I’m a retired internist/hospitalist/academic and appreciate your Substack blogs. Those of us who were doing exclusively clinical work have held doubts about legacy journals and especially since Dr Angell shared her opinions several years ago. You are doing good work. Please keep on the path you’ve created.
I’m very grateful for to the independent thinkers getting information to people like me trying to figure out what the hell happened to us.
I’ve never been invested in the medical community. If not for brave independent people like you I’d still be sick and crippled up.
Back in 2021 I went to see a doctor about crippling shoulder pain, hip pain, and debilitating fatigue. He told me I was suffering from old age and that it was something I was gonna have to live with. Gave me a steroid shot, and some pills, sent me home.
That was the beginning of me trying to fix myself. However, I stayed depressed, and felt hopeless for months after that visit.
8 months later I decided to get a second opinion. That doctor ran all kinds of test. Test showed I had two tick borne illnesses and one I had had for over a year. Doc said this was the cause of my fatigue. Possibly some of my pain. It took eight months of antibiotics to rid myself of the illnesses. That doctor has since died.
Meanwhile, I went on a ketogenic diet. Decided to get the weight off. And I did. Went from 196 pounds to 110 pounds. But, I still had pain in my shoulders. I figured out that what I had and the doctor missed was frozen shoulder. First one, and six months later the other one.
51 days ago my IBS flared up real bad for the second time this year after being in remission for 25 years.
It was the damn fiber (a bulking agent) the doctors kept telling I needed. I read Fiber Menace and everything clicked. It was the damn fiber and it was expanding and tearing me up. Literally tearing up my colon and rectum.
I discovered DMSO around the same time. I diluted and used it, and decided to go on a carnivore diet.
I’m happy to report that IBS is in remission and I no longer suffer from constipation, shoulder pain, or anything else. I have my health back. I can clean my house and go for long walks. I’m happy and healthy at 61 years old. What I was going through was not normal.
I remain unjabbed. And honestly, the people that got jabbed still have an attitude. And many are still doing it. I have a dear friend that is very I’ll. He know how I feel. This last jab he apologized to me for getting it, but said he didn’t care as he couldn’t take the chance. He’s in the hospital as I type. It breaks my heart because it didn’t have to be this way.
People are going to have to step up and do the hard work and heal themselves through nutrition. Get off the pills, and stay the hell away from the medical community. Your life literally depends on doing this. Use the medical community to your advantage. Get the test done, take their pills and throw them in the trash. Doctors are not in it to do good. Most are in it for the money money money. Even the online influencers. They want your money money money.
At this point I’m so tired of having to weed through the internet for medical information as most everything you find is a lie. Take your statins. Why?
Praying for healing and self discovery for my friends and family, but they are not interested. They want their sugar, they want their sodas, and they want their doctors to make it all better and all I can do is sit back and watch the horror show.
John Ioannidis has been saying this out loud for 2 decades. His 2005 essay "Why Most Published Research Findings Are False" (https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124) was the most-accessed article in the history of Public Library of Science (PLOS), with more than three million views.
After 4 decades of stumping the pulpit on Evidence-based Medicine, I have retired with a deep sense of loss and regret. Mark Twain's "Lies, damned lies and statistics" sums up the vast majority of medical research and publishing.
Academic publishing is controlled by a small cabal of for-profit publishing houses which make obscene profits - much larger than Big Pharma can dream of. So called "peer review" panels are mostly old boys' clubs which are only too keen to pander to the interests of the publishers and industry-sponsored research.
Ventures like PLoS have been fighting the good fight but remain largely ineffective.
The internet, as a medium of open public discourse, offered great promise but has been swamped by bad actors and is currently a cesspool pool of misinformation, disinformation and lies.
I am deeply appreciative of your efforts to fight the good fight. We can't give up. The present scenario reminds me of the first Star Wars episode where the good guys are banished to a remote corner of the galaxy. May the Force be with you.
So important for sites like this to thrive so we can return to medical research and discussions that are based in honest discussions, different opinions and a reminder of where we need to be in medicine and research. I look forward to supporting these sites for a long time.
Thanks for your continued work, and that of your collaborators.
I agree, the vast majority of what is published in the “big” journals is pointless stuff that is of zero clinical relevance (and nowhere near ready for medical prime-time). And this is no doubt even worse at journals with lesser banners. It is little more than an exercise in padding CV’s, and a venue for marketing opportunities.
What has changed in the last 10 years is the development of places for informed medical skeptics to discover they are not alone. I used to wonder “am I the only one who thinks this?” about a new trial, new drug, or new guideline recommendation. That is no longer the case. And that is a happy and welcome development.
I wish you the same and thanks again for your posts!
I have learned more from Stop and Think, Sensible Medicine and Cardiology Trials than från the journals I have been subscribing. Even most editorials are soft and many times biased.
I am a cardiologist and I work as a clinician and as a researcher in Brasilia, Brazil. As a PhD student a few years ago I tried to write a comment to the editors about a paper published in a high-impact factor journal. The authors were prolific professors and the paper was very well written. However, the subject was completely out of their area of expertise. It was exactly related to my field of research and I disagreed with almost all of their arguments. At that time, the letter should be submitted within a 7-day window and be revised by the staff. So I followed the rules as requested, but I never knew if it was even read... Of course, I was frustrated and nothing could be done but move on and "forget it" as I heard.
My point: social media and spaces like this are absolutely necessary for "scientific citizenship." In other words, independent forums to debate and learn from controversial and opposite points of view are the cornerstone of evolution, at least if we consider that skepticism represents a growth mindset. The publishing world is not democratic, not inclusive, full of biased decisions, and yes, full of nonsense. The exercise of being critical is the way we can protect our patients from non-intentional consequences.
I am not sure if legacy journals are dying. Honestly, I hope not! But definitely, editors must rethink their role and ensure they can be our safe harbor. Spaces like this and the good use of social media by key opinion leaders are evident ways to push journals to improve. It was just stated publicly by Dr Ed Livingston that they are listening. We may not agree 100% with Dr John, Dr Prasard and Dr Cifu, but that's exactly the point right?!. Particularly Dr Jonh, who I have been following for a while in the cardiology field, is someone I stop and listen to. I can agree with him or not, BUT BUT no doubt my ability to navigate medical literature improved thanks to him. And spaces like this allow us to exercise our scientific citizenship towards better practices. Thank you.
Yeah, the anti-journal position is a pseudo-radical one, sort of like the "defund the police" ideology. It gets clickbait attention but then when people go to actually do anything about it -- crickets.
Actually, both of these positions have a ton of merit if taken from the right perspective (e.g., issues with publication go far beyond reviewers, it's more about the money -- issues with policing all follow the money as well, because people are unwilling to take the time and effort to do something other than call the cops every time they have a problem, for instance, build a strong local community instead).
The issue is that there's nothing stronger in place and so everyone just ends up doing the default thing -- and the most important part (which is why science has so many problems generally anyway): the way funding is set up only reifies the structures that exist and don't provide support for better publishing.
I’m a retired internist/hospitalist/academic and appreciate your Substack blogs. Those of us who were doing exclusively clinical work have held doubts about legacy journals and especially since Dr Angell shared her opinions several years ago. You are doing good work. Please keep on the path you’ve created.
I’m very grateful for to the independent thinkers getting information to people like me trying to figure out what the hell happened to us.
I’ve never been invested in the medical community. If not for brave independent people like you I’d still be sick and crippled up.
Back in 2021 I went to see a doctor about crippling shoulder pain, hip pain, and debilitating fatigue. He told me I was suffering from old age and that it was something I was gonna have to live with. Gave me a steroid shot, and some pills, sent me home.
That was the beginning of me trying to fix myself. However, I stayed depressed, and felt hopeless for months after that visit.
8 months later I decided to get a second opinion. That doctor ran all kinds of test. Test showed I had two tick borne illnesses and one I had had for over a year. Doc said this was the cause of my fatigue. Possibly some of my pain. It took eight months of antibiotics to rid myself of the illnesses. That doctor has since died.
Meanwhile, I went on a ketogenic diet. Decided to get the weight off. And I did. Went from 196 pounds to 110 pounds. But, I still had pain in my shoulders. I figured out that what I had and the doctor missed was frozen shoulder. First one, and six months later the other one.
51 days ago my IBS flared up real bad for the second time this year after being in remission for 25 years.
It was the damn fiber (a bulking agent) the doctors kept telling I needed. I read Fiber Menace and everything clicked. It was the damn fiber and it was expanding and tearing me up. Literally tearing up my colon and rectum.
I discovered DMSO around the same time. I diluted and used it, and decided to go on a carnivore diet.
I’m happy to report that IBS is in remission and I no longer suffer from constipation, shoulder pain, or anything else. I have my health back. I can clean my house and go for long walks. I’m happy and healthy at 61 years old. What I was going through was not normal.
I remain unjabbed. And honestly, the people that got jabbed still have an attitude. And many are still doing it. I have a dear friend that is very I’ll. He know how I feel. This last jab he apologized to me for getting it, but said he didn’t care as he couldn’t take the chance. He’s in the hospital as I type. It breaks my heart because it didn’t have to be this way.
People are going to have to step up and do the hard work and heal themselves through nutrition. Get off the pills, and stay the hell away from the medical community. Your life literally depends on doing this. Use the medical community to your advantage. Get the test done, take their pills and throw them in the trash. Doctors are not in it to do good. Most are in it for the money money money. Even the online influencers. They want your money money money.
At this point I’m so tired of having to weed through the internet for medical information as most everything you find is a lie. Take your statins. Why?
Praying for healing and self discovery for my friends and family, but they are not interested. They want their sugar, they want their sodas, and they want their doctors to make it all better and all I can do is sit back and watch the horror show.
The propaganda works. It works very well.
John Ioannidis has been saying this out loud for 2 decades. His 2005 essay "Why Most Published Research Findings Are False" (https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124) was the most-accessed article in the history of Public Library of Science (PLOS), with more than three million views.
After 4 decades of stumping the pulpit on Evidence-based Medicine, I have retired with a deep sense of loss and regret. Mark Twain's "Lies, damned lies and statistics" sums up the vast majority of medical research and publishing.
Academic publishing is controlled by a small cabal of for-profit publishing houses which make obscene profits - much larger than Big Pharma can dream of. So called "peer review" panels are mostly old boys' clubs which are only too keen to pander to the interests of the publishers and industry-sponsored research.
Ventures like PLoS have been fighting the good fight but remain largely ineffective.
The internet, as a medium of open public discourse, offered great promise but has been swamped by bad actors and is currently a cesspool pool of misinformation, disinformation and lies.
I am deeply appreciative of your efforts to fight the good fight. We can't give up. The present scenario reminds me of the first Star Wars episode where the good guys are banished to a remote corner of the galaxy. May the Force be with you.
So important for sites like this to thrive so we can return to medical research and discussions that are based in honest discussions, different opinions and a reminder of where we need to be in medicine and research. I look forward to supporting these sites for a long time.
Thanks for changing your hobby. It’s making a difference!
Thanks for your continued work, and that of your collaborators.
I agree, the vast majority of what is published in the “big” journals is pointless stuff that is of zero clinical relevance (and nowhere near ready for medical prime-time). And this is no doubt even worse at journals with lesser banners. It is little more than an exercise in padding CV’s, and a venue for marketing opportunities.
What has changed in the last 10 years is the development of places for informed medical skeptics to discover they are not alone. I used to wonder “am I the only one who thinks this?” about a new trial, new drug, or new guideline recommendation. That is no longer the case. And that is a happy and welcome development.
Keep up the great work. And happy new year.
Wise and sharp analysis!
I wish you the same and thanks again for your posts!
I have learned more from Stop and Think, Sensible Medicine and Cardiology Trials than från the journals I have been subscribing. Even most editorials are soft and many times biased.
I am a cardiologist and I work as a clinician and as a researcher in Brasilia, Brazil. As a PhD student a few years ago I tried to write a comment to the editors about a paper published in a high-impact factor journal. The authors were prolific professors and the paper was very well written. However, the subject was completely out of their area of expertise. It was exactly related to my field of research and I disagreed with almost all of their arguments. At that time, the letter should be submitted within a 7-day window and be revised by the staff. So I followed the rules as requested, but I never knew if it was even read... Of course, I was frustrated and nothing could be done but move on and "forget it" as I heard.
My point: social media and spaces like this are absolutely necessary for "scientific citizenship." In other words, independent forums to debate and learn from controversial and opposite points of view are the cornerstone of evolution, at least if we consider that skepticism represents a growth mindset. The publishing world is not democratic, not inclusive, full of biased decisions, and yes, full of nonsense. The exercise of being critical is the way we can protect our patients from non-intentional consequences.
I am not sure if legacy journals are dying. Honestly, I hope not! But definitely, editors must rethink their role and ensure they can be our safe harbor. Spaces like this and the good use of social media by key opinion leaders are evident ways to push journals to improve. It was just stated publicly by Dr Ed Livingston that they are listening. We may not agree 100% with Dr John, Dr Prasard and Dr Cifu, but that's exactly the point right?!. Particularly Dr Jonh, who I have been following for a while in the cardiology field, is someone I stop and listen to. I can agree with him or not, BUT BUT no doubt my ability to navigate medical literature improved thanks to him. And spaces like this allow us to exercise our scientific citizenship towards better practices. Thank you.
Yeah, the anti-journal position is a pseudo-radical one, sort of like the "defund the police" ideology. It gets clickbait attention but then when people go to actually do anything about it -- crickets.
Actually, both of these positions have a ton of merit if taken from the right perspective (e.g., issues with publication go far beyond reviewers, it's more about the money -- issues with policing all follow the money as well, because people are unwilling to take the time and effort to do something other than call the cops every time they have a problem, for instance, build a strong local community instead).
The issue is that there's nothing stronger in place and so everyone just ends up doing the default thing -- and the most important part (which is why science has so many problems generally anyway): the way funding is set up only reifies the structures that exist and don't provide support for better publishing.