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Reasons to Distrust This Post

Reasons to Distrust This Post (And All Other Posts) Plus a Guide to Finding Truth Amid Lies and Exaggerations

1. If you have something to sell, you can’t be totally trusted.
2. Bias is everywhere.

Reason # 1: We’ve All Got Something To Sell

There are all kinds of reasons to distrust what I write on this blog, but I’d like to start with my favorite which is the fact that I am writing it. There are only two reasons for me to write anything and make it public: either to help other people or to help myself. While I can tell you that I do want to help people, it is also true that I would like to pay off my student loans and I would imagine that a part of me really wants to be known and respected.

So that’s the first reason I can’t be trusted. As long as I’m selling something (even if it’s just myself), you have to wonder about the validity of what I’m saying. Now, I’m going to cite scientific studies and present some things as irrefutable fact and I will also believe what I’m saying is true, but keep a close eye on me because I will interject my interpretation of the evidence between every line and then I will smear the whole thing with my opinion.

I would argue that this applies to almost every person who is publishing anything, including the most reputable of scientists, the most persuasive chiropractors, the most objective journalists, and the seemingly unconflicted family doctor. The big drug companies obviously have a product to sell, but so does anyone who writes a blog or a book or even anyone who opens up a medical office.

Reason Number 2: Bias is Everywhere

Let’s pretend for a moment that I don’t have any conflict of interest here and that I truly am 100% altruistic. (Which I would really like to make a reality.) Would my publications then be trustworthy? Definitely not. Because, where am I getting my information? I’m getting it from a lot of people with something to sell. Almost 75% of research being done today (some of which my medical school curriculum was based on) is funded by pharmaceutical companies. The American Academy of Family Medicine (who I receive my board certification from) accepts money from drug companies to run ads in their publication, which is one of my most important sources of continuing education. But that’s not the only kind of bias. Later, I’ll dedicate a whole post just to different types of bias. There is a great TED Talk on Publication Bias. I think analytical bias may be among the most important type. We may have great data from science but make the wrong conclusions about how to apply it.

What Can We Do? Who Do We Trust?

  1. Get a second opinion. Especially if someone is recommending a surgery.
  2. Ask questions. Ask about how much evidence there is that the particular intervention being recommended is the best intervention and ask how the evidence applies to you.
  3. Get answers that you can understand. When doctors, including myself, feel like we don’t have the right answer, we start talking about the scientific stuff we do know instead of saying we don’t know. If you aren’t understanding what we are saying, keep asking questions until you understand or until we finally admit we don’t know the real answer.
  4. Don’t throw out the baby with the bathwater. In light of all of these reasons to mistrust, we may want to dismiss all of scientific medicine. When we do this, we may cause pain and suffering from a problem with a clear scientific solution. I once met a couple with two children in the pediatric ICU with pertussis. They were anti-vaccine believers who had “saved their kids” from the harmful chemicals in vaccines. When I asked if they intended to vaccinate their new baby, they said they did not believe that their children having had pertussis was related to the fact that they had not vaccinated them. They had so little trust in doctors, that even a life threatening disease couldn’t change their mind.