Does your doctor understand the NNT?
The more you understand the importance of NNT (Number Needed to Treat), NNH (Number Needed to Harm), RRR (Relative Risk Reduction) and ARR (Absolute Risk Reduction) the better you can consider the value of the drugs that are recommended to you. If the very best drugs are only effective in 10% to 30% of cases and many drugs are only effective in 2% or less of cases, then it is in your best interested to understand these numbers. I believe it is not to much to expect your doctor to understand these numbers. But sadly many doctors are blinded by the manipulation of the statistics, same as consumers. So it is your responsibility to manage your health.
In this interview Dr. Len Saputo will discuss the NNT from a doctor’s perspective. He also discusses why we have this problem. He discusses the relationship between pharmaceutical companies, medical colleges and research universities, medical journals and direct to consumer advertising.
So it comes down to this. The drug model is to treat many patients who do not need and will not benefit the drug in order to have a small benefit for few. Pharmaceutical companies manipulate the data to make the drugs sound better than they are. FDA accepts this norm and enables these drugs to come to market without full disclosure to doctors and consumers. Medical journals publish studies that prop up the illusion that drugs are safe and effective. Medical researchers are driven by financial gains provided by the pharmaceutical companies. Medical colleges continue to educate doctors who are poorly prepared to think independently about health care and continues to think largely in terms of drugs and ignore the importance of lifestyle, diet, exercise and nutritional supplementation as viable adjuncts to medical care. If drugs are in reality of such limited benefit, then what is the solution to better health?
The solution is for you to become as knowledgeable as possible, taking responsibility for your health, make better choices. Health comes from your body and what you do. I happen to believe that nutrition and supplementation are critical. Drugs are not nutrients. They are foreign molecules that cause powerful changes in your body. Drugs do not help you be healthier. They may help manage your disease but they do not generally help you be healthier and have better outcomes. Let’s not confuse drugs and supplements. Supplements nourish the body, drugs do not. Supplements are recognized by the body, drugs are foreign substances.
I realize it is challenging to grasp the NNT and the related numbers. You can learn more by visiting my previous podcast. The NY Times published a two part series on this topic that are very helpful in understanding this topic. While you may question how did we come to this point, it is more important to realize that this is our current state of affairs. Failure to understand this issue means that you will not be able to properly evaluate what is being offered to you. These articles will help you grasp the significance of the issue.
Can This Treatment Help Me? There’s a Statistic for That, NY Times Jan. 16, 2015
How to Measure a Medical Treatment’s Potential for Harm, NY Times Feb. 2, 2015
You should also listen to my interview with Dr. Michael Murray where we discuss his book “What the Drug Companies Don’t Tell You, and Your Doctor Doesn’t Know.”
About Dr. Len Saputo
Len Saputo, MD is a graduate of Duke University Medical School and board certified in Internal Medicine. He was in private practice in affiliation with John Muir Medical Center in the San Francisco Bay Area for more than 30 years. His approach to healing has evolved from mainstream medicine into “Health Medicine”—an integrative, holistic, person-centered, and preventive style of practice. Dr. Saputo is the author of “A Return to Healing“.
Over the past 15 years, Len has led the Health Medicine movement as the founder of the Health Medicine Forum, a non-profit educational foundation. Since 1994, “The Forum” has sponsored more than 350 public and professional events including lectures, workshops, and conferences. In 2001 Len founded the Health Medicine Center, an integrative medicine center that is located in Walnut Creek, California, that is bringing the model of Health Medicine into clinical practice. You can visit his website at DoctorSaputo.com.