How American Medicine Changes its Mind.
Channel: BioBalance Healthcast
Date: 2023-03-06

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog
In the history of medicine over the last 2 centuries there have been many changes in the recommendations given to patients by their doctors.  In general, to change the way medicine is practiced improving the care of patients, a new treatment had to be opposed by one or two courageous doctors who were willing to put his/her livelihood and status in the society of medical doctors on the line.   Any medical practice that was contrary to the dogma that had been taught to doctors in training was looked down upon by medical peers and often the doctors who were trying to improve the life of their patients were ousted from their practices and lost their livelihood.  I have been one of those doctors trying to improve the practice of medicine in the face of criticism and “name calling” by other doctors who didn’t want to change any of their practices.  In all cases it took a decade or more to regain my status and acceptance by other doctors and in some cases the changes I have made for the sake of my patients are still not accepted, and most likely won’t be for another decade.  How and why medicine improves is a painful and complicated process that is always opposed at first.

How Progress of Medical Practice Has Been Thwarted by Doctors’ Dogma

Example #1 Hand washing between examining patients, When Did That Become a Medical Requirement?

Doctors now embrace the practice of washing our hands between examining patients, and the practice of wearing one-use disposable gloves to do a vaginal exam on pregnant patients. However, before 1847 doctors didn’t believe in hand washing between examining patients. There were no sterile procedures or wash basins available in doctors’ suites, and vaginal exams were done on many patients in a maternity ward, one after the other without handwashing. Bacteria had not been discovered in that century and therefore washing away bacteria was unknown, then bacteria were discovered and the presence of dangerous “bugs” that one couldn’t see was questioned by the older doctors and the, but Ignaz Semmelweis proved that ha dogma of the day. With the discovery of bacteria by young doctors and scientists presented a change to the practice of medicine that the older physicians in charge didn’t accept. Then Dr. Semmelweis showed up on the scene, touting the new knowledge, and insisting that he must wash his hands between Obstetric patients in the ward.  This set off an explosion and pitted the old guard versus one young, new doctor.  His insistence in washing his hands caused the doctors to throw Dr Semmelweis off staff of his hospital and peer pressure caused him to be shunned by all of the physicians on staff. He had a hard time finding a medical practice and ended his life destitute and without anyone recognizing that he was right the whole time.

Medical hand washing became mandatory long after Hungarian physician Ignaz Semmelweis discovered its effectiveness (in 1846) in preventing disease in a hospital environment.  He was before his time, and if he had been listened to, thousands of laboring women would have survived childbirth, instead of dying from childbed fever!

In retrospect we can sympathize with him because we now know he was right, and his refusal to accept a dangerous practice and to help women live through childbirth, was a personally costly stand to make, but was the first step toward an advance in the practice of medicine.

Example #2 Is Estrogen Replacement for Menopause: Dangerous or Healthy?

Reference–Menopause: The Journal of The North American Menopause Society Vol. 26, No. 12, pp. 1366-1374
DOI: 10.1097/GME.0000000000001405
ß 2019 by The North American Menopause Society

Estrogen for menopausal women has always been a hot potato for medicine. Many studies done in the 1950s and 1960s documented the benefit of giving women estrogen after menopause.  Medicine embraced this belief, and the majority of women were put on Premarin, the most popular estrogen replacement.  All went well until late in the 1960s and early in the 1970s doctors noticed that women with uteruses were getting uterine cancer at a very high number and the majority of women were taking Premarin.  Research confirmed that estrogen replacement without progesterone/progestin could cause uterine cancer!  This caused two things to happen:  Research began within the drug companies to see if giving Provera®, a synthetic progesterone, would protect women from uterine cancer; The second thing that happened was that women immediately stopped their Premarin therapy and were suffering all over the US.