It is very disappointing how we sometimes still meet with narrow minded physicians or even pharmacists that only want to discuss treatment options they favor and would not listen to their patients concerns or thinking. I also understand that sometimes patient become so desperate that they just search on google or existing literature and come up with treatment plans or information that might not be evidence based or effective; however, I believe that educating the patient about why those options would not work for them is always better than being so resistant about discussing or learning about other options. - Omniah

First Do No Harm - Sim Taleb

When Lori Reimuller learns that her young son Robbie has epilepsy, she first trusts the judgment of the hospital staff in how best to bring it under control. As Robbie's health slides radically downhill, however, she becomes frustrated and desperate, and so does her own research into the existing literature on treatments. When she decides to try an alternative treatment called the Ketogenic Diet, devised long ago by a doctor from Johns Hopkins, she is met with narrow-minded resistance from Robbie's doctor, who is prepared to take legal action to prevent Lori from removing him from the hospital. This movie is an indictment of those in the medical profession who discuss only the treatment options they favor. Several of the minor characters are portrayed by people who have been not just helped, but cured by the Ketogenic diet.

It is very eye opening how parents turn to existing literature on treatment looking for alternatives when not satisfied with conventional treatment.Ahmed Youssef

It is very interesting to learn about other options to control epilepsy than AED medications. Probably the doctor needed to be convinced by evidence about ketogenic diet, which could encourage mental health clinics to start on trials with ketogenic diet.

Noha

A very interesting commentary of the movie. Medical doctors tend to push patients towards particular choice of therapy or procedure. Healthcare provider should provide patients with the needed facts and information that will help guide the patient in choosing their drug therapy and they should alone patients to make their own decision especially when they are considering alternative treatments.

Omolola Asielue

Omolola, I think it's hard for doctors to allow consideration of alternative treatments sometimes. If you consider the digital age we live in, and some of the ridiculous things that appear on the internet that patients may take as gospel, I can understand some of their frustration. Contemporary medical practice leans toward evidence based decision making, and there's rarely going to be a double blinded RCT for the alternatives. I wish there was more effort to conduct robust trials on some of the alternatives. In any case, you're right that they should provide facts and their professional judgement to patients, but support patient decisions, even when all their advice isn't applied. L

This is the true depiction that once parents do not find cure for their sick child, they are ready to try any possible solution. It is sad at the same time how these parents faced difficulty from the same people who they look upon as a help. Overall, your post remind us as a health professional our attitude towards patients and their care givers should only be of a guide. (Syed Rashid)

Hi Sim, thank you for sharing your post. I had not heard about this movie before, so it’s interesting to me. Unfortunately, often in healthcare more emphasis is placed on traditional medicine and in some instances, there is more evidence behind traditional medicine and either we are more drawn towards it or form a bias. This movie would be a reminder for us in healthcare to support and educate patient but always keep an open mind with alternate therapy, especially when harm from it is minimal. Trusha Patel

Sim: A friend of mine once said that a smart person doesn't need advice and a fool wont take it! Sometimes its hard to determine which side someone is on. I don't know if anyone remembers the story of H. pylori and two physicians who discovered that it was the cause of stomach ulcers. The entire medical community was against them. They won the Nobel Prize in 2005 for their discovery. I always try to keep this in mind when some patient/parent tells me about something they think will help them or their loved one.

Hi:

I agree with all of the previous comments in regard to how healthcare providers can be so reluctant sometimes to hear from their patients or their advocates about their willing to try new or different approach to treatment especially if the old ones are not working well. taking into account patient's preferences can highly improve outcomes and patient satisfaction and adherence. Educating patients and healthcare providers about this is essential and must be a core element in every healthcare system.
Sim.

Hi Sim,

I used to teach First Aid for the American Red Cross many decades ago. Interestingly, we only presented a brief 5 minute topic of instruction on Epilepsy. During the class, we described patient's biting their tongue off and the recommended avoidance of a spoon because it would cause a choking hazard and could result in broken teeth. It is amazing to me how naive we were and how insensitive to our the future patients that we may encounter. Recently, I read a national survey done in the mid 1990s that found most Americans believe people with epilepsy should always be restricted from driving or participating in sports. As a pharmacist, I hope to correct the misconceptions that our own patients with epilepsy may have adopted. I plan to express that epilepsy patients who are seizure-free on medication can do anything as long as they are compliant with their seizure medicines and remain free of seizures under the direction of their provider.

[ Comment by Brian Marcantel ]