Respectful Insolence

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I am Locutus of Borg. Resistance is futile. Your life as it has been is over. From this time forward, you will service us.- Locutus of Borg.

Strength is irrelevant. Resistance is futile…Your culture will adapt to service ours.– The Borg.

I’m a bit depressed these days.

Maybe a better term for it would be pessimistic, as I’m not really depressed about the state of my life per se. More precisely, I’m becoming increasingly pessimistic about the state of science- and evidence-based medicine in this country. What brought this pessimism to the forefront was last Thursday’s post, which referenced a droll and spot-on post by Dr. Wallace Sampson asking why medical schools would associate with quackery, about how scientific medicine appears to have lost the linguistic high ground to unscientific and pseudoscientific nostrums going by the brilliantly Orwellian monikers of either “complementary and alternative medicine (CAM) or “integrative medicine” (IM). Pile on top of this the most recent of a series of posts by Dr. Atwood about how the mish-mash of a little valid herbal medicine mixed with a whole lot of woo (otherwise known as the “profession” of naturopathy) is pushing for–and achieving–greater legal legitimacy, and there is truly reason to wonder if the golden age of scientific medicine is over and we are now drifting towards a new Dark Age of pseudoscience. Perhaps I exaggerate, but, I fear, not that much.

Of course, I’ve written about this before on this very blog, including my (in)famous Academic Woo Aggregator, a list of medical schools that have embraced CAM, and my lament about a medical school that has even gone so far as to “integrate” so-called “integrative” medicine into every aspect of its curriculum from day one of the first year. These disheartening trends accompany and draw succor from the $120 million a year budget of that center of woo in the heart of the National Institutes of Health, the National Center for Complementary and Alternative Medicine, the equal amount of money coming yearly from, alas, the National Cancer Institute, and, of course, the financial clout of the Bravewell Collaborative.

No, unfortunately things are not looking good for science-based medicine in academia right now. I say this in particular because I just learned of a press release issued three weeks ago by Andrew Weil and his University of Arizona Program in Integrative Medicine that, as Emeril Lagasse would say, “Kicks it up a notch,” but not for the better. Indeed, it shows that the forces arrayed against scientific medicine are indeed kicking it up far more than just a notch.

The press release begins:

TUCSON, Ariz., June 12 AZ-UofA-CoMPIM-Award TUCSON, Ariz., June 12 /PRNewswire/ – The Arizona Board of Regents recently conferred Center of Excellence status on The University of Arizona College of Medicine Program in Integrative Medicine — a move that reaffirms the positive impact integrative medicine has had on health-care system transformation.

Now known as the Arizona Center for Integrative Medicine (AzCIM), the program underwent an intensive evaluation process and earned unanimous endorsements from UA health sciences program directors and college deans. The new designation formally recognizes the center’s achievements in the field over the past 14 years, and its status as the world leader in integrative medical education.

Founded in 1994 by internationally renowned author and integrative medicine pioneer Andrew Weil, MD, the Arizona Center for Integrative Medicine joins nine other Centers of Excellence at the UA College of Medicine.

“Having our work recognized in this way is among our greatest accomplishments to date,” Dr. Weil said. “The Center of Excellence designation formally recognizes us as an innovator in educating the next generation of physicians and health-care professionals. Our challenge now is to remain at the forefront of innovation so as to make integrative medicine available to everyone, regardless of economic or geographic limitation.”

Indeed it is one of Andrew Weil’s greatest accomplishments in pushing his not-so-unique blend of some science-based nutrition advice mixed with a whole lot of woo. Steven Novella once rightly referred to him as wanting to change the rules of scientific evidence supporting the efficacy (or lack of efficacy) of various medical interventions, and indeed he clearly does, favoring “uncontrolled clinical observations” over well-controlled, double-blind randomized trials:

But for all the other stuff, we don’t have time to do that, so we have to have other methods of estimating how things work. Now one of the attitudes that I run into in the research community that just drives me up the wall is people who dismiss what they call anecdotal evidence. And I have challenged some of these people in public to strike the word “anecdote” from the medical vocabulary.

I think it is a trivializing word. If you want to call this uncontrolled clinical observation, that’s fine with me. The fact is that the scientific method begins with raw observation. You notice something out there that catches your attention, that doesn’t fit your conceptions. You see it again. That gives you an idea that generates a hypothesis which you can then test. It is this kind of uncontrolled observation which is the raw material from which you get hypotheses to test in a formal manner. If you dismiss all that stuff, if you drop it into a mental wastebasket labeled “anecdote,” you cut yourself off from the raw material of science.

Of course, Dr. Weil is being disingenuous. Either that, or he’s totally obtuse. (Take your pick.) In science- and evidence-based medicine, anecdotes are indeed the raw material from which we as medical scientists derive hypotheses, and “anecdotes” are published all the time in the medical literature. They’re called “case reports.” We do not dismiss them out of hand just because they are “anecdotes.” When appropriate, we dismiss “anecdotes” because frequently they are “testimonials” and not controlled observations or because anecdotes themselves, even when the observations are controlled, are often deceiving, which is why further study in the form of more controlled trials is always necessary before science-based medicine will accept a claim. Anecdotes are not enough, but doctors like Dr. Weil want to give them far more weight in medical science, often (as Dr. Weil does) reducing their arguments to a tu quoque fallacy, as Dr. Weil does in characterizing research on St. John’s Wort and depression as “useless information.”

But I digress. However it is a relevant digression, because the real effect of the CAM movement is to downplay the importance of science in medicine and to elevate anecdotal evidence far above what its role should be. In this, CAM is moving medicine back to the days of Hahnemann and homeopathy. Indeed, in this it is not the outright quacks like Hulda Clark who are the biggest threat to science- and evidence-based medicine. Rather, it is physicians like Dr. Weil and Dr. David Katz, doctors who combine sound science-based recommendations with the unproven (or even with outright woo like homeopathy, as Dr. Katz advocates), mixing them together and blurring the lines so that even skeptics have a hard time telling where the science ends and the woo begins. Not only do they advocate a more “fluid concept of evidence,” apparently, but diluting science fluidly with woo.

They’re succeeding, too, in a way bigger than one “integrative” medicine program being recognized by its university as a so-called “center of excellence” (which makes me wonder just how low the University of Arizona’s standards are in that respect). The real significance of this press release is that it also amounts to another huge step made by Dr. Weil and his fellow ideologues in “integrating” non-scientific and non-evidence-based medicine into science- and evidence-based medicine and doing it–dare I say?–fluidly. It is the next logical step after the “integration” woo “seamlessly” into the medical school curriculum:

The Center of Excellence designation will enhance the center’s ability to court top-tier faculty and inspire a new era of program growth — led by the center’s most ambitious program to date: the Integrative Medicine in Residency (IMR). The center’s integrative medicine curriculum soon will be incorporated into standard three-year family medicine residency programs across the nation. Residents will learn to incorporate integrative medicine concepts into their practices, including patient-centered care techniques that facilitate lifestyle change.

Through funding raised from both public and private sources, an IMR pilot program will be launched in July at eight family medicine residency programs nationwide, including the UA; Beth Israel Medical Center, New York City; Carolinas Medical Center, Charlotte, N.C.; Maine Medical Center, Portland, Maine; Maine-Dartmouth, Augusta, Maine; University of Connecticut, Storrs, Conn.; Hennepin County Medical Center, Minneapolis, Minn.; and the University of Texas Medical Branch, Galveston.

“This will be the first program in the nation to create a required curriculum in integrative medicine for physicians during residency,” said Victoria Maizes, MD, executive director of the Arizona Center for Integrative Medicine. “Over the next 10 years, development of IMR into the national model for residency education is a major goal for the center. We will gradually move beyond primary care into subspecialty training.”

I can’t help but mention that clearly I need to find time to add each and every one of the above medical schools and academic medical centers into my Academic Woo Aggregator, clearly a project for the impending Fourth of July weekend. That aside, this accomplishment represents a quantum leap in the infiltration of CAM into academia. In one fell swoop, Dr. Weil has transformed CAM from a mere elective to a fully co-equal and mandatory element of the family medicine residency. True, it’s only eight residencies now in a pilot program. However, given the current attitude in this country and in medicine, it’s highly likely that this pilot program will be “successful” (successful for woo, a disaster for science-based medicine), in which case it will spread, and it is no longer unthinkable to visualize something like IMR insinuating itself into the national standards of the American Board of Family Medicine in a decade–or even less. Certainly it doesn’t help that Medicare and third party reimbursements have become so paltry for primary care doctors that woo suddenly becomes attractive as an “alternative” (or should I say “integrative”) additional source of income; that only makes resisting it more difficult.

If Dr. Weil succeeds, before too long every single new family practice physician will graduate from his or her residency program with a knowledge of CAM. This would not be a bad thing if it were truly a science- and evidence-based approach to CAM and a knowledge of what herbal remedies might interact with “conventional” pharmaceuticals. I’ve always thought that such education would be appropriate in medical school. The optimist in me would like to believe that that’s what would happen, but the realist in me knows that it’s not. The reason is obvious: The curriculum was designed by true believers, with nary a skeptic in sight. Given that, we can certainly expect that rigorous science is not going to be the order of the day in “integrating” these modalities into the residency training curriculum. Indeed, given the history of CAM programs in medical schools and academic medical centers thus far, where credulous promotion of quackery–yes, I say quackery–such as reiki, therapeutic touch, and even that quackery of quackeries, homeopathy, somehow manage to be “integrated” into science-based offerings with not a word of skepticism about the extreme (and I do mean extreme) lack of scientific plausibility and the preponderance of scientific studies demonstrating no greater efficacy for these modalities than placebo, I fear that when I visualize myself in the hospital 20 or 30 years being subjected to therapies parodied in this video, I may look back at the video as prophetic, not funny. Steve Novella once wondered whether a golden age of quackery and antiscience is upon us. My fear, though, is that 20 or 30 years from now, when the fruits of the current movement toward CAM will manifest themselves in the form of today’s woo-steeped medical trainees having reached leadership positions in medicine, both academic and private, will represent the true golden age of quackery. My fear is that we will look back upon these days in the first decade of the 21st century as beginning of the end of scientific medicine.

Unfortunately, the Brave(well) New World appears to be upon us. Science is irrelevant. Resistance is futile. From this time forward, medical culture will adapt to service CAM. Think I’m exaggerating? I guess we’ll find out. Still, no matter how powerful the forces of woo have become in academia, I think it’s still imperative that science-based physicians make a stand. I’m just hoping it doesn’t turn out like Battle of Wolf 359.

Comments

  1. #1 wintermute
    June 30, 2008

    The Federation was victorious at Wolf 359. It was a hideously expensive victory, but hey won nonetheless.

  2. #2 Ronald
    June 30, 2008

    I think one of the reasons this is because of some inherent human trait to favour “the underdog” and that CAM always presents itself as ‘the little guy’ against big pharma.
    The uninformed masses do not want to read about complicated protocols and double blind trials, they want snake oil.
    Furthermore, I once struck up a conversation with someone who claimed to be cured by ‘bach-flowers’ and now was an avid supporter of this ‘therapy’. I tried to find out what made her tick.And then suddenly I realised why people who claim to be cured via CAM are such fervent supporters and proselytisers:
    The simple logic is that if they admit that CAM is a sham, they should also admit to themselves they have been shamming their illness.
    Even if their affliction may have been ‘real’ in some sort of strange logic an unreal cure makes the illness unreal as well. So these people are in their minds between a rock and a hard place, and as with many people who have a mental affliction they try to convert the rest of the world to their point of view. (and succeeding nicely)

  3. #3 Chris Granade
    June 30, 2008

    It seems to me that a lot of the public motivation for this has come from a deep distrust of the pharmaceutical companies, and by extension, of doctors. That said, if CAM– I mean quackary– suceeds in uprooting science-based medicine sufficiently that it takes on the responsibilities of real medicine in the public’s eyes, then it will inevitably fail, as it produces no actual results!

  4. #4 cyperus_papyrus
    June 30, 2008

    I was educated as a scientist, and I do my best to avoid woo. But I can understand why woo appeals to people. I have two medical problems that my doctor says nothing can be done about. They are not life-threatening problems, but they cause me discomfort and affect my quality of life. It’s awfully disappointing to try to get help with them from the medical establishment and be told there is no help. As far as I can tell, there is no research being done into solutions for my problems either.

    Certainly research costs money. But don’t expect the average person to understand or care about what it takes to come up with evidence-based treatments when they are desperate to find help.

    For many people, science and medicine come across as very unfriendly. Whereas the woo peddlers can seem more sympathetic to their pain.

    Practitioners of evidence-based medicine need to remember that they are treating human beings with feelings. Unsympathetic attitudes and lack of solutions drive those who don’t know better to look for sympathy and solutions elsewhere, whether those solutions are appropriate or not.

  5. #5 albatross
    June 30, 2008

    To a first approximation, our institutions don’t respond to logical arguments or evidence, but rather to interest groups. Effective lobbying and PR, funding sources, willingness to buy commercials, write angry letters, protest, etc., are way more important than peer-reviewed papers, well-designed experiments, proofs, etc. A large woo industry and a large pool of woo believers almost inevitably means some level of media and institutional support for woo.

  6. #6 T. Bruce McNeely
    June 30, 2008

    http://www.rateitall.com/i-893024-vomiting.aspx
    (Scroll to Comment 3 by Drummond)
    I wonder if this will be on the curriculum at U. of Arizona?

    Actually, considering the tuition for Medical School these days, I would be furious at wasting my time and money on this crap if I were a student.

  7. #7 Phoenix Woman
    June 30, 2008

    Actually, give it about five years: There will be a wave of woo-related deaths, and — assuming the ability of patients or their next of kin to sue hasn’t been totally gutted by that time — a whole passel of very expensive lawsuits.

    The medical schools will soon go back to actual medicine. It’s cheaper in the long run. MUCH cheaper.

  8. #8 Klem
    June 30, 2008

    Exactly, albatross. Where are there lobbying groups for evidence-based medicine? Is there a union of concerned biomedical professionals?

    Scientists and clinicians still have a lot of respect and influence in society, but they don’t seem all that organized.

    Interestingly, Edward Bernays, who coined the term “public relations”, got his start as the editor of a medical journal (right out of college!). His first PR campaign was for a play about STD’s (very controversial in 1912). Using his position at the medical journal he formed a committee of prominent physicians to support the play. Details here in a biography excerpt.

  9. #9 JThompson
    June 30, 2008

    Damn, I’d always been worried snake oil people would gain enough traction I’d have to worry about going to a real doctor and getting my humours balanced.

    It’s not just human medicine. I had a friend ask me what I thought of http://www.mypetspainrelief.com/formula.aspx one day.
    Which was pretty baffling. Apparently they advertise the hell out of this stuff on TV. That and she’s too stupid to click the link that lists the ingredients.
    A few ground up rocks, ground up (poisonous) plants, and mercury. How could it go wrong?!
    It doesn’t help the person that invented the stuff claims to be an M.D. so he’s probably giving it to people too.

  10. #10 Phoenix Woman
    June 30, 2008

    I was educated as a scientist, and I do my best to avoid woo. But I can understand why woo appeals to people. I have two medical problems that my doctor says nothing can be done about. They are not life-threatening problems, but they cause me discomfort and affect my quality of life. It’s awfully disappointing to try to get help with them from the medical establishment and be told there is no help. As far as I can tell, there is no research being done into solutions for my problems either.

    Certainly research costs money. But don’t expect the average person to understand or care about what it takes to come up with evidence-based treatments when they are desperate to find help.

    For many people, science and medicine come across as very unfriendly. Whereas the woo peddlers can seem more sympathetic to their pain.

    Practitioners of evidence-based medicine need to remember that they are treating human beings with feelings. Unsympathetic attitudes and lack of solutions drive those who don’t know better to look for sympathy and solutions elsewhere, whether those solutions are appropriate or not.

    Very true. Part of this is due to doctors being overworked almost by design; this, combined with the rampant ego that docs need to get their often-ornery patients to heed what they say, gives patients a rather negative view of doctors. Recent studies have found that, contrary to what one would think would be the case, places that do a lot of one type of procedure aren’t always the best at it, usually because the doctors and interns are so overworked they’re too exhausted to do it right much of the time.

    To a first approximation, our institutions don’t respond to logical arguments or evidence, but rather to interest groups. Effective lobbying and PR, funding sources, willingness to buy commercials, write angry letters, protest, etc., are way more important than peer-reviewed papers, well-designed experiments, proofs, etc. A large woo industry and a large pool of woo believers almost inevitably means some level of media and institutional support for woo.

    Uh-huh. I had no idea that the whole ethyl-mercury/autism link had been discredited for nearly a decade until I started reading blogs like this one. Do a Google search on autism or vaccines or mercury, and look at how woo-based links dominate the first page of searches — and realize that most people can’t tell woo from science, especially if it’s slickly-packaged woo, and that most people won’t go beyond the first results page.

  11. #11 BB
    June 30, 2008

    What about the effect of the market economoy on medical school curricula? I see it where I am. Students want to learn woo (Lord knows they want to limit lecture time but maybe woo lectures don’t count as much as immunology or biochemistry), so the med school delivers.

  12. #12 steve
    June 30, 2008

    I’m getting depressed too. I’m a medical physicist and the leading journal in our field just published a debate about the effectiveness of magnet therapy. I posted to a medical physics mailing list objecting to the inclusion of the topic and specifically to this statement:

    A view exists that the lack of consistent evidence from randomized trials and the lack of a plausible physiological mechanism are enough to discourage the use of static magnets as an effective treatment for pain relief. This conclusion has shades of “guilty until proved innocent.”

    I was shouted down by a chorus of voices, including some of the leading figures in the field, defending the value of alternative medicine. These were all people with advanced degrees in physics. If we’ve lost them, how can we hope to win over the general public?

  13. #13 barbie123
    June 30, 2008

    I agree with Phoenix Woman……make the woo-practitioners liable for ‘errors’ as we do with science-based doctors (i.e., huge malpractice premiums and attendant jury or settlement awards) and we will see the woo fade away on a wave of shame.

    At least that is my hope. What bothers me so very much about the glassy-eyed devotees of “alternative” medicine is their seeming inability to recognize the potential for harm by such practitioners, while gleefully regaling each other with tales of evil mainstream docs and the “harm” caused by those darned allopaths. Oh, and their insistence that all the docs are in bed with Big Pharmacy and its nefarious plans to . . . I’m not sure, poison us all? Destroy our kids? I can’t keep it all straight.

    Maybe a reference to Picard, arms crossed, ominously intoning, “The Borg won’t stay on level 16….” would be appropriate here, also.

  14. #14 Mike O'Risal
    June 30, 2008

    I’ve always had a bit of a phobia about doctors. Now I have even more.

    Science is in a general decline in the United States. It’s hard. Americans don’t like hard. We like to push a button and get an answer. CAM is really so much simpler than reality, I’m sure. “Here, chew this leaf and sick this magnet up your nose for a week and your diabetes will disappear, your impotence will be relieved, ad your coat will be shiny and manageable.”

    Somebody wake me up when the twentieth-first century arrives from its apparent lunchbreak.

  15. #15 ecoli
    June 30, 2008

    don’t despair, Orac. Your blog is one of the reasons I’m trying to get into an Md/PhD program, so that I can do research with the specific goal of applying it to medicine.

    Things may look grim, but keep doing what you’re doing… you’ve already influenced people like me to make progress!

  16. #16 MarcW
    June 30, 2008

    You wanna see pessimistic? I’ll show you pessimistic.

    We’ll be glad that woo is so pervasive and so many physicians are trained in it when we fall off the Olduvai Energy Cliff* in a few more years and science-based medicine more technologically advanced than casting a fractured limb becomes prohibitively expensive for anybody but high-level government employees. The woo won’t work any better than it does now, but at least it will sound very authoritative and produce as much placebo-based relief of suffering as can be had. We’ll be the sorry ones – we’ll know it doesn’t work and our St. John’s Wort infusions won’t do us any good.

    Now THAT’S pessimistic.

    M

    *If you’re not familiar with the Olduvai Theory, you can read about it here:

    http://en.wikipedia.org/wiki/Olduvai_theory

    Warning: it is very, very depressing. I’m not saying I think it’s inevitable, but the headlines are making me wonder.

  17. #17 Ab_Normal
    June 30, 2008

    Please hang in there! I’ve just been diagnosed with celiac, and the woo-detection skills I learned from this blog and many others have come in handy, as the support group forums (fora?) I’ve found tend to be woo-heavy. Thanks!

  18. #18 Grodge
    June 30, 2008

    Resistance is futile, indeed.

    Belief in the irrational has been with us since Homo sapiens first scurried about the earth and my guess is that our lizard brains will grasp idiocy until the last Homo sapiens breaths his or her final breath of noxious anthropogenically polluted air.

    The CAM movement is due to several compelling trends in society:

    1. The perceived and real failures of modern medicine to help humankind and the desire by patients for immediate results.

    2. An abundance of economic wealth that allows patients to spend their resources on unproven products and services.

    3. An enormous lack of scientific understanding and appreciation by the general public. But is it any worse than a generation ago?

    4. Norman Cousins once said that the practitioner’s job was to entertain the patient while the body healed itself. I think much of the attraction of woo is for entertainment value. If I can find a knockout redhead to give me therapeutic touch while my inflamed psoas muscle settles down, what the heck.

    5. A genuine mistrust of establishment medicine, especially when patients perceive physicians making large salaries without providing commensurate results. The debates about the growing problems of health care costs and uninsured people act to fuel the fire, however unjustified it may be.

    As a physician and devout proponent of scientifically-based medicine, I see this every day and have empathy and compassion for patients who are frustrated and/or ignorant and/or suffering. For most, they just want to be well.

    Medical school deans, on the other hand, should know better.

    Keep up the good work, Orac!!

  19. #19 Random Lurker
    June 30, 2008

    It occurs to me that science, in a way, is its own worst enemy. Because scientists constantly observe and record and adjust descriptive equations/medical protocols/lists of adverse reactions/whatever in accordance with their observations, it appears that they don’t really know anything and are in a constant state of flux. Which I suppose is actually not far off the truth in some areas.

    So (s)CAM pushers can say: “That proves science is always wrong and doesn’t know what it’s doing because it keeps changing things. Whereas is based on ancient wisdom passed down the generations and/or works through the guiding forces/principles/powers/whatever in tune with the universe, which has been known for hundreds of years by .”

    And the sadly ignorant general public naturally goes for the thing which is apparently well-known and safely fixed and doesn’t change all the time.

  20. #20 Random Lurker
    June 30, 2008

    Damn, forgot you can’t use > and < tags … should have read:

    So (s)CAM pushers can say: “That proves science is always wrong and doesn’t know what it’s doing because it keeps changing things. Whereas [insert (s)CAM here] is based on ancient wisdom passed down the generations and/or works through the guiding forces/principles/powers/whatever in tune with the universe, which has been known for hundreds of years by [insert random ancient civilisation here].”

  21. #21 llewelly
    June 30, 2008

    “Here, chew this leaf and sick this magnet up your nose for a week and your diabetes will disappear, your impotence will be relieved, ad your coat will be shiny and manageable.”

    I can’t wait for the great new herbal magnet treatment that makes me grow a nice coat of sleek, shiny fur.

    Surely it works by quantum magnetism, which causes my qi energies to send out soft, furry vibrations, resulting in the growth of fur on the skin?
    ow, wait, I’m sure memorized water plays an important role here too.

  22. #22 bones
    June 30, 2008

    I was speaking to a friend of mine the other night, and we both agreed critical thinking has gone out the window – in this country at least (U.S.A.).

    The fast easy answer, the sound bite, the headline grabber, and the political rhetoric are the most convenient and, therefor, the widely accepted; especially when it comports to an already foregone conclusion.

    We’ve forgotten how to second guess ourselves – to validate our own conclusions, if you will. Why would we second guess an alleged “expert” when his/her conclusions are in uniform with ours?

  23. #23 Dr. T
    June 30, 2008

    I actually won a battle against woo five years ago. A private hospital I was loosely affiliated with wanted to introduce therapeutic acupressure, acupuncture, and naturopathy in its “Lifestyle Center.” The administrators thought this would be a good idea because other regional hospitals were doing it. No one on the Therapeutics Committee spoke up. I was a non-voting member, so I spoke against these woos, explained what they were based on, and asked if the hospital wanted to endorse such nonsense. Immediately, other physicians and pharmacists spoke up (they apparently were too afraid of the administrators until I led off), and the proposal was nixed. That hospital still isn’t offering woo five years later.

    Despite that one victory, I am nearly as pessimistic as Orac. Most of the med students I teach do not understand the scientific method or how to evaluate medical studies. Many of them believe various types of woo are effective, and my counterarguments fall on deaf ears. (They know what they know, and no clinical pathologist can change their minds.) The general public displays ever increasing ignorance about science and medicine. Its almost as if they are shunning science because they hated it in school. They seem to think their ignorance is nobly rebellious or something. The media is worse: reporters and editors should (and often do) know better, but woo reports draw more readers and viewers than science or medicine reports.

    Therefore, except for medical school teaching, I’ve given up on the woo issue. I’m now callous enough to say “let the ignorant jackasses suffer and die if they are stupid enough to choose woo over medicine.” This might be the only way modern society can achieve Darwinian evolutionary improvement of the human race! The stupid will die of woo while the intelligent will live on.

  24. #24 PSC
    June 30, 2008

    Let me make a statement, perhaps for people to argue against:

    Medical students need to be taught woo, in order to understand what their patients are saying.

    Suppose a patient comes to a doctor and says: Doctor, I’ve tried your pills and they’re ineffective, I’m also trying woo-ology, and my woo-ologist says do X, Y and Z – Doctor, what should I do?

    If the doctor can show that they understand the guts of what woo-ology claims to be, they immediately gain credibility with the patient. Patients will present to doctors taking all sorts of odd treatments and doing all sorts of odd things. Doctors need to be on top of this.

  25. #25 DLC
    July 1, 2008

    Gah.
    Is there even a medical school or teaching hospital anywhere that does not include some level of woo-ification ?
    It seems to me that, as pervasive as this stuff is, it would be easier to build a list of institutions that do not include such quackery in the curricula. But, I could be wrong.
    Disgusting, isn’t it ?

  26. #26 Grodge
    July 1, 2008

    PSC,
    Yes, and NASA scientist need to spend valuable training time learning the teachings of Fundamentalist Latter Day Saints who preach that the moon and planets have been reserved for their after-life.

    On one level I agree with you, but the context in which woo is being taught is not as invalid bankrupt philosophies of medicine but rather as appropriate alternatives to modern scientific practice.

    I had one instructor in medical school tell me he could tell someone’s blood sugar by palpating their trapezius muscles. Seriously. This, however, was 20 years ago… so I do not know if such woo is actually on the rise now or if it has always had a low-level place in medicine.

  27. #27 Dr Aust
    July 1, 2008

    Have you checked out this bit on the U of A Programme’s website? Woo is going corporate.

    I suppose this is hardly a surprise given that Bravewell is pretty clearly the Corporate World-goes-woo. But it should be food for thought for those who think Woo is somehow counter-cultural or anti-corporate.

  28. #28 Oldfart
    July 1, 2008

    Therefore, except for medical school teaching, I’ve given up on the woo issue. I’m now callous enough to say “let the ignorant jackasses suffer and die if they are stupid enough to choose woo over medicine.” This might be the only way modern society can achieve Darwinian evolutionary improvement of the human race! The stupid will die of woo while the intelligent will live on.

    This is only true if the ignorant jackasses don’t infect the intelligent (or aware) with whatever it is that they have. I.e. the loss of herd immunity due to the woo of anti-vaxers.

  29. #29 XPM
    July 1, 2008

    The Federation was victorious at Wolf 359. It was a hideously expensive victory, but they won nonetheless.

    Erm… IIRC they were thoroughly creamed and Earth was doomed until Picard told Data how to mind-woobie the Borg.

  30. #30 ak
    July 2, 2008

    Any opera lovers out there can console themselves with the Mozart parody of Mesmer in Cosi Fan Tutte. Dear Mozart parodies quacks and rigid authority often and well and beautifully.

  31. #31 Robert
    July 5, 2008

    Come on people – you know what the push for woo really means –

    Money! Why get paid measly rates by medicare or insurance to use conventional evidence-based medicine when you could do any sort of snake oil and get paid straight cash, playa! I’m surprised med schools weren’t doing this already.

  32. #32 Dr. Scifi
    July 6, 2008

    Staying in Trekker mode, watch the Star Trek episode Sacred Ground, where Captain Janeway agrees to undergo a purification ritual that will allow her to save a crew member’s life. She plans to use a scientific approach and discover the biochemical changes in her body that will allow her to pass unharmed through an energy field. In the end, the experience leaves her spiritually affected. When the overly enthusiastic doctor finally solves the medical puzzle, she seems unimpressed.

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