Todd D. Gastaldo, D.C. remarks:
While it is perhaps true that "conventional medical SCIENTISTS" follow the basic
scientific medicine, some have noted that that the medical profession as a whole has been
behaving quite unscientifically throughout its history.
Harold Wachsman, M.D. discusses this matter in Lethal Medicine [NY: Holt 1993]...and David
M. Eddy, M.D. concluded in 1990 that:
"The intellectual foundation of medical care...is that whatever a physician
decides is by definition correct." [Eddy DM. The challenge. JAMA (Jan12)1990]
In 1976, distinguished epidemiologist Kerr White reportedly told the clinical staff at
Wellington Hospital in New Zealand that 15% of physician interventions were evidence
based; after which distinguished epidemiologist Archie Cochrane reportedly called out,
"Kerr, youre a damned liar, you know it isnt more than 10%." [Kerr
personal communication to Iain Chalmers, 1992. Quoted in Johnathan Ellis, Ian Mulligan,
James Rowe, David L. Sackett. Inpatient general medicine is [sic; see below] evidence
based. The Lancet (Aug12)1995;346:407-10]
In 1978, the U.S. Office of Technology Assessment of the U.S. Congress estimated that
"only 10 to 20% of all procedures currently used in medical practice have been shown
to be efficacious by controlled trial."
[Ellis et al. 1995.]
In 1979, Williamson et al. concluded that fewer than 10% of common medical practices for
three subspecialties of internal medicine have any foundation in published research.
[Williamson JW, Goldschmidt PG, Jillson IA. Medical practice information demonstration
project: final report. Baltimore, MD: Policy Research, 1979. Cited in Ellis et al.
1995.]
In 1983, the U.S. Office of Technology Assessment of the U.S. Congress repeated its
estimate that "only 10 to 20% of all procedures currently used in medical practice
have been shown to be efficacious by controlled trial." [Office of Technology
Assessment of the Congress of the United States. The impact of randomized clinical trials
on health policy and medical practice. Washington, D.C.: U.S. Government Printing Office,
1983. Cited in Ellis et al. 1995.]
Epidemiologist Kerr L. White issued a challenge at meetings of the Health Advisory Panel
to the US Congressional Office of Technology Assessment. He challenged doctors to provide
better evidence than the 10-20% figure - but "No-one could." [White K. Evidence
based medicine (letter). The Lancet (Sep23)1995;346:837-8. Kerr L. White, 2401 Old Ivy
Road, 1410, Charlottesville, VA 22903-4858.]
In "countless addresses and conferences" afterwards, epidemiologist White
"often challenged others to provide better evidence but none was forthcoming."
[Kerr 1995]
In 1991, the editor of the British Medical Journal noted that a health care conference in
Manchester, UK, had been told that "only about 15% of medical interventions are
supported by solid scientific evidence."
[Smith R. Where is the wisdom..." the poverty of medical evidence. BMJ
1991;303:798-99. Cited in Ellis et al. 1995]
In 1992, the same editor of the British Medical Journal further lamented the paucity of
solid scientific evidence for most medical interventions. [Smith R. The ethics of
ignorance. J Med Ethics 1992;18:117-18. Cited in Ellis et al. 1995]
In response to this apparently "gloomy" and "depressing" state of
affairs, the A-Team, Nuffield Department of Clinical Medicine studied their own medical
behavior for one month and determined that "more thannb half" of their care was
evidence based, thus "support[ing] the view that learning how to practice
evidence-based medicine is not just an academic exercise but CAN influence clinical
decisions." [Ellis et al. 1995, emphasis added.]
Ellis et al. concluded, "We do not know how far our experience in one month on a
general medical service is generalisable" - and then they erroneously titled their
paper, "Inpatient general medicine IS evidence based" (emphasis added).
According to Ellis et al. [1995], members of the A-Team, Nuffield Department of Clinical
Medicine are: Jonathan Ellis, Ian Mulligan, James Rowe, David L. Sackett, Ben Box, Laura
Burgoyne, Camille Caroll, Jo Chikwe, Gerry Christofi, Derralynn Hughes, Katie Jeffrey,
Rowena Jones, Sharon Peacock, Moyra Reid, Kopal Tandon, Clare Wood-Allum, and Sebastian
Walter. (Correspondence should be sent to: Prof David L. Sackett, FRCP, Centre for
Evidence-Based Medicine, Nuffield Department of Clinical Medicine, Oxford-Radcliffe NHS
Trust, Headley Way, Headington, Oxford, OX3 9DU, UK.)