I had an interesting conversation with a young Polish cardiologist recently. He was friendly and open to discussing views on health, without resorting to the 'Me expert, you idiot' approach of yesteryear.
I talked about some of the things I've learned about preventing heart problems and mentioned the work of Dr William Davis. The cardiologist turned to his computer, typed in Dr William Davis in the PubMed search engine and found no results. He then told me that Dr Davis must be one of those American charlatans, who are just trying to make money out of empty assertions and selling snake oil. I explained that Dr Davis has had stunning results by recommending diet and lifestyle changes in order to reduce coronary arterial plaque. The cardiologist dismissed this telling me he could claim numerous positive results and that this would prove nothing. He told me that he would need to see peer reviewed articles to convince him that Dr Davis had anything valuable to contribute to the field.
I then asked for his views on the lipid hypothesis and the idea that saturated fats contribute to heart disease. He told me that there is evidence that they do, took my email address and promised to send me links to peer reviewed articles substantiating this fact. That was at the end of November 2011 and to date I've heard nothing.
Later I typed the young cardiologist's name into PubMed and found zero results, despite the fact that this doctor routinely prescribes heart drugs and surgery to deal with various symptoms. I also checked on my GP colleagues, with whom I've worked for 20 years, and found no peer reviewed papers by any of them. I've witnessed and heard from patients testimony to their efficacy in dealing with a wide range of medical conditions. I doubt if patients need peer reviewed articles to show that their doctors aren't charlatans.
Dr Davis relies on the results of scans to show his patients' calcium scores. It's possible to challenge the cause-effect relationship between diet and heart disease that he proposes, but his results are impressive.
Dr Davis is generous with his knowledge and shares his experience freely on his blogs and in interviews. He does have a heart disease prevention programme with a membership and also sells 2 books. I don't think this automatically discounts his work.
In a previous post I mentioned the difficulty of getting research published in peer reviewed journals if it challenges orthodoxy or a sticky metaphor. Lynn Margulis persisted and made a difference to how we understand the process of evolution. The way that the Helicobacter was brought to public attention so that research was financed and appropriate antibiotics developed for the treatment of stomach ulcers is another example of this trend.
Commentators are challenging how pharmaceutical companies chase gold mine drugs and jump to conclusions about cause-effect relationships rather than correlations to research treatment for serious conditions. Some claims for drugs have been undermined by research or more detailed analysis of the initial findings on which claims for the drug were based. 'Why Science is Failing Us' is a provocative article in this vein.
Another angle in this debate focuses on the trend towards senior researchers to claim credit for all breakthroughs (and to quash evidence that young juniors have found something new.) Peter Lawrence claims that the heart of research is sick. He describes the push for publication in a few high profile journals so that your papers are cited by colleagues. This means that small, obscure areas of research are overlooked and that papers on planned genetic research are favoured, an area which seems to be reaching some dead ends. The outlook for UK scientific research is depressing.
I think it's absurd to assert that a doctor can only treat people if he/she has published research in a peer reviewed journal on the subject. The history of medicine has been built on doctors and surgeons applying the results of other people's research. Some members of the field indicate that the true charlatans may be those who change the paramaters of their research AFTER the results are in or those who conceal or understate side effects and statistically insignificant results by manipulating the data.