“Why”, asks Jeffrey Braithwaite, writing in the Journal of the Royal Society of Medicine, “do we still believe unquestioningly in the benefits of modern medicine, when healthcare delivers high levels of iatrogenic harm, often fails to provide optimum treatment and has become unaffordably expensive?”
He argues that in some ways modern medicine can be compared to an ant colony. Each member of a colony of foraging army ants lives by a simple rule, but when things go wrong they march endlessly in a large circle. “We (doctors) often trudge together along the same trail, neglecting to look around for alternatives”.
“Modern health systems consistently deliver at least 10% iatrogenic harm.2 Despite very large investments and intermittent but important interventional successes, such as checklists in theatres3 and clinical bundles in ICU,4 there is no study showing a step-change reduction in this rate, systems-wide. Only half of care delivered is in line with guidelines,5 one-third is thought to be waste,6 and much is not evidence-based,7 notwithstanding concerted efforts to optimise that evidence and incorporate it into routine practice.8
The reality is that progress is slowing, and medicine seems to be reaching the limits of its capacities.
He ends the piece with this quote from AlbertEinstein: ‘The significant problems we face cannot be solved at the same level of thinking we were at when we created them’.17 If we can humbly accept that we need new perspectives for healthcare – and radically different ways of thinking – we will be better placed to free ourselves from the hold of these peculiar viruses of the mind.”
The Medical Miracles Delusion. Jeffrey Braithwaite. J R Soc Med March 2014 vol. 107 no. 3 92-93