Dr. Vinay K. Prasad's work has demonstrated that a large percentage of medical procedures, diagnostic tools, and medications are destined to be found useless — or even harmful — to patients. To describe the instances where common or established healthcare practices or therapies are found faulty and, as a result, discontinued, he uses the term medical reversal.
Medical reversals occur when testing is not adequate and there is actually little or no evidence to support the efficacy of a therapy, screening, or drug. As these are often sound in theory and well entrenched by the time they are proven flawed, their elimination from prescription commonly takes years. They jeopardize patient health and waste limited healthcare resources long after the reversed practices are proven ineffective, and they erode overall trust in the medical community.
Dr. Prasad takes fascinating examples from nearly every medical specialty — such as the arthritis drug Vioxx, female hormone replacement therapy, and mattress covers for dust mite allergies — to explore "advances" that turned out to be dangerous or useless. He explains how current healthcare industry and media support the establishment of ultimately "reversed" practices, and he outlines a comprehensive plan to reform medical education, research funding and protocols, and drug approval processes to help prevent them. To further help ensure that more of what gets done in doctors’ offices and hospitals is truly effective in improving outcomes, he provides suggestions for patient scrutiny and advocacy.
Vinay K. Prasad MD / MPH is a hematologist-oncologist and Assistant Professor of Medicine at the Oregon Health and Sciences University. He holds appointments in the Division of Public Health and Preventive Medicine, and as a Senior Scholar in the Center for Health Care Ethics.
A graduate of the University of Chicago Pritzker School of Medicine and recipient of their Chairman's Award in Internal Medicine, Dr. Prasad trained in general internal medicine at Northwestern University in Chicago where he received the Gerald Grumet award for best resident teacher. He completed his fellowship in Hematology and Oncology in the joint program between National Cancer Institute, and National Heart, Lung and Blood Institute both at the U.S. National Institutes of Health, where he was also a Cancer Prevention Fellow, and he holds a Masters of Public Health from the Johns Hopkins Bloomberg School of Public Health.
In addition to being co-author, with Dr. Adam Cifu, of Ending Medical Reversal: Improving Outcomes, Saving Lives (Johns Hopkins University Press, 2015), Dr. Prasad has written extensively for publications including the New England Journal of Medicine, the Journal of the American Medical Association, The New York Times, and The Washington Post.