In a month SBM will have been operating for a decade – 10 years and over 3,000 posts. How has the SBM project been faring in the last decade, and where do we go from here?

As a blog, SBM has been reasonably successful. Just surviving for 10 years is a milestone for any social media project, and SBM has done more than just survive. We have built a fantastic audience and have established ourselves as a premiere site for medical information, analysis, and commentary. We have drawn the attention of the media, the NIH, and regulatory agencies who have sought our opinions and input. We have also drawn the attention of quacks, which means we are doing our job. And I have noticed that the term, Science-Based Medicine, coined by this very blog, has come into common use in the conversation about the science and medicine.

SBM has also spawned the Society for Science-Based Medicine (SfSBM), a membership organization which is still building but doing well. We have also sponsored several SBM conferences, attached to the NECSS conference held in New York.

How effective has SBM been at stemming the tide of pseudoscience in the medical profession? That is an impossible question to answer, because we can’t know what the world would have been like had SBM not existed. But we can take a look at what has been happening and we can speculate about what we need to do going forward.

Help support SBM

SBM is a project of the New England Skeptical Society, which is a 501(c) non-profit organization. We receive no corporate backing and have no major sponsors. SBM is supported mostly by donations. We have experimented with online ads to help pay for bandwidth and technical support, which is substantial for a blog with the traffic of SBM. However, you may notice that with a recent update we have removed ads from the site. Essentially we concluded, after several tries, that there were no ad services that were compatible with our editorial policy. So we decided to just get rid of the ads, despite the fact that they were a significant source of revenue, and rely entirely on donations for support.

This means that SBM needs the support of its readers, and anyone who thinks that medical care should be safe and effective as determined by the best scientific evidence available. There is a Donate button in the upper right of the page, through which you can make one-time or recurring donations to SBM. We greatly appreciate any amount of support you can give. The more support we can get, the more we can do to further our mission.

It is an unfortunate reality that the forces we are up against are extremely well-funded. Quackery, fraud, and snake-oil are highly profitable. The billions of dollars generated by the supplement industry, homeopathy, and countless worthless health services and products have been funding several decades’ worth of concerted efforts to infiltrate pseudoscience into medical schools. These funds have been used to lobby state and federal governments for quack-friendly laws. They have been used to market a narrative of medical pseudoscience to the public, fostering a distrust of genuine expertise, and promoting conspiracy theories and blatant misinformation.

They have literally millions of times more funding than we do. There is no profit in defending science and critical thinking, in medicine or elsewhere. All of the SBM editors and contributors are volunteers. We actually sacrifice time we could be expending more profitably elsewhere to promote SBM. But we have learned how to accomplish a lot with a little.

There are actually several ways you can support SBM. Of course, ultimately we need to keep the lights on, so please consider financial support. But we also need people to help spread the word. Link and share articles on SBM. Be the voice of reason in your job and in your social group. Write your representatives about bad laws, and file complaints when you confront health fraud. Even just giving your personal health care providers feedback about your desire to be treated with science-based medicine will help push back against pseudoscience.

Our mission

SBM is operating on several fronts simultaneously. Mostly we are engaged in a public conversation about the proper relationship between science, evidence, and the practice of medicine. This discussion is with professionals, regulators, the media, and the public at the same time. In the last decade we have actually learned quite a bit about the nature and extent of the problem of pseudoscience in medicine. A decade ago I had never heard of p-hacking, of researcher degrees of freedom, or the Dunning-Kruger effect. In that time we have also learned about the seriousness of the replication problem in biomedical research, and the statistical effects of prior plausibility.

There have been some improvements – journals rethinking the role of the p-value, publishing only registered clinical trials, retracting bad systematic reviews of alternative medicine, and a greater awareness of Bayesian analysis.

Assaults on the quality of science in medicine continue, however. We have had to face the challenge of open access journals, many of which are predatory, publishing any nonsense for a fee. But they have also been exposed.

Much of what we do feels like an endless game of whack-a-mole (to use that now overused metaphor). But if we didn’t, the “moles” would breed and spread unchecked.

Perhaps our biggest regulatory victory was with homeopathy – the FTC has updated their policy, strengthening their regulation of these entirely worthless fake medicines. The FDA is still, apparently, reviewing their regulation but the current political environment may have put that on pause.

Going forward, in addition to continuing to do what we have been doing, I would like to see SBM expand our pool of regular contributors. Above all else, we are an intellectual trust of health care professionals who have developed an expertise in pseudoscience in medicine, regulation, science communication, and the application of critical thinking and skepticism to medicine. The more we can nurture other professionals with these same skills the better.

I do think we need to become more active in the regulatory sphere. This is a little difficult as a poor non-profit, mostly run by people with day-jobs, but if we are able to expand our resources that would be one place I think we need to expand our efforts. I also think we need to become more active in mainstream academic circles. Too many of our academic colleagues do not recognize the problem of pseudoscience invading our profession. We need to get the word out, before they are bribed to turn the other way while nonsense is “integrated” into our profession.

There is endless work to be done. But we have a powerful message that we have also been forging over decades. Science-based medicine is where the medical profession needs to go. Despite our many challenges, I am optimistic about the next ten years.

Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the president and co-founder of the New England Skeptical Society, the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also contributes every Sunday to The Rogues Gallery, the official blog of the SGU.