Informed criticism

Issue: BCMJ, vol. 43, No. 2, March 2001, Page 64 Editorials

I read an article in the Medical Post recently which is where, along with the BCMJ, I get most of my continuing education these days. In it was an analogy I use when referring to the frustration I often experience as a physician today. When I fly in an aircraft I trust that the pilot has been properly trained and is in full control. I wouldn’t dream of popping my head into the cockpit demanding to see his credentials or suggesting that he should lift his undercarriage earlier and would he mind dipping his wing as we fly over Burnaby. We must be the only profession other than judges where our actions and decisions are the subject of so much comment and ill-informed criticism.

Many patients today are better informed than ever before thanks to the Internet, but the phrase "a little knowledge is a dangerous thing" was never more apt. A recent series of articles in the Province entitled "Drugging Our Children" illustrates the point. The journalist had previously lambasted the medical profession on Ritalin prescribing—conclusions subsequently refuted by a College of Physicians and Surgeons study. This time the attack was on a much broader front and embraced the entire spectrum of pediatric psychiatric prescribing.

The tone was clearly biased against drug management, against the medical profession, and further stigmatized psychiatric treatment and mental illness. There was no corresponding attack on drugs used for arthritis, diabetes, leukemia, etc., and only lip service was paid to the views of experts in the field. The writer has no qualifications in the subject, and yet her opinions were given front page coverage for several days.

The practice of medicine grows more difficult by the day, and the rewards continue to diminish. We should not be immune to criticism, but it should come from an informed source with the appropriate training. Medicine is difficult enough without having to justify every decision against ignorant and prejudiced attack.

Many of my age group have seen the golden years of Canadian medicine when we had control of the quality of our work and the resources to practise at the highest standard without being undermined by government and media. Contrary to public perception we are not rich, but have prepared for the future, and it would take very little to push us over the edge into the green fields of early retirement; the consequences for medical manpower in the province would be significant. Just try me.


Anthony F. Shearer, MB. Informed criticism. BCMJ, Vol. 43, No. 2, March, 2001, Page(s) 64 - Editorials.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply