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Dr. Amy Tuteur has decided to leave Science-Based Medicine

The editors and crew at SBM have an announcement that needs to be made. This morning, Dr. Amy Tuteur tendered her resignation and will therefore no longer be a blogger at SBM. Some of you might already be aware of this development because Dr. Tuteur has already announced her decision on her own blog. That is why we considered it important to post an announcement here on SBM as soon as possible.

While we are sorry to see Dr. Tuteur go and wish her well in whatever future endeavors she decides to pursue, over the last several weeks it had become clear to both the editors of SBM and Dr. Tuteur herself that, although Dr. Tuteur had routinely been able to stimulate an unprecedented level of discussion regarding the issues we at SBM consider important, SBM has not been a good fit for her and she has not been a good fit for SBM. Over the last few days mutual efforts between the editors and Dr. Tuteur to resolve our differences came to an impasse. Unfortunately for all parties, that impasse appeared to be unresolvable and resulted in Dr. Tuteur’s decision to leave SBM.

As a result of Dr. Tuteur’s departure, we will be adjusting the posting schedule in order to cover her normal Thursday slot. Final decisions have not been made yet, but we expect that every weekday will continue to be covered, with at least one post per weekday. 

Posted in: Announcements

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167 thoughts on “Dr. Amy Tuteur has decided to leave Science-Based Medicine

  1. I’m sad about this.

    Amy Tuteur’s posts were not always careful and reasoned; they were often a mixture of defensible and undefensible statements and provoked a good deal of discussion in the comment threads as lay readers tried to tease out one from the other. I tried to work on the assumption that this mixture was deliberate and was having the desired effect. It was stimulating and engaging.

    There is a limitation on this style in a blog directed at lay readers in that most lay blog readers cannot go to the medical library and look up seven articles on a subject to present them in the comment thread at 7:00 the next morning as an intern might at morning rounds. I appreciate that an attempt was made to vary the style of SBM blogging and further engage the readership. I hope that while this particular attempt may not have been a good fit, that SBM will continue to experiment with its format.

  2. windriven says:

    I’m sorry to see Dr. Tuteur go. I didn’t often agree with her but that, in fact, is why I most hate seeing her go. Reading the daily posts on SBM is always informative but rarely provocative. Comments tend to be of the pat-on-the-back sort or snipping over minutiae. Yes, we all belong to the same congregation. We’re all educated, articulate scientific types and forward thinking in the bargain. Hooray. It is nice, it is comfortable, but it doesn’t often advance the cause, it simply rallies the choir.

    Dr. Amy waded fearlessly (recklessly?) into shark infested waters. People were challenged to think about why her positions were right or wrong; people were forced to do literature searches and dive in to support their positions. Perhaps most importantly people were forced to confront their own prejudices. I’d like to think that a lot of readers are better skeptics as a result of her time here.

  3. jonny_eh says:

    I am sad to see Dr. Tuteur go, I enjoyed her posts, and the ensuing debates very much.

    As for a replacement, can I nominate the pharmacist Scott Gavura from Science-Based Pharmacy?

  4. Fifi says:

    I’m happy to see Dr Tuteur go since she seemed unwilling or unable to act like an ethical SBM blogger and I come here (and send people here) for critical science writing, honest skepticism and to see how people who are really passionate and interested in science, skepticism and SBM communicate about it. The internet is filled with cheap sensationalism, that’s not science writing even if it is a means to promote oneself. I would have been happier to see Dr Tuteur simply become an ethical SBM blogger and help educate the public about medical science, to have grown from being someone who sold medical advice over the internet and cynically sells products she railed about on SBM on her site to someone who is an example of why science is superior to woo and why it’s not a slave to Big Money.

    If I want to simply argue with ideologues or read sensationalist diatribes, I’ll spend my time taking on the many sCAM promoters out there or read someone who’s actually a good writer too. (Generally I prefer rants to at least be humorous, otherwise you might as well be watching Fox News.) I find that the other bloggers here do a much better job of challenging people to confront their own prejudices and to consider the evidence in a rational manner. Not to mention they do a much better job of explaining the complexity of medicine and actually holding intelligent discussions. What can I say, I like my SBM to be science-oriented and not just sensationalism that pretends that sound and fury makes up for actual content and context. Sure some people find that boring but a lot of real science (and medicine) is kind of boring, slow and not very sensational if you don’t happen to be intrigued by that kind of thing.

  5. Fifi says:

    Besides, those who miss Dr Tuteur can go read and interact with her at her own blog or website, or in the comments sections of many other bloggers where she seems to spend a lot of time promoting herself. She’s running a business, it’s not like she’s about to close up shop and disappear.

  6. Fifi says:

    Actually, in my experience, the tone of SBM does “advance the cause” much more than the sort of polemic sensationalism that Dr Tuteur uses to promote herself. Most people like to think that their ideas are actually based in reality and supported by science, that’s why woo merchants use pseudoscience to sell their wares. If you’re going to challenge someone’s beliefs then calmly explaining the science and allowing the person to feel informed (rather than stupid or ignorant simply because they don’t know something yet) is much more effective. (Particularly if your talking out your own ass half the time.) I’ve used SBM posts to start to inform many people about vaccines and autism and other SBM topics and found it to be very effective. Dr Tuteur’s approach just makes people see science/medicine and pseudoscience/altmed as being competing ideologies. Sure it’s gratifying to rant about how stupid people are or make fun of ridiculous ideas sometimes but that’s not science, that’s venting.

  7. Bummer.

    IMO childbirth woo predisposes parents to embrace other dangerous woo like CAM and vaccine refusal. If we can dispel some of the myths surrounding childbirth, perhaps we can prevent some parents from falling into that vortex. I hope SBM will continue to occasionally focus on the topics Dr. Tuteur introduced.

  8. StatlerWaldorf says:

    I’m not sad, because the best place for Amy Tuteur is her own blog where the only standards she needs to meet are her own.

    I do hope that the SBM editors can keep an eye out for another ob-gyn contributor to add to the team, because discussion on SBM in obstetrics and gynecology is very useful.

  9. mikerattlesnake says:

    in the comments on the last post I read by her I was definitely turned off by her condescencion, arrogance, and repeated pleas for a seemingly infinite amount of flawless evidence from those who disagreed with her post (which seemed to be almost entirely based on (informed) opinion), while not bothering to cite nearly anything herself and not replying to valid and interesting speculations about evolutionary forces. While the opinions presented in her post did spark discussion, and though she did have some reasonable things to say, I would agree that her style definitely did not fit in with that which I have come to expect and appreciate from this site. I’m sure she’s a great doctor and has valuable things to add to discussions in her area of expertise (and an occassional guest article on an appropriate topic might be more fitting than a mandotory weekly article which might encourage her to write outside of her expertise), but I think this is a good decision.

  10. micheleinmichigan says:

    Although I occasionally agreed with Dr. T’s post and I thoroughly enjoyed some of the discussions, I felt her style was too heavy on provocation and too light on evidence and reasoned discussion. That is not the reason I enjoy visiting SBM. I enjoy the thoughtful and in depth looks at how and why SBM is conducted. I have to admit a concern that some of Dr. T’s approach might undermine the credibility of the site.

    I’m sure this has a lot to do with my personal taste. As a profound liberal, I still can not tolerate Micheal Moore.

    I do agree with windriven and Alison that the challenge to dispute and discuss rather than sing with the choir was engaging and a real lesson (particularly for someone like me who has little opportunity for that kind of discourse in everyday life.) Perhaps that will be something to consider in choosing new contributors or topics.

  11. wales says:

    What’s to be sad about? Amy has multiple blogs. I’m sure that any of you commenting there would improve the level of dialog. Perhaps if Amy had confined her posts to OB/GYN subjects she would not have excavated such a deep hole for herself. It was those topics on which she had no expertise and did not provide any reference citations that served as her achilles heel.

  12. arjuna79 says:

    I am relieved. Thank you.

  13. wales says:

    I agree on the importance of “dispute and discuss rather than sing with the choir” but either side of any topic should be supported with factual information and legitimate reference citations, or be clearly stated as personal opinion. Clarity of communication is key.

  14. Fifi on effectiveness:
    “Actually, in my experience, the tone of SBM does “advance the cause” much more than the sort of polemic sensationalism that Dr Tuteur uses to promote herself. … If you’re going to challenge someone’s beliefs then calmly explaining the science and allowing the person to feel informed (rather than stupid or ignorant simply because they don’t know something yet) is much more effective. … I’ve used SBM posts to start to inform many people about vaccines and autism and other SBM topics and found it to be very effective. Dr Tuteur’s approach just makes people see science/medicine and pseudoscience/altmed as being competing ideologies. ”

    Yes, that has been my most important concern. I felt quite conflicted and hypocritical for enjoying engaging in Amy Tuteur’s comment threads, while not wanting to refer my woo-ier friends here for fear that they would just come away with the impression that science/medicine and pseudoscience/altmed are competing ideologies that they can simply choose between.

    One way around that might be to have a Devil’s Advocate post where someone uses science (or appears to use science) to come to a controversial conclusion, or makes un-nuanced statements, and throws down the gauntlet with a challenge to “Discuss.” It would be clear that the post is to be treated as an exercise and the poster could use the comment thread as required to help clarify the difference between true science and pseudoscience, or where nuance is appropriate and where it is not.

    I don’t know if this would be as effective in stimulating discussion as the combative approach/persona that Amy Tuteur used. (Probably not.) I’m pretty sure it would not be as effective in drawing out the nutcases for us all to see and be amazed by. (The Jew-baiting that surfaced in the circumcision thread might be routine for some of you, but the reminder was instructive for me.) But it might be a way to engage the readership in the science rather than simply demonstrating it.

    Anyway, I laud the effort and it’s too bad it didn’t work out the way it had been hoped.

  15. Lawrence C. says:

    Interesting development, and

    …SBM has not been a good fit for her and she has not been a good fit for SBM….”

    pretty much says it all.

    I wish her well, hope that SBM finds a new contributor, and hope that any lingering problems held by anyone will find themselves totally resolved.

  16. moderation says:

    Although, I too found Dr. Tuteur’s post to lack some of the vigorous self review, I have come to expect at SBM. I too appreciated the increased focus on Obstetrics and hope that a suitable replacement can be found. I think Windriven summarized it best.

    I thnk most people have been respectful in their comments, however – Fifi – you might as well be wearing pom-poms and shooting off fireworks – the gloating is very childish. And you are a hypocrit for using the same inflammatory language you accuse Dr. Tuteur of using. I am not aware of any “unethical” behavior that Dr. Tuteur engaged in on SBM … that is a very serious and “sensationalistic” accusation.

  17. This site is and should be a crucible in which extraneous fluff is burned away, leaving only well reasoned AND supported arguments.

    I think it speaks well of the contributors and commenters at SBM that we endeavor to hold everybody to the same standards of evidence and logical argument, regardless of whether we perceive them to be “on our side”, or agree with the ideas being expressed. The discussion threads on her posts were indeed interesting and perhaps occasionally more worthwhile than the posts themselves.

    I think we all could tell Dr. Tuteur was having a rough go of it in a very different context than she was accustomed to. I had hoped she would adapt to the environment and standards of argument here at SBM, though I felt she was not long for this blog. She had some interesting, if not well supported, things to say on subjects that are very ripe for attention by SBM.

  18. David Gorski says:

    I wish her well, hope that SBM finds a new contributor, and hope that any lingering problems held by anyone will find themselves totally resolved.

    We will be recruiting soon. I had meant to be trying to recruit in order to make our bench deeper for a while now, but February is an NIH grant submission deadline, meaning that the two or three months leading up to these deadlines have been ridiculously busy. My grants have been submitted now.

  19. edgar says:

    “I am not aware of any “unethical” behavior that Dr. Tuteur engaged in on SBM … that is a very serious and “sensationalistic” accusation.”

    yes, I found Fifi to be gloating as well, however, in her defense, I take offense at Amy’s repeated shots at Johnson & Daviss integrity, and accusations that the deliberately used wrong data sets to be egregious. She had no evidence of this, and I called her on it. She refused to admit her mistake.
    I found her posts to be full of half truths and deliberately misleading information.

  20. Zoe237 says:

    The problem with Dr. Tuteur isn’t that I disagree with her on some issues, or that she rarely uses actual scientific evidence to make her position, or that she’s condescending, or her logical fallacies and simplistic thinking. Those are all fun to debate, and I’ll miss the thursday posts.

    The problem is her complete lack of ethics. What first made her start wondering who this person was was her post “Midwives and the Assault on Scientific Evidence.” She didn’t make any exceptions for nurse midwives, but denigrated an entire medical field based on a few wackos. It’s like having a SBM endorsed post on here “Nurses and the Assault on Scientific Evidence.” It’s also interesting given the long history between obstetricians and midwives. The only midwife I know a little bit is on my soccer team, so it’s not personal for me. Yes, there are others out there who routinely denigrate obstetricians, and that needs to stop too

    So I started poking around her blog and her open salon articles and found that she trolls parenting message boards looking for stillbirths to “call out” these recently grieving mothers publicly in order to support her point. She had often tens of comments on any media article entailing childbirth accusing midwives and mothers of being baby killers. She often posts sexually charged articles on open salon in order to garner hits, along with bashing anybody with a different opinion and calling it “debate.” She even apologized once on OS for being an “ahole” but nothing changed.

    Therefore, I was not surprised to find out that she charges 4.95/14.95 for an email regarding, let’s be honest, medical advice (despite the disclaimer), doesn’t disclose her retirement on askdramy.com, and sells the very products she denigrates in her online store. I think she craves money and attention and will do anything for it, quite honestly.

    So I’m glad SBM is taking a stand on this one (surprise, surprise!). Anybody is welcome to go out and argue with her on her own blog.

  21. desta says:

    YAY.
    Her style was not in keeping with the quality and level of discourse I too have come to expect (and recommend to others) at SBM.

    It was odd that a writer here was having such trouble confusing an argumentative attitude with one of skepticism.

    The ob/gyn topics were interesting, and I’m all for a good heated discussion, but the style(or lack thereof) left me distracted rather than educated. Some of her responses and arguments could have easily made it onto the ‘name that logical fallacy’ segment of the SGU.

  22. As someone who is often not familiar with some of the topics that Amy discussed, I have to say that I learned substantially from her posts and the resulting discussion.

    Admittedly, her tone may have been a bit more defensive/negative in response to criticism than you’d hope from a skeptical blogger but, she is, like the rest of us (though some might not qualify), human.

    It was helpful (and is helpful) to have logical fallacies identified as many (for our benefit, often at Amy’s expense) of the comments did. There were times when the method of identification was somewhat condescending or negative – and I suggest, in a venue like this, it wasn’t ultimately beneficial.

    In saying all that, however, I think that SBM benefits from being straight and sticking with the facts (unless otherwise identified). The discussions were educational but could take away from the true value of this site. I, too, would use it as a place to direct others and the regular “conflict” is not beneficial.

  23. What makes Amy Tuteur on SBM different from Amy Tuteur on SOB (skepticalob.blogspot.com) is the commenters. I don’t want to be the only one objecting to her logic on her website, or the only one arguing that homeopathy is useless and unethical on naturalnews.com. The interesting part is less Amy herself than the discussions with other engaged commenters with a scientific bent. It’s the other commenters who make the discussions interesting; Amy merely provides lots of occasions for them. If there are no more Thursday debates on SBM, for instance, I’m going to miss micheleinmichigan who doesn’t comment as much on other threads.

  24. Zoe237 says:

    Oh, and I also have to express thanks to SBM for not editing or deleting any negative comments and even letting this decision be commented upon. I think that fact speaks for itself what kind of a site SBM is.

  25. wales says:

    In the interest of fairness, Fifi may be wearing pom poms, but so is Amy at her skeptical ob site where her comment on leaving sbm is “what a relief”.

  26. micheleinmichigan says:

    Very kind of you, Alison. Sadly, the wide ranging discussions on Dr. T’s thread were more akin to my tangential nature. I feel guilty pulling comments off-topic on something as serious as vaccines and don’t have much to add to topics as out of my league as virology. (Although sometimes I can’t resist.)

  27. Basiorana says:

    While I understand that she was not routinely maintaining the tone intended for the blog, I hope that she will be invited to share her occasional well-reasoned critiques of recent developments. While she does prefer to be provocative, her blogs on obstetrics specifically (Homebirth Debate, then Skeptical OB) will occasionally have very interesting and informative analysis of important issues– such as her well-researched comparative analysis of fetal death rates with providers of various qualification levels, and her critiques of some of the really bad studies that are used by woo advocates to support their points.

    Perhaps she could return as an occasional guest blogger or be linked to when she has a particularly good post up, thus not requiring her to produce a SBM piece every week yet still providing us with the information when she has the time to devote to it on her own schedule. In particular if a link method was used you could precede it by saying, it’s not the same tone as usual, but the points are good, or something similar.

  28. lizkat says:

    Dr. T’s style did not fit here at SBM. This is not supposed to be an overtly political blog, but that’s what her posts sounded like. No amount of reason or evidence could convince her to qualify any of her absolutist statements. The most frustrating experience was debating her assertions that lifestyle doesn’t make much difference. There is abundant evidence for the importance of diet and exercise, but she couldn’t bring herself to admit it.

    She wouldn’t ever give a millimeter on anything. If anyone presented undeniable evidence, she would ignore it.

    I realize I tend to be somewhat holistic in my orientation, so I often have differences with the bloggers here. But most of them are able to admit it when the evidence obviously contradicts their statements.

  29. Amy’s version on SOB:

    “The sticking point was the lack of a moderation policy. Every comment thread spun out of control because certain people (almost all of whom came from here) were free to post garbage that they could never get away with on this site.

    Interestingly, I rarely remove comments here (can’t remember the last time I did) and I almost never ban people, yet people are able to control their behavior because they know it could happen.”

    http://skepticalob.blogspot.com/2010/02/i-quit-sbm.html

    Interesting. Completely in contrast to my previous comment.

  30. Basiorana says:

    Also, while you’re looking for another OB expert, you should look for a psychiatrist who’s willing to contribute! Never have I seen a field more filled with woo and unethical providers than psychiatry, and so many people fall for it. My partner’s psychiatrist (who, alas, is an attending physician, a Harvard med school professor, and sees individual patients in therapy thus could never do it) is constantly complaining about patients who expect him to put them under hypnosis or have been robbed blind by unethical therapists who take advantage of their mental state– and since he tends to only see severe, complicated cases, it’s especially heinous that anyone would take advantage of them like that.

  31. bluedevilRA says:

    While I agree that Dr. Tuteur’s posts were not as well referenced as the other contributors’ posts, I found them most enjoyable. They generated much discussion (not always constructive) and IMO, they were science based, even if they were not heavily evidence based.

    She often provided her opinions, which were supported by reasonable scientific assumptions and/or evidence, in much the same way that Dr. Gorski, Dr. Novella, and Dr. Hall sometimes do.

    In fact, I find it refreshing to not always have to read tons of references in addition to the post itself. So thank you, Dr. Tuteur, for your contributions. I also think this is a good time to address comment posting etiquette. Some of the things people said were downright nasty. SBM is no place for ad hominem attacks. Amy attracted the majority of these insults. To disagree with her or to demand references is your right as an SBM reader, but to insult because you have no other way of debating is pure idiocy.

  32. Michelle B says:

    I re-read her latest post here to make sure that I am correct in remembering how impressed I was by her clarity. No idea what is meant by a mutual agreement that she did not fit in (really none of my business either), but Amy was one of my favorite contributors here because it was very easy to understand her writing. Some authors here do ramble, and her style was immensely refreshing. Amy also consistently spent mucho time in the comment discussion–very admirable.

    I will add her site to my News Reader. And though gender should not be the only reason why a writer should be invited here to contribute, it was mighty comforting to have another female in addition to Harriet and Val as part of the SBM writing stable.

    Amy was unflinching in her presentation of science-based medicine, and she did it in her own inimitable style. I also regard that some of the negative reaction was because she pulls the rug under the so-called natural approach to child bearing.

  33. James Fox says:

    It did seem there was an infusion of a more polemical and argumentative style with Dr Tauter. I enjoyed some of her posts and really feel there remains a need to discuss the woo and non scientific notions that are often advanced concerning pregnancy and child birth. I appreciate the confident and researched opinions of the medical professionals who post here. The confident assertions and cautious disclaimers seem appropriately based on available evidence and a conviction that science is the best avenue to inform medical practice. Amy’s confidence and argumentative style often appeared reactive and full of hubris based on strongly held opinion. While this may not have been the case it certainly was the appearance, and appearances do matter.

  34. Akheloios says:

    Dr. Tuteur’s post on circumcision was awful. She used straw-men, used the results of a small test study to advocate wide scale interventions (go acupuncture!), ignored the ethical issues of elective (parental) surgury without consent (the infant’s), and fell back on religious arguements when challenged in some of her replies.

    I’ve read her other posts with much interest though and have learnt a lot. I can see how raising thorny issues in a combative manner opens up debate and makes medicine a more 3 dimensional subject.

    It’s not science based medicine though. I wish her well, and hope she continues to stimulate debate in the future. Just not here. I come here to learn about what the evidence and the science says about the medicine I, or a loved one, may need, not lively debate on extrapolations, conjecture or opinion.

  35. micheleinmichigan on commenting:

    “Sadly, the wide ranging discussions on Dr. T’s thread were more akin to my tangential nature. I feel guilty pulling comments off-topic on something as serious as vaccines and don’t have much to add to topics as out of my league as virology.”

    Exactly.

  36. Geekoid says:

    Sorry to see her go, but I am not surprised. She was consistently berated in the comments by people who simple had no logical position. OB and child care are two areas with an entrenched history of Woo, so while and active comment thread wasn’t a surprise, I did find it to be surprising at how many peoples responses to her posts boiled down to “Your just wrong cause I know better.”

    For example:
    Clearly some people here have an entrenched views on midwifes and refuse to look at any data she presented with a rational mind.

    It is a very stark example of why there should be a moderated system in place. Ideally an active moderator who points out when people are falling back on logical fallacies, and can remove pope from posting under a specific article.

  37. David Gorski says:

    It is a very stark example of why there should be a moderated system in place. Ideally an active moderator who points out when people are falling back on logical fallacies, and can remove pope from posting under a specific article.

    We have no plans to change our current commenting system.

  38. wales says:

    Windriven said “Dr. Amy waded fearlessly (recklessly?) into shark infested waters” I would add “while relentlessly chumming”.

  39. David Gorski says:

    From Amy’s blog:

    The sticking point was the lack of a moderation policy. Every comment thread spun out of control because certain people (almost all of whom came from here) were free to post garbage that they could never get away with on this site.

    Interestingly, I rarely remove comments here (can’t remember the last time I did) and I almost never ban people, yet people are able to control their behavior because they know it could happen.

    Of course, Amy is free to present her side of the story as much as she likes on her blog. For now, we are going to take the high road and not get into a “he-said-she-said” sort of exchange. However, since Amy has cited our moderation policy as a reason for her departure, I no longer see a reason not to confirm that one unresolvable issue was that Amy strongly favored a more heavily moderated commenting system, and Steve and I were very reluctant to change our commenting policy. But the disagreement over the commenting system was certainly not only the bone of contention that we could not resolve.

    Other than this, our post announcing her departure is all we will have to say for now, although we reserve the right to change our minds depending on circumstances.

  40. Harriet Hall says:

    Some of Dr. Tuteur’s critics are guilty of two sins of their own:

    (1) Responding to what they wanted to think she said rather than to what she actually said, and
    (2) Offering personal criticism of the author instead of just criticizing the content and discussing the issues addressed in the post.

    The comments are a valuable part of SBM, but they will be more valuable if they contain fewer straw men and ad hominems. I urge commenters to aspire to the same high standards they have come to expect from SBM authors.

  41. wales says:

    I disagree with Amy’s stance (on her blog) that standards was not the issue for her departure. Her writing style on sbm did not meet minimal science writing standards.

  42. Zoe237 says:

    Ha! So she does delete comments on her site. Explains a lot. If you can’t take the heat…

  43. David Gorski on the high road:

    [W]e are going to take the high road and not get into a “he-said-she-said” sort of exchange.

    I would not expect anything else.

    I was simply intrigued that what I perceived to be stimulating and valuable comment threads seem to have been perceived by Amy Tuteur to be undisciplined garbage. Presumably the experience of posting and commenting regularly here was about as fun for her as posting and commenting regularly on the Age of Autism would be for me — that is, not at all. (In which case at least some of her inaccurate statements must have been sincere and not deliberate provocations.)

  44. David Gorski on the high road:

    “[W]e are going to take the high road and not get into a “he-said-she-said” sort of exchange.”

    I would not expect anything else.

    I was simply intrigued that what I perceived to be stimulating and valuable comment threads seem to have been perceived by Amy Tuteur to be undisciplined garbage. Presumably the experience of posting and commenting regularly here was about as fun for her as posting and commenting regularly on the Age of Autism would be for me — that is, not at all. (In which case at least some of her inaccurate statements must have been sincere and not deliberate provocations.)

  45. wales says:

    Harriet I appreciate your points here, but I have to say that complying with your point number one was often difficult as Amy’s terse and provocative writing style without qualifiers often left me wondering what it was that she actually meant. As a medically trained person she would obviously know of the importance of qualifiers in communicating science, so I assumed she intentionally left them out, not for effect but because she had absolute black and white views. I decided the only way to deal with it, rather than reading between the lines (which I found to be fraught with the risk of personal prejudices) was to take her comments at face value. I think that regarding your number two point, criticizing her writing style is not a personal attack as writing style with regard to science and medical topics is extremely important for conveying information with clarity, accuracy and credibility. As I have said elsewhere, were Amy to make her posts labeled clearly as “opinion” then I have no problem with her style.

  46. micheleinmichigan says:

    On moderation – In this setting, I would rather learn from being corrected by another commenter or contributor AND have others learn from my error than just have my post removed with a rebuke that it is too heated or off-topic (as I have seen on other sites/groups).

    As Dr. H says I’m sure mistakes are made, but there always seems to be another poster willing to point out those mistakes. I think this respects the readers, giving them the ability to come to their own conclusions. And it has been a great exercise for me, ad hominems, straw men, confirmation bias, etc. All things I’ve learned about on this site (nope, they don’t teach it in Art School:). And it’s just more interesting to learn by demonstration (or demolition) sometimes.

  47. Lawrence C. says:

    Gorski says: “We have no plans to change our current commenting system.”

    Indeed, and rightly so.

    I retired before the internet age, so perhaps what I now say isn’t applicable to the fast, fast world of blogs, but it seems obvious that if the former contributor’s posts were properly edited they would not have fed so much criticism. This is not a personal comment but rather about the simple, necessary mechanics and steps one takes before publishing something.

    Again, I am much more comfortable with pre-internet ways and perhaps it is acceptable now to “revise as you go” but I think it helps to get it as right the first time as one is able, especially given the noble goals of this site.

    Hall requests: “I urge commenters to aspire to the same high standards they have come to expect from SBM authors.”

    I commend this sentiment and note that such aspirations require some real work! One can have the very strongest of disagreements with an idea or proposition but need not bring someone else’s motives or mother into the discussion. :-)

  48. Erica871 says:

    “Interestingly, I rarely remove comments here (can’t remember the last time I did) and I almost never ban people, yet people are able to control their behavior because they know it could happen.”

    She claims to not delete comments often, yet, there are two deleted comments from that VERY entry. (And the second comment on her announcment post is hers – and it is responding to now deleted comments speculating on why she left SBM)

  49. weing says:

    I think a skeptical psychiatrist would be a good addition.

  50. wales says:

    I also want to thank David and Steven for not budging on the commenting policy. Censorship would lead your readers to mistrust the process. I do find irony here, Amy promotes moderation by editors, but then complains that readers are trying to censor her (in her last post). And of course Harriet is correct that we should all attempt to remain civil in our comments.

  51. wales says:

    On my last comment, make that “lead your readers to develop mistrust in the process”.

  52. Dawn says:

    I will miss some of Dr Tuteur’s posts, but will also say that she had her set feelings and stance, which she has a right to have. However, they did make her very inflexible regarding the points other people might have had that opposed her stand. There were many times I stayed out of comments because I didn’t have the time to argue my point time and time again, and she would not accept the information others gave.

    I come to SBM to learn, to read, and to experience other ideas.

    Thanks to Dr Gorski and Dr Novella for keeping the commenting policy unchanged.

  53. Todd W. says:

    Gotta add my voice to the support for staying firm on the more open commenting. It’s what sets places like SBM apart from places like, oh, Age of Autism. I’d hate for someone to feel the need to create a “Silenced by SBM” blog like I did for AoA.

  54. David Gorski says:

    I think a skeptical psychiatrist would be a good addition.

    I agree. Got any suggestions? :-)

  55. markf says:

    Amy Tuteur was harming the credibility of SBM.org. Her departure was overdue.

    She seems have a distaste for reasoned argument. Her opinions were supported too frequently by oddly manipulated statistics or simple assertions.

    I have no “rooting interest” in the issues she wrote about. My wife has had two drug-free births, but both were in a hospital and attended by doctors and nurses. I questioned quite a bit in the “natural” childbirth classes we took, so I’m not a flag-waver for the other side.

    I root for the revelation of truth and facts, whatever direction they take. Amy Tuteur is clearly partial to a particular point of view and uses any means necessary to advance it, including brushing aside inconvenient facts or arguments.

    That sort of writing is available everywhere. I come to SBM.org for more clear-minded assessments. Since Amy Tuteur’s arrival my visits to the site dropped dramatically — her self-righteous polemics were so tissue-thin that I didn’t understand why the editors were tacitly standing by her. I stopped sending friends here, lest they stumble upon one of her articles.

    Glad that’s over.

  56. edgar says:

    Some of Dr. Tuteur’s critics are guilty of two sins of their own:

    (1) Responding to what they wanted to think she said rather than to what she actually said”
    (2) Offering personal criticism of the author instead of just criticizing the content and discussing the issues addressed in the post.

    1. I think the difficulty comes in when people are familiar with Amy’s other posts on other blogs, have more background about her stance than others. I think Amy attempted to be more nuanced and show more restraint on this blog, but her often polarizing position shone through to those who were familiar with it.

    2. This is no doubt true

  57. mikerattlesnake says:

    “I did find it to be surprising at how many peoples responses to her posts boiled down to “You['re] just wrong cause I know better.””

    Really? Admittedly I am a relatively new reader of this blog (though I’ve been reading longer than I’ve been commenting), but I read several of her responses that boiled down to pretty much what you are attributing to her detractors. There may have been a disproportionate amount of ad hominem attacks in the comments, but that’s primarily because she wasn’t as good as Dr.’s Novella and Gorski (and others) at diffusing them with factual rebuttals. Often she responded in kind or, even worse, responded to factual, cited posts with ad hominems (or at least condescending dismissal), inviting more attacks on her.

    I feel like some people are really not giving a lot of credit to commentors who disagreed with her tone and lack of citations by implying sexism or ideology as the primary motivator for disagreement. It’s telling that her primary supporters in this thread seem to be the I-don’t-know-much-about-science-but-she-makes-a-lot-of-sense crowd.

  58. Plonit says:

    I wonder if Nicholas Fogelson over at academicobgyn.com might be a good choice, if he were interested in the gig.

  59. Plonit says:

    And for gynaecology, I have always found Margaret Polaneczy to be a good read at TBTAM. I use her visual representations of absolute risk quite often! Of course, neither blogger may want to take on a regular SBM slot, and probably have enough on their plate writing their own blogs.

    Whoever you get as a replacement, a thorough reading their existing oeuvre will probably tell you a lot of what you need to know about their suitability for SBM in advance of inviting them to contribute.

  60. Adam_Y says:

    I agree. Got any suggestions?

    Oooo come on….. It only took me 59 Seconds to figure this one out.

  61. Zoe237 says:

    Plonit, I emailed Dr. Gorski awhile back recommending Fogelson (as an addition to Dr. Tuteur though, didn’t realize then she was so unethical). He shares many of the same views as her, but uses evidence instead of ad hominems, hasty generalizations, anecdotes, and false causation to back up his points. I don’t always agree with him, but he’s fair at least.

    I second the suggestion for a female. I like TBTAM too. It is a lot of extra work though.

  62. weing says:

    I thought Amy’s posts were thought provoking. I hope we never come to the point where we all agree with each other.

  63. Plonit says:

    Ben Goldacre – for skeptical psychiatry at its best.

  64. bluedevilRA says:

    Dr. Gorski, I am a psychiatric research coordinator. I am not an MD and it may be a silly idea to have a mere grunt of the medical system posting on such a popular blog…

    However, I am a big time skeptic. I think psychiatry is a field that needs skepticism. As much as we all dislike NCCAM for wasting tax payer dollars, NIMH also tosses away tons of money on poorly designed studies. As this blog advocates, EBM is not the same thing as SBM.

    Despite some of the flaws of the field, it is a fascinating subject. I just opened my own blog on wordpress to discuss various issues in psychiatry and medicine. I will also be starting medical school in the fall. My first post goes up on wordpress tonight on the subject of prayer and outcomes (more or less a take down of Dr. Oz advocating prayer in the OR during CABG operations). Let me know if you are interested in hearing more.

  65. I will miss the discussions Dr. Tuteur’s posts engendered, because I love reading what the other commenters here have to say as much as reading SBM posts themselves.

    Thus I am doubly thrilled that the commenting policy here will not change. That is part of what makes this site a must-read for me.

  66. miketherattlesnake on the I-don’t-know-much-about-science-but-she-makes-a-lot-of-sense crowd:

    “I feel like some people are really not giving a lot of credit to commentors who disagreed with her tone and lack of citations by implying sexism or ideology as the primary motivator for disagreement.”

    Mike, I don’t understand your comment or what you are referring to. Amy Tuteur is sexist or commenters are sexist?

    For myself, I secretly wondered if one of the reasons people responded so strongly to Amy Tuteur is that we are used to women being conciliatory. Which she is not.

  67. Fifi says:

    While I’m happy to see Dr Tuteur go, I’m not doing jumping jacks or waving pompoms. Nor will I be giving her any more of my time and attention elsewhere. Like I’ve already said, I would have rather she learned from the experience and this was about standing up for SBM for me (science in medicine, not particularly the blog, as much as I appreciate that this blog exists and allows discussion). For my part, I was totally unaware of Dr Tuteur before she started blogging here and it was how her posts here just didn’t sit well in the context of SBM that I found problematic. When I started to look into who she was, all kinds of things turned up that seemed pretty unethical and antithetical to being an SBM blogger to me (the main one being selling medical advice over the internet, which is exactly the kind of quackery that SBM criticizes). But enough about that, I’m happy to move back to SBM again and anyone who thinks I’m a big meanie or was unfair is obviously entitled to their opinion.

    I’m all for a truly skeptical OB or, even better, Gynecologist (or someone with practical experience working in both women’s health and obstetrics). I also second the vote for a skeptical pharmacist or pharmacologist. I’d also love to see a skeptical psychiatrist who was willing to take on both Big Pharma and psychiatric woo, it would be even better if it was balanced out by a cognitive scientist or psychologist. Some of my favorite pscyh/neuro bloggers are too ranty (and probably delve into culture a bit too much) for SBM but here are a few suggestions…

    As suggestions for a skeptical psychiatrist…Dr Carlat
    http://carlatpsychiatry.blogspot.com/

    A skeptical neuroscientist…anonymous but maybe you can drag him out of the closet in the lab…
    http://neuroskeptic.blogspot.com/

    A skeptical psychologist…Scott Lilienfeld
    http://www.psychologytoday.com/blog/the-skeptical-psychologist

  68. bluedevilRA says:

    I know I already threw my own hat in the ring (admittedly undeserved). But after dismounting my Theodore Roosevelt high horse, I got smacked in the face by the most obvious of answers.

    When I think of skeptical psychiatrist…one man comes to mind. Arguably the founder of online medical skepticism, Dr. Stephen Barrett!

  69. weing says:

    Women conciliatory? They haven’t met my wife.

  70. SD says:

    Damn, Cde. Gorski. You call *me* a troll, but Dr. Tuteur trolled SBM a lot better than I could if I was even *trying* to troll. (~500 comments for a single post? DAMN. DAY-UMN. Girl’s got MAD skillz.)

    Still, this post forces me to acknowledge one thing – you come down on the right side of openness of debate, and I will credit you (and the other SBMistas, regardless of our ideological differences) at the very least with not being her. The shortest path to an intellectually inbred and self-limiting consensus-cluster is to choke off debate, regardless of whether you like it. Executing critics – or its forum equivalent – is a wonderful way to eventually wind up a tin-plated Lysenko.

    “vive liberte!”
    -SD

  71. Dacks says:

    Much as I am interested in ob and gyn issues, I’m relieved to see Dr. Amy resign. Her pugnacious style really didn’t fit at SBM, and it brought out the worst in the commenters. Some of her discussions were very informative, but they were undercut by her unwillingness to consider viewpoints other than her own.
    However, though others sometimes resorted to ad hominum attacks, she always maintained a level of professionalism.

    Well…now I will return to reading Thursday’s posts!

  72. micheleinmichigan says:

    I too like the idea of a psychiatrist. Another idea, and this may be off the wall and I’m not sure how it’d work, but possibly a patient advocate?

    Since it is a site about medicine, perhaps the patient’s perspective could have an intelligent skeptical representation. I’m afraid I don’t have anyone to nominate though. I suspect they’d have to be a pretty tough cookie and good nature-ed at that.

  73. Dacks says:

    A nurse! You definitely need a skeptical nurse. And from talking to the nurses I know, there is a goldmine of questionable practices passed along within nursing culture.

  74. jupiter says:

    I am relieved, and agree with Markf.

    I am personally surrounded by homebirth woo and have been trying to sort fact from fiction for months. I admit I have a bias towards Dr Amy’s “side” of the fence. I *want* to believe what she is posting, but her style and frequent plays on statistics and jumbling of studies to suit her ends continuously pushed me away and turned me off.

    I would absolutely love to have an OB on SBM that posts well reasoned, well cited, unaltered evidence and science without the snarky holier than thou attitude.

  75. David Gorski says:

    A nurse! You definitely need a skeptical nurse. And from talking to the nurses I know, there is a goldmine of questionable practices passed along within nursing culture.

    An excellent idea. Any suggestions? :-)

  76. TimonT says:

    I second the suggestion of Scott Lilienfeld. The fields of Psychology/Psychaitry are bursting at the seams with pseudoscience that needs addressing.

  77. Hitting both psychiatry and nursing categories together, Zarathustra of Mental Nurse. http://www.mentalnurse.org.uk/2008/08/nursing-research-is-it-a-load-of-old-wibble/

  78. Dacks says:

    Only the obvious one: Linda Rosa. But I’m sure there is a reason she’s not already on the roster here.

  79. nrsingstudnt says:

    I would love to have a skeptical nurse blogging on SBM. There is a load of woo at my nursing school-instructors who are reiki practitioners, one who promotes iridology of all things!

    Also, thank you for retaining the commenting policy. The comments are almost always as eduational as the posts.

  80. bluedevilRA says:

    On the nursing topic, what about Winkler County nurse Anne Mitchell? She did a nice job taking down Rolando Arafiles.

  81. JMB says:

    I will miss Dr Tuteurs posts because they were more of a mental challenge than a simple statement of evidence. Why even post on an article that is clearly supported by the evidence?

    However I do appreciate SBM’s comment/moderator policy. If you wish to promote the scientific method, then you have to allow freedom of discussion, rather than filtering posts based on judgments of scientific validity. Personal attacks need to be limited, but there is a fine line between personal attacks, and criticizing scientific integrity or logic processes. I haven’t read much on SBM, and certainly don’t know the comments that may have been removed, but it appears you are doing a good job walking that fine line.

  82. windriven says:

    @ wales

    “I would add “while relentlessly chumming”.”

    I laughed out loud. So true.

  83. David Gorski says:

    Damn, Cde. Gorski. You call *me* a troll, but Dr. Tuteur trolled SBM a lot better than I could if I was even *trying* to troll. (~500 comments for a single post? DAMN. DAY-UMN. Girl’s got MAD skillz.)

    For once SD actually made me laugh.

  84. SomePapa says:

    As a Psychiatric Mental Health NP, I would love to see a skeptical psychiatrist and/or nurse on board. Alas, I have no suggestions, but I will keep my nose to ground.

  85. Noadi says:

    I was sorry to see her go until I read her own blog post. Upset because SBM doesn’t censor comments? That says it all about her level of maturity.

    I join in on saying I’d love to see someone in psychiatry here in SBM and another OBGYN to talk about those issues in a more rigorous way.

  86. Adam_Y says:

    I was sorry to see her go until I read her own blog post. Upset because SBM doesn’t censor comments? That says it all about her level of maturity.

    I join in on saying I’d love to see someone in psychiatry here in SBM and another OBGYN to talk about those issues in a more rigorous way.

    Well it does cause problems here time from time. For example Dr. Novella had a problem last week with a woo basically gish galloping him on his blog.

  87. StatlerWaldorf says:

    wales said, “I also want to thank David and Steven for not budging on the commenting policy. Censorship would lead your readers to mistrust the process. I do find irony here, Amy promotes moderation by editors, but then complains that readers are trying to censor her (in her last post). And of course Harriet is correct that we should all attempt to remain civil in our comments.”

    Second that! And second contributions from psychiatry and nursing practitioners.

    I apologize for my part in the fiasco. I have great difficulty separating what I have known from Amy Tuteur on her own websites and comments on other blogs over the past year, and the few articles she wrote here.

    In the future I will try to stick to the topic alone.

  88. JerryM says:

    I’m sorry to see her go.

    It did seem to be headed that way, unfortunately.

    From the start there was what I thought was a ‘who is this new girl that is given time on my favourite blog? and about women’s issues, ew. childbirth, yuck. circumcision, ouch!’ attitude.

    I hope the next new contributer(s) will be welcomed with slightly more open arms.

  89. Fifi says:

    Jerry – “From the start there was what I thought was a ‘who is this new girl that is given time on my favourite blog? and about women’s issues, ew. childbirth, yuck. circumcision, ouch!’ attitude.”

    Are you sure you’re not projecting? And who are you calling a “girl”? There seems to be a pretty unanimous call for another more appropriate SBM Ob/Gyn to replace her, particularly from most of us who were commenting. Besides, circumcision is hardly a women’s issue since we’re not the ones with penises. The male doctors here also address women’s issues (abortion and if it’s related to breast cancer risk, for instance) and I don’t see that as being problematic…when we’re talking about science and it’s a rational discussion and not driven by ideology or bias, it doesn’t really matter who’s presenting the evidence.

  90. tanha says:

    What about a skeptical homeopath?

  91. David Gorski says:

    Besides being an oxymoron, wouldn’t combining skepticism with homeopathy rend the fabric of space-tiime?

  92. tanha says:

    haha I suppose

  93. Harriet Hall says:

    Maybe not such an oxymoron. Dr. Edzard Ernst and Dr. Willem Betz are both (former) homeopaths who are now active skeptics highly critical of homeopathy as well as other forms of CAM.

  94. IndianaFran says:

    I would second the nomination of Dr Fogelson if he is interested and available.

  95. DREads says:

    I would be very pleased to see a good, skeptical statistician join the ranks to complement the medical expertise of the other contributors. Fortunately, it often doesn’t take much intellectual effort to expose basic flaws in studies advocating so-called “Complementary and Alternative Medicine”. To the credit of the editorial staff of this blog, it would be tough for a statistician to improve SBM because the current staff already do a good job at keeping the blog analyses sound. That being said, a statistician might offer better insight on more subtle issues when evaluating more complicated studies. While doctors spend their careers studying human disease, statisticians devote their life’s study to developing statistical methodologies and algorithms as well as thinking in the abstract about variables, populations, densities, risk minimization, regression, and prediction. Doctors already collaborate with statisticians at major medical universities to help design experiments more rigorously, monitor their sound execution, and actively participate in analyzing the data and formulate findings. Their contributions help maintain the integrity of scientific inquiry and this leads to more definitive discovery of novel medical science. Employing their expertise on this blog might offer more authoritative statistical skepticism.

    Just a thought,

    Damian

  96. StatlerWaldorf says:

    A statistician would be a great idea!

  97. Reviewer 3 says:

    Dr Tuteur’s position as a blogger on SBM clearly became untenable after her last post in which she wrote about beliefs that romanticize life prior to modern times. Despite a fairly uncontroversial topic for a sceptical website, the post generated huge volumes of comments, mostly by a small group of commenters. Some were fair, but many were extremely critical, not related to what she said and held her to standards not required from other bloggers. The comments then degenerated to a sustained personal attack, including insinuation about her motives as a blogger, her skills as a doctor, etc etc. I found it thoroughly distasteful. As a long time lurker, but very infrequent commenter, I was motivated to delurk and comment here.

    If Dr Tuteur couldn’t write about a topic like this without the comments going in this direction, either she had to resign or SBM had to sack her.

    So what now for SBM? The group of commenters who appeared to run a vociferous campaign against Dr Tuteur have got their way. Their behaviour would have been called bullying if it occurred in the workplace. Even now she has quit, some continue to gloat.

    The SBM website title says: Exploring issues and controversies in the relationship between science and medicine. But is that really the case? Dr Tuteur explored controversial issues on SBM and lasted about 3 months. How long will the next person who explores these issues last, or will they just not venture into controversial areas?

  98. StatlerWaldorf says:

    Reviewer 3, read on Amy Tuteurs blogs for a while, check the archives and also review her Ask Dr Amy website and then come back and tell us that she was an excellent choice to write here at SBM.

    When I commented on Amy Tuteurs articles I always tried to comment on the topic itself, but recently slipped into commenting on her bias, ethics, and credibility as the topic shifted there. It was never my intention to force her removal/resignation. I was confident that she’d end up leaving SBM anyway because of the quality of her posts and the critiques they attract, but just didn’t anticipate that it would take only 3 months to happen.

    And I do hold other SBM bloggers to the same standards.

  99. David Gorski says:

    Maybe not such an oxymoron. Dr. Edzard Ernst and Dr. Willem Betz are both (former) homeopaths who are now active skeptics highly critical of homeopathy as well as other forms of CAM.

    Of course, the key word here is “former,” is it not?

  100. BillyJoe says:

    I sort of enjoyed reading Amy’s posts and comments while she was here, but I probably won’t miss slogging through 500 comments to her articles now that she is gone.

    I agree with Harriet that posters read a lot into her posts that simply was not there, and I think I demonstrated that with her summary of CAM as useless, particulary in reference to herbal treatments where she readily agreed with all the qualifiers that I offered.

    I think the three second grab comments are fine, but there also needs to be some more in-depth analysis and references which Amy did not feel the need to provide. But I also think some of the attacks on her were over the top and unnecessary. It would have been better for her to do a “no comment” on those.

    I do not agree with Amy that there should be moderation.
    I have given up commentating on altmed blogs because, no matter how respectful you are, once they catch wind of where you are heading with your line of reasoning, you get moderated and the antivax sympathiser (as a frustrating recent example) gets the last say.

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