Dr. Nagler's Tinnitus Site

Dr. Nagler’s Tinnitus Site

Four Questions - My View

You may recall "Nagler's Law" from September 1997 Tinnitus Today: "No tinnitus sufferer who found even a small amount of relief ever cared one iota whether or not the treatment which resulted in that relief was based on science."

The issue then arises: science or non-science, traditional Western medicine or traditional Eastern medicine, leading international medical center or small clinic in an obscure European city, herbal or pharmacological, homeopathic or naturopathic, found in small print in a health magazine advertisement or recommended by a certified audiologist - whatever/whomever/wherever - how does a responsible health care consumer evaluate various potentially effective treatments when there is yet no definitive cure for intrusive tinnitus? How does one avoid fraud? How does one assess the recommendations of well-intentioned honest individuals, who may or may not be "on-the-mark" with those recommendations? Or, for that matter, how does one know whether or not it is advisable to purchase the product mentioned in that magazine column?

The solution is not easy, especially not easy for those so desperate for relief. Below are some very simple guidelines (not hard-and-fast rules), which may be of some assistance.

Four questions -

Ask the individual making the recommendation, or ask the manufacturer of the advertised product:

What is the success rate of the proposed treatment?
What are the potential risks?
How is success determined?
What is the definition of success?

I am not suggesting here that less-than-optimal answers to the above questions should result in unequivocal rejection of a particular treatment. In fact, when I personally asked those questions along my own odyssey in search of relief, a sincere, "I don't really have hard data, but it makes good sense to me in your particular case because..." counted a whole lot more than, "I claim an 85% success rate with no complications, and - besides - your insurance will pick up most of it, so what have you got to lose?"

I am suggesting, however, that the answers and the manner in which those answers are given should assist the tinnitus patient along a reasonable path towards satisfactory resolution.

To the cautious health care consumer, one last note about that success rate is in order. Remember the fellow who claimed the 85% success rate with no complications? Well, I asked him how he determined "success" (see Question #3). It seems that he gave his "treatment" to about twenty patients in the previous year. Three called back complaining that it did not help. The other seventeen? The good "Doctor" figured (very conveniently) that if it had not indeed helped them, they too would have called to complain. And thus - the phenomenal 85% success rate. How does this guy sleep at night?

There are many ethical dedicated health care providers in the U.S. and throughout the world who wish to be of assistance to people with tinnitus for all the right reasons. Be your own best advocate. Ask the questions. Find them.

Stephen M. Nagler, MD, FACS

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