Debate in Medicine Is Good for Everyone

Though it can appear confusing to the public, scientific debate is critical to medical progress.

U.S. News & World Report

AS I WRITE THIS, MORE than a year into the COVID-19 pandemic that has rocked our world, you might be sick of hearing about the “unprecedented time” in which we’re living. Perhaps you’re fatigued by the multitude of “experts” who may not always agree on how the virus mutates, spreads, is mitigated or how we should ultimately conquer it.

The truth is, whether we like it or not, each of us is living inside an active, real-time science experiment when it comes to COVID-19. It’s a virus that was utterly unknown to us, not much longer than a year ago.[ 

When we watch scientists or health experts on the news discuss their viewpoints about the pandemic, we may observe that they don’t always agree with each other. For a profoundly concerned public, that disagreement may be frustrating to watch. However, it isn’t new or unique to COVID-19. To be honest, debate among scientists and medical experts is precisely how the targeted and most effective therapies and treatments develop. Throughout my career, I have either been involved in or moderated dozens of medical debates. Medical debate, when done correctly, is healthy and thoroughly necessary for scientific progress. The public is just unaccustomed to a live stream of “how the sausage is made,” so to speak.

One way to look at the concept of debate in medicine is to consider the scientific method. The steps of this method are rooted in how we scientifically observe and answer questions about our world. This is something most of us began to learn and apply in elementary school. Beyond the initial inquiry and research, a scientist must formulate a hypothesis. A hypothesis is simply an educated guess (based on research) about how something works. At that point, the scientist must test the theory via experiment. That experiment is then analyzed, and conclusions are drawn about it.

To simplify the scientific process, consider the widely accepted fact that the planet Earth is round. You know it, I know it and science has repeatedly proven it for centuries. But at one point in time, no one knew the Earth’s roundness to be unequivocally true. Someone or multiple people (in this example, Greek astronomers) had to believe it, hypothesize on it, then prove it. That’s the scientific method at work; we just have the benefit of looking at it through a rearview mirror, in history books.[ 

Our scientific approach to the COVID-19 pandemic, or whatever currently unknown phenomenon comes after it, is no different than the way countless other scientific and medical facts have been proven for millennia – through rigorous testing and, yes, debate. For all the people who believed the Earth to be round, there were likely plenty of others who disagreed. That’s what makes the scientific method, and debate as a tool within it, so exceptional. It requires reasoning, study and testing.

Concerning medical debate specific to my spine surgery field, I have seen some of the most innovative and effective treatments for patients be born from a healthy debate among experts. For example, we’re not even 50 years into the notion that minimally invasive spine surgery is a safer, more effective alternative for patients than the traditional “open” way that spine surgery was historically performed. But for scientific debate to be genuinely useful in advancing medicine, it requires real experts.

A word of caution, especially for a never-before seen or studied virus, is the reliance on people who have opinions but aren’t experts. For instance, I wouldn’t debate the specifics of spinal surgery methods with someone who wasn’t a qualified physician or researcher. The public should beware of those who have ideas on how to proceed regarding the pandemic but don’t have appropriate medical or scientific credentials to back their opinions.[ 

So, the next time you see experts debating how to overcome COVID-19 or any other scientific or medical phenomenon, don’t despair. If you can quickly identify that these are indeed experts (infectious disease specialists, vaccine scientists, etc.), try to take some comfort in knowing that the scientific method is alive and well and working. We will get there, I promise.

Neel Anand MD