No 83 - Can you live your life according to EBM?
Faith in EBM or just faith
https://linktr.ee/jakemat91
This will be short. I haven’t published much recently due to work deadlines, portfolio shenanigans and MSc revision. So, the thought for your Sunday morning coffee…
Do you think that you currently live an EBM based life?
Do you carefully balance your carbs and fat intake? Weigh out the exact amount of ground coffee to reduce your risk of dementia and avoid being put into AF?
Do you take your 30 mins of daily walking, mixed with your twice weekly dose of HITT and weight lifting?
Do you avoid smoking, put statins in your drinking water and put extra flouride on your toothbrush?
Be honest… we know most doctors are not great at taking their own advice. I am not sure if other healthcare professionals are as hypocritical. I expect most physios are healthier than the average doctor?
Can you hand on heart swear that you currently believe that we know enough about the human body, our environment and society at large that you are able to confidently say that you have cracked the rules of life to ensure healthy aging?
I am really not sure that I have.
For me, this was an uncomfortable thought. I have rejected the idea of faith, since I was about 4 year olds and refused to go to Sunday school anymore. I have always looked for ways to have rational belief in something.
I have faith in the procecss of EBM and I think I can truly say that “I believe, in 100 years from now, we will be able to advise people on how to live the healthiest life”. Thanks to an extra 100 years of RCTs, very long cohort studies and more drug development.
But right now?
There are very few settled “facts” in biology or medicine. We are complicated creatures. We are individuals. It is very difficult to translate a statistical result, from a population of different people, who lived 20 years ago and had very different lives to how we are living now, to the person in front of you.
That combination of EBM, clinical experience, judgment and FAITH in your advise, is still as complicated now as it was 50 years ago.
Here is a list of things that I currently wish I had evidence for, but currently have faith in:
Eating steak regularly won’t cause me harm, maybe eating a sausage regularly will.
Drinking coffee has got to be good for my brain, even if it one day gives me an arrhythmia.
Squatting heavy won’t destroy my knees, but the rugby injuries have already started the OA process.
Exercise daily is good for you, playing sport to a high level probably isn’t.
High fibre vegetables might be good for you, they might cause a leaky gut.
Fruit is probably unnecessary.
High doses of vitamin D are probably good for you, but being in the sun is probably better.
Protein shakes and multi-vitamins are probably unnecessary if you have a good diet, but they are probably not going to do you any harm and might help balance your needs if you are short of time or money.
Doing night shifts and working in healthcare is probably going to raise your cortisol and cause you to die younger. Switching to GP will probably make you live longer (if you avoid doing OOH night shifts).
Anyone else have any good suggestions for healthcare beliefs they have faith in but would like more evidence?