TLC vs CYA: The Medical-Legal Reality of Medicine

Imagine this scenario:
 
After a routine checkup with your doctor, which includes some blood work, you discover you have high cholesterol. Like millions of others, you’re prescribed Crestor. Later, your blood cholesterol level is checked again, and it’s lower.
 
All is right with the world. Right?
 
Several months later, though, you find you don’t like how you feel on the drug. Perhaps your muscles ache a little, your digestion is a little off, or you just don’t feel right.
 
After a little research, you begin to feel that maybe this stuff is neither good for you, nor is it particularly useful. You also discover that you can in fact lower your cholesterol by changing your lifestyle. Armed with this new info, you head to the doctor with your new plan.
 
Your doctor, however, has a different opinion. She says you must stay on the drug—if you don’t you could have a stroke or die of a heart attack. 
 
What’s going on? Why is your doctor reluctant to change your prescription despite a mountain of evidence that statin drugs are nonsense for all but a narrow demographic group?
 
Here’s what’s happening, and what you need to know to properly advocate for your health.
 
1. Standards are created based on averages, not individuals
The “gold standard” that your doctor uses to prescribe care isn’t usually based on you so much as a research done on large groups of people. That works, to an extent, and it’s cost effective for developing pharmaceuticals, but people are individuals. I can tell you that the average dress size in North America is 14, but does that mean it’s going to work for you? The same applies to treatment tools like statins. Your doctor is doing the best she can working from averages, not individuals.

2. Data is compromised
Time and time again we hear about the problems with research study. Data is faked or withheld. Studies are selectively chosen to support a hypothesis. The research with the best potential payoff is the one that’s funded. Some of these may be unavoidable, but you need to treat the “latest study” with a certain degree of caution. Research does not care about you. Research is also not terribly motivated to reveal how much impact lifestyle change can really have.

3. Legalities get in the way
In this highly litigious age patients will often get advice that will hold up in court, not necessarily a candid conversation about options. Don’t assume that you’ll get the information you need to make informed decisions and manage risks in the way you see fit. Never forget that the legal side of medicine is playing a role in the care you receive. It doesn’t mean you’re getting bad care…just don’t forget that it’s a factor.

4. The choices is ultimately yours
This is what matters the most.  Even the best doctor doesn’t care about you more than YOU do. No matter what any doctor tells you, it’s your choice how to deal with your health. The lesson is this: You cannot abdicate responsibility for your care. Not to doctors, not to research, not to pills, tablets, injections, tools or machines. If you want great health, you need to cover your own a**. You can’t rely on the system to do it for you.