The fight between medicine and scepticism needs to be resolved by evidence: Book reviews

Medical scepticism is on the rise worldwide. It is very important to differentiate between uneducated scepticism (e.g. the anti-vaccination movement) where valuable areas of medicine are disputed and well-informed scepticism, where legitimate experts reveal flaws in mainstream medicine. It is assumed that medicine being a science will be self-correcting and inevitably move towards a stronger evidence-base, but a competing factor is the profit motive. Three excellent books are reviewed, all Australian and all covering primarily musculoskeletal medicine (Back Up by Mannix; Surgery: The Ultimate Placebo and Hippocrasy by Harris and Buchbinder). These texts reveal that musculoskeletal medicine has many treatments where the desire to offer hope and, also, make a profit is taking precedence over scientific evidence. Because many healthcare presentations of young people are musculoskeletal, doctors risk losing the younger generation to medical scepticism in general if they continue to offer and promote flawed treatment options over effective ones. The most effective long-term treatments in musculoskeletal medicine (exercise load management and psychological reassurance) are less profitable because they require so much time investment. Health care professionals need to be true to their science background and aim to do only what is effective, not be drawn to drugs and procedures that are more profitable but ultimately more harmful.