Medicine has been decribed as both an art and a science. At it’s best, it can be without question a most wonderful merging of the two.

The forces that shape our decisions regarding health care, particularly for our children, are enormously complex. We make these decisions in the context of our personal experience, our educational, cultural, ethnic, and religious background, and our own personality. They are effected by our access to information, the way we interpret information, and the way we filter information, and hence by our biases and prejudices. History also plays a major role in creating the frame on which our decision making process takes shape. The history of the medical profession, from heretical sorcerers and alchemists to paternalistic shapers of social order, to cutting-edge evidence-based practitioners, has often placed the receivers of health care in a distanced and alienated corner, and has fostered a level of mistrust that has become a part of the culture of the doctor-patient relationship. The rise of medicine from the dark ages unfortunately took many dark-age manifestations with it. As the medical model grew in complexity and as the science behind both illness and the functioning of the body in health grew at an exponential rate, the knowledge and power of the expert also grew. With it so grew the gulf between physician and patient. The real advances in medical science were not matched with a similar evolution in the social interrelatedness of the providers and receivers of health care. When a knowledge gap of such breadth exists between individuals in a relationship, especially one as personal as that which must exist between care giver and receiver, the ensuing imbalance leads to vulnerability of the receiver. This in turn can lead to mistrust, and this mistrust breeds resentment. From mistrust and resentment follows the desire to rebel and gain control. The paternalistic power of the medical profession, which has been blamed for a pattern of “medicalization” of society, has created a backlash of rebellion in which many feel the need to reclaim their health and challenge the all-knowing authority of the healthcare establishment. This movement has created a resurgence in the use of herbal, homeopathic, chiropractic, and other “alternative” modes of health care, and has called into question some of the most basic elements of modern health care practice. And while the call to arms against the great white beast can at times seem justified (the excessive rate of caesarian sections and the over use of antibiotics being commonly highlighted examples), when medicine is at it’s best and follows the evidence-based scientific model, it is quite the wrongful victim. Evidence-based medicine, which bases diagnostic and treatment decisions on a careful analysis of the data found in the volume of existing rigorously peer-reviewed literature, is the method we use to assure that medicine is practiced according to the best standard available. It merges medicine with the scientific method, the western framework upon which all modern advances in science have been based. And while not every physician follows this model, major teaching institutions and public healthcare organizations most assuredly do.

Through this site I will attempt to shed a rationalist’s light on topics that are often irrationally interpreted. In so doing, I hope to offer a reasoned and rational approach to health care decision making. As a pediatrician, I may often focus on issues pertaining to children and children’s health. The fundamental ideas, however, will hopefully have more universal relelvance.