Quillette Narrated The Malpractice of Menopausal Medicine Reveals a Broken Medical System
Oct 17, 2025
A critique of how menopausal and perimenopausal care routinely fails patients due to training gaps and systemic negligence. Discussion of evidence shortfalls, statistical illiteracy, and missing diagnostic education in medicine. Examination of hormone therapy controversies, timing effects, and risky progestin choices. Practical tactics for patients to bring research and data to clinicians.
AI Snips
Chapters
Transcript
Episode notes
How Sander Greenland Changed My Research Skills
- Amy Alkon learned to vet research after meeting epidemiologist Sander Greenland and exchanging columns with him.
- Greenland taught her how to assess scientific studies, prompting her deeper dive into menopause science starting in 2007.
Statistical Illiteracy Drives Overtreatment
- Many doctors are statistically and scientifically illiterate, impairing risk-benefit judgments and fostering defensive medicine.
- Statistically illiterate clinicians overestimate benefits/harms and may overtreat to avoid lawsuits, per Gerd Gigerenzer's critique.
Diagnosis Skills Are Under taught And Harmful
- Diagnostic reasoning is rarely formally taught, leading to many preventable errors and deaths annually.
- Mark L. Graber estimates 40,000–80,000 deaths a year from diagnostic error and urges curricula in clinical reasoning.