I suspect that installing a stent is more effective than diet recommendations (my physicians is after me about what I eat every time I go in, and I haven't changed a thing yet).
I expect that has a very great deal to do with it. If patients aren't going to participate in prevention, a doctor can easily rationalize not pursuing it.
As for effectiveness, just read a study recently that demonstrated that installing stents does not improve outcomes. Even statins, their other rationalization, don't improve outcomes for the vast majority of patients. So why do they continue to pursue those avenues? If the only tool you have is a hammer, you hammer as much as you possibly can whether it works or not as long as it keeps you in good standing with your peers, feeling like you're doing something, and supporting the lifestyle you desire.
Of course, I'm not a patient, so I can't say for sure.
My cardiologist, who I believe to be excellent in her field, is typical of mainstream cardiology. I'll give you one example. There are studies that show pretty clearly that statins don't improve outcomes for men over 65 or women of any age. Statins have side effects. So I suggested that I take a few months off to see what happens but she was adamant that I continue to take them. She couldn't give me a good reason. (I will try it anyway later this year.)
I don't see them putting their own interests ahead of those of patients.
Once again, I am not accusing doctors of doing that deliberately and callously. I'm merely describing what I see as the extant scenario. Part of it is that they have to believe they are effective because even considering the possibility that they are not pulls the rug out from under their life's work. If they start looking at their effectiveness and find out that they aren't the heroes they think they are... To protect themselves, they get cognitive dissonance whenever they encounter evidence that contradicts establishment practice. That is not ill intentions, just human nature. It's also expensively ineffective medicine.
(Re out earlier discussions about the aspect of health care reform that studies outcomes, this is one of the reason's I'm in favor of it despite the risks of the info being used to our detriment.) |
