Today marks the five year anniversary of the blog. I was not part of the initial stable of writers, my first entry published Jan 31. As I remember it shortly thereafter they browbeat me into writing twice a month. I had a lot of hesitancy participating as I was uncertain I could keep up with the twice monthly writing requirements. I am a slow writer and a slower typer, but it has been one of the most intellectually rewarding experiences of my life.

I have become a better writer, but more importantly a vastly better thinker, as a result of interactions with SBM. I have also been convinced I have some sort of language processing disorder as I still can’t see how those pesky typo’s disappear during my countless rewriting only to reappear in the final draft. Either WordPress inserts them automatically or it is magic most foul.

Five years on, and a new year, are as good an arbitrary time as any to reflect on both the past and future of SBM. As I age the more I am of the opinion that I have the carte blanche of the elderly to say whatever I want. It’s all about wearing the purple.

I want to thank Steve and David for asking me to participate in SBM in all its forms. I also appreciate their support by what they don’t do: they let us write about anything we want any way we want. It makes it fun to write each post and has helped me develop as a writer.  Steve in particular to pulling me out of obscurity and  into, well, a bit less obscurity, with not only the blog, but with the interviews on SGU.   I want to thank Orac, that logorrheic computer, as a continual example how to be complete, precise and always an enjoyable read.

I read every word of every post and I have learned a ton from my fellow bloggers. Kimball Atwood’s entries have been particularly influential in my understanding issues around prior plausibility and medical statistics. His entries should be required reading for all health care providers. Kimball, come home, we need you.

I also read almost every comment, and I have learned much from our readers. We have a very thoughtful group of commenters. I often wish I had the time to rewrite my entries and incorporate the ideas from our readers. A few readers have made me laugh. And a couple have driven me to scream in fury at the computer screen at such an incredible inability to think clearly. I have learned more in the practice of medicine by my mistakes than my successes and there is much to be learned from those who think different.

For the more frequent commenters I have a mental picture of who you are that I am sure has nothing to do with reality. Unless some women do have neck beards.

This blog represents an amazing resource for information covering the breadth and depth of SCAM, all the more incredible as it is the result of what we do in our spare time, after work and family.

I have though a lot about what makes a good blog entry. It is more than a clear recitation of facts. There also needs to be an interesting writing style and a sense of the personality of the writer. Blogs are more personal than textbooks or journal articles. I find that the few blogs I read consistently have a sense of the person behind the blog. Blogging, at least my conception of blogging, is more intimate. If I want facts I can go the PubMed or Wikipedia.

I been puzzled by the lack of coverage of SCAMs relative to their importance. For morbidity, mortality and worthless expense I can think of only one subject with more adverse consequences than SCAM, yet SCAMs are a minor part of the skeptical meetings and magazines. There are endless SCAM conferences, but I have never heard of an SBM oriented conference.

Looking at the iTunes podcasts there a multiple skeptical podcasts but they rarely address SCAMs. There are over 400 podcasts that pop up on itunes with a pro-SCAM focus. There is one SBM/SCAM podcast. Mine.

Dr. Oz spreads credulous nonsense unopposed by reality based medicine. As the Bravewell report depressingly documents, Flexner must now be spinning like a hard drive.

In the medical world, the skeptical world, and in pop culture, SBM is outnumbered and undermanned. And underwomaned.

Anyone can become an expert in Bigfoot or UFO’s. It requires no special training. It is extraordinarily difficult to be in a position to analyze SCAM. First you have to become expert in medicine. It takes a long time to become a doctor, nurse or other health care provider. Then you have to learn the ins and outs of thinking skeptically and then apply it to medicine. And then you have to give a rats ass and find enough of what little free time you have to devote to the topic. And then you have to do it consistently over a long period of time before you might gain a bit of traction.

It makes me realize what a precious resource this blog and its writers and readers are. The few who care and have the passion and training to analyze the world of SCAM and science based medicine.

Where will the blog go in the next 5 years? No idea. More of the same I suppose. And I hope more.

A last thanks to everyone, writers and readers both.  It has been a blast and I expect it will continue to be.

(And by that destiny) to perform an act
Whereof what’s past is prologue; what to come,
In yours and my discharge.

The Tempest Act 2, scene 1, 245–254



Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He is a founder and  the President of the Society for Science-Based Medicine where he blogs under the name sbmsdictator. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His growing multi-media empire can be found at