Why You Should Read Beyond the Headline

The Daily Mail is making a headline claim that medical experts refuse the treatments they prescribe for the rest of us. The reality, as usual, is a little more complicated.

The headlinne could not be clearer:

From the psychiatrist who’d never take anti-depressants, to the heart doctor who steers clear of statins, we reveal the medical treatments the experts REFUSE to have themselves

Read the examples writer Chloe Lambert gives, however, and the fabric of her story starts to fray a little.

Let’s start with that psychiatrist, since Ms Lambert does:

Dr Joanna Moncrieff, senior lecturer in psychiatry at University College London and author of The Myth Of The Chemical Cure.
I’ve been practising psychiatry for 20 years, and in my experience antidepressants don’t do any good at all. I wouldn’t take them under any circumstances – not even if I were suicidal.
All the research shows is that, at best, antidepressants make people feel a tiny bit better than a placebo. But this doesn’t mean they actually treat depression…

…I believe depression is an extreme reaction to our circumstances, and the best way to recover from it is to work out the cause.

I have no doubt that some, perhaps the majority, of depression cases are due to external causes – bereavement, relationship problems, shitty job etc – but there is no evidence that all are. I am afraid Dr Moncrieff is arguing from authority rather than evidence here. Furthermore, she contradicts herself; “antidepressants don’t do any good at all” is followed by “antidepressants make people feel a tiny bit better than a placebo”.

To me, that second quote suggests that ADs are working for some people but are plainly not a cure-all. Still this narrative is reasonably convincing and at this point you’d be forgiven for thinking the story backs the headline. But you really should read further – and not just the sub-headings because they’re misleading too because next, we have “Weight-loss GP who wouldn’t go on a diet”:

All the evidence is that diets rarely work long term.
I’ve been working with people to help them lose weight for decades and my experience has shown me that the only way to achieve long-term success is through asking: ‘Why?’ – why do we comfort eat, why do we prefer fatty foods, why do we drink too much alcohol and why do we find physical activity unattractive?
Techniques based on changing behaviour (similar to cognitive behavioural therapy), combined with strategies such as keeping a food diary and setting realistic goals, are what really help people lose weight effectively.
Diets which encourage polarised approaches, such as low-carb, 5:2 diets or any other ‘reductionist’ approaches, will only ever achieve short-term success – you’ll regain the weight you lost.

My reading of this is that trendy diets (usually gushingly reported by the press, I might add) are not much use but finding the root causes of over-eating will result in reduced food intake and – er – weight loss. So it isn’t actually true that said GP would refuse to diet.

Then we have “Heart doctor who refuses to have statins”:

Statins have had a huge effect in reducing the number of strokes and heart attacks and there’s now a movement to give these cholesterol-lowering tablets to everyone.
But I wouldn’t take one unless I had proof I was at significant risk.
Whenever you’re taking a drug, you’ve got to think about the risks and the benefits.
Statins reduce your chance of heart attack or stroke by about 30 per cent, so, yes, there’s a benefit. But in real terms it’s very small.
As a 60-year-old, healthy, non-smoking man, statistically my annual risk of a stroke or heart attack is about 1 per cent – very low. Taking a statin would take it down to 0.7 per cent – still very low. And I’ve spent my professional life prescribing statins, so I know about the side-effects: muscle aches, general debility and stomach upsets.
Some say statins should be given when the risk is 1.5 per cent, but I personally wouldn’t consider taking the drug unless my risk was 3 per cent.
Anyone who’s had a stroke or heart attack has a risk of about 3 per cent and for them the pain is definitely worth the gain.

Now it becomes clear how misleading the headline and sub-headlines are. Professor Channer is quite clear on the benefits of statins and is currently “refusing” them because he doesn’t actually need them.

“Former GP who says vitamin C is pointless”:

Despite what many patients say, vitamin C probably doesn’t cut short colds. It probably won’t do you any harm and it won’t break the bank, but on the whole the evidence is pretty limited.

This is hardly going against received wisdom. It’s only health woosters who bang on about the virtues of vitamin C supplementation, not conventional doctors.

“Health Professor who says exercising isn’t enough”:

Indeed he does. He says that exercise has many benefits but needs to be combined with reduced food intake if you want to lose much weight.

“Orthopaedic surgeon who’d avoid X-rays”:

This would appear to be implying that he considers x-rays themselves to be dangerous. Not the reality:

Too often, patients see their doctor about stiffness, aches and pains, wanting something to be done. The doctor sends them for an X-ray, which may or may not show a bit of wear and tear, and tells them they have arthritis.
As soon as they get that diagnosis, people tend to lose control and become victims. They take anti-inflammatories (which can have gastrointestinal side-effects), feel frightened to exercise and generally become miserable.
That’s why, as long as I didn’t have red-flag symptoms of severe arthritis – such as constant pain, or pain that comes on at night – I would avoid an X-ray.

The argument here is surely that doctors and surgeons should explain the benefits of exercise to people with joints problems, not avoid x-raying them.

There are more examples but the rest, as far as I can see, are not cases of experts refusing treatments normally prescribed, quite the opposite, such as the obstetrician who would not have her first child at home.

So the question has to be asked: do Daily Mail sub-editors actually read the stories they are editting, or are they stupid, or are they dishonest?

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