Always remember, it’s in our nature as doctors to just do something– our tools are pills or scalpels. We may get sued if we don’t do something, when a treatment exists, despite the scant evidence for that treatment. But say we prescribe a pill, and something bad happens, we can chalk it up to not being our fault. It’s simply a side effect of the medication.
A friend of a friend recently contacted me after he had a pulmonary embolism. His doctor put him on Coumadin and Lovenox to prevent another embolism. The Lovenox has costed him $1700. But when you look at the number needed to treat for anti-coagulation after a pulmonary embolism, you see that, for those who got the anti-coagulation:
- 100% saw no benefit
- 0% were helped by being saved from death
- 0.9% were harmed by a major bleeding incident
- 0.9% were harmed by dying due to a major bleeding incident
Lovenox does thin the blood. True. But does thinning the blood to prevent another clot offset the risk of having too thin blood and bleeding out? Good question. But at least we’ve got a shiny new pill we can offer.