Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

When physicians deviate from evidence-based medicine

Michael Kirsch, MD
Conditions
December 1, 2019
Share
Tweet
Share

From time to time, patients ask my advice on colonic hydrotherapy, vigorous sessions of enemas that aim to cleanse the body of toxins that are reputed to cause a variety of ailments. The logic sounds plausible to interested patients. Over time, toxins accumulate and leech into the body, wreaking havoc. Indeed, using the label “toxins” already suggests that these are noxious agents. If one accepts this premise, it is entirely logical that cleansing the body of these injurious agents would have a salutary effect.

Not surprisingly, the health benefits of hydrotherapy usually target very stubborn and vague symptoms and conditions that conventional medicine does not treat adequately. It makes sense that if your own physician is not making sense of your chronic fatigue, for example, that you would entertain other options. I get this. Who wouldn’t want to enjoy having more energy, better concentration, an enhanced immune system, or delayed aging? But, in medicine and in life, just because one pathway seems blocked, doesn’t mean that an alternative pathway will be a better avenue.

The reason that I do not actively recommend hydrotherapy is because there is absolutely no persuasive and credible medical evidence that it is effective. While their advertising materials may boast of “clinical studies,” there is no firm scientific basis for their claims. And, these sessions can be costly as patients are often advised that several visits are necessary to address years of toxin build-up.

If gastroenterologists did believe that the treatment works, we would be offering it in our ambulatory surgery centers along with our standard endoscopic amusement activities. (A cynic might suggest here that if medical insurance covered these treatments, then we would!)

It may very well be that practitioners of this treatment believe in the therapy and genuinely want to provide healing. And, I have no doubt that many who undergo hydrotherapy feel better. I’ll never talk a patient out of success from my or anyone’s treatment. If a hydrotherapy patient were to tell me that his depression has eased, I would express great satisfaction over this.

I admit readily that I, along with every other breathing physician, prescribe treatments and remedies for which no supportive medical evidence exists. We physicians may sanitize this fact by claiming that our action is an example of the art of medicine, but we are more likely hoping for the placebo effect.

Physicians who deviate from evidence-based medicine shouldn’t casually criticize other practitioners who practice off the grid, particularly when patients have great faith in complementary and integrative medicine.

However, all of us who claim to be healers should aspire for supportive scientific evidence for our recommendations, and we should admit to patients when such evidence is lacking.

If you opt for periodic colonic cleanses, and you perceive a personal benefit, then be aware that you are engaging in an art and not a science.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Image credit: Shutterstock.com

Prev

What car racing taught me about physician burnout

December 1, 2019 Kevin 1
…
Next

There is always that one patient

December 2, 2019 Kevin 8
…

Tagged as: Gastroenterology

Post navigation

< Previous Post
What car racing taught me about physician burnout
Next Post >
There is always that one patient

ADVERTISEMENT

More by Michael Kirsch, MD

  • Are Ozempic patients on a slow-moving runaway train?

    Michael Kirsch, MD
  • AI-driven diagnostics and beyond

    Michael Kirsch, MD
  • The surprising truth behind virtual visits

    Michael Kirsch, MD

Related Posts

  • Considering the recent setbacks of evidence-based medicine

    Kenneth Lin, MD
  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • The risk physicians take when going on social media

    Anonymous
  • Beware of pseudoscience: The desperate need for physicians on social media

    Valerie A. Jones, MD
  • Does the FDA approval of aducanumab mark the return of science-based medicine?

    Robert Trent
  • When physicians are cyberbullied: an interview with ZDoggMD

    Monique Tello, MD

More in Conditions

  • Why Hollywood’s allergy jokes are dangerous

    Lianne Mandelbaum, PT
  • Coconut oil’s role in Alzheimer’s and depression

    Marc Arginteanu, MD
  • Ancient health secrets for modern life

    Larry Kaskel, MD
  • How the internet broke the doctor-parent trust

    Wendy L. Hunter, MD
  • Mpox isn’t over: A silent epidemic is growing

    Melvin Sanicas, MD
  • How your family system secretly shapes your health

    Su Yeong Kim, PhD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast
    • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

      Trevor Cabrera, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast
    • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

      Trevor Cabrera, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

When physicians deviate from evidence-based medicine
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...