The Best Science from The New England Journal of Medicine

The editor-in-chief of The New England Journal of Medicine has selected a dozen articles published during his tenure that epitomize the best of science-based medicine. This is the Science-Based Medicine blog, but all too often we talk about things that are not science-based medicine. Examining what is not science-based medicine is a good way to better understand what science-based

Critical Thinking in Medicine

Rodin’s Thinker is doing his best to think but if he hasn’t learned critical thinking skills, he is likely to make mistakes. The human brain is prone to a multitude of cognitive errors. Critical thinking in medicine is what the Science-Based Medicine (SBM) blog is all about. Jonathan Howard has written a superb book, Cognitive Errors

Should Evidence-Based Medicine Be Replaced By Interpersonal Medicine?

An opinion piece in the New England Journal of Medicine complains about the limitations of evidence-based medicine (EBM) and recommends a new approach they call “interpersonal medicine.” In my opinion, good clinical medicine is already interpersonal medicine; there is no need for something new. The 22 November 2018 issue of The New England Journal of Medicine carried an opinion

The Future of Medicine

April 17, 2012 Eric Topol, MD, has written a book about the convergence of the digital revolution and medicine. It is full of fascinating information and prognostication, but I wish he had given it a better title.  He called it The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. Medicine

Colonoscopy: More Misinformation from Mercola

Joseph Mercola, D.O., runs the website mercola.com which is full of misinformation, advocates all kinds of questionable alternative treatments including homeopathy, and discourages vaccination and other aspects of conventional medicine. Like Dr. Oz and Andrew Weil, he is more dangerous than easily recognizable quacks in that he combines some good medical information with egregious misinformation, and readers who

Coca’s Pulse Testing to Diagnose “Allergies”

I recently got an email from a gentleman who told me I was wrong about many things because I “come from an era of incomplete medical education and information.” He rambled on but had two main points: modern doctors fail to recognize a kind of allergy that defies standard diagnosis and that is the cause

Mainstream Doctors Actually Do What CAM Claims They Don’t

Alternative medicine proponents criticize mainstream medicine and think they can do better. Evidence from medical journals shows that their criticisms are not valid. Advocates of complementary and alternative medicine (CAM), including naturopaths and functional medicine practitioners, constantly criticize mainstream medicine. The recurrent themes are: Doctors don’t do prevention They only prescribe drugs and surgery and

Consumer Reports Misses the Boat on Back Pain

Consumer Reports’ recent articles on low back pain address anecdotal customer satisfaction rather than scientific evidence of effectiveness. A correspondent e-mailed me, saying: “I received my latest issue of Consumer Reports with great interest because the cover story is about back pain. However after reading the article I walked away disappointed. How this well respected publication printed

Confessions of a Quack: Holistic Harry Tells the Inside Story of Alternative Medicine

Confessions of a Quack is fiction, but it provides real insights into the thinking processes and motivations of quacks, alternative medicine providers, and their patients. He told her the butterbur had flushed out her triple heater meridian, spilling into Pingala Nadi, flooding her Agnya chakra and setting off a Herxheimer-like reaction. In the SBM comments section, someone (thanks,

How Do Doctors Learn to Diagnose, and Can Machines Learn to Do It, Too?

Siddhartha Mukherjee weighs in on how doctors arrive at a diagnosis and how computers can assist but not replace them. Is this the doctor of the future? Probably not. I am a big fan of Dr. Siddhartha Mukherjee, a cancer physician, researcher, and stem cell biologist who is also a phenomenally gifted writer and an unequaled