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Thursday, October 1, 2015

Medicine based on some science, mostly consensus

You'll often hear the phrase: "Medicine is an art based on a science."  A more accurate phrase would be: "Medicine is an art based on some science but mostly consensus."  Lost in the discussion is the fact that science is not a consensus, or if it's a consensus it's not science.  The irony of it all is that most of the theories in medicine are based on consensus, not science.

Think of it this way.  Science is an attempt to understand things. Studies are performed, groups of data collected and then interpreted in several ways by observers.  'Consensus' is definitely important in that the more observers you have (i.e. scientists, researchers) that agree with a given interpretation, the more likely said the interpretation is accurate.

So, basically, a consensus is a group of scientists who agree with a given interpretation.  In other words, it's the results of a vote.  For instance, back in the 19th century a consensus of physicians believed that asthma was a psychosomatic disorder.  This conclusion, or consensus, resulted in researchers and scientists looking for solutions in the wrong area.  They tried to find medicines to allay the mind when they should have been looking for answers elsewhere.

So, you can see, the consensus is not always guaranteed.  If it were science, it would be guaranteed. The purpose of science is to find solutions that can be duplicated. Every time you do a certain thing, you will get the same results.  That's science.

You see, a consensus is not always guaranteed.  Those who agree with the consensus have been found to be wrong occasionally.  I can give you a ton of examples both from medicine and from the non-medical world to prove my point here.

The consensus had it that asthma was all in your head.  Later on, after years of wasted effort and resources, science learned that asthma is a physiological process that results in chronically inflamed airways that are hypersensitive, and exposure to asthma triggers causes bronchospasm and dyspnea.  This discovery created results, and now asthmatics can obtain control of their disease.

Another example is the hypoxic drive theory. It was based on a study of only four COPD patients.  Dr. EJM Campbell gave a presentation where he described the theory, and consensus of physicians began to worship it and teach it as fact.

So then once a consensus is formed it's nearly impossible to break it.  If you say the consensus is not right, then you are laughed at and mocked. Even though hundreds of studies have disproved it since that fateful day when Campbell gave his presentation, the consensus had been engrained so deep into the medical profession that even facts, even actual scientific facts, do not change consensus.

In the nonmedical world, you can look at global warming. My friends argue that a consensus of scientists believes in global warming, therefore it is a fact. I'm not going to sit here and deny global warming (but I will here), but a consensus is not evidence; it's not science.

So, based on this consensus, many regulations have been created that have prevented many people from going into business because they can't afford them, and many others have closed their doors because they can't afford them. Many jobs are not created based on a consensus, rather than proven science. This affects millions of lives every day, and it destroys economies.

Now they're talking about how they want to genetically engineer people to prevent climate change that might not even be caused by man. They want to genetically alter human eyes so we can see in the dark in order so humans can save all kinds of electricity and, therefore, pollute less, and therefore not destroy the planet via climate change.  And this theory is wholeheartedly supported and endorsed by those who support the consensus. And if you call these people lunatics they say it is you who is the lunatic even thought the facts are on your side and not theirs.

Look, I'm not bashing climate change 'theories' here, I'm just trying to make a point that it's a consensus that mankind is destroying the planet, it's not science. We should always love and respect the planet and the environment. We should always be searching for better ways to produce things, but we must not destroy what we have in the meantime based on a consensus.

So let's get back to health care. It's the same thing. Based on a consensus that bronchodilators cure everything pulmonary related, doctors order albuterol up the ying yang. This helps some patients but does nothing for most of them but make them feel we are doing something.  What it does cause is burnout and apathy among the respiratory therapy profession.

All of this in the name of a consensus. And no one sees it, no one knows it's going on, except respiratory therapists.  Yet no one listens to us. Here we are the ones who dole out treatments all day, we are the ones who should know, yet we are not even listened to. When we say someone doesn't need a breathing treatment just because they are short of breath, we are called liars and lazy.

 Let's look at bronchodilators.  Let's look at albuterol.  I think you will agree with me when I say that a consensus of physicians believe that albuterol breathing treatments will somehow treat pneumonia. Yet there has never been any evidence of this.

Still, in order to be admitted, pneumonia and COPD patients must have three breathing treatments that show results. So now we are required to give three breathing treatments to all these patients, and some work and most don't.  This is what passes as science today. It's infiltrated politics and not for the better.

So the consensus is not always created based on evidence. It is not always made based on proof.  It is too often based on the notion, "Well, it sounds good." Sounds good is not sound evidence. Sounds good is not science. Sounds good is not science.

Still, when you challenge the consensus, you are put on the spot; you are made fun of; you are treated like the idiot.  I always find it neat when you have all the evidence on your side yet you are treated like the idiot because you oppose the consensus.

This is the whole point of this blog.  It is here, and only here, where we challenge that of which we are forced to do but of which makes no sense at all.  For instance, we give oxygen to patients all the time, and they do not drop dead. Yet when you have a hypoxic COPD patient we can't give them oxygen based on a consensus; based on a hoax. It's a sad truth.

We give breathing treatments all day long because the medical consensus is that they treat all annoying lung sounds; that they cure all pulmonary problems.  Yet we give albuterol to these patients all day long and the only patients who benefit are those with actual bronchospasm. We complain this causes burnout and apathy, but we never get our way because our facts oppose the consensus.  It's a sad truth.

If we're going to believe in something just because of a consensus, then we're on shaky ground.  Now, you can have a consensus that agrees on something that is true, but the consensus is not what makes it true. A consensus may believe albuterol reverses bronchospasm, but the consensus does not make it true: it's true because it's reproducible.

And do you not think it's a little dangerous that doctors and nurses and some respiratory therapists sign on to medical consensus and believe it? So we have the absolute absence of science being presented as science. N science that albuterol treats pneumonia. Yet people in Washington just take it and run with it and create mandates based on it. 

It is unquestioned by anybody outside the small respiratory therapy community. And when somebody like me comes along with valid, penetrating questions rooted in common sense, that person has to be laughed at, mocked, made fun of, distracted, and distorted. Their consensus doesn't hold up, gets blown to smithereens, and they can't handle anything contrary to this belief system they've all evolved.

Look, just because 9 out of 10 scientists, or 9 out of 10 physicians, agree on something doesn't make it true. The fact that they agree is not what makes it true. Science is independent of opinion. Science is what it is. True scientific discovery is incontrovertible fact, and it is immune to whatever human beings think it is or assume it is.  So just because 9 out of 10 physicians think albuterol cures all respiratory ailments does not make it true, that's all I'm saying.

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