David SackettBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2639 (Published 14 May 2015) Cite this as: BMJ 2015;350:h2639
- Richard Smith, London, UK
David Lawrence Sackett is widely regarded as “the father of evidence based medicine,” which is arguably the most important movement in medicine in the past 25 years. But he is perhaps most appreciated by doctors for repeating his residency in medicine some 20 years after first training because, although a professor in the medical school, he “wasn’t a good enough doctor.” This was an act of great courage and shows how Sackett, although at one time a professor in Oxford, had no pomposity whatsoever. Of Oxford he said, “They have 20 ways of saying ‘interesting,’ all of them negative.”
The third son of a bibliophile mother and artist-designer father, Sackett grew up in a suburb of Chicago. He remembered his large Victorian house as filled with love, neighbourhood kids, border collies, bagpipe and classical music, and books for every age and interest. He lived in such houses all his life and was always a voracious reader.
After completing his medical training at the University of Illinois, Sackett was in 1962 drafted into the US Public Health Service as a result of the Cuban missile crisis. In Buffalo, New York, he met epidemiologists, was diverted from his career in bench science, and became interested in how the methods of epidemiology could be applied to his “first love,” clinical medicine. He called this combination “clinical epidemiology,” a term that had been used in the 1930s, only then it aimed to pull physicians away from individual patients while Sackett wanted them to go in the opposite direction. In 1963 he read a paper by Alvan Feinstein, a clinician and researcher at Yale, on boolean algebra and clinical taxonomy and wrote him a “fan letter.” Feinstein then became a mentor for Sackett.
Another mentor for Sackett was Walter Holland, professor …