During his address October 26, 2017 at the NASS Annual Meeting in Orlando, President F. Todd Wetzel, MD, told
attendees that spine care providers must get back to using
effective critical thinking skills if they are to offer the best
care to their patients.
To a standing-room-only crowd, Dr. Wetzel said it’s easy
to abandon critical thinking and rely on opinions from
mentors or other respected authorities. It’s also easy to
become confused by the large, and ever growing, volume
of scientific literature—leaving physicians without a clear
The complexity and ongoing growth of data can make it
difficult for clinicians to offer the best possible care, he said,
because it becomes daunting to digest the evidence and
determine what’s true from what’s false.
Difficult? Yes. Impossible? Not so, says Dr. Wetzel.
During his address, Dr. Wetzel pulled from his love of
paleontology and evolutionary biology to address several
questions aimed at getting the audience to think critically.
Against the framework of some evolutionary human biology,
he discussed the question of who humans are and why they
have low back pain. He then asked why the profession hasn’t
been able to figure out how to effectively treat low back pain.
“With all this technology, with all these systems we have
for analysis, why haven’t we figured out how to treat it?” he
asked. “I would submit to you that it’s because we’ve moved
away from the scientific method.”
Finally, he asked, if given the current diagnosis and
treatment paradigms, can the profession develop a rational
strategy to analyze data and create a sound plan? The key to
this, Dr. Wetzel said, is critical thinking, so he took the audi-
ence through some examples of fallacies in scientific studies
and offered tools for examining literature logically.
“We need to be able to access and filter information to
determine how valuable it is to us as spine care providers,”
he said. “Most of us with scientific backgrounds think logi-
cally, but when reading huge volumes of literature, it’s easy
to get confused. You can read something well-constructed
that seems to make sense, but still have a nagging suspicion
that something is wrong.”
To help clinicians sniff out what doesn’t add up, Dr. Wet-
zel reviewed both formal and informal principals of logic
using examples from medicine to highlight logical fallacies.
Concluding his address, Dr. Wetzel thanked the NASS
membership and staff for the opportunity to serve as president of the society.
“This has been a fantastic year—making friends and acquaintances with colleagues internationally, working with
an incredible group of people at NASS, an incredible membership and incredible organization. I really can’t overstate
the honor this had been,” said Dr. Wetzel.
“I’d like to thank every member of the Society for
wanting to do it a little bit better, for wanting to be well-informed, for wanting to look at it from the point of view of
a multidisciplinary society. It has been an honor that will
never be equaled and a privilege that will never be surpassed,” he said.
Dr. Wetzel’s full address is published in the January
2018 issue of The Spine Journal and available at www.
thespinejournalonline.com. His address is also available as
part of NASS’ OnDemand proceedings at www.spine.org/
presentations, login and password required.
For indepth coverage of the annual meeting, visit the
NASS 2017 Daily News at: https://www.nassdailynews.org/
32nd Annual Meeting Presidential Address
“I would ask everyone here to choose to think and act
critically... We really do need to make the choice now.”
F. Todd Wetzel, MD
NASS President, 2016-2017