The case for being a medical conservative
I only know anything about one of the authors of this (Prasad). The history leading up to this article is relevant. His modus operandi is to severely criticise clinical trials to an audience that is only peripherally or not at all involved in the field. You can see why this works - being extremely shrill about something to people that don&#x27;t have any idea tends to garner agreement, since they can&#x27;t evaluate your claims and you seem so adamant about it. It creates the illusion of someone that is &#x27;telling it like it is&#x27; and not just following the norms of the profession.<p>The problem is that this doesn&#x27;t generate anything of actual value, except for Prasad. It is easy to criticise medicine. It is easy to criticise any complex and difficult human endeavour. He takes the practice of critical thinking about studies and results and what they mean, something which all doctors do and are taught to do, and turns it into a blood sport which plays to the masses. There are plenty of academics who do what he does, and publish in well respected journals. At any conference where a major result is presented, people in the audience get up and ask questions about the value of the intervention, the conduct of the study etc, just the kind of things Prasad rants about. The difference is that Prasad has monetised this practice by pretending that he is the only one doing it. He writes books, publishes endless articles which are mainly reviews and rehashings of other&#x27;s work and the person that hired him to a faculty position openly admits they chose him because of his propensity for scathing criticism.<p>This article therefore, I find largely self-indulgent and in some parts sheer nonsense. The authors style themselves as custodians of some higher art, a priesthood of common sense and clear thinking. They pull the trick of trying to cement their importance by defending themselves against a bogeyman, the force of &#x27;commercialisation&#x27;. Of course, there is no single person or group who is causing this commercialisation, so there is nobody to question them. They also bizarrely say that they are better placed at evaluating medical evidence than the people who know most about it (&#x27;content experts&#x27;), because the experts are too enthusiastic.