What defines a good drug?

Most people will naturally assume that when a doctor prescribes them a drug, it’s because the doctor thinks they will receive a meaningful benefit from it. Most people have never heard the term NNT, which stands for Number Needed to Treat, or to put it another way, the number of people who need to take a drug for one person to see a noticeable benefit. … Read more

Is insulin life-saving for type 2 diabetics?

There are two diseases that share the name “diabetes mellitus”. This is unfortunate, because the diseases have very little in common, except for the fact that both are associated with high levels of glucose in the blood stream. Type 1 diabetes is an auto-immune disease, in which the immune system destroys the insulin producing cells that reside in the pancreas. Type 1 diabetics quickly die … Read more

Why medicine is broken, with Seamus O’Mahony

Seamus O’Mahony is an Irish physician who’s written a trilogy of books that explore the varied ways in which modern medicine is broken. The first book, “The way we die now”, discusses how the movement of death in to hospitals in the modern era and a culture of denial around mortality has resulted in horrendous overtreatment of dying patients up until the very moment … Read more

Does covid cause brain damage?

The latest in the long succession of attempts at maximizing people’s fear of covid is the claim that it causes brain damage. And not just in those who have spent time in the ICU, in everyone, even if all they had was a mild cold. The claim is currently doing the rounds on social media (apparently alarmist propaganda only counts as misinformation if it’s going … Read more

Do drug trials underestimate side effects?

One commonly used trick in drug trials is to exclude any group that might make the drug look worse, such as those that are more likely to experience side effects. A good recent example of this is the covid vaccine trials, which largely excluded people with auto-immune diseases (more likely to develop an auto-immune disease after vaccination), people with allergies (more likely to have an … Read more

Are regular health checks good for you?

Regular health checks (a.k.a routine visits) are probably the bane of many a primary care physician’s existence. I can’t imagine many things more boring than running through a standardized list of questions with a patient who feels absolutely fine, then going through a list of lab values that are almost invariably within the normal reference range, and finally topping it off with a perfunctory physical … Read more