WELCOME to the penultimate edition of MJA InSight for 2016, a year that has been both unforgettable and very much in need of forgetting.

The deaths of a string of pop culture icons that included David Bowie, Alan Rickman, Glenn Frey, Harper Lee, Jon English, Ronnie Corbett, Prince, Muhammad Ali, Kenny “R2D2” Baker, Gene Wilder, Liesel von Trapp (Charmian Carr), Arnold Palmer, Leonard Cohen and Mrs Brady, for crying out loud, turned 2016 into a year for the baby boomers among us to say goodbye to mighty chunks of our misspent youth.

But, as Jane McCredie pointed out last week, we are now living in a “post-truth” world.

If Brexit and the election of Donald Trump to the bully pulpit of the US Presidency have taught us anything, it is that getting facts, logic, evidence and, in short, truth, out into the universe where patients, parents and policy-makers can both find it and understand it, is more important, and more difficult, than ever.

Anyone with a smartphone, an internet connection and half a brain can tune into a world of news. So much news in fact, that we filter and sort and gatekeep according, usually, to our own opinions and world views.

People seem to live in an echo chamber, never hearing opposing views, having their own prejudices and misinformation confirmed and bounced back at them, ever louder and into infinity.

What does this mean for evidence-based medicine?

It will come as no surprise to you, gentle reader, that the top 10 most popular articles published by MJA InSight this year include a swathe of topics about which public opinion can be most often shaped by celebrity chefs, pseudoscientists, lobbyists and those looking to make a quick buck from the latest trend in potions and poultices.

The Paleo diet, antivaccination, chiropractors, the Health Australia Party, diet supplements, complementary medicines – these are all topics that can be hijacked by people defensive about their own beliefs and, therefore, willing to shout down any suggestion of an evidence-based contrary view.

A case in point is our most clicked-on article of 2016 – Slow and steady on medicinal cannabis. Here was a story that said nothing more controversial than “let’s not get ahead of ourselves without gathering some more data”. The accompanying poll was “bombed” by a large group of pro-cannabis advocates who rendered it pointless, so we closed it. The string of comments on the article tells a tale of how difficult it is to get a simple message through. And they’re just the publishable ones!

At MJA InSight, part of our brief is to kick-start debate via our opinion pieces, or “Views”, which are an opportunity for various experts, policy-makers and big thinkers to present their ideas and opinions – backed up by appropriate evidence, of course!

You may not always agree with those opinions, or the interpretation of the evidence, but the wonderful nature of online forums is that they allow for real-time responses via the comments section, or more considered rebuttals that can be published within a short timeframe.

Next Monday, for example, we will be publishing a View from prostate cancer specialists in response to Professor Ian Haines’ recent article, The scandal of prostate cancer management in Australia. Stay tuned.

All year long, I have had a small pink Post-it note attached to my computer monitor. It has just one word on it – persist. It’s a frustrating business, being an advocate for evidence, but it’s a task we all must continue to undertake, no matter how tin-eared the naysayers appear to be.

MJA InSight has thrived this year, I’m proud to say. Our website numbers are up by almost 28% on this time in 2015.

So, thank you to you, our readers, and also to those physicians, researchers, educators, policy wonks and leaders who have contributed their opinions and expertise to our pages. Particular thanks must go to our regulars – Dr Evan Ackermann, Dr Will Cairns, Dr Ken Harvey, Dr Simon Hendel, Dr Sue Ieraci, Professor Erwin Loh, Professor Ian Maddocks, Jane McCredie, and Dr Joseph Ting. Champions, all.

Big thanks, too, to our five journalists – Sarah Colyer, Louise Goodwin, Nicole MacKee, Charlotte Mitchell and Caitlyn Wright – who have covered a staggering breadth of topics and issues this year, have hit every deadline and generally kept their editor calm and sane. And finally, big ups to our medical editor, Dr Zoe Silverstone and our proofreading team.

Enjoy next Monday’s final edition for 2016 – it’s a cracker. Make the most of whatever summer holidays are coming to you, and may the celebrations be happy, safe and laughter-filled. MJA InSight will be back on Monday 16 January 2017, to coincide with the first issue of the MJA, so we will see you then with more news, views, evidence and debate!

MJA InSight’s 2016 top 10:

  1. News: Slow and steady on medicinal cannabis, by Nicole MacKee
  2. News: GPs best to fight Paleo “celebrity hysteria”, by Cate Swannell
  3. Views: The scandal of prostate cancer management in Australia, by Professor Ian Haines
  4. Views: Time for government to tackle anti-vaxxers, by Dr Simon Hendel
  5. News: Female doctors’ suicide rate tops non-doctors, by Louise Goodwin
  6. News: Chiros and kids: time to make a stand, by Cate Swannell
  7. Views: Health Australia Party: buyer beware, by Dr Simon Hendel
  8. News: More to osteoarthritis than overloaded joints, by Cate Swannell
  9. News: Talimogene “first ever melanoma vaccine”, by Charlotte Mitchell
  10. Views: Homebirth in Australia: eminence- vs evidence-based care, by Professor Euan Wallace and Dr Miranda Davies-Tuck

Cate Swannell is the editor of MJA InSight, and is the news and online editor for the MJA. She is a journalist with 29 years’ experience.


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One thought on “Convincing the doubters: persist, persist, persist

  1. Leviathan says:

    The explosion of informal online publishing, from social media to blog sites to fake news sites, exposes the entire population to enormous amounts of unfiltered information. Little wonder the undereducated public (and even a proportion of the supposedly educated) have been swayed by the quacks, the scammers, the generally unhinged and the “new religion” of science objection. If there is one good thing about this brave new world it will be the building of a strong culture of critical analysis beginning in primary schools and continuing upwards, as well as the strengthening of science education.
    Meanwhile, the war on quackery is being won gradually with sheer persistence. But that depends on the science trained health elite (the doctors) to show individual plus collective leadership. We must do that by very publicly examining every aspect of our own individual practice. We must stop being passive facilitators of fake “alt-med” treatments and not simply take the lazy path and not provide patients with accurate scientific education when confronted with an altmed believer. We must make the consumption of new health science findings more mandatory, despite the fact it is time consuming, through CPD structures. We must absolutely not cave in to populism ourselves, such as doctors doing acupuncture or dry needling, and Colleges need to show leadership in censuring and suspending colleagues who endanger patients in this way and indirectly undermine quality evidence based care required of the entire profession.

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