How to Get Physicians Interested in Junk Science

Marcia Angell N Engl J Med 1996; 334: 1513-1518

It has been somewhat challenging to get people to pay attention to the harm junk science causes. Physicians, who are supposed to be more knowledgeable about science and should be easier to persuade concerning junk science, are no exception. For example, my father-in-law, chief-of-staff at a major hospital, is convinced that second-hand smoke causes cancer because EPA issued a risk assessment saying so.

Dr. Marcia Angell has written a special article in the New England Journal of Medicine railing about the travesty of the breast implant controversy, including the associated junk science. Of course, I applaud Dr. Angell for taking notice of junk science -- in fact she links junk science with other issues including asbestos, diethylstilbestrol (DES), Benedictin, the Dalkon shield, Agent Orange, Alar-treated apples, radon and electromagnetic fields -- but junk science transcends the breast implant and eight other listed travesties. Junk science happens every day. Where are Dr. Angell and other physicians in these cases?

As another example, late last year the Journal of the American Medical Association (JAMA) published an article linking cholesterol-lowering drugs to increased cancer risk. Despite publishing the study, JAMA published a blistering editorial that all but called the study junk science. Why? That piece of junk science threatened physicians' ability to treat patients with cholesterol lowering drugs. The editorial correctly pointed out that it would be silly to take away a beneficial treatment for a real disease based on unfounded fears of hypothetical cancer risk.

As with cholesterol lowering drugs, the breast implant junk science threatens physicians' ability to treat their patients as they see fit. What I'm not sure that Dr. Angell realizes is that if she and other physicians don't want junk science to harm their patients in the future, they must be continually vigilant -- even when the target of junk science may not be of immediate professional interest or so politically correct.

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