Are medical journals balanced?

Can we agree: they should try just a little?

On Sensible Medicine, we publish disagreement. Adam and I have disagreed on many issues, including masking and whether doctors should disclose their mental health ailments. We published essays by people supportive of and critical of Robert Kennedy Jr. When I praised the indirect cuts to the NIH, we published an essay defending those (excessive ;) ) indirects. We even published an administrator’s response to my popular essay in defense of medical personnel who directly care for patients. You hear that: we even published a pro-admin essay!

https://www.sensible-med.com/p/blood-shit-piss-and-pus

Increasingly, I feel that we are alone in this endeavor. Medical journals cater to a fraction of academic researchers, and they don't allow a word in edgewise. Here are some examples. The most recent NEJM.

From the same journal that brought you the great debate: should pediatricians tell parents not to let their kids play football comes two tablespoons of equity. Just swallow, ok.

What am I to think with a selection of articles like this? Many Americans loathe culture competency training. They think (correctly) it has no evidence it improved outcomes for any patient population. Many americans believe in equal opportunity but don't believe in equity in all outcomes. Some Americans think doctors should not be getting a climate justice curriculum until every one can read a clinical trial that might affect their practice with the skill of John Mandrola. That day has yet to arrive.

If you think I am picking on NEJM. Some more examples.

The article laments that more medical organizations don't comment on the middle east. Hmmm, would the crisis stop if 50% issued a statement? 75%? What about the fact that Americans disagree on the solution.

No statement will please everyone except the vague: can't we all just get along. Also: are they just trying to help Trump generate a list of organizations that need their federal funds frozen?

Remember, Nature— a British journal! —endorsed Joe Biden for president. (And also criticized foreign interference in elections. J/k). Here is their newest selection

Look, I am not saying don't publish these articles. I am saying: could you at least publish even one article that says, for instance:

1 Men are better at sports than women for biologic reasons

2 Medical societies should not comment on Gaza-Israel. It serves no purpose besides loss of trust.

3 Scientists did a bunch of bad things during the pandemic and people are rightly pissed off, and some cuts and firings and accountability is desirable. And we brought this on our own heads.

4 Science is largely irreproducible or useless or both. We can cut a lot of grants, especially those with DEI in the title, and nothing bad will happen.

5 American football is important to Americans maybe the pediatricians who told us to mask toddlers shouldn't lecture us about what a 12 year old should do. (PS. NFL data informs kid data like drinking 30 drinks a day informs drinking 1).

6 Bringing merit back to medicine: ending the quest for equity, by Norman Wang MD, newly reinstated EP director.

7 Actually there are things about vaccines that need better study. And, why can't we delay hep b till age 6, for e.g., if the mother is hep B negative.

8 There is no proof tallow is worse than seed oil or vice versa, but let's agree the fry tastes better in tallow and that is why Anthony Bourdain didn't cook in safflower seed oil.

The list goes on and on. Again, I am not saying don't publish the woke, left wing editorials,.I am just asking why they cannot, even occasionally, publish at least one center right editorial.

Shouldn't journals at least aspire to air all the views held by doctors? Shouldn't they at least try to meet Americans where they are? Could they be at least 10% balanced. More Atlanta and less San Francisco.

In the meantime, we will continue to do what we do on Sensible Medicine. I hope you agree that we are doing something invaluable and become a supporter. And if someone wants to disagree with me and write an essay: Why Medicine Is not yet Woke Enough: How the NEJM should embrace marxism and every doctor who disagrees should be cancelled. We will be happy to consider it. Just, please, one thing we can all agree on: keep it under 800 words.