Doctor No

What doctors would not do
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01.Medicine and surgery

Dr Amanda Bray, psychiatrist

I would not keep taking a medicine that doesn’t seem to help

It always worries me when patients I see for the first time are taking medication that they know have not helped their symptoms, yet they’ve continued to take them, often for years. If a medication was working for me, I think it would be very much worth putting up with the expense and possible side effects involved, to feel well again. But if a medication hadn’t helped after two or three months of taking it, I would be going back to my doctor to have it adjusted or ceased in the right way.


Dr Geraldine Moses, consultant pharmacist

I would never take a complementary medicine without weighing up the benefits versus the risks

Firstly, the benefit needs to be clearly identified. This goes way beyond taking herbs or supplements for reasons such as “good for…” fill in the dotted line. I want to know exactly what it’s going to do, how long it will take, the chance it will actually do that, what dose to take, and how much it’s going to cost. Don’t worry – I do this with conventional medicines too!

Then I would calculate the potential risks: side effects, drug interactions, cost, delay of more effective therapy, and disappointment. Researching this information is quite easy now that Google does all the legwork. Finally, I’d weigh the potential risks against the potential benefit. If the benefit clearly outweighs any potential risk then it would be quite sensible to give the remedy a go, in a structured fashion. But if the potential risks become too weighty for a goal I may never achieve, then I wouldn’t bother.


Dr John McLennan, paediatrician

I would never reject government-provided health services for children

Services for children are provided to identify problems early (screening) or to implement preventative strategies (like immunisation) for some of the most serious illnesses that children may experience. These have been so effective that most younger parents don’t realise how a return of diseases such as measles and polio, and such screened conditions as hypothyroidism, could affect their children and their own lives, and are vulnerable to complacency and philosophical scaremongering.

Governments are reluctant to spend money without being convinced of clear benefits based on the best available scientific evidence. The high standard of free obstetric care, neonatal care, hearing screening in newborns, the immunisation program, and the maternal and child health nurses who monitor growth and development are all part of this evidence-based preventative network paid for by your taxes. Don’t ignore it.



Dr Angus Gray, orthopaedic surgeon

I would not undergo spinal fusion for back pain

Reviews of the medical literature indicate that surgery is no more effective than intensive rehabilitation therapies for what is termed "non-radicular" back pain. This means that the pain is not caused by compression of the nerves in the spinal canal. Less than half of people having back surgery for this type of pain get an optimal outcome – defined as experiencing only sporadic pain, slight restriction of function and occasional pain killers.

I would concentrate on programs aimed at improving fitness and core strength. For pain relief, paracetamol and anti-inflammatory medications are effective, without the side effects of those containing opiates (codeine and morphine). Physiotherapy can help for short periods, but the evidence is weak to support its use for more than a few months. I would not recommend chiropractic.

In cases of sciatica – a spinal disc bulge or spinal instability (one bone moving abnormally on another due to disc degeneration) – surgery has been shown to give better results than non-surgical treatment.


Kimberley Bardsley, heart failure clinical nurse consultant

I would not go to bed and “sleep off” chest pain

I would proceed immediately to the nearest large metropolitan hospital for help. Nor would I be complacent about my heart health as I age. I would keep an eye on my blood pressure, and if required I would take medications to manage and control my blood pressure, which will lessen the chances that I could develop heart failure.

Professor Alastair MacLennan, professor of obstetrics and gynaecology

If I were a pregnant woman, I would never self-medicate without medical or obstetric advice

And I would never plan to have a home delivery – unless it was pizza.


Dr Mary Stewart, acting medical director, Family Planning NSW

I would not use “natural” hormones to treat my menopause symptoms

So-called bioidentical hormones are mixtures of various untrialled “natural” hormones synthesised from yam, soy and other products. These come in the form of lozenges sucked and absorbed through the mouth, or creams rubbed into the skin. They usually contain oestrogens and may contain a variety of other hormones in various doses.

Because these therapies have not been subjected to the vigorous testing of approved hormone replacement therapies, the concern is that there is no certainty that these therapies are effective or safe. Of particular concern is that if oestrogen is used without adequate progestogen, there is a risk of uterine cancer developing. If I developed menopausal symptoms requiring treatment, I would want to choose from the most scientifically proven, effective, safest treatments available.

Professor John Dwyer, immunologist

I would not avoid the Medicare-funded child vaccination regimen

Boosting the immune response to infectious agents is the single most important strategy ever developed by scientific medicine, and helps to protect other children and even adults. I would urge parents to read the evidence supplied by a medical doctor or government health authority. I assure them that all the scaremongering that is so common is based on concepts that have been proven to be wrong by scientific studies. For example, we know from major research that vaccination has nothing to do with a child developing autism.

At least 80,000 Australian children are at risk of serious infections as they haven’t been vaccinated. Anyone who has seen a baby with whooping cough would do anything to try to protect their baby from such suffering – and in fact, it can also be fatal. I always warn parents not to fall for the “alternative” line from homeopaths who say they have preparations that can immunise children against all the infections tackled with orthodox vaccines and then some like TB, malaria, HIV etc.



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