Something disconcerting is unfolding in the field of medicine, and many of us sense it even if we haven’t voiced it: evidence-based medicine is gradually being undermined, not only by external forces but from within our own ranks.

Patients today are seeking quick solutions more than ever, and healthcare professionals are increasingly entering the market to fulfill that need. Hormone pellets. “Longevity regimens.” Scientific-sounding peptides that lack substantial human data. The trend is clear. And it should alarm us all.

As doctors, we were trained to propose treatments grounded in safety, efficacy, and evidence. Somehow that benchmark is being compromised by the lure of new revenue opportunities, patient eagerness for immediate outcomes, and the stress to remain “competitive” in a healthcare environment that is difficult to recognize.

However, medicine was never intended to be about competition. It was meant to emphasize caution.

The Surge of Quick Solutions and Physicians as Promoters

Patients are exasperated. They seek relief. They crave hope. They demand results immediately. And in a time of social media-driven medicine, convenience frequently outweighs caution.

But now it’s not merely influencers advocating for quick fixes. Physicians are progressively offering:

– Testosterone pellets to females, despite limited and inconsistent safety information
– Costly hormone “optimization” programs
– Customized longevity combinations
– And most recently, injectable peptides, many of which lack peer-reviewed human trials and a defined therapeutic dose

These clinics are expanding due to existing demand. But demand doesn’t equate to evidence. And popularity doesn’t guarantee safety.

What happened to “first, do no harm”?

Along the way, primum non nocere seems to have become optional.

We ceased to inquire about crucial issues: Is it effective? Is it safe? Is the risk justified by the potential gain? Do we genuinely understand the long-term impacts?

For numerous modern “wellness” interventions, the candid answer is: We don’t know.

And medicine should never function on the basis of we don’t know.

Take the booming peptide market. Many are promoted with grandiose promises: tissue repair, fat reduction, anti-aging, gut restoration, muscle enhancement. But behind the hype lies a stark reality:

– There are no strong human clinical studies backing these assertions.
– There are no established safe dosages.
– Regulatory bodies categorize many of them as unapproved substances.
– And the long-term risks are not only unclear; they are unknown.

Yet they are being widely marketed, often branded as “cutting-edge medicine.” Cutting-edge compared to what? Certainly not actual scientific rigor.

HRT vs. Hormone Pellets: A Comparative Lesson

Consider hormone therapy. There exists solid evidence supporting appropriate, tailored HRT in women. We now possess decades of information, evolving guidelines, and a detailed understanding of risk.

In contrast, hormone pellets are a trending cash-pay option often advertised to women as a superior choice. However, the evidence does not align with the marketing:

– Limited long-term safety information
– Inconsistent dosing
– No method to reverse once inserted
– And minimal standardization or protocols

Yet pellets are presented as though they represent a proven standard of care. They do not. This is not innovation. It’s mere improvisation.

Why This Is Important

The degradation of evidence-based practice is not merely an academic issue; it impacts patient safety and professional identity. When physicians advocate for treatments without robust data, we place patients at unknown risks. We undermine public confidence in our field. And we transform into salespeople rather than clinicians.

Medicine loses credibility each time we favor trends over truth. Innovation is crucial. Curiosity is vital. Emerging therapeutics are thrilling. But none of this can replace evidence.

If we forsake caution, if we cease to insist on data, if we allow commerce to dictate practice, then indeed, evidence-based medicine may very well perish. It won’t be a sudden downfall, but rather a gradual decline, accomplished through countless small compromises.

Corinne Rao is an internal medicine physician, engaging as an independent contractor at various healthcare facilities, the owner of an internal medicine practice, and a member of FlexMedstaff. In her free time, she enjoys ballroom dancing.