Carabelli is always a gentleman .......

How delightful, your posts are so educational. Great addition to the
discussion.

It is noted you can't stand the truth, so you snip.

None of the dentists dare get real, they might be exposed. I wonder what WB is
gonnadonow???

Robert W. Maver, F.S.A., M.A.A.A.
Reprinted from The World Research News, 1st quarter 1998 issue, with
permission.

The premise is that there are innovative medical therapies existing
today that offer solutions to some of our most pressing health
problems and that at the same time offer a significant reduction in
health care costs. These therapies are largely being ignored or in
some cases ridiculed.

To most of us involved in scientific research, this seems an odd
notion at first. Surely, one would think, discoveries and
breakthroughs offering great promise in the treatment of disease
would be at once communicated and embraced by the scientific/medical
community. However, those who study the history of scientific
progress conclude otherwise. Science frequently fails to demonstrate
the dispassion we attribute to it.

Historical citations of science resisting new ideas are too numerous
to review in any depth, from Copernicus to Galileo to Darwin, Mendel,
Ohm, Young, Pasteur, lister, Fleming ... the list goes on and on. It
is perhaps more instructive to briefly examine the reasons for resis
tance to innovation in medicine.

Tomato Effect - The tomato effect in medicine occurs when a highly
efficacious therapy for a certain disease is ignored or rejected
because it does not '.make sense" in the light of accepted theories
of disease mechanism and drug action. Doctors at the University of
New Mexico School of Medicine introduced the tomato effect in JAMA.
May 11, 1984. Its name is derived from the history of the tomato in
North America. By 1560, the tomato was becoming a staple of the
continental European diet. However, it was shunned in America until
the 1800's. Why? Because we knew it was poisonous. Everyone knew
tomatoes belong to the nightshade family. The leaves and fruit of
several plants in this family can cause death if ingested. The fact
that Europeans were eating tomatoes without harm was not relevant. It
simply did not make sense to eat poisonous food.

Peer Review - Ile peer review process probably has done more to
discourage innovative research than any other factor that I have
observed. The March 9, 1990 issue of JAMA was devoted entirely to the
topic of peer review. One article in particular, by Horrobin (himself
editor of a peer reviewed medical journal) , cited 18 examples of
peer review attempting to suppress medical innovation. The article
observed: " ... some of the most distinguished of scientists may
display sophisticated behavior that can only be described as
pathological. Editors must be conscious that, despite public
protestations to the contrary, many scientistreviewers are against
innovation unless it is their innovation. Innovation from others may
be a threat because it diminishes the importance of the scientist's
own work.

"Peer review in the grant giving process is so restrictive that most
innovative scientists know they would never receive funding if they
actually said what they were going to do. Scientists therefore have
to tell lies in their grant applications. Such views have explicitly
been stated by at least two Nobel Laureates."

The (JAMA) article contends that medicine has lost sight of the basic
purpose of peer review, asserting, "the true aim of peer review in
biomedical science must be to improve the quality of patient care."

Wrong Economics - When a new therapy comes along that is cheaper,
safer and more effective, it is seen as a competitive threat to those
engaged in the therapy it will displace. Those who stand to be most
economically disadvantaged naturally endeavor to block its
acceptance.

International Barriers - A combination of communication problems
(language barriers) and national chauvinism (if it wasn't discovered
here it can't be of much value) keep some innovative practices
developed in Europe and Asia from reaching the United States.

Cumbersome Bureaucracy - It has been estimated that the FDA approval
process takes an average of 12 years and costs $231 million. This
presents unique difficulties for independent researchers and for
therapies that do not lend themselves to patentability.

It is my observation that there is a role for the insurance industry
in advocating evaluation of innovative medical thera pies. Actuaries
should be almost immune to the tomato effect. We are focused almost
exclusively on statistical results as opposed to theory. Since the
insurance industry pays most of the bills, it should have great
economic motivation to see safe., effective and inexpensive therapies
extensively evaluated and widely disseminated. Consideration of an
industry-wide fund for innovative research could deal with the
problem of peer review. The insurance industry is a sleeping economic
giant. When it awakens to the cost containment possibilities
available through innovative therapies, we will see enormous changes
in the practice of medicine.
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Volume 6 No. 3 The Road Back Foundation" Antibiotic Therapy for
Rheumatic Diseases Summer 1998