PATIENT, HEAL THYSELF :

And Now for a Hot Flash : Who’s to blame for hormone therapy? (Anna Quindlen, July 29, 2002, Newsweek)  

By deciding to willy-nilly prescribe hormones to every female patient, from those who had dry skin to those tormented by hot flashes from hell, doctors were just doing what was easiest. By deciding to sell that medication by overstating its benefits and understating its risks, pharmaceutical companies were just doing what was most profitable.

Both groups are culpable, but so are patients, who need to take responsibility for their decisions, or for deciding not to decide and letting doctors and the marketplace decide for them. The case of hormone therapy is particularly glaring in this regard. How could the most ostentatiously self-aware generation of women in the history of this country allow themselves to be led like lemmings to a “cure” for a condition that is not a disease and a “remedy” for symptoms that were originally described largely in terms of how they inconvenienced men?

It is easier to simply take the pill, whatever it is, instead of studying up on diet, exercise, alternatives, the risk-benefit equation of surgery or drugs. What an orderly world it would be if the pill always did what it ought to, with no ill effects, no downside. But that’s sci-fi, not reality. “I understand that medicine is not an exact science,” it says on one surgical consent form. Where does that admission leave us? With choices, preferably informed ones, not the “yes, doctor” of years past. The day of the MDeity should be over; doctors have acted like little gods because patients have treated them as though they were. The woman who looks to a doctor to dictate rather than advise may wind up with treatment that she lives to regret. Or perhaps doesn’t.

The usually loathsome Ms Quindlen very nearly writes an insightful column here. She's right that female patients deserve much of the blame for the whole hormone replacement mess but wrong about the reason. It's not that they simply took doctors' advice but that women demand medical care at levels that are absurd and expect treatment for even the most ridiculous "ailments". Doctors told them to take this stuff because they knew it would shut them up.
Posted by Orrin Judd at July 24, 2002 2:51 PM