Loeb’s laws

Sometimes we doctors are prone to do too much to our patients, especially in high-tech environments like the PICU. The bewildering array of all the tests and therapies we have can confuse us more than enlighten us. Robert Loeb, a well known physician and medical educator at the College of Physicians and Surgeons at Columbia University long ago offered a simple way to cut through all the confusion, offering what have come to be known as Loeb’s Laws. We all learned them in medical school, but now and then need to be reminded of them. Here is one formulation of them:

1. If what you are doing is doing good, keep doing it.
2. If what you are doing is not doing good, stop doing it.
3. If you do not know what to do, do nothing.
4. Never make the treatment worse than the disease.

Dr. Loeb was not a surgeon, so one occasionally hears a tongue-in-cheek substitution of his fourth law that goes something like this: “If at all possible, keep your patient out of the operating room.”

Sixty years later, Dr. Loeb’s wisdom is still often useful.


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