I was seeing a patient in follow-up in clinic at the end of his antibiotic course. We discussed the whys and wherefores of his disease and I finished up with my usual 'Do you have any questions?'

It was at this point the patients daughter spoke up.

What do you know about …?

and asked about a pseudo-medicine.

I honestly do not remember which one. Something to do with gut health, leaky gut and boosting immunity to prevent autoimmune disease by taking supplements and probiotics. It does not really matter what the pseudo-medicine was, as will be seen.

I asked why they wanted to know.

My patient had just returned from a seminar about the pseudo-medicine and was going to give it a try.

Well, I said, as far as I know it is not based on reality, has no scientific validity and is a crock.

Is there any harm? the son asked.

Just to the bank balance.

What do you think? I asked my patient.

And we had a conversation about the topic. Here was his opinion.

The anecdotes of the intervention being successful was far more impressive to him than my medical opinion. I may know something about treating infections, but the experience of others was far more compelling.

That clinical trials showing lack of efficacy were not as credible as his trying it and seeing if it worked for him.

I will know whether or not it works when I try it.

His experience is the only valid determinant as to the effectiveness of the pseudo-medicine and it was his money to spend.

There is no time in a 20 minute clinic visit, most of it devoted to the infection, to have the in-depth discussion needed to suggest that his approach to evaluating medicine could be flawed.

Which is how it always is. Every day and in every way that is how we make our choices.  I ask a friend, Google it, look it up on Yelp etc.  We trust the experience of ourselves and others. I do. I like to say that the three most dangerous words in medicine are 'in my experience' while in the real world it is the three most important words.  Why not use the same criteria for our medical therapies? To do otherwise is an unnatural act.

The daughter was glad to hear my opinion; she obviously did not want her father to waste money tightening up his bowels.

The patient? He was going to give it a try. It was the only way to know if it would be of benefit.

Points of Interest 09/16/2015
Points of Interest 09/15/2015