Medication – by protocol or evidence-based?

When my friend reacted adversely (very seriously) to increasing amounts of a particular medication, I asked her medico (on her behalf) whether he should review her treatment. He said that he had been only following protocol. Whose? I challenged. As recommended by the pharmaceutical manufacturer was the reply. What about the evidence displayed by the patient? The treatment was moderated. Is a one-size-fits-all approach to buying a T-shirt or a caftan applicable to medical treatment?

Quite a few years before that, a specialist (a professor) had recommended to my friend a particular treatment to counter her tendency to fall. She had reacted adversely to that too. When I challenged the specialist, it became clear that he was treating her for what he expected her condition to become, based on a scan. He expected her (he said) to develop symptoms of epilepsy. I recommended that he treat her on the available evidence. He agreed. She did not develop epilepsy. She also regained her balance.

Her latest GP told me that “somehow diabetes is implicated in depression.” Although a second opinion found no evidence of clinical depression, the GP persisted with the medication for clinical depression – and then attempted to find evidence of diabetes. She failed. Infallibility in a medico is a health hazard to the patient.

I myself have suffered from a couple of medicos who were somewhat casual in their diagnosis – which were either incorrect or incomplete. What protection is there for a person without a supportive friend when dealing with medical practitioners who do not practice evidence-based treatment?

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