cover of episode #317 ‒ Reforming medicine: uncovering blind spots, challenging the norm, and embracing innovation | Marty Makary, M.D., M.P.H.

#317 ‒ Reforming medicine: uncovering blind spots, challenging the norm, and embracing innovation | Marty Makary, M.D., M.P.H.

2024/9/16
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Marty Makary: 本书探讨了医学界普遍存在的群体思维和认知失调现象,以及这些现象如何导致对缺乏证据的观点产生盲目跟风。作者认为,科学的目的是挑战根深蒂固的假设,而群体思维阻碍了这一目标的实现。书中列举了多个医学盲点案例,例如阑尾炎的治疗、花生过敏症的流行、激素替代疗法(HRT)的误解、抗生素的过度使用以及分娩方式的演变等,并分析了这些案例中存在的认知偏差和错误决策。作者呼吁医学界加强循证医学,挑战传统观念,拥抱创新,以改善医疗实践。 Peter Attia: 主持人与Marty Makary就书中内容进行了深入探讨,并就如何平衡科学怀疑与盲目信任、如何应对医学界的认知失调以及如何改进医学教育等问题提出了自己的看法。主持人还分享了自己在临床实践中遇到的困惑和挑战,并与Marty Makary共同探讨了如何更好地将科学证据转化为临床实践,以及如何提高公众对医学知识的理解和应用。

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The impact of groupthink and cognitive dissonance on medical decision-making, highlighting how deeply held beliefs can hinder the adoption of new evidence, as exemplified by the non-operative treatment for appendicitis and other medical practices.
  • Groupthink and cognitive dissonance hinder adoption of new evidence in medicine.
  • Non-operative treatment for appendicitis is effective but faces resistance.
  • Challenging deeply held assumptions is crucial for scientific progress.

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Marty Makary, a Johns Hopkins surgeon and New York Times bestselling author, returns to The Drive to discuss his latest book, Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health. In this episode, Marty explores how a new generation of doctors is challenging long-held medical practices by asking critical new questions. He discusses the major problems of groupthink and cognitive dissonance in the medical community and delves into several of the "blind spots" raised in the book, including treatments for appendicitis, the peanut allergy epidemic, misunderstandings about HRT and breast cancer, antibiotic use, and the evolution of childbirth. He explains the urgent need for reform in medical education and the major barriers standing in the way of innovative medical research. Throughout the conversation, Marty offers insightful reflections on where medicine has succeeded and where there’s still room to challenge historic practices and embrace new approaches.

We discuss:

  • The issue of groupthink and cognitive dissonance in science and medicine [2:30];
  • How a non-operative treatment for appendicitis sheds light on cognitive dissonance [7:00];
  • How cognitive dissonance and effort justification shape beliefs and actions [13:15];
  • How misguided peanut allergy recommendations created an epidemic [17:45];
  • The enduring impact of misinformation and fear-based messaging around hormone replacement therapy allegedly causing breast cancer [25:15];
  • The dangers of extreme skepticism and blind faith in science, and the importance of understanding uncertainty and probability [28:00];
  • The overuse of antibiotics and the rise of antibiotic resistant infections and poor gut health [33:45];
  • The potential correlations between early antibiotic use and chronic diseases [40:45];
  • The historical and evolving trends in childbirth and C-section rates [50:15];
  • Rethinking ovarian cancer: recent data challenging decades of medical practice and leading to new preventive measures [1:05:30];
  • Navigating uncertainty as a physician [1:19:30];
  • The urgent need for reform in medical education [1:21:45];
  • The major barriers to innovative medical research [1:27:30];
  • The dogmatic culture of academic medicine: why humility and challenging established norms are key for progress [1:38:15];
  • The major successes and ongoing challenges of modern medicine [1:51:00]; and
  • More.

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