JASMA

If you have ever wondered who keeps a skeptical eye on that “miracle detox” in your
social media feed, you have already brushed up against the kind of work Kimball C.
Atwood IV, MD helped pioneer. An anesthesiologist by training and a sharp scientific
critic by temperament, Atwood spent much of his career asking an unfashionable but
essential question: Does this medical claim actually make sense in light of what
we already know about biology?

As an emeritus editor at Science-Based Medicine, Atwood focused on
separating plausible medical innovation from wishful thinking dressed up in a lab
coat. His essays, policy work, and teaching pushed medicine to be more honest about
the limits of evidence, more rigorous about basic science, and far less credulous
about “alternative” treatments that promised the world but rarely delivered.

Who Is Kimball C. Atwood IV, MD?

Clinical roots in mainstream medicine

Kimball C. Atwood IV trained and practiced squarely within mainstream academic
medicine. He practiced anesthesiology in the Boston area, working at hospitals such
as Newton–Wellesley, and he is also board-certified in internal medicine. For many
years he served as an Assistant Clinical Professor at Tufts University School of
Medicine, mentoring residents and medical students on the nuts and bolts of patient
care, perioperative medicine, and clinical reasoning.

That combination of internal medicine and anesthesiology is not just a résumé
flourish. It put Atwood in a useful position to understand both long-term disease
management and the acute physiology of patients in the operating room. When a
patient is asleep on the table and their blood pressure is drifting down, there is
no time for magical thinking. You need physiology, pharmacology, and data you can
trust. That everyday reality strongly shaped how he later thought about
science-based medicine.

From operating room to public advocate for science

During the 1990s and early 2000s, hospitals and medical schools saw a surge of
interest in complementary and alternative medicine (CAM). Clinics
for acupuncture, homeopathy, “integrative” nutrition, and naturopathy began popping
up under the banners of world-class universities and academic medical centers.
Government agencies funded research centers to explore these therapies, and
marketing materials often sounded more like endorsements than investigations.

Atwood watched this shift with growing alarm. From his perspective, medicine was
flirting with giving fringe practices a free pass just because they were popular,
traditional, or wrapped in calming spa aesthetics. Instead of asking,
“Is this plausible? Does it fit biology? Are the data reproducible?”,
institutions were too often asking, “Will this make patients feel like we’re
listening?” His response was not to dismiss patients’ experiences, but to insist
that compassion should never require abandoning scientific standards.

What Is Science-Based Medicine?

Beyond evidence-based medicine

To understand Atwood’s importance, you have to understand the idea of
Science-Based Medicine (SBM). Most clinicians today are familiar
with Evidence-Based Medicine (EBM), which emphasizes using the
best available clinical studies to guide decisions. That sounds perfectly sensible
and it mostly is. But Atwood and his colleagues pointed out a hidden trap:
evidence does not exist in a vacuum.

Imagine you test a claim that wearing blue socks cures diabetes. If you run enough
small, poorly controlled studies, statistical noise will eventually spit out a
“positive” result. Taken at face value, that result could be cataloged as
“evidence.” EBM, if applied mechanically, might treat it like a legitimate signal.
SBM adds a crucial extra step: ask whether the claim is remotely plausible
given everything else we know about physiology, chemistry, and disease.

Atwood argued that treatments like homeopathy or certain naturopathic regimens fail
this basic plausibility test. Homeopathic remedies are often diluted beyond the
point where any molecules of the original substance remain. From a chemistry
standpoint, there is simply nothing there to act on the body. When prior
probability is that low, even a handful of “positive” clinical trials are more
likely to be flukes, biases, or methodological errors than proof of a real effect.

Why prior probability matters

One of Atwood’s recurring themes is the importance of prior
probabilitythe idea that claims should be judged in light of existing
knowledge. If someone proposes a slightly better blood pressure medication, that’s
plausible; we understand the biology, and small incremental improvements happen all
the time. If someone claims that adjusting your spine cures asthma, that clashes
with everything we know about airway inflammation and immunology. In that case,
the burden of proof must be extraordinarily high.

This is not just an abstract statistical point. Prior probability tells clinicians
where to look, how skeptical to be, and how much weight to give surprising results.
Atwood’s work helped popularize the idea that truly science-based medicine must
integrate basic science, clinical evidence, and rigorous reasoning about mechanism,
not just count up clinical trials and call it a day.

Critiquing Complementary and Alternative Medicine

Naturopathy under the microscope

One of Atwood’s most widely discussed contributions is his critique of
naturopathy. Naturopathy presents itself as “natural” or
“holistic” medicine, but Atwood examined its actual training, licensing standards,
and recommended treatments. He found a patchwork of herbal remedies, homeopathic
products, detoxes, and diagnostic methods that ranged from unproven to flatly
implausible.

In a widely read article on naturopathy, Atwood argued that the profession had not
demonstrated that its core therapeutic toolkit worked better than conventional
careor even, in many cases, better than doing nothing. He pointed out that
naturopathic doctrine often incorporates vitalism (the idea of a special “life
force”) and other concepts that conflict with modern biology. Proponents frequently
highlighted isolated positive trials while ignoring the larger body of negative or
inconclusive data.

Atwood’s criticism was not that herbs are useless or that lifestyle changes are
unimportant. Quite the opposite: he emphasized that many “natural” interventions
are already part of good mainstream carelike exercise, diet, smoking cessation,
and stress management. The problem, in his view, was building an entire profession
around a mixture of reasonable advice and scientifically unsupported therapies, and
then asking legislatures and insurers to treat it as equivalent to medicine.

Hydrogen peroxide infusions and other dubious therapies

Atwood also examined specific CAM practices, such as intravenous hydrogen peroxide
infusions marketed for conditions ranging from “immune boosting” to chronic
infections. From a pharmacologic standpoint, flooding the bloodstream with a strong
oxidizing agent is a terrible idea: it risks damaging blood vessels and tissues
without any clear mechanism for benefit. Yet such infusions were promoted with
impressive-sounding but misleading scientific jargon.

By tracing the history of these treatments and dissecting the underlying studies,
Atwood showed how a few poorly designed or misinterpreted experiments could be
recycled into glossy marketing copy. His work offered clinicians and patients a
template for evaluating other “cutting-edge” alternative therapies: follow the
chain of evidence back to its source, and see whether the basic science and study
quality actually support the hype.

CAM education in medical schools

Another arena where Atwood made waves was in critiquing how CAM is taught in
medical schools. As universities embraced “integrative medicine” curricula, many
courses were designed around promoting CAM practices rather than critically
examining them. Students might hear enthusiastic guest lectures from alternative
practitioners, with little attention paid to the quality of the evidence or the
internal contradictions between different CAM systems.

Atwood argued that this was a wasted opportunity. Instead of using CAM as a way to
teach scientific skepticism, research methods, history of medical progress, and
professional ethics, some courses merely added gloss to implausible treatments. He
pushed for curricula that would explain why certain therapies are
implausible, what good evidence actually looks like, and how to communicate that
honestly to patients who are understandably curious about “natural” options.

Writing, Teaching, and Policy Work

Science-Based Medicine and skeptical publishing

Atwood’s most public-facing work came through his role at the blog
Science-Based Medicine. There, alongside colleagues such as Steven
Novella, David Gorski, Harriet Hall, and others, he wrote long-form articles that
took apart medical claims with a mixture of dry humor and relentless detail.
Whether he was dissecting naturopathic licensing, a vitamin megadose fad, or a new
“integrative” clinic at a prestigious university, the format was similar:
describe the claim clearly, dig into the evidence, explain why plausibility
matters, and conclude with what is actually known versus what is wishful thinking.

Outside of SBM, Atwood contributed to skeptical and medical publications that
focused on pseudoscience in health care. His writing style combined a clinician’s
practicality with an academic’s love of careful argument. He took ideas seriously,
but he was not above a well-placed wry aside about magical thinking, vague
marketing buzzwords, or the tendency of some practitioners to reinvent old
fallacies with new branding.

Professional societies and public policy

Atwood’s work was not limited to the printed page. He served as a founding fellow
of organizations devoted to promoting science in medicine and sat on commissions
that advised state regulators about licensing for alternative practitioners. In
Massachusetts, for example, he helped review proposals to license naturopaths and
contributed to reports highlighting the lack of solid evidence behind many
naturopathic treatments.

This policy work mattered because licensing sends a powerful signal to the public.
When a state licenses a health profession, patients reasonably assume that the
state has vetted its underlying science and standards, not just its political
popularity. Atwood believed that granting naturopaths the same kind of legal
recognition as physicians, despite major gaps in evidence and training, risked
confusing patients and diluting the meaning of science-based care.

Why Kimball C. Atwood’s Work Still Matters

In an era of wellness influencers, algorithm-driven health misinformation, and
viral “miracle cures,” the kind of thinking Atwood championed is more important
than ever. The tension he highlighted has not gone away: patients want humane,
holistic care, and they often feel that mainstream medicine is rushed and
impersonal. Alternative medicine promises attention, hope, and agencybut it too
often delivers untested treatments, high out-of-pocket costs, and delayed
diagnosis.

Atwood’s science-based approach offers a better path. It says:

• Listen to patients carefully and treat them as whole people, not just lab
  values.
• Be honest about uncertainty and the limits of current treatments.
• Hold every claimconventional or alternativeto the same scientific standards
  of plausibility, evidence quality, and risk–benefit analysis.
• Teach critical thinking so that patients and clinicians alike can navigate an
  overwhelming health-information landscape.

That mix of compassion and rigor is the core of science-based medicine. Atwood’s
legacy is not just a set of articles about naturopathy or specific therapies; it is
a mindset that asks, with a raised eyebrow but an open mind, “How do we really
know this works?”

Experiences and Lessons from Science-Based Medicine in Practice

To see the impact of Atwood’s ideas, imagine a few everyday scenarios from modern
clinical practice.

A middle-aged patient arrives with chronic fatigue and joint aches. She has a stack
of printouts touting a detox protocol, high-dose vitamin injections, and a
“natural” thyroid booster bought online. The marketing promises restored energy,
balanced hormones, and a glowing review from someone who sounds remarkably like
her. Without a science-based approach, the clinician might shrug and say, “If it
makes you feel better, go ahead.” But an Atwood-style mindset asks tougher
questions: Is there a plausible mechanism? Are the doses safe? What do controlled
trials show? Is this going to delay a proper workup for autoimmune disease,
anemia, or depression?

In another clinic, a trainee is excited about an elective in integrative medicine.
The course description promises exposure to acupuncture, herbal blends, and
energy-based therapies. Instead of simply cheering or sneering, an instructor
influenced by Atwood’s work could turn the elective into a master class in
critical thinking. Students might review the evidence for acupuncture in specific
indications, dissect placebo effects, and discuss where patient expectations,
culture, and bedside manner intersect with biology. They would learn that it is
possible to respect patients’ beliefs while still insisting that treatments be
grounded in reality.

Hospital administrators face similar dilemmas. A wellness center offering IV
vitamin drips and “immune-boosting” ozone therapy looks like a potential new
revenue stream. The marketing department loves the spa-like vibe; the legal team
is nervous. A science-based review, in the spirit of Atwood, forces the institution
to ask: Are we offering something that actually helps patients, or are we renting
out our reputation to sell expensive placebo treatments? Will we be proud of this
decision in ten years, when more dataand perhaps more lawsuitshave accumulated?

Even outside the clinic, ordinary people encounter these questions every day.
Should you spend $300 on a DNA-based supplement plan that claims to “unlock your
genetic potential”? Should you trust the influencer who warns that standard cancer
treatments are “toxic” but offers a proprietary protocol of juices, supplements,
and vague talk of “cellular cleansing”? Atwood’s work encourages a practical,
down-to-earth response: look for independent evidence, consider whether the claim
matches what we know about biology, and be especially wary when someone is asking
for large amounts of money or urging you to abandon proven care.

One of the most hopeful lessons from science-based medicine is that skepticism is
not cynicism. Atwood did not argue that innovation is impossible or that new ideas
are unwelcome. On the contrary, he embraced medical advancesfrom anesthesia
monitoring to modern intensive carethat were built on solid science and
careful trials. What he resisted were shortcuts: skipping plausibility, skipping
rigorous testing, or wrapping old-fashioned quackery in new branding and then
calling it “integrative.”

For clinicians, educators, and patients alike, Atwood’s career serves as a
reminder that good medicine is both humble and demanding. Humble, because we admit
what we do not yet know. Demanding, because we refuse to accept comforting stories
in place of hard-won evidence. That balanceclear-eyed and compassionateis what
keeps science-based medicine on course, even when the latest wellness trend tries
to pull it off into the weeds.