We are so different – we are not statistics

Evidence is good – but clinical experience is even better. I got my life back when I changed to a doctor who used his clinical experience.
When I was treated according to the statistics, I continued to feel sick with numerous symptoms; indeed, at the time I was only a mere shadow of myself.

When patients with hypothyroidism continue to have symptoms when treated with the standard medication (T4 – like e.g. synthroid), they are often told by the doctor that there is nothing more to do – and they might be referred to a psychiatrist.

So many people are told they must learn to live with their symptoms and the consequent inconveniences and limitations. If they ask for another kind of treatment, the answer from the doctor is often: “There is no evidence that other types of treatment work better than the one you’ve got.” So they stay on the same medication for years with no change in their condition as they are still sick – and they continue to be beggars that can’t choose.

Statistics are indispensable
First, let me tell you this: I love statistics. Statistics often provides clarity and reveals interesting correlations that might otherwise remain hidden.

In medical research statistics, methods in the experimental design can ensure that studies are carried out in a way that you can interpret the results afterwards.

Statistics are also used as a tool to interpret the degree of evidence regarding the impact of, for example, a certain type of treatment – it can tell you something about how well a treatment works and how safe it is.

Statistics are an indispensable part of reliable and honest research.

Statistics are only statistics
However, statistics also have limitations. Statistics will never be absolutely accurate.

It is precisely only statistics – an attempt to say something meaningful about many from the data on a few. In addition, statistics are completely dependent on the way you select the studied group.

As my 12-year old son once said after a math class: “The average human has two eyes, two arms, two legs, one chest, one ovary, one testicle, half a penis, half uterus, etc.
There are very few average people around!”

And there are very few average patients.

Why do we need doctors?
It is clear and quite logical that doctors always assume and begin to treat a disease or a variety of symptoms with the type of treatment that statistically gives the best result for as many patients as possible. On that, there’s no doubt.

Moreover, if the patient becomes asymptomatic and feels good again, everything is fine.
However, if it were always that simple to treat people for a certain condition, we would not need doctors.

Instead, a software developer might easily be able to create a program from a range of symptoms, blood values and other parameters such as gender, weight and age in order to quickly give a diagnosis and prescribe a treatment with statistical evidence – and this would yield the desired result.

However, evidence-based treatment works on the average person – but not everybody is average. That is why we need doctors with clinical experience.

Patient care will improve when the doctor bridges clinical experience with evidence-based treatment. And it’s when standard treatment is not working properly that the doctor must prove his expertise and use his clinical experience.

We need skilled, educated and empathetic doctors, because people are not statistics. Because they, with all their personal and common clinical experience and knowledge, ought to be able to assess when and how to individualize a treatment.

It is when standard treatment does not work properly that the doctor must prove his/her value. The doctor becomes indispensable when s/he, after a thorough examination and discussion with the patient, assesses how s/he can optimize treatment for this particular patient.

The good doctor knows when it’s time to put the numbers aside and draw on his/her clinical experience.

Skilled doctors dare to deviate from the evidence
Almost anyone can read the statistics and look up tables, but not everyone can be a really good doctor. Of course, a good doctor masters the theory and the facts, but the good doctor is also able to judge when it’s time to put the tables aside and draw on his/her own clinical experience or those of colleagues.

In the treatment of hypothyroidism, there are more than 100 years of clinical experience with extract from desiccated animal thyroids (NDT), and there are lots of experience with the addition of Liothyronin – T3 – to the T4-treatment regimen – combinationtherapy.

Statistically, there is no evidence that these types of treatment work better on most patients compared to the standard treatment with thyroxine – T4 (e.g. synthroid). But again, there are only very few average patients around …

On the other hand, there is no evidence either that these kinds of medicine are less efficacious than the T4-medicine.

In addition, there are in fact evidence that T3 and NDT work on a group of patients if they are selected according to the criterion that they do not thrive on standard treatment.

Choose a doctor with care
Fortunately, there are physicians who use their clinical experience, and look at the patient in addition to looking at blood samples and statistics. I myself am so lucky to have had such a doctor.

Several doctors had told me that I was being well treated at the time simply because my blood tests were within the preferred range. Hence, they did not see the need to change my treatment with T4-medication.

But then I got a new doctor – a professor in endocrinology who actually asked me about my symptoms, which at the time were numerous and severe – so he changed my treatment. It was his clinical experience which informed him that a combination therapy might help me.

And it did.

As those who have read my book would probably know, I feel really good today. I feel healthy. And my lab tests are still within the reference values. The reference range is very broad.

I got my life back when I changed to a doctor who used his clinical experience.
When I was treated according to the statistics, I continued to feel sick with numerous symptoms; indeed, at the time I was only a mere shadow of myself.

 

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