No when to hold ‘em, know when to fold ‘em

I read an article yesterday morning that stood out to me as being a particularly clear example of how we as a society can end up pouring good money after bad, for an apparently good reason. We are on the verge of a health crisis. I’m not speaking of health care reform, but instead of the rapid development and spread of superbugs that are resistant to all known antibiotics.

One of the best known superbugs, MRSA (methicillin-resistant staphylococcus aureus) now kills more Americans every year than AIDS. The scary part about it is that I understand that most people contract MRSA in hospitals while in for care for other conditions!

Many health care professionals and researchers attribute the rise in superbugs such as MRSA to the over-prescription and subsequent overuse of antibiotics. The argument goes that the bacteria have steadily gained the upper hand by virtue of an expedited process of natural selection since the advent of penicillin in the 1940s.

The NY Times article, titled “Antibiotics Research Subsidies Weighed by U.S.,” describes the challenge faced by policymakers: antibiotics are highly effective (until they are no longer effective) but unfortunately they are relatively less profitable for the pharmaceutical companies than drugs designed for cancer, diabetes and other diseases.

Taken on face value, the idea that we should find ways to make it easier to develop new antibiotics is a worthy cause, but such an approach fails to fix the problem, in fact, it specifically perpetuates it. What I don’t understand is why we would consider investing more into a failing strategy and expect different results.

A wise investor knows when to cut his losses. As Kenny Rogers sang “You gotta know when to hold ’em, know when to fold ’em, know when to walk away, know when to run.”

Antibiotics used rightly are a blessing. Antibiotics used incorrectly could lead to a disastrous outcome. I fear that we’ve only just begun to see the consequences of their misuse and my vote would be to find ways to strengthen the host so that the pathogens have less of a chance at overcoming our defenses in the first place.

We have to find the way to turn the platitude “Prevention is the best medicine” into a lifestyle embraced by the majority. The majority of medical dollars spent in the United States relate to preventable diseases and yet the majority of the health care policymakers remain fixated on the failing approach that is based in intervention, rather than prevention.

The sooner a deviation from the ideal course is identified and the earlier a correction is made, the better…in all spheres of life. This is especially true with health care. A weak host is more susceptible to infection and the weaker and the more unhealthy we allow ourselves to become as a nation the more likely it is that we will be trapped in the vicious antibiotic-dependent cycle Congress is contemplating funding.

I’d love to hear your thoughts on the matter…

15 thoughts on “No when to hold ‘em, know when to fold ‘em

  1. Pingback: A Change in Tactics | Gregg Hake's Blog

  2. jaymorrow

    Our individual responsibility is to speak up to our personal physicians. We don’t have to challenge them or create a contest but by asking questions and continuing to seek answers that are not only understandable but make rational sense to us; then they have the opportunity to learn as well. Not settling for “because I think this is the course to take” but wanting to hear why and what the options are.
    This is where doing our own research is so important. We can’t blame the system if we spend more time researching our next car purchase or summer vacation then we do on our health options.
    We also have to be prepared to look for a new doctor. There are doctors that know the system is ridiculous and they’re looking for patients that are willing to do something different.
    Such an important subject.


  3. Colin

    It seem like the changes we have made in the last 100 years or so have created many more variables to search through in the hunt for what ails us. A broad spectrum antibiotic seems like the perfect cure- you don’t even have to know what ails you! But like every good thing, its overuse can turn ugly. And also, if you don’t fix the cause of something, you can expect it to come back or to never really go away in the first place. Health care needs to be looked at as a long term event. The body is a complex system where one part affects all the others, and the world functions in a similar, but larger, manner. We all affect each other, and any change can have big consequences.


    1. There are many changes on the horizon in the field of health care. Integrative medicine, functional medicine and other systems are re-membering what has become a chronically and critically disjointed approach to health and wellbeing.


  4. k

    i’ve been living with constant use of antibiotics for almost 30 years now. i am the result of “progress” and, even though my body can’t fight one type of infection, i’m perfectly healthy. i often think that i’m part of a huge group of people that would’t have survived without antibiotics and now must depend on them. sometimes i get really angry because they weren’t able to cure me and nature would have left me to die as a kid and now i must live with constant infections and constant use of antibiotics. sometimes i think that, if they knew they couldn’t cure me, why did they make me survive? ok, i know that it’s way too radical, but i am really angry. the last time i went to see a doctor, he told me that here in brazil the pharmaceutical industry is very strong and it’s all about money. we have been having lots of trouble due to use of antibiotics and where i live almost 20 people died last month because no antibiotics would work anymore. and then i asked my doctor: “why can’t people try to find ways to avoid infections before they happen?”. i mean, in my case, it would avoid those terrible pains i must live with. he said:”because people would get cured”. sometimes i think that the whole system is wrong… next year i’ll try something new, something that doesn’t work for everybody, but, well, what do i have to lose?


    1. Thank you for sharing your personal story. Antibiotics are quite a blessing, but as you say, they have their limits like all other medicine. I’d love to hear more about your condition as I have a number of contacts who may offer a unique perspective. Just let me know…


      1. k

        it’s funny to read that somebody wants to know more about my condition. my doctors can’t stand me anymore. =D it would be great to see if any of your contacts could help me try to find ways to avoid antibiotics… but i live in brazil! any contacts here? =) [wow, you were born in heidelberg! i love that place! i was very happy there]


  5. David Placek

    Uncontrolled prescription of ATB, misusage of ATB (for wrong diagnose or treatment of virus based diseases) and excessive consumption of ATB in general is obviously international problem.
    Lets have a short look on a consumption of ATB in such a small country in the middle of Europe (Czech Republic) with a population of 15 million:
    Year quantity (packages) out
    1985 15 163 970
    1990 16 826 770
    2000 13 199 820
    2005 12 244 130
    2008 12 050 230
    2010 (-> June) 5 892 240

    (more about the topic:

    More than half of prescribed ATB are not used at all (because patient non-compliance, misusage etc.). On one side is it a value (over 1 billion CZK = over 6 million USD paid by health insurances but ATB never used) but on the other side is the huge risk effect loss and of course reinforce of resistance.
    In 2000 issued WHO Global Strategy for Containment of Antimicrobial Resistance, where is ATB resistence discribe as a serious international problem. Probably as well after the statistic from 1999, where only in EU was consumed by human about 8,528 tons of ATB substances (65%) and 4,688 tons of ATB substances in a veterinary care…
    In the Czech Republic were very active working task forces (called ATB centre under the Committee for efficient Pharmacotherapy) since late 1962. After 1990 came the idea of cancellation of those centers (political reasons) but the experts enforced theirs safeguarding. With the benefit of hindsight we can see how wise and efficient these centers were.
    Some details under (unfortunately all articles are in Czech language…):

    Click to access NAPAP_VR.pdf


  6. Isabelle Kearney

    It really is amazing how much effort and money is spent on a failing system. There are so many brilliant minds and a vast array of resources that are available to be put towards addressing the cause of our healthcare system, instead of the effects.

    Unfortunately, this tendency to just see and want to “fix” effects is prevalant in more places than just our government. It’s worth looking at personally, as we can’t fix the big things until we’re willing to do what it takes to change ourselves.


  7. James


    Couldn’t agree more. Antibiotics given for viral infections is another big antibiotic no no, costly and useless!

    Yet another example of government policy backing short sighted improvement over the long term wellness, this is ubiquitous, and not only in medical policy but in all realms of government policy, fiscal or otherwise.

    In our new Health Economics series we will be showing how ‘preventative and holistic’ medicine will actually be more effective clincially, and reduce the cost of healthcare.

    James Maskell


  8. Joshua

    Albert Einstein’s quote:

    Insanity: doing the same thing over and over again and expecting different results

    I thought of the recent movie Avatar, when Jake Sulle is visiting the indigenous people and their first concern was “Can he be cured of his sickness”

    Spiritual and mental illness are most certainly the point of leverage in clarifying matters here on earth, we just need people willing to actually do so, and lead the heard out of the darkness they have insanely wandered into, and eagerly.
    Thanks for this consideration this morning Gregg
    Many implictations here, backed by a great deal of room for application!


  9. Flow

    A healthy immune system requires bacteria. In fact, a healthy human body contains hundreds of different strains of good immune bacteria. A balance of the right types of bacteria is an essential component in maintaining health. These tiny microbes assist with a wide variety of the body’s processes including the absorbtion of vitamins and other nutrients from food.

    Antibiotics kill bacteria and as a result, disrupt the natural balance of bacteria.

    This imbalance can lead to chronic infection and the need for more antibiotics.

    It’s a loop! And the only way out is to restore the natural balance.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s