As far as I’m concerned, doctors can write pretty much whatever they want on blogs. I might not agree with opinions expressed, I might disapprove of the unprofessional tone a few blogs take, but they’re blogs and not usually purporting to provide medical advice. It’s different when someone has a website for a medical practice and is supposedly providing patient information.
Medical explanations on practice websites ought to be accurate. The above-pictured sample is inaccurate and harmful. Patients struggling with a decision on what type of medicine to take wonder why their doctor wants such strong meds, yet this doctor on the internet says conservative treatment is fine. Patients who take the plunge and fill a DMARD prescription have spouses/siblings/parents try to dissuade them because they found a website saying they don’t need anything more than simple ibuprofen. Patients struggling with the fact that most of the world has no clue about RA also have to deal with doctors who can’t tell the difference between RA and OA.
Rheumatoid arthritis needs early, aggressive treatment. You will piss off the RA community if you publish bad advice on this subject. We had a very difficult time finding good information when we were diagnosed, and are trying to make life a little easier for those who are unfortunate enough to come behind us. NSAIDs do not lead to a good outcome. DMARDs are needed. If milder DMARDs fail to work (it’s the med that fails, not the patient, btw), then biologics are needed. It is scary enough to read the side effects of these medicines and contemplate taking them, without having a medical doctor telling people that they only need conservative treatment.
I’m truly astonished at how bad just a few paragraphs can be and still get published. If this were handed in as a school assignment, it would be returned with red ink all over it and have to be re-written.
Web pages like this scare me. I don’t think I will ever again believe that “MD” after someone’s name automatically equates to credibility when discussing medical information. The fact that a surgeon (substitute specialty of your choice here) gets referrals for RA patients does not necessarily mean that the surgeon (__) has kept current on rheumatology.
Consider the source. Don’t ask a neurologist for advice about cardiology. Don’t ask a surgeon about RA treatments.
Edit to add:
Just to clarify, I have intentionally not named the doctor who wrote the article in question so that googling his name won’t bring up this post. I believe that:
- the author does not understand RA enough to be publishing online definitions.
- people should look at the article in context. The author is a surgeon. A surgeon’s website about how to deal with back pain is going to have the option of surgery as a presupposition, whether or not that is explicitly stated. Surgeons tend to define “conservative” as “not surgery,” so it is reasonable to believe that the author did not intend to say “stick with NSAIDs; avoid DMARDs and biologics” but might have meant “try medicine/PT to treat this, instead of jumping straight to surgery.” That is not what he says, but it’s entirely reasonable to think that’s what he intended to say.
- the author needs to update his website to reflect current medical knowledge of RA.