A few years ago, when my arthritis got pretty bad, I asked my doctor for suggestions on dealing with the pain. She told me to take ibuprofen and something else I’d never heard of: glucosamine chondroitin. “It will make you feel better,” she promised. So the next time I was in the grocery store, I bought some. It cost a lot. It didn’t seem to make any difference. So the next time I went to the doctor, I told her it wasn’t helping. “It’s helping,” she told me. “Keep taking it.” And I did, for another year or so.
Then I read the results of a study that showed glucosamine chondroitin didn’t help with arthritis pain, so I stopped taking it. The next time I saw my doctor, I told her I’d stopped.
“Keep taking it. It helps,” she told me.
“It doesn’t help me. And it’s been scientifically proven not to help,” I told her.
She shook her head. “It helps,” she said.
I didn’t go back to taking it. But a few months ago, I found out my husband, who has a touch of arthritis in his knees, was taking glucosamine chondroitin.
“Are you out of your mind?” I asked him when I found out. “It doesn’t work!”
“It’s been proven not to work!” I told him. “And it costs so much!”
He didn’t listen to me. Which is nothing new.
But maybe he’ll listen to the American Academy of Orthopedic Surgeons. As part of “Choosing Wisely”—an initiative spearheaded by the Philly-based ABIM Foundation to help doctors promote care for patients that’s supported by evidence, non-duplicative, free from harm and “truly necessary”—the academy has issued a list of five medical procedures that doctors shouldn’t suggest and that patients should say “No thanks” to, because there’s no evidence they make any difference at all. Among the five? Taking glucosamine chondroitin. Also not worth your time or money? Needle lavage for knee pain, lateral wedge insoles for arthritic pain (sorry, Dr. Scholl!), and wrist splints after carpal-tunnel surgery.
The Choosing Wisely website offers similar five-point “don’t bother” lists for family physicians (no Pap smears for women under 21), pediatricians (no cough or cold meds for kids under four), geriatrics (don’t make antipsychotic drugs your first choice in battling dementia), ophthalmologists (no antibiotics for pink eye!), cancer specialists (don’t remove a suspicious breast lump unless you can’t perform a needle biopsy), and many, many, many more fields of medicine. These lists make for fascinating reading. One of the big problems in the American health-care system is over-testing and over-treatment—both because patients demand it, and because physicians feel compelled to cover their arses. The “Choosing Wisely” initiative could go a long way toward dialing that back—if people pay attention.
Doug, honey, are you listening?