Never Get Ahead of Others

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. We physicians have been expected to be the elite and leaders of our society. We have recognized ourselves or have been considered by others as more intelligent and gifted than ordinary people in every aspect of life. Hence, you may wonder why we should not get ahead of others. What I mean is that we should not be competitive at least in treating patients and performing surgery. No one can deny that we should go the extra mile with research and publication. However, I doubt whether taking an aggressive stance with regard to patient care would be beneficial. I would like to make it clear that I do not intend to depreciate the efforts by doctors or hospitals to explore or implement a new treatment. However, it is another matter whether we should jump on the bandwagon for innovative treatments. Newly developed treatments are not rigorously tested for safety and efficacy in most cases. So they should be publicized and recommended to the public only when their safety and efficacy are proved by several years of follow-up. Let me site an example of spinal surgery, and especially disc surgery, which I specialize in. Between the 1980s and 1990s, chymopapain injection was praised as a simple and effective treatment for lumbar disc herniation. However, it is no longer in use since it caused severe side effects. Thereafter, laser disc surgery and nuecleotome became popular, which were known for involving a minimal skin incision, but they have turned out to be less effective than the established techniques and they have gone the same way as chymopapain injection and the Dodo bird, that is, into oblivion. It is worrisome that new treatments become popular due to the media publicity, but they are without scientific evidence and then they just disappear when their side effects are revealed. Considering that medicine is about treating human beings, extreme care should be taken with using a new treatment. Most importantly, the short-term treatment results observed in some patients should not be described as if they were obtained from all of the patients with the same disease. A doctor's personal experience with some limited number of patients is just an anecdotal episode. People tend to see what they want to see. No wonder then, that we often find ourselves generalizing …