The Problem of Outdated Medical Knowledge

Medicine is constantly advancing, and a clinician must keep learning to keep up. I have seen a large number of patients and read their discharge orders, and I deeply feel that the problem of outdated medical knowledge is quite widespread among clinicians. Some orders are still at the level of ten or even twenty years ago, when the understanding of certain diseases has now been proven wrong. This happens because the textbooks these doctors studied from differ from current ones, and their medical knowledge has not been updated in time.

I once read an American report on a social survey in the United States. The survey showed that more than half of oncologists in the US have seriously inadequate tumor knowledge and lack understanding of many up-to-date common-sense questions in oncology. I believe this phenomenon is equally widespread in China.

For example, a recent medical report showed that the long-held medical guidelines for lowering cholesterol contained serious errors, causing millions of people to be misdiagnosed and prescribed cholesterol-lowering statin drugs that they did not need at all. At present, many cardiologists are surely still stuck in the old understanding and prescribing according to the currently prevalent medication guidelines. This is a very typical example.

Judging from my own firsthand experience, neurologists prescribing aspirin to most patients with cerebrovascular disease is also unnecessary. Such medication not only fails to reduce these patients' risk of stroke but can cause gastric bleeding. This treatment policy is likewise open to question. Three stroke patients in my own family all died of a sudden stroke while taking aspirin. My wife's aunt, a patient of the same kind, after onset I prescribed Modified Xiaoyao Wan in place of aspirin; three years on, she remains well.

Sometimes I see discharge orders in which the management of the patient's condition is the opposite of the latest medical literature I have read. For example, it is recommended that liver cancer patients with cirrhosis and hepatitis B background eat more high-protein food. This medical view, now doubted or even abandoned by many doctors, still appears in the orders of a great many clinicians. When some patients develop serious adverse reactions after eating high-protein food, they do not know what to do.

Sometimes highly esteemed senior experts, even academicians, have the same problem. When I bought a famous academician's medical work on Amazon, I saw some reader reviews saying that the academician's medical views were outdated. At the time I did not think much of it, but after buying and browsing the book I found it was true. I once read an article discussing the retirement of academicians, in which one academician's words impressed me deeply. He candidly admitted that as he grew older, his own knowledge had become stale, and that learning new knowledge was now beyond his power; therefore he suggested that academicians should retire.

Medicine advances day by day, so the obsolescence of medical knowledge is an unavoidable problem. Both doctors and patients, to achieve the most ideal treatment outcomes, need to engage with the latest medical knowledge, especially the latest concepts of evidence-based medicine that have been rigorously verified.

Decades ago in China, if integrated Chinese-Western medicine could treat a liver cancer patient to a survival of more than one year, that was enough to publish a paper in a medical journal and exchange experience. But now many liver cancer patients survive more than five years. Medicine has never developed to its ideal state; only by constantly learning can doctors strive for the best outcomes for their patients.