Most people tend to think that everything that's done in medicine, in medical practice, is the result of extremely rigorous testing using the scientific process. That nothing is allowed to be done in medicine that hasn't passed these rigorous requirements.
That is, indeed, the case with many things in medicine, in most countries. Most if not all prescription drugs need to be approved by the highest authority in the country, and this approval is given only if the drug in question has passed some of the most rigorous testing procedures that exist in this world. The same is true for most medical devices. In fact, in many countries there are strict laws that regulate the use of such devices and drugs for medical purposes, or from any substance from being sold and advertised as "medicine" if it hasn't been tested appropriately.
It is most probably for this reason that most people think that everything in medicine has gone through this rigorous testing.
Sadly, this is actually not the case. Which is quite scary when you think about it.
There's an enormous amount of medical practice, actions and procedures, that are based solely on what could be called "medical tradition", which has not been subjected to the same rigorous testing as the above.
The main problem is that even if actual physical tools and substances have gone through the testing, how they are used, and what doctors instruct the patients to do often has not. A lot of such actions have not gone through any kind of testing and are essentially just word-of-mouth customs that someone came up with and was never tested.
You can hear this all the time, ie. how something that used to be very common in medical practice has recently changed due to further studies having been done to it. One would think that why such studies hadn't been done earlier, and that would be a good question.
Some years ago I fell and got a small fracture on the head of my ulna (the outer bone of the forearm). The traumatologist, when telling me how to handle it over the next weeks, told me that for the longest time (decades and decades) the arm would be tightly tied and immobilized for several weeks for this exact type of fracture, but that that wasn't being done anymore. The reason for this is that not only was immobilizing the arm rather useless, but it could actually have negative side effects, as it could permanently reduce the range of motion of the elbow as the fracture healed. Nowadays it's recommended to just keep the arm free, and to carefully exercise it from time to time in order to keep its mobility.
While he didn't directly say it, it struck me that the practice of immobilizing the arm for this type of elbow fracture was quite clearly done just as a tradition, essentially word of mouth, rather than it being the result of extensive studies and testing, and how more recent studies had shown the practice to be detrimental, and thus not recommended anymore.
Another relatively recent change I have noticed is that doctors and pharmacists are not recommending over-the-counter cough medicine to deal with coughs resulting from the flu and similar infectious diseases. At least here if you go to the pharmacy to ask for something for your cough, they will directly tell you that cough medicine is not recommended anymore (even though they still sell it), as it's useless, it has not been found to have any positive effects beyond placebo, and some warm tea with honey will do the same thing, even better.
Yet, cough medicine has been sold in pharmacies (and in some countries even in grocery stores) all over the world for decades and decades, and have become a standard solution. Apparently a rather useless placebo solution, latest studies have found. Once again, it appears that over-the-counter cough medicine has not gone through any rigorous testing for efficacy, even though it's one of the most sold over-the-counter medications in the world.
Another example is that nowadays it's not recommended to artificially lower fever, if it stays within safe limits, even though this was common practice in many countries for many, many decades (especially since it was very easy and relatively safe, as some over-the-counter painkillers have the curious side effect of also lowering fever.) This is because fever exists for a reason: It helps the body fight infectious pathogens. By artificially lowering the fever you are only making things worse and prolonging the infection. Allowing the fever to run its course will make you heal quicker.
Yet again something that was done mostly because of tradition rather than it being the result of extensive rigorous medical studies and testing.
I'm sure that a medical professional could give dozens and dozens more examples of this.
It's scary to think how much of medical practice is done because of tradition and beliefs rather than rigorous testing. How many of current practice are like this, and are actually detrimental? It's impossible to know because much of it isn't being actually tested!
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