Most patients worry about surgical errors or misdiagnoses, but Dr. Marty Makary, a surgeon and professor at Johns Hopkins University, says the bigger, hidden risk is how doctors think.
In his new book, “Blind Spots,” Makary suggests that cognitive dissonance keeps doctors clinging to outdated practices and prevents the medical field from adapting to new evidence, resulting in treatments that can be ineffective or even harmful.
At the heart of the problem is a health care system entrenched in convention, where long-held beliefs persist despite scientific advances. “Some medical practices are rooted in good data, while others become folklore,” Makary told The Epoch Times.
Medical Dangers of Cognitive Dissonance
Cognitive dissonance is the discomfort people feel when confronted with evidence that contradicts their established beliefs. Instead of adapting to the new information, they often cling to their old views to avoid the mental effort of changing—which can have dangerous consequences in medicine.“The human brain can do amazing things,” Makary writes. “But when it comes to receiving new information that conflicts with old information, it’s predictably lazy.”
Such mental blocks mean outdated practices can linger for years. Long-standing beliefs about cholesterol, antibiotics, or dietary advice have persisted despite mounting evidence that they’re no longer the best course of action.
Even experienced doctors struggle to abandon methods they’ve relied on for decades, Makary points out. “Admitting that what we once believed is no longer true requires humility,” he told The Epoch Times.
Adding to the problem is “groupthink,” where widely accepted ideas are rarely questioned simply because they’ve become the norm. Makary argues that this collective mindset allows medical dogma—practices followed more out of habit than evidence—to survive unchallenged for far too long.
Convention Over Evidence
Makary says that many treatments used in modern medicine are rooted more in convention than scientific proof. He defines medical dogma as an “idea or practice given incontrovertible authority because someone decreed it to be true based on a gut feeling”—not solid research. Over time, these assumptions are treated as fact, he says, even as evidence emerges to challenge their validity.Makary suggests that the rise of centralized medical authority and an increasing intolerance for dissenting views have made it harder for doctors to question these long-held beliefs.
“Dogma may be more prevalent today than in the past,” he writes, as many health care professionals hesitate to deviate from accepted norms, even when the data no longer support them.
Makary illustrates his point with an example from a former editor of JAMA, who said, “60% of what we as physicians do in medicine is discretionary.” That means 60 percent of medical practice is based on subjective judgment rather than concrete scientific proof. As a result, Makary says, outdated treatments often persist long after they have been debunked.
4 Medical Myths That Persist Despite Evidence
Makary identifies several long-standing medical recommendations proven wrong by new research that still influence patient care. Four of these are outlined below.1. Peanut Allergies
In the early 2000s, the American Academy of Pediatrics (AAP) recommended that pediatricians across the United States delay peanut introduction to children until age three to prevent allergies.2. Hormone Replacement Therapy
For much of the 20th century, hormone replacement therapy (HRT) was hailed as a revolutionary treatment for menopausal women. It helped alleviate symptoms like hot flashes, brain fog, and sleep disturbances while also showing promise in reducing the risk of heart disease, osteoporosis, and Alzheimer’s.Makary says that the study’s results were misinterpreted. “The study showing that HRT causes breast cancer does not show that HRT causes breast cancer,” he writes, noting that the findings were not statistically significant.
While the media latched onto the idea that HRT was risky, follow-up research later showed that, in some cases, HRT actually reduces the risk of breast cancer and provides important health benefits. Despite this, many doctors still hesitate to prescribe HRT, adhering to the outdated 2002 study’s conclusions.
Makary emphasizes that not all studies are created equal. Doctors and the public alike need to know when the data doesn’t support the headlines, especially when it can dramatically impact lives, as we saw with hormone replacement therapy.
“Yet, to this day, the dogma lives on,” writes Makary. “The data are clear. HRT saves lives.”
3. Antibiotic Overuse
Antibiotics have saved countless lives by treating bacterial infections, but overuse has led to unintended consequences. Makary says that antibiotics are like TNT for the body’s microbiome, the delicate ecosystem of bacteria in the gut that is vital for digestion, immune function, and even mental health.In particular, overprescription in children has been linked to serious long-term health issues.
“You don’t just inherit genes,” Makary was told by an expert when writing his book. “You also inherit your microbiome.”
4. The Cholesterol Myth
For decades, Americans were told to avoid cholesterol-rich foods like eggs and butter, as doctors believed that dietary cholesterol was a direct cause of heart disease. The fear stemmed from the work of Dr. Ancel Keys, whose “Seven Countries Study” in the 1950s suggested a link between saturated fat consumption and heart disease.But, as Makary explains, Keys’ study was fundamentally flawed—he cherry-picked countries that supported his hypothesis and ignored others, such as France and Switzerland, where high-fat diets coincided with low rates of heart disease. Despite numerous follow-up studies, including the Minnesota Coronary Experiment and the Framingham Heart Study, failing to support Keys’ claims, the low-cholesterol message stuck.
What Doctors Can Learn
“People who actively work to be open and objective are impressive,” Makary writes. “They don’t hop on bandwagons without compelling evidence. And they possess the courage to challenge assumptions and swim against the current.”In other words, the best doctors aren’t afraid to question the status quo, even if it means going against the grain of widely accepted practices. However, Makary points out that remaining open to new information requires conscious effort.
“Resisting our natural tendency to reject or reframe information to make it fit our preexisting ideas is important. It also makes for good character,” he writes. This mindset is especially critical in the medical field, where lives are at stake, and clinical decisions must be based on the latest, most reliable evidence, he says.
This doesn’t mean that doctors should abandon clinical wisdom or experience. Makary advises a balance between clinical intuition and evidence-based medicine.
“It’s okay to use clinical wisdom to fill the gaps where research has yet to be done,” he notes. But, it’s essential to distinguish between opinion and evidence-backed recommendations.
“Recommendations lacking proper scientific support should be recognized as opinion, not scientific evidence,” he said.
Hope for Change
Makary sees a brighter future for health care, driven by a new generation of physicians and medical students rejecting the “hamster wheel” of medicine. Instead of accepting the conventional, often rigid, system they’ve inherited, young doctors are focusing on patient-centered, evidence-based care.“I’m ultimately optimistic about the future of healthcare,” Makary notes. “Today’s young innovators—students and residents—are rejecting the broken system they are inheriting.”
This new mindset is critical to improving the system.
“They are not dismayed when we question conventional thinking,” says Makary. “It energizes them.”
By embracing this openness to new ideas, younger doctors are creating a health care landscape that values adaptability and critical thinking over long-held, unchallenged beliefs. This openness breaks free from dogma and ensures that patient outcomes are prioritized over convention.
Makary sees this movement as laying the groundwork for a more progressive and effective health care system, one that moves beyond harmful medical dogmas and toward practices rooted in the most up-to-date, reliable evidence.
Take Charge of Your Health Care
The future of health care relies on open-minded doctors as well as empowered patients. Makary says patients who ask tough questions and seek evidence-based treatments will drive much-needed change in the system.“An informed patient is an empowered patient,” he told The Epoch Times.
Nevertheless, immediate emergencies call for quick action.
“In an emergency, do whatever the doctor tells you,” Makary advises. Managing chronic conditions requires a different approach, and he urges patients to be proactive.
“There may be lifestyle and preventive options that are not being adequately explored,” Makary said.
Makary points out that many treatments, such as those for heartburn, can be solved with diet changes rather than defaulting to medication.
Yet, he says, “We don’t talk about ‘Food as Medicine’ enough in our culture, and when we do, it’s often based on outdated or flawed information. Don’t hesitate to ask tough questions about your treatment options. Seek second opinions if something doesn’t feel right.
“The era of passive care is over,” Makary says.
Together, patients and doctors can build a health care system that values innovation, evidence, and, above all, patient well-being.
Copy
