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Comment by dudzik | Hacker News Reader

> Nobody has the knowledge base to make a real informed decision on the efficacy of a drug.

This is probably true for most patients, but not doctors. Normally, a patient consults a doctor on what drugs to use for their illness and the risk of taking it.

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This is the idealized spherical cow theory of medicine. Doctors have more knowledge but it’s not any more reasonable to expect them to follow the scientific literature for hundreds of different topics than it is to expect the average HN reader to follow the standards and development process for every technology they use. This is especially true given the amount of money at stake: a company has enormous windfalls if they can convince doctors to prescribe it and there’s plenty of evidence showing that they’ll try everything to do that. The amount of money going into sales to doctors & advertising is similar to their R&D spend and there’s no reason to expect the steady stream of ethical complaints would go down with less regulatory oversight.

Agreed, it is not to be expected that a doctor is able to follow the scientific literature for hundreds of different topics. However, I would expect a specialist to know their field well enough to assist a patient/guardian in making a somewhat informed decision.

I take your point that companies can falsely advertise their products. I think there is a place for a government body to make sure claims about healthcare products are factual. In this particular case we are talking about a drug that appears to not cause any harm. So I don’t see any reason to prevent an adult to make a decision with the help of a physician to administer said drug.

> I take your point that companies can falsely advertise their products. I think there is a place for a government body to make sure claims about healthcare products are factual.

The problem is that deciding whether something is factual is a lot easier for simple things. For something like this, there are vaguer connections between facts like plaque removal and more nebulous things like meaningful outcomes for patients.

> In this particular case we are talking about a drug that appears to not cause any harm.

Other than brain swelling or bleeding, headache, falling, diarrhea, and confusion, delirium or disorientation, you mean?

Doctors are doctors not research scientists. They are much more akin to engineers than scientists. There is also a massive amount of specialization in medicine (but not always in prescribing of medicine). Doctors absolutely rely on the work of scientists to help guide them. Doctors are not really trained in how to gauge the efficacy of medicines.

Isn't it more or less fact that doctors are (for obvious reasons) the target of marketing campaigns by the pharma industry to encourage prescribing certain products? Yes, doctors presumably have a higher degree of informedness/resistance to bullshit, but I think you are fooling yourself if you believe that everything is fine with doctors as the thing standing between you and the obvious financial incentives of the pharma world.

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