Detailed, evidence-based help for common painful problems

Doctors are not scientists 

 •  • by Paul Ingraham
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I got one of the quackiest emails I’ve ever seen … from a physician. (Or at least someone sticking those letters behind his name.) It’s a good reminder that every profession has its cranks and kooks. The proportions do matter, of course, but no profession is immune and someone is at the bottom of every class. And a bunch more in the bottom third.

One of the most chilling articles on ScienceBasedMedicine.org is the one about how many doctors actually object to evidence-based medicine — more or less all due to ignorance of what it actually means. Scientific literacy is certainly higher in medicine than alternative medicine, but by no means is it actually high. Doctors are not scientists any more than chiropractors or stock brokers. Epistemology (the science of knowledge) is an exotic topic that the average clinician (of any kind) is way too busy to tackle.

Knowing the history of science and medicine is vital for anyone trying not to repeat the many egregious mistakes of the past, but ain’t nobody got time for that. Without those skills, how is anyone supposed to understand what makes sense in medicine? About the best the average patient or provider can do is be aware of some of the “greatest hits” of health care foolishness. It’s important to know, for instance, how many classic snake oils have been not just ineffective but downright harmful … and yet were still extremely popular! That’s how crazy wrong people can be about things they “swear by.”

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