A Year of Science-Based Medicine

On January 1, 2008 I wrote the first blog entry on Science-Based Medicine introducing the new blog. Now, by coincidence, I have the privilege of writing the last entry of 2008. It seems like a good time to look back over the last year and reflect on our little project.

I am happy to write that by all measures SBM has been a satisfying success. Most blogs end after a few months. We not only kept up our schedule for the entire year, we expanding our writing about midway through the year. Given that there are millions of blogs, by necessity most blogs are relatively obscure. SBM rather quickly garnered a respectable readership and gained the attention of the some in the media as well as those with oppossing views.

I am very proud of the quality of the articles we have published here. Of course I have to thank all of my co-bloggers – David Gorski, Kim Atwood, Harriet Hall, Wally Sampson, and Mark Crislip who were with me from the beginning and Val Jones, David Kroll, Peter Lipson, and David Ramey who joined us part way through the year. Every week they each contributed a magazine-quality article, and then hung around to discuss their articles and others in the comments section. They all do this without any compensation, out of a pure desire to have a positive effect on the world.

I also have to give a special thanks to David Gorski for stepping up and filling the role of managing editor. As most of you are aware, I produce two podcasts and contribute to four blogs in addition to running a local skeptical organization and having an academic medical career. So it was a great help for David to take some of the administrative duties off my hands. He has helped from the beginning with moderating comments and managing the site, and then volunteered to be responsible for recruiting new talent. The expansion of our contributors was entirely due to his efforts.

But all of the editors offer their energy, experience, and insight into this project.  We also have plans for the future that go beyond running a successful blog. Most of us have been involved for years in efforts to educate the public about science and medicine, resist the erosion of the scientific standard of care in medicine, and oppose infiltration by fraud and quackery. Wally headed a peer-reviewed paper journal called The Scientific Review of Alternative Medicine, that Kim, I and others also contributed to. SRAM, however, did not achieve our goals. Wally discovered through tireless efforts that the CAM proponents were already the gate-keepers of information on CAM. They were able to block SRAM from being listed as an official peer-reviewed journal by the International Library of Medicine – that is death to a medical journal. While SRAM still continues, we all knew it would never have the impact we wanted.

We chatted for several years about what we could do to be more effective in our anti-quackery efforts. It seemed like a losing battle, and in many ways still is. That is why a year ago I decided to start the SBM blog. I had already learned of the potential of the new media through my other efforts, and a science-based medicine blog seemed like the perfect venue to get our efforts off the ground. I coined the term science-based medicine because I wanted our blog to be about what we are for, not what we are against. We advocate for a univsersal science-based standard of care in medicine. The term is also a play on evidence-based medicine, which almost gets it right but fails to properly consider prior plausibility in its evaluations.

The term has grown on me over the last year, and I think it is catching on. It serves as a useful catch-phrase to summarize what we are all about. I like telling patients and others that I practice science-based medicine. It nicely encapsulates my approach. It also gives us a hook on which to hang our philosophy of medicine. We get to define what science-based medicine means, because we coined the term to refer to our own position.

This blog, although a very useful tool, is also not the end of our ambitions. It was always meant to be a means to an end and not an end unto itself.  We are still not sure what form our future efforts should take – how to build on the success of SBM. In many ways this is an experiments, and we are just figuring it out as we go along. We know what we want to achieve. We want to give voice to all those physicians, health care professionals, and patients (and potentially we are all patients) who are disturbed by the infusion of antiscience and nonsense into medicine. We feel a vocal minority has controlled the conversation for too long. We have all had the experience of having colleagues come up to us to express their solidarity with our views, but also express that they do not feel empowered to express it or do anything about it out of fear of being labeled as politically incorrect, closed-minded or biased. Therefore we want to make the promotion of science-based medicine politically correct again (which always amazes me that we have to), to give voice to the silent majority that is fed up with the nonsense.

And of course we want to make health care more scientific – at all levels. This does not mean only fighting against the worst forms of pseudoscience in medicine (although we do that quite a bit), but advocating for the highest standards of science for all medical practices. We want to re-establish a single scientific standard, and abolish the double standard that has been created specifically so that scientifically invalid modalities can sneak into the practice of medicine.

So, thanks again to all our contributors for helping make SBM a successful blog. Thanks to all our readers, and especially those who take the time to engage us in the comments section. The feedback is part of the strength and vitality of this blog.

Have a happy new year, everyone, and here’s to another successful year of science-based medicine in 2009.

Posted in: Science and Medicine

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