Jerry Avorn is a professor of medicine at Harvard and an internist at Brigham and Women’s Hospital. He’s also the author of “Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs.” He wrote an eccentric and slightly polemic opinion piece in The New York Times that connects Marie-Henri Beyle, pseudonym Stendahl, with the current state of primary care treatment techniques.
Avorn says in the piece, “It would take dozens of hours each week for a conscientious primary care doctor to read everything he or she needed in order to stay current — a dizzying and impractical prospect.” And to fix this problem many medical groups give out what are called clinical-practice guidelines. They’re comprised of expert opinions in various fields done by poring over reams of clinical research and drug studies, then culling out what seems to be most effective and beneficial. These published summaries are supposed to help primary care physicians choose new treatments that work so that they can offer the most appropriate, up-to-date care.
While this sounds straightforward, the process can go astray. Avorn says the guidelines “emphasize the riskiness of established treatments like insulin and glipizide, which now carry yellow warning labels in the A.A.C.E. summary.” And why would this happen? Avorn asserts that some of these guidelines are supported with funding from major drug companies. Interesting, right? We can only guess how “un-biased” these guides are given this fact.
As Avorn concludes, Stendahl, who was experiencing palpitations, dizziness and an overwhelming feeling due to an abundance of great art, may have been given experimental drugs that weren’t actually good for him. The reason? Because drug companies wanted doctors to distribute the drugs in order to make money on their investment. And what happened to the great writer Stendahl? “Back from Florence, Stendhal ended his life racked by disabilities attributed to his syphilis. It now appears that many of his symptoms were probably adverse effects of the drugs his doctors were using to treat him, following the not-so-scientific treatment guidelines of their time.”
Check out the complete op-ed piece. Avorn is no whippersnapper. He’s worried that in a time of information deluge, we primary care doctors might be drinking from a fire hose of “expert opinion” that’s sometimes laced with profiteer arsenic. He doesn’t want us to wind up like Stendahl, overwhelmed and traumatized by unbound discoveries. And he also doesn’t want us committing our patients to a Stendahlian fate, an avoidable one caused by distributing faulty remedies. We like how Avorn is thinking about healthcare.