Monday 5 August 2013

What your doctor probably knows about cholesterol

The YouTube that I invite you to watch is to my mind hilarious. Human experience never to ceases to provide us with a constant supply of comedy. Sadly, underlying most comedy there is tragedy.

The realities of life can be bewildering and those of you who visit doctors will understand this. I recently met in the outpatient clinic a lady who had just spent about ten days in hospital and during this time she had been seen by 18 doctors (she counted them carefully, being surprised by the profusion). She told me that she had been discharged from hospital without any comprehension of her illness and no clear diagnosis. “If only two doctors had told me the same thing I might have been satisfied, but I received 18 different opinions”. When I told the retrospective diagnosis she informed me that one of the 18 doctors had said the same thing and so she believed me. Perhaps she was also confident of my knowledge and plausibility.

You might be bewildered about what we are told about cholesterol. Most doctors will conform to existing popular “wisdom” (= misinformation), that cholesterol is poisonous, toxic or generally bad for you. You might also find a few cholesterol sceptics but no-one is likely to sit on the fence. Who do you believe?

What it is important to understand is that most post-graduate medical education is funded by the pharmaceutical industry. This might be just free lunches at a regular hospital meeting (without the free lunch the doctors would be unlikely to attend) but it extends to major international conferences. Cardiology in particular is funded to a major extent in this way, including financial support for some academic departments. Major medical journals must now insist on conflicts of professional interest being declared by the authors. Extravagant coercion by pharmaceutical companies has been constrained by government action in recent years.

It is sad that so few doctors seem to keep up-to-date with original articles in the medical journals, but to do so is a big undertaking. The internet gives immediate access to the papers but not the time to read and digest them. The doctor is therefore likely to give an uncritical popular view, reinforced by what he or she has been told by the pharaceutical representative.

So enjoy watching the YouTube movie about the patient who visits his doctor concerning his cholesterol level. He is being encouraged to take Lipitor, atorvastatin, one of the major statin medications. 

The blood cholesterol level of 225 is in units of mg/100ml as used in the USA, corresponding to the UK and European SI units of 5.5 mmol/L

The Lipitor paradox:

1 comment:

  1. What a hilarious video. On second thoughts no. What a tragedy that the truths expounded in the video pass by 99% of the population