I like to point out from time to time that arguably the most striking difference between science-based medicine (and the evidence-based medicine from which we distinguish it) and alternative medicine, “complementary and alternative medicine” (CAM), or (as it’s called now) “integrative medicine” is a concerted effort to change practice for the better based on science […]
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One of the major differences between science-based medicine (SBM) and alternative medicine—or, as they call it these days, “complementary and alternative medicine” (CAM) or “integrative medicine”—is that SBM is always questioning itself, always reevaluating its practices. Related to this difference is that SBM does change its practice, discarding treatments that don’t work and incorporating those […]
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Over the years, I’ve written a lot about overdiagnosis and overtreatment. Basically, overdiagnosis is the diagnosis of a condition that, if left untreated, would very likely never cause the patient harm. Because I’m a cancer surgeon, I’ve almost always written about overdiagnosis in the context of–you guessed it–cancer, particularly breast cancer. In breast cancer, for […]
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There’s a misconception that I frequently hear about evidence-based medicine (EBM), which can equally apply to science-based medicine (SBM). Actually, there are several, but they are related. These misconceptions include the idea that EBM/SBM guidelines are a straightjacket, that they are “cookbook medicine,” and that EBM/SBM should be the be-all and end-all of how to […]
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If there’s one lesson that I like to emphasize while laying down my near-daily dose of Insolence, both Respectful and not-so-Respectful, it’s that practicing medicine and surgery is complicated. Part of the reason that it’s complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their […]
