Category: Commentary
Thinking With Your Emotions About Medicine
The mental pathway of least resistance, what psychologists often refer to as the “default mode” of human thought, is to go with our “gut feelings.” We evolved emotions, heuristics, and cognitive biases partly so that we could make quick judgments that are good enough and err on the side of survival. This can be adaptive – if we smell something rotten we...
The New Chiropractic. And I thought SBM had an uphill battle.
Over at the Society for Science-Based Medicine we have Sisyphus as the logo on the website. Sisyphus, as you may know, is the Greek who had to push a boulder up a hill every day, the archetypal metaphor for futile labor. It was meant to be a bit tongue in cheek, but only a bit. As quackademia proudly expands I sometime feel...
About Herbs: an app to avoid
Medicine has an intellectual hierarchy. Supposedly the best and the brightest are in the academic medical centers and are the thought leaders in their field. Those of us lower in the hierarchy are well aware of some of the warts present on our betters, but I would expect those at the top would adhere to the highest intellectual and ethical standards. People...
The Harm of Integrative Medicine: A Patient’s Perspective
I was diagnosed with cancer and entered treatment, at which point I directly experienced both excellent scientific care, and also the utter nonsense that is alternative medicine, rebranded as integrative medicine. Here are my reflections on the experience.
A Harris Poll on “Alternative Medicine”
Mark Twain popularized the phrase, “There are three kinds of lies: lies, damned lies, and polls and surveys.” (He may have said “statistics” at the end, but I think this version works as well.) A new Harris Poll on “alternative medicine” nicely demonstrates some of the problems with polls. The biggest problem is how you frame the questions. You can dramatically affect...
Is the Annual Physical Unnecessary?
I was approached by The Wall Street Journal to write an article for their Big Issues in Health Care debate series. The subject was “Is the annual physical unnecessary?” I was to take the “yes” side and an internist was to take the “no” side. I wrote the following article. The editor wrote me a couple of times with questions. The internist...
The Brown M&M’s of Science-Based Medicine
Medicine is constantly changing, and like most health professionals, I am required to maintain my competency to practice. I doubt pharmacists are unique in being inundated with offers of continuing medical/pharmacy education. Some courses are free, some cost hundreds of dollars, and it can be difficult to distinguish the high-quality programs from the biased or low-quality education that furthers a agenda, rather...
The “It Worked for Me” Gambit
It is almost inevitable that whenever we post an article critical of the claims being made for a particular treatment, alternative philosophy, or alternative profession, someone in the comments will counter a careful examination of published scientific evidence with an anecdote. Their arguments boils down to, “It worked for me, so all of your scientific evidence and plausibility is irrelevant.” Both components...
What Not To Say When Someone Is Sick
I understand the impulse, but you are well-advised to resist it. When someone you know has a serious illness, maybe even dying, you want to say something to them that is helpful, positive, and hopeful. The hopeful tone takes away some of the sting and the awkwardness of not knowing what to say to someone who just told you they are dying....
The Public’s Love-Hate Relationship with Technology
There are many complex factors driving up the cost of healthcare, but one major factor is increasing medical technology. Often new expensive technologies provide incremental, or even questionable, additional benefits but can dramatically increase the cost of health care. This is especially true of in-hospital treatments. There are also, of course, medical technologies that provide significant benefits, and others that improve our...