Medical myths: Common treatments that may be doing you more harm than good

Dr Rachelle Buchbinder has been heckled and intimidated. Once, she had an email from a stranger suggesting that she put her head in a microwave and turn it on. And that was relatively mild compared with the more recent harassment she has experienced via email, social media, blogs and letter-writing campaigns.

“They’ve been trying to besmirch my reputation, get me sacked or not funded. It’s been vicious and horrible, and sometimes I ask myself why I’m doing this,” says Buchbinder, an Australian rheumatologist, epidemiologist and researcher.

The microwave-related message was an angry response to a 2002 study in which Buchbinder showed that ultrasound-guided shock-wave therapy is no better than a placebo when it comes to easing the pain of the foot condition plantar fasciitis. And the harassment that continues to this day was the result of her 2009 trial that found a procedure called vertebroplasty – injecting a type of acrylic cement into vertebrae that have collapsed or fractured – is no more effective than a sham treatment.

The abuse isn’t the only thing that has persisted. Both of these procedures continue to be performed, despite the science debunking their usefulness.

Given the personal cost and the apparent lack of impact, you might wonder why Buchbinder bothers. However, rather than allowing herself to be silenced, she has teamed up with Australian orthopaedic surgeon and author Ian Harris to write a book, Hippocrasy, that exposes the many ways modern medical professionals are betraying the ideals of the Hippocratic oath and the commonly associated pledge, “First, do no harm”.

“We’re both clinicians, and we’re increasingly aware of the harm that comes from overdiagnosing and overtreatment,” she says.

In the book, Buchbinder and Harris claim that one of the greatest threats to human health is, in fact, the healthcare system. Unnecessary tests are leading to treatments that may not benefit a patient and may even hurt them. Some of those treatments were accepted into practice before being properly evaluated, and the subsequent science is being denied or overlooked.

We are all at risk of too much medicine – it has been estimated that a third of clinical interventions are futile at best and medical care remains a leading cause of death.

Harris has written about this before, in his book Surgery, The Ultimate Placebo, but Hippocrasy goes further, looking at medicine from birth to death. The wide-ranging treatise covers the overmedicalisation of ordinary human experience; the perils of healthcare being run as a business; the routine screening that carries a risk of detecting abnormalities that may never have caused a problem; the creation of new diseases and the lowering of thresholds; the surfeit of end-of-life care; and the dilemma of doctors as they try to meet the expectations of their patients.