Letter to the Editor
The article, “The Problem with Physiology (and Why You Should Rethink Your Practices)” by Rinaldo Bellomo, MBBS, MD, was offensive to me. (2019;41:20; http://bit.ly/2TqdTI0.)
I am a neurointensivist and an emergency physician. I think practicing good medicine involves evaluating the literature to make sure it is applicable and then applying what we have learned about physiology and pathophysiology. There will always be studies that change our practice patterns, and then the data change and we change our practice patterns again. It is impossible to know everything in medicine, which is why there are always studies as we look for hard evidence on ways to make our patients better (or prevent harm).
I believe most physicians take studies with a grain of salt, try to understand if the studies are applicable, and remember that each patient is an individual and we have to do the best with what we know to take care of him. This article took the tone of physicians blindly following what they think should work and causing harm. If we can't rely on the literature and use our brains to work out the pathophysiology, then we are not left with much to treat our patients.
Rachel Garvin, MD