Swept away and squashed between myth based medicine and eminence based medicine. Metaphor of medical meta-cognition. What are we doing wrong with our patient?

Myths have played essential social functions throughout human history, and modern medical culture makes no exception. Despite ongoing scientific efforts, clinicians still encounter biological phenomena that they can hardly explain. In this ocean of uncertainty they continue, either consciously or unconsciously, to convey a number of myths, which are also used as professional tools. Although in recent decades clinical research and randomized trials have emerged as the main arbiters of truth in medicine, there are still large areas of uncertainty that are consistently filled up with tradition, common sense and experience. In this context, mysticism seldom represent a latent source of error, especially when it penetrates education and medical literature, so growing to the role of indisputable truth, which can hardly be eradicated. The aim of this article is to discuss some paradigmatic examples of medical myths, such as the use of beta-blockers in patients with heart failure, the risk of administering opioids in patients with abdominal pain, the suggestion to drink at least eight glasses of water per day, the risk of using contrast media in patients with shellfish allergy, the indiscriminate prescription of a huge number of laboratory tests to achieve an efficient diagnosis, the use of garlic for treat a kaleidoscope of human disorders, fructose as a viable replacement for sucrose, the relationship between obesity and mortality or between sex and caloric consumption, and the cognitive biases.