The Need for Science-Based Medicine

We are coming to the end of the 14th year of Science-Based Medicine (SBM), having published over 4,000 articles. The end of another year is always a good time to look back and see how we are doing. Of course, it’s a difficult thing to measure – what would be different had we not been around the last 14 years?

Our primary mission is to be a forum where professionals, the media, and public can go for a rigorously science-based perspective about popular treatments and claims that tend to avoid scientific scrutiny, or who distort the scientific process to their advantage. At the same time we acknowledge that science communication is not just about giving information, or countering misinformation. We need to cultivate the skills to distinguish science from pseudoscience, and to tell reliable from unreliable sources of information. Further, misinformation is often woven into a comforting or compelling narrative, often with a specific goal (usually to sell something). SBM needs to provide a counter-narrative, one based on science and reason.

In addition to helping people make better medical decisions for themselves, we hope to influence society as a whole. This means pushing scientific and medical institutions to remain clear-eyed on what SBM is and to hold the line against the creep of pseudoscience into medicine. There are well-funded forces at work constantly trying to insinuate nonsense into the institutions of medicine, and these institutions are not as well defended as we might hope. Scientists and professionals generally don’t understand how pseudoscience works – that is where we try to fill the gap.

There are also constant battles of regulation to be fought, again with well-funded groups pushing to ease regulations that are designed to protect consumers from health fraud. They provide constant pressure to lower standards, or remove them entirely, and to move us toward a world where the health consumer is almost entirely on their own. Without rules, fraud and deception can thrive.

Finally we are constantly questioning and refining how to optimize SBM itself. It’s a complex question, how best to connect scientific evidence to medical practice. In fact it’s a science unto itself. I have learned a tremendous amount myself over the last 14 years. At the beginning of this project I had never heard the terms “P-hacking” or “citation bias”. Nor did I fully understand how so-called “pragmatic” studies were abused to make efficacy claims they were not designed to test. But these nuances are exploited by pseudoscientists with an agenda, and they crop up with well-meaning professionals who simply need to do better.

In the last two years the pandemic has also brought our current situation into sharp focus. It has been a “battle royale” for all the forces of science and pseudoscience within not just medicine but the broader society. All the factors, from social media to mainstream outlets, government bodies, and medical institutions, are involved as we try to find our way through a deadly pandemic. Everyone, now, has a strong opinion about vaccines and those who refuse them, and the “what’s the harm” argument about tolerating magical thinking in medicine is getting more obviously flimsy. We are all living through the harm.

This is also the time of year when we ask for your support. SBM is not just a blog or an approach to medicine, it is a community of people who want to improve the world, to push back against exploitation and health fraud, or who just want to be better informed and more critical thinkers. All of the writers and editors at SBM donate their time without any compensation, and it is absolutely our pleasure and a labor of love. But we recognize that we are pushing back on many fronts, against many well-funded interests. At the very least, we need to keep the lights on so we can continue our work.

If it’s within your means, please consider becoming an SBM patron, or making a one-time donation (links are on the homepage). For any professionals out there, also please consider contributing to SBM. The greater variety of voices we have the better.

The mission of SBM will never be over. This is not the kind of goal where we can declare victory and stop. Society will always need people advocating for consumer protection, and for high standards of science in medicine, not for any personal gain but simply because it needs to be done. And there will always be those who try to game the system to their own advantage, or are simply misguided or misinformed. Like science itself, SBM is a process, not a conclusion or destination. We’ll be here in 2022 and beyond – thanks for being there with us.