Observation is the cornerstone of the scientific method. Without observation, science falls prey to all the same dogmatism that plagues religion.
Modern “scientism” has fallen prey to the fallacy that someone else’s observations, as reported in scientific journals, are somehow a replacement for our real-world experience. Many truths are hidden by and many falsehoods are misrepresented as truths by modern scientific research.
The literature is indispensable to treating patients, but ignoring robust and consistent anecdotal experience is just as foolish as ignoring the literature. Likewise, the corruption of the scientific process has at this point compromised so much of the literature that it is hard to know what to trust.
William Osler said, “Trust the patient. He is telling you the diagnosis.” The patient will also tell you candidly what works, and what does not work. What works for one does not necessarily work for another. But we must be mindful of costs, benefits, and complications. For example, I frequently recommend empiric treatments for patients. I do not have double-blinded, randomized, placebo-controlled, cross-over trials to suggest that what I am offering will work. I just have anecdotal experience or a theory. And my patients can choose whether or not to give it a try. I like to tell my patients that, “I’m not here to tell you what to do – I’m here to give you the benefit of my experience and guidance.” I’ll tell them if I think something is absolutely necessary, but otherwise it’s their life, their time, and their money – I can’t stand to treat my patients like children (a lot of doctors still do this).
Too many people rely on the opinions of experts over the powers of their own observation. Experts are misguided by their own biases. They are often promoted for their biases, rather than their actual clinical or scientific originality. You would be amazed by the clinical results that fringe ideas sometimes get. Is it placebo? Is it real? At the end of the day, my priority is to get positive results for my patients. To leave no therapeutic stone unturned. To do more for them than simply prescribe an endless train of scopes, surgeries, pills, powders, potions, and even purges.
Most of the fallacies of modern science and medicine are easily refuted with simple observation. What is not easily observed or interpreted is each person’s unique constitution and context. What is right for one is not necessarily right for another. That’s why trying to shoe-horn yourself into one diet or another so often leads to disaster. You are unique. You are special. And you deserve a doctor who will treat you accordingly, without offering you sweeping, one-size-fits-all prescriptions. That is the power of quantifying your unique physiology, rather than assuming you are just like everyone else. The most gratifying thing about my career at this point is seeing this process bear fruit for myself, my family, and my patients.