After 15 years of SBM: Lessons learned and what the future holds

I was shocked when I sat down with my laptop and wrote this post that it would be my last post. Last week, Dr. Steve Novella wrote a post that reminded me of the 15-year anniversary of this website. Yes, that is correct. On January 1, 2008, Steve introduced the science-based medicine blog with a post. He followed up with a post about the false dichotomy between plant-based medicine and pharmaceuticals to address a common misconception. Our readers have become familiar with concepts such as how randomized controlled clinical trials (RCTs) of homeopathy reveal the drawbacks of evidence-based medicine, thanks to the introduction of Dr. Kimball Atwood. Steve said that the Cleveland Clinic and the University of California, San Francisco, embraced "integrating" quackery and promoted a worthless treatment based on un. In the early years, this was the main concern.

When I read the post again, I cringed a bit, but I decided to use a quote from Stockdale who famously introduced himself during the first Vice Presidential debate. I don't know why I'm here. At the time, I was mostly unknown under my real name, but I had built a following on my not-so- secret other blog. It has been fifteen years since I was first on the site, and I am still in some ways not much better known and in others too well known. 15 years ago, I was invited to join this enterprise, and I still feel like that person. I'm not It's no longer possible. It won't happen after fifteen years. I sometimes feel like Aragorn in The Lord of the Rings as I deal with medical misinformation after 15 years. I hope to awaken the troops metaphorically.

We want the troops to go into what looks like a futile battle.

The managing editor is me. In practice, I don't do a lot of actual editing, but I do mostly choose and edit guest posts. There's more on that later. I would be lying if I said that the landscape with respect to science and medicine has improved since we began this quixotic effort. I can look back and forward at this time. Steve focused on what we have accomplished and what is next. I am going to give some ideas on what to do next, as well as give some lessons learned from the Pandemic, which I think is the biggest challenge to the idea of a website and a blog.

Successes in context

Steve outlined some successes in his last post. There has been a new post every weekday and weekend for 15 years.

…we have published 4,328 articles covering just about every topic in the science of medicine. Hopefully we have at least added a useful voice to the much needed conversation surrounding how best to apply the latest science to the practice of medicine.

This is perhaps our greatest ongoing contribution and utility. SBM has become a resource for journalists looking for a science-based viewpoint for stories about various topics due to the fact that a number of our posts have ranked high in searches of various topics. Our Bloggers commentary is featured in many news stories. I had never been contacted by a reporter to speak about a medical story. I can say that it's not uncommon, even though I wouldn't say it's common. Sometimes my pearls of wisdom show up in stories as a result of my comments.

I have to agree with Steve when he writes.

It is, of course, very difficult to assess the impact of SBM. There is no way to know what the world would have been like had we not engaged in this project. There is no controlled experiment. We must make due with anecdotal evidence. We frequently hear from practitioners who find our articles and our perspective useful in their practice, even changing how they practice medicine. We are often a resource for the media who would otherwise have only promotional or gullible voices on topics involving pseudoscience in medicine. And we hear from many health care consumers who were able to make a much more informed decision before turning to “alternative” interventions. I like to think we even influenced the FDA and FTC when they were reconsidering their regulation of homeopathy. We also engaged with the NIH regarding their funding of pseudoscientific research.

Steve is probably correct when he says that the FDA and CDC are influenced. We collaborated with the Center for Inquiry to make comments to the regulatory agencies. As our only lawyer, I was proud to shine a light on the efforts of naturopaths and other practitioners of unscientific "medicine" to lobby state legislatures to license their pseudoscientific quackery. I like to think that frequent posts by Jann and me about " right-to-try" bills, which I first likened to the movie Dallas Buyers' Club, was a strategy to build momentum and make a difference.

It was coining and defining the term "science-based medicine" in the first place and introducing it into the discussion and hierarchy of medical evidence to point out how what we are doing is important. Mark put it 11 years ago when he rejoined the fold.

If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.

The first lesson is brought about by this. The Pandemic has shown us that SBM is more than just an approach to medicine.

Ivermectin: SBM could have prevented this

There is a line from an old song that I like to quote to the point of annoyance.

“You really think it’s all new,”” “You really think about it too,”” The old man scoffed as he spoke to me,

“I’ll tell you a thing or two”