Critical Thinking in Medicine
Most people who choose the health care profession seem to naturally possess empathy,
Although helping patients toward optimal health is our common goal, we don’t always choose our sources of information in a common way. Without a reliable approach to evaluating the sources of medical information and claims, we cannot be certain that we are making the best choices. We owe it to our patients to use the best information available when making decisions about their lives.
Traditionally, we are trained in the clinical art of medicine. The ‘art’ involves connecting with our patients, communicating effectively, being empathetic and compassionate. The art of medicine involves being thorough, yet concise. It also involves persuasion. In medical training, we become clinical thinkers. However, we receive little (if any) formal training in critical thinking. Yet, the practice of medicine requires critical decision making that can be life-saving if done properly, or dangerous if flawed. Critical thinking is a necessary part of our job and our art. In order to practice this art, we need reliable information.
During the intense education process, we memorize volumes of facts and consume information. We often take it for granted that this information is correct. We’ve been taught about the scientific method and know something about the psychological biases that influence our beliefs. Most of us realize that some information is more trustworthy than others. Since we want to deliver the best health care that we can, we need to be equipped with critical thinking skills to help us sort out the good information from the bad, the science from the bunk.
Here, we will learn the basic tools of skepticism and critical thinking. We will scratch the surface of the philosophy of science. We will explore ideas that are practiced today that have no basis in science, yet are still firmly believed. The information on this site will be updated and corrected from time to time, just as science must be updated and corrected from time to time.
This site aims to help us to identify these errors, not only in others’ thinking, but in our own.
Skeptical Medicine: 2 Themes
The running theme throughout this site is that, while our policies and decisions are philosophic in nature, we should use science and reason to inform these policies and decisions. Our reasons for connecting claims to decisions should follow established rules of logic. However, our initial resolution to use science and reason in the first place is purely philosophic. As we make the decision to value science, reason and logic over other “ways of knowing”, we ground ourselves in a way of thinking that demands adherence to the rules of science, reason and logic.
** It is logically contradictory – and therefore forbidden – to embrace science and logic when they support an idea, but then to reject them when they do not.
** It is possible and necessary to deliver science-based medicine with compassion.
How to Use This Site
This site is meant for the health care provider with an interest in critical thinking and science based medicine. The sections are meant to be read like a book. The arguments of the later pages build on premises established in the earlier pages. It starts on a level playing field with a foundation of philosophy. Hopefully, we can see how the bricks are stacked from the foundation to the conclusion.
The sections on Medical Practices Unsupported by Science and Pseudoscience in Health Carehighlight practices in common use today despite disconfirming evidence and sound philosophy. In these sections, we will apply the ideas and skills from the previous sections to evaluate medical claims that have been marketed to the public.
My name is John Byrne. I am a doctor of Internal Medicine and Pediatrics in a private practice and I am the creator of this site. The information presented here represents my thoughts and learning as well as the thoughts of the other contributors. It does not necessarily represent the official stances of any institution with which the site’s authors are affiliated.
I give special thanks to Andrea Wilkins for her time and expertise in editing this site, and to Sarah Byrne for drawing the “Doctor-Thinker” logo.
I am learning too. The information here represents my best understanding of the issues discussed. I try to learn from experts from various fields. Access to some of their expertise can be found through the Links section of this site. Other than this paragraph, I will try to refrain from writing in the first person.
The costs of health care and the expectations from health care professionals are rising. We should not waste time, effort, resources and money by promoting ideas that are incorrect, dangerous, or both. We have learned to be clinical thinkers. Now we must learn to be critical thinkers. It is time for us to take some skeptical medicine.
John Byrne, M.D.
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