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  • Why are doctors reluctant to accept change?


    Why are doctors reluctant to accept change?

    Let me start by saying that I don’t know the precise answer to this question. In our defence, it isn’t only doctors who are reluctant to accept change. Most of us are creatures of habit and are probably all a little bit guilty of following accepted dogma blindly. And if a change leads to a loss of face, or to more work, or to a feeling of incompetence, then it is even more difficult to institute.

    For example, one day HRT is the best thing since sliced bread, the next it is the devil incarnate. And one day calcium supplements will beef up your bones, the next day they might be clogging up your arteries.
    These kinds of about turns make for difficult conversations with patients. “Actually, the advice that I’ve been giving you for the last x number of years might have been slightly erroneous…”

    So if the powers that be were to inform doctors that they have been giving their patients incorrect dietary advice for 50 odd years, that would indeed be a difficult pill to swallow; but swallow it we must, as must our patients.

    I know that I keep coming back to this story, but the unwillingness of the medical community to accept change is so well illustrated in this tragic tale of a 19th century doctor who was ridiculed by the medical profession during his lifetime.

    The Story of Dr Semmelweis:
    Dr Semmelweis worked out that women giving birth were less likely to die if the attending doctor washed their hands in a chlorinated solution of lime before delivering a baby. Prior to this, the normal practice used to be that doctors went straight from doing an autopsy to delivering a baby without washing their hands.

    Well before the discovery of bacteria, Dr Semmelweis worked out that doctors were transferring something that he called a “cadaverous agent” from mortuaries to the birthing suites. He came to this conclusion through meticulous examination of data from various maternity clinics, and then instituted the policy of doctors and medical students having to wash their hands after doing autopsies and before examining patients.

    Several publications by Dr Semmelweis showed that mortality in childbirth could be reduced from 20% to 1% by this simple hand washing technique – yet he was denigrated and forced to leave his job.

    The outraged doctor then began writing open and angry letters to prominent obstetricians denouncing them as irresponsible murderers.
    Everybody, including his wife, believed he was losing his mind and Dr Semmelweis was committed to an asylum, where after being beaten by guards, he died at the age of 47 of septicaemia (ironically the very same illness that was killing the women that he was trying to save). And all because Dr Semmelweis went against the accepted thinking of his time in an attempt to save the lives of women in childbirth.

    Orthodoxy gets in the way of facts sometimes; after all it is human nature to assume that a longstanding doctrine must be correct. It once took a long time to convince the world that the earth is not flat.
    So to those of you who have not yet come over to the Palaeolithic way of eating, don’t give in to the Semmelweis Reflex; i.e. the reflex-like tendency to reject new evidence because it is unconventional.

    And remember that normal isn’t necessarily the best way to be. It is normal for weight and blood pressure to go up with age in the Western world. It is normal to die of a heart attack, stroke or cancer. One day it might be normal to be diabetic.

    Who wants to be normal? Don’t follow the herd mindlessly; always be open to new (or in this case pre-historic!) ideas.

    Just as 19th Century women’s lives might have been saved by washing hands, mimicking the diet of pre-historic Man might save you from the clutches of cardiovascular disease and dementia.

    Posted in Quick Soundbites.

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