In this conversation, Mark Kargela interviews Ian Harris, an orthopedic surgeon and researcher, about the challenges and problems in healthcare. Ian discusses his journey from being a practicing surgeon to becoming interested in the scientific method and evidence-based medicine. He talks about the resistance he has faced in challenging the status quo and the difficulties in changing the way surgeons think. They also discuss the placebo response in surgery, the blurring of normal and disease states in healthcare, and the overuse of procedures like spinal fusion and regenerative medicine. Ian shares his projects on placebo studies for rotator cuff repair and spine fusion, which aim to provide high-quality evidence to change practice.

Takeaways

• The scientific method and evidence-based medicine are crucial in improving healthcare practices.
• Surgeons often face resistance when challenging the status quo and trying to change the way they think.
• The placebo response in surgery is complex, and contextual factors play a significant role.
• The blurring of normal and disease states in healthcare leads to unnecessary interventions and medicalization of normal conditions.
• Procedures like spinal fusion and regenerative medicine are often overused despite limited evidence of their effectiveness.
• Placebo studies for rotator cuff repair and spine fusion aim to provide high-quality evidence to guide practice.

Books (Affiliate Links)
Surgery: The Ultimate Placebo
Hippocrasy: How Doctors are Betraying Their Oath

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