Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health

Peanut allergies were rare before health policy makers decided that children should abstain from eating any peanut products the first years of their lives to address those very infrequent occurrences. The result: peanut allergies exploded among children who never had any contact with peanuts during their early years.Silicone breast implants were satisfying many patients who needed reconstructive surgery or who wanted augmentation until some medical researchers (who it appears did not approve of cosmetic surgery) used very weak study linkages to proclaim them dangerous. Lawsuits exploded and millions of women had their implants removed. Later scienced proved that wrongheaded. The FDA reversed itself and today labels Silicone breast implants safe.Dr. Makary (at this writing, the nominee to run the FDA), has written an important book that is eye opening to the public and I imagine also many physicians.His book illustrates several medical policy positions beyond peanut abstention and breast implants taken by the medical establishment (AMA, AHA, FDA, leading medical journals) which have stood upon weak evidence, evidence that contradicts the policy position, or even the strongly held beliefs of medical policy gatekeepers who rely on their wisdom that certain causations “just make sense.”Almost all of these have been reversed or superseded - but usually only after years or even decades of existence guiding standards of care and medical interventions. Some of these did great harm to patients and people and some like over reliance on antibiotics reverberate today.This book is very well written and accessible to non-physicians and the public. He explains medical topics for the layperson. It is very much worth reading.In addition to those standards of care named above, Makary tells the stories of over prescribing of antibiotics and the effect on the gut biome, the lack of understanding that dietary cholesterol has little to no effect on body cholesterol levels, and how wrong thinking around many aspects of medical care related to childbirth led to premature babies having worse outcomes and children born of c-sections having altered gut biomes (due to lack of maternal germs gained through passage down the birth canal) which negatively influences other aspects of their development. Perhaps the most interesting to me is that science has recently concluded that ovarian cancer actually starts from cancerous fallopian tube cells that migrate to the ovaries. It appears generations of women who had ovaries removed as a preventive measure were removing the wrong organ to no benefit (and even to their detriment as ovaries provide important hormones for the body). Today due to studies that appear sound, many physicians recommend a fifteen-minute procedure to remove fallopian tubes for women who are either not having more children or past child baring age in some cases.What gives credence to Dr. Makary's examples is that in each case he goes back to the initial study that resulted in new and mistaken medical standards of care and explains poor data, lack of causation or just incorrect data assessments, or poor study structure that changed lives for millions because of physician adherence to promulgations by our medical standards gatekeepers. His arguments are greatly enhanced because he tracked down either the initial study authors or the AMA committee members or medical journal editors that blessed the care changes and talked to them about the data and study problems that underpinned these changed standards. These people either admitted they were wrong, or the studies were not conclusive, or defensively fall back on arguments of "needed to not upset the public," or "keeping consistent with our positions" as reasons for why they made or supported positions that turned out to be wrong. None of the original protagonists with whom he discussed these wrong turns did or were able to defend their original positions.Some of the conclusions the author makes which are important if we are going to get new standards of care right:1. The data underpinning studies must be made available for review (shockingly to me they were not available in most cases)2. Authors of studies should be blinded so reviewers / journal editors cannot play favorites among their colleagues or support studies done by their own institutions3. The AMA, FDA and other gate keepers must become comfortable with saying “we don’t know” instead of perceiving a need to quickly solve frustrating and high visibility issues for public satisfaction4. Leadership positions at medical societies and journals need to be rotated so fresh thinking can be injected into assessment processes and defensiveness minimized5. Journals and associations and the government need to embrace studies related to care delivery more than they historically have.6. Topic myopia – where grants go in large part to the same narrow topic areas and fresh ideas are shunted aside needs to be reduced so that new thinking can be tested and studied7. Politics and extraneous considerations need to be removed from grant making, publication, and committee work.This is a captivating book that seems to show difficult to refute case studies (usually because in most cases the offending incorrect standard of care has been reversed or significantly altered). His prescriptions to improve the environment in which medical knowledge is advanced and standards of care embraced make a lot of sense and are worthy of open debate.

The Blind Spot by Dr. Marty Makary is an uplifting, reassuring book. At least, somebody is looking out for our wellbeing, alerting us to questionable medical practices based on groupthink or on opinion rather than good science. Some such unproven treatments may be motivated by financial gain, narcissism, a natural resistance to change, or bias (against silicone breast implants). By promoting low fat over sugar free products, the food industry has contributed to the obesity epidemic today.Makary highlights treatments that save lives but were withdrawn on a whim or shabby evidence, such as the ban on hormone replacement therapy in postmenopausal women. Many people stopped taking the hormones, increasing their risk for heart disease and other age-related conditions. Such stoppage reminds me of Propulsid that worked wonders for heart burn or acid reflux. The drug was one of many that could trigger a fatal heart rhythm abnormality. Susceptibility to the abnormality could also be congenital. In my medical practice, when I found out that Propulsid had been voluntarily withdrawn by the manufacturer in 2000 because it could trigger the heart condition, and other medications that could also do so only carried a warning, I was taken aback. I had not seen any studies showing that Propulsid put more patients in danger than the other medications did. I still feel for the patients today. I would also like to see evidence of the adverse effects artificial sweeteners can have on the body.I rank Dr. Makary among those dedicated to improving the health of the public through evidence-based medicine and adamantly stick to their guns to inform us regardless of the risk for ostracization. But the truth has a tendency to come out, sooner or later.Makary has been nominated to be the next head of the FDA. I’m looking forward to his leadership, as I’m sure that his decisions will be based on good science.The Blind Spot contains a lot of information with examples written in a readable story-telling-style. It deserves 5 stars.https://a.co/d/fAQNZi2

Shocking stories of medical research and how it's been manipulated to prove something contrary to the results because it goes against prevailing medical "group think". Very interesting!!! Love this author!!!

Great read of evidence based medicine and the many treatments or discontinued practices which were branded medical dogma. Very educational for those who like to advocate for their own health.The only reason I deducted a star is (my opinion/blindspot) that the author has completely missed the point on Covid vaccine injuries. Whether that may make the content of a future book it is to be seen. He is highly complimentary of Dr Kariko the inventor of mrna vaccines yet misses the harm this invention caused to many people.

This book was very interesting and eye-opening. There is a lot of stuff going on in healthcare that we are not privy to. This book exposes a lot of it. My daughter is a physician, and she disagreed with a couple of things, but it was very good and easy to read.

Rather shocking, informative, well researched book. While the medical field is mostly full of people wanting to help patients, there is a lot behind the scenes that this author talks about. Easy to understand. Worth reading to be informed, not to slam the medical men and women who do their best to do good.

Excellent book for all to read. As a retired nurse, I learned so much regarding how many times our medical experts "got tit wrong" and refused to admit it, even when science proved beyond a doubt that what they were recommending was not backed up by science. Dr Marty Makary will bring much needed assistance to the MAHA movement it our country.