Extended Interview with Nortin Hadler, MD, Professor of Medicine, Microbiology and Immunology at the University of North Carolina at Chapel Hill. He is attending rheumatologist at UNC Hospitals. His books include The Last Well Person: How to Stay Well Despite the Health Care System and Worried Sick: A Prescription for Health in an Overtreated America.

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  1. bf
    Reply

    I see. So discount a reliance on evidence based medicine because you have a proximate anecdotal datum?
    PEOPLE’S PHARMACY RESPONSE: ON THE CONTRARY. DR. HADLER’S APPROACH IS BASED ON CAREFUL EXAMINATION OF THE EVIDENCE.

  2. DD
    Reply

    Despite many good points raised by Dr Hadler, I choose to discount his overall thesis because I prefer to listen to the conclusions of a cardiologist rather than a rheumatologist when the discussion is about a cardiologic problem. Here is why. In my 40’s, I developed hypertension and an EKG also showed an inverted ST wave. At the time, I was being treated by an endocrinologist. I had 3 children in school and wanted to increase my disability insurance, but nothing the endocrinologist could do would convince the insurance co.
    I switched MDs, and over the next several years, was treated by different internists with different subspecialties in gasrtro. and rheumatol., They were very good doctors, but couldn’t help me increase my disability coverage. By this time, my oldest was in medical school and suggested that I go to a cardiologist. I did. He prescribed a few tests, sent the results to the insurance co. and I was approved for the increase in disability insurance. The results of the tests showed that my heart was sound and that the inverted ST wave was, in my case, not indicative of ischemic heart disease, but just an individual normal occurrence.
    This was the evidence that the insurance co. was looking for. I was surprised that the other MDs didn’t know to prescribe these tests years before, as they were available then. As I later realized, however, the knowledge content of medicine is so great that these other MDs had all they could do to stay current in their chosen subspecialties and were not inclined to be as expert in cardiology as a cardiologist, although they treated patients with heart problems. Since then, I have a general internist, but choose to see a cardi, urol., gastro, ophthal. for specialized problems. Fortunately, my medicare Pt. B allows this.

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