Your Expert Doctor May Be His Own Best Advocate
Posted Sun, Dec 6, 2009

One of the rewards of a career in medicine is getting to know people from many walks of life on an intimate basis. This is also true of meeting other doctors who possess many skills including intelligence, wit, perspicaciousness, verbal skills, and so on. I have enjoyed countless hours listening to great teachers lecture on everything from basic science to pathophysiology; from the psychology of illness to compassion for the infirm; from immunology to quantum physics. And on several occasions I have had the pleasure to teach with them and to spend an evening regaling each other with stories of experiences had and some exaggerations to be enjoyed.
And so it was with some regret that I watched NBC News this week promote a new breakthrough in fat destruction that would revolutionize body contouring. The breakthrough is a machine that freezes fat causing the fat to self destruct. The expert was one of my most esteemed colleagues who described (promoted) this technology even though it has not passed through any testing by the FDA (or any other scientific body to my knowledge). He said his group had tested it on 32 patients and found it to be safe. Now look, I can run 32 people across a busy Chicago street and all 32 may make it across the street. Does anyone want to advocate that running across a busy Chicago street is either a safe or effective way of crossing a street? Then he tells us that his studies show that on average a lump of fat on the body was reduced by up to 20%. What a bargain! You come in with a 5 inch waistline of fat and after you pay your dues you can look forward to a 4+ inch waistline of fat!! Any takers? You bettcha. There will be many takers who ante up their 600 bucks to get less than a 1 inch reduction in one small area of the body so they can look the same to everyone except what they might think they see in a mirror.
I wish this was an isolated incident. The truth is that I see experts in medicine, many of whom I have known, selling their reputation for money, or stock, or profit from individual patients. I see experts hawking lasers that have “special” wavelengths to destroy fat, lasers to vanquish signs of aging (Dorian Gray did not have to sell his soul to the devil), and now lasers that destroy fungus under your toe nails. I see anti-aging doctors selling bio-identical hormones as safer than God’s own creation, anesthesiologists selling pain clinics that numb your pain and your brain, and rheumatologists who will repeat your blood tests every month to prove that, yes, you still have rheumatoid arthritis (as if your morning pain told you anything different). I see a callousness among some doctor experts that is only matched by a naiveté and infantile willingness to be a victim on the part of some patients. And when all is said and done I see a public repudiation of accepting responsibility for our own health.
The cure: use your intelligence to evaluate your situation and investigate your possible remedies.
• Get a diagnosis before you get a cure. A laser may be a good tool, but it won’t treat every disease
• The treatment must fit the disease. Spot fat reduction is like wearing a new tie on a crumpled shirt.
• Your expert is as good as the time and concern he invests in you. If his nurse practitioner, physician assistant, medical assistant or other paramedical person is diagnosing and treating you, beware!
• Not all experts are expert. Some of the framed certificates on the wall are certificates of attendance at 3 day courses. There are so many Harvard and Yale certificates of training in Chicago I am wondering if there was a mail-order sale and I missed it.
• Two opinions are better than one. Two doctors in the same community equal only one opinion. It’s OK to travel 30-60 minutes to insure the quality care you deserve.

Edward B. Lack MD


4 Responses to “Your Expert Doctor May Be His Own Best Advocate”

David Shear says:

Couldn’t agree more. It’s incredible how many medical “breakthroughs” are sold without having passed any type of scientific testing. I can understand trying to aviod FDA testing due to the exuberant costs involved which most companies cannot afford, however, there are perfectly good testing bodies overseas which at the very least should be explored. How people can willingly give their body to “experimentation” without the proper backing is shocking.

I agree that all experts are not what they are cracked up to be. It should always be “patient beware” out here. Your health is all that you really have. I do, however, resent the fact that you say that patients should beware when it’s a NP or PA diagnosing. I have found things that other physicians have missed by not listening to their patients. Not every provider is equal, but some are better than others and you don’t have to be a doctor to be one of them.

admin says:

Edward Lack MD
I do not disparage the value of nurse practitioner or physician assistants. The point is that 13 years of training in medicine is a lot more reliable than 2-6 years of nursing when a diagnosis is needed. I don’t see paramedicals consulted on “House”.

Edward Lack
Edward Lack MD is a board certified dermatologist and a board certified dermatologic cosmetic surgeon. He is President and Medical Director of MetropolitanMD, a multispecialty cosmetic surgery center in Chicago,which is unique in having a double board certified cosmetic dermatologic surgeon, a double board certified facial plastic surgeon, and a double board certified cosmetic plastic surgeon. Dr. Lack is also the Past President of The American Academy of Cosmetic Surgery.

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