The Right Tool

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fullsizerender“I’ve got to use the right tool,” I thought to myself as I attempted to pound a nail into the wall with the bottom of my coffee cup. Kneeling on the exam room table, I was attempting to hang a picture on the wall before the clinic day began. I have all sorts of useful tools in my clinic – scalpels, special scissors and a multitude of precision instruments for surgical procedures and other medical care. But on that day I did not have a hammer for pounding in a nail to hang a picture. I smiled, and reflected on how comical I must look, awkwardly perched on the exam room table trying to put a nail in the wall with a coffee cup. I had opted for what was convenient but not what was appropriate. Without the right tool, I was not successful in getting my job done and was wasting valuable time. Hoping I was now a little wiser, I climbed off the exam table with the picture, walked back to my office, picked up my stethoscope, and began the clinic day seeing patients.

Using the right tool is critical. I was immediately reminded of this as my first patient – a 65 year old man – came in for a physical. As is the case for many Americans, the biggest threat to his health was the risk of having a heart attack or a stroke. He had several important risk factors for heart disease: he was overweight, had high cholesterol, high blood pressure, and was recently diagnosed with diabetes. He needed to lose weight, but weight loss was difficult for him. During the course of the visit we discussed his weight, and he shared with me that he was trying the “Ketosis Diet” to help him lose weight. He had read about this diet on the internet and purchased a book. He explained the diet was rich in cheese, bacon, and other meats. Apparently by avoiding all carbohydrates and eating mostly fat, one loses weight. The diet fit in nicely with his existing eating habits. After considering his diet, I cautioned that the types of foods he was eating were exactly the type of foods medical research recommends avoiding to prevent heart disease. I attempted to steer him towards the right tools – heart healthy foods and physical activity – for his job, the job of preventing a heart attack.

When it comes to preventing disease, individuals need to stop pounding nails with coffee cups. Pounding a nail requires the right tool: a hammer. When it comes to medicine, the hammer is science. Evidence based research – the scientific process – is the perfect tool for promoting health and has an excellent track record. Modern medicine has been successful at preventing and treating disease because of the scientific process. To make health decisions based on the latest internet popular opinion is using a coffee cup instead of a hammer to pound a nail.

Healthcare providers need the truth of science to guide them in making sound recommendations for both individual patients and for the population as a whole. Vaccines are a perfect example. Vaccine medicine is medical science at its best, in that it offers a clear example of scientific research that originates in the laboratory, and that is later applied to people and populations to prevent deadly infections. Every day, vaccines prevent diseases that could have been; every day, vaccines save lives. Thanks to science, Polio is almost eradicated from the globe and the Americas have been declared free of Measles. Meanwhile, looking forward into the future, Zika – a more recent threat – may well prove to be a short chapter in history books, as a number of promising Zika vaccines are currently undergoing clinical trials. Vaccine science is the right tool to prevent infectious disease.

The scientific process is critical not only for advancing medical care and vaccine science, but is vital to all realms of scientific research. Whether it is medicine, public health, or climate change, science is the best tool to understand our world. Science has a proven track record; it works. The alternative to using science is nothing more than a popularity contest of opinion. If we as a society choose to value proclamations devoid of facts over scientific research, we might as well equip all the carpenters in America with coffee cups. We need to choose the hammer and get the job done; science is the right tool to improve health, prevent disease, and has the potential to make the world a better place.

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