| > > Rarely do we even consider that the cost of doing something might outweigh the benefits. > Cost vs benefit is the main thing that people consider when making decisions. This article also makes the mistake of equation "we", the average reader of the blog, with the doctors who are making prescribing decisions. Understanding the risks and side effects of prescribing a medication or procedure is core to the practice of medicine. It's integral to everything doctors do. The field of medicine is often criticized for not being aggressive enough with treatments, though these criticisms often come from people who only see the potential upside but not the risks. We saw this most recently with complaints about how long the FDA took to get vaccines out (which was actually lightning fast) or in how the field of medicine didn't rush to recommend theoretical COVID treatments based on small-scale studies and petri dish studies (which turned out to be the right choice, given that none of them replicated at scale in controlled studies). It's also the reason why the most effective medication may not be the first-line treatment, because the first-line treatment is chosen as a tradeoff of risks versus benefits. Doctors know all of this. Unfortunately, doctors who decline to give patients the medications they think they need or recommend against surgical procedures patients think they want are subject to a lot of negative pressure in today's medical system. If someone goes into a doctor and demands antibiotics for their cold, the doctor must find a way to talk them down without risking another negative review which can impact their career and compensation in many systems. Some doctors just don't care enough, and will hand out prescriptions as asked. It's becoming a real problem now that medical systems have so many layers of middle management trying to put NPS scores and other feedback loops into the medical system, combined with social media pushing so many people to think they know they need antibiotics or thyroid medicine or other treatments that come with more downsides than benefits. |