption that was required back then is no longer needed. We have studies we can get. We can get MRIs and echocardiograms. Fifty years ago you didn't have those things, and you would have to do a diligent physical examination, really listen to someone's heart, and make some guesses. The clinical acumen of physicians back then were much greater than they are now."
Dr. Alexis Cowan: "Yeah. Something I think quite a bit about is how we allowed ourselves for having all this innovation in medicine and science, and yet most of our innovation is literally to deal with problems we created through our ignorance and our use of technology and our detachment from nature.
"And I also think the evidence-based label never really sat right with me because, like you said, in a doctor's office, that's an N of one setting. You want the doctor to be able to understand what's wrong with you, not what's wrong with a population, on average. If you're looking at averages in science and translational science, you're losing a lot of information about the individuals within that group, because you're averaging everything together and you're looking at the average response. But the average response may not apply to any one individual within the group. And now we're just sticking that label onto people, or putting them in a bucket that may not actually be for them."
Dr. Madhava Setty with Dr. Alexis Cowan @ 46:33—50:50 https://youtu.be/KzvBjI6fYS8&t=2793