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Why New Medicine May Not Be Best Medicine--An Editorial

By Anonymous
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Wellness related image Photo: Getty Images

My kids are all about the latest technology: the coolest, fastest smartphones, video games, computers, gadgets of every kind. “What will they think of next?” is the way we traditionally marvel about it. And, as Americans, we celebrate it with our dollars. But when it comes to medicine, the latest is often not the greatest. There are risks when you are putting something new in your body and there can be consequences that are more significant than trying a new piece of electronics.

The latest example is hip implants. These are the medical devices used when someone has debilitating hip pain – usually from arthritis. A new hip ball and socket could give that person back their mobility and relieve them from pain. Hip joint replacement has been around for years and several companies make hundreds of millions of dollars selling them. It’s lucrative for orthopedic surgeons and hospitals too. It’s competitive. Should you have this model or that one? Should you go to Dr. Smith at hospital X where he has performed more with the new device than anyone in the region? Or should you go to Dr. Brown who is more conservative? Marketing muddies the water, and your interest in getting the latest medicine has to offer colors your choice.

If you decided to go with the newest and latest version of the hip replacement device, thinking that newer means better, in this case it appears that you may have picked wrong. It is turning out that fairly new, U.S. Food and Drug Administration-approved metal on metal hip joints have a problem that wasn’t seen in lab testing. Some of the time microscopic pieces of metal from the joints are floating around the body. And the doctors who pledged to “do no harm" unwittingly did. Devices are being removed in second surgeries.

As a patient you’d have to wonder, how did this happen? How did the FDA approve something that later proved harmful? Why did board certified doctors stake their reputations on something new that turned out to be inferior to, and more risky than, the old standby approach? Unfortunately, that is the state of medicine today.

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The FDA will be quick to point out they do not 'approve' drugs or medical devices, the 'clear' them. Mr. Schorr is quite correct, though, there is no need for a drug or device to be an improvement on time tested items already on the market; they must only submit data proving equivalency in effectiveness and safety. Although testing --often requiring years--is done there is no way to expose the drug or device to the number of applications it will see in the real world; therefore, the lower probability risks will escape notice until after market release. A conservative physician will steer patients to the standard-of-care treatment and await further reports.

June 27, 2011 - 7:58am
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