As you note this kind of insanity is a longstanding history in medicine. What is different is that this "misinformation board" is overtly saying what has been somewhat well understood about medical boards: stay in line or there will be consequences to your ability to "practice".
And it's called "practice" for a reason, right?
Lat night we had dinner at a restaurant. I ordered a salad with my meal, as I often do (yes I know that is stuff is what food eats). When it arrived I scanned the table for a shaker of salt but none was to be found. So I had to ask for salt. "Oh we don't put out salt because it is bad for you" but being a friendly restaurant the brought be some anyway. This "it's bad for you" is a perfect example of not only medical organizations getting it wrong, but how difficult it is to kill the myths once adopted by the AMA. Anyone who cares to research the topic finds quickly that the AMA guideline for "low sodium" began with a story (and I mean story, not study) in the NEJM reprinted by the AMA which cited a study which claimed to find a correlation between reduced salt and reducing hypertension. Dig only one level into it, as in read the cited study, and you find the story gets it all wrong: the study, which observed dozens (!) of patients with a very specific type of hypertensive pathology found that lowering sodium "correlated" with a reduction in hypertension while it found this insignificant as it did nothing to address the underlying pathology of which hypertension was a symptom. Dig a bit further and you realize the "correlations" was in fact invalid, mathematically, as there were no controls. Subsequent studies that included larger samples and control groups subsequently found no correlation, even in that very specific population. Did NEJM or AMA change the recommendations based on the actual science? Not yet...almost 5 decades after.
In those 5 decades volumes of studies have shown the dangers of low-sodium diets. Blanket "recommendations" can be like that. Especially when based on flawed understanding of the source material. As a non-medical professional who knows how to read a scientific paper (and do the math that medical researchers seem unable to do so often), I am not a credible source for what is "right" but I can with some confidence point out the flaws in the math and inconsistencies in the logic.
How can you trust a professional organization such as the AMA, or state run medical boards, who continue to endorse "Body Mass Index" as a metric of health? The average athlete is "overweight" by BMI and a really healthy athlete is "obese" by there metric. I challenge those MDs who believe in this metric to walk up to an NFL player and tell them "you are obese". It makes no sense but that's what the "guideline" tells them.
You are so right about incrementalism. It is extremely powerful. What changed in 2020 was the size of the increments. 2021 abolished any pretense of subtle. I have for decades warned people that "reasonable restrictions" does not lead to a slippery slope: that is a cliff and once you step off it all feels fine until the last second when you hit bottom.
Spot on. What about all the warnings about "fat" that led to the low-fat food explosion (i.e. foods laced with sucrose). The correlation between fat in the diet and heart disease was the obsession of one pathologist who made up the data. As a real doctor seeing real people, I neither trust nor follow most guidelines. Medicine as a trusted profession is DEAD.
As you note this kind of insanity is a longstanding history in medicine. What is different is that this "misinformation board" is overtly saying what has been somewhat well understood about medical boards: stay in line or there will be consequences to your ability to "practice".
And it's called "practice" for a reason, right?
Lat night we had dinner at a restaurant. I ordered a salad with my meal, as I often do (yes I know that is stuff is what food eats). When it arrived I scanned the table for a shaker of salt but none was to be found. So I had to ask for salt. "Oh we don't put out salt because it is bad for you" but being a friendly restaurant the brought be some anyway. This "it's bad for you" is a perfect example of not only medical organizations getting it wrong, but how difficult it is to kill the myths once adopted by the AMA. Anyone who cares to research the topic finds quickly that the AMA guideline for "low sodium" began with a story (and I mean story, not study) in the NEJM reprinted by the AMA which cited a study which claimed to find a correlation between reduced salt and reducing hypertension. Dig only one level into it, as in read the cited study, and you find the story gets it all wrong: the study, which observed dozens (!) of patients with a very specific type of hypertensive pathology found that lowering sodium "correlated" with a reduction in hypertension while it found this insignificant as it did nothing to address the underlying pathology of which hypertension was a symptom. Dig a bit further and you realize the "correlations" was in fact invalid, mathematically, as there were no controls. Subsequent studies that included larger samples and control groups subsequently found no correlation, even in that very specific population. Did NEJM or AMA change the recommendations based on the actual science? Not yet...almost 5 decades after.
In those 5 decades volumes of studies have shown the dangers of low-sodium diets. Blanket "recommendations" can be like that. Especially when based on flawed understanding of the source material. As a non-medical professional who knows how to read a scientific paper (and do the math that medical researchers seem unable to do so often), I am not a credible source for what is "right" but I can with some confidence point out the flaws in the math and inconsistencies in the logic.
How can you trust a professional organization such as the AMA, or state run medical boards, who continue to endorse "Body Mass Index" as a metric of health? The average athlete is "overweight" by BMI and a really healthy athlete is "obese" by there metric. I challenge those MDs who believe in this metric to walk up to an NFL player and tell them "you are obese". It makes no sense but that's what the "guideline" tells them.
You are so right about incrementalism. It is extremely powerful. What changed in 2020 was the size of the increments. 2021 abolished any pretense of subtle. I have for decades warned people that "reasonable restrictions" does not lead to a slippery slope: that is a cliff and once you step off it all feels fine until the last second when you hit bottom.
Spot on. What about all the warnings about "fat" that led to the low-fat food explosion (i.e. foods laced with sucrose). The correlation between fat in the diet and heart disease was the obsession of one pathologist who made up the data. As a real doctor seeing real people, I neither trust nor follow most guidelines. Medicine as a trusted profession is DEAD.