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November 25, 1983

Why Not Scientific Administration?

JAMA. 1983;250(20):2795. doi:10.1001/jama.1983.03340200029023

Physicians are practitioners of the art and science of medicine. Academic and practicing medical leaders and editors insist on the best possible data prior to drawing conclusions and taking actions. In those roles, we dogmatically adhere to the great desirability of prospective, randomized, double-blind clinical trials with numbers great enough to ensure statistical power. We use anonymous referees to exert true academic rigor and expert biostatisticians to critique the experimental design, validity of data, and conclusions prior to publishing any important scientific article. Clinicians in practice, researchers, teachers, house officers, and medical students teach, are taught, and live by such critical rigor of scientific method applicable to patient care decisions.

Then how is it that these same groups of people will tolerate the creation and application of laws, regulations, standards, and guidelines that have an immense impact on the practice of medicine when virtually no scientific method has been applied?