This war taking place in our nation’s medical schools and academic medical centers. Orac at Respectful Insolence has been tracking this trend, as have those of us writing at Science-Based Medicine. It is a war between those who feel that medicine should continue to be based on science and those who want to integrate faith-based practices. The model for this war is not that of pedagogical disputes or funding scuffles. More than anything else, it resembles a religious war.
The basic story goes like this: medical schools are in charge of educating future doctors. Individual hospitals are in charge of educating recent medical school graduates in their specialty of choice. Once they are out and practicing, very little stands in the way of doctors practicing medicine however they see fit. While the standard is that we should all be practicing science-based medicine, this practice is not universal. There are plenty of physicians who fail to follow evidence-based guidelines, such as following blood pressure and blood sugar goals for diabetics. Mechanisms are slowly developing to bring physicians into the fold, as it were. There are more and more incentive programs that reward or punish physicians financially based on how well they follow established evidence-based guidelines.
But there are also plenty of physicians who not only don’t follow current guidelines but who don’t even follow the basic scientific principles on which modern medicine is based. As we have discussed many times before, they follow faith-based practices which have no plausible mechanisms of action and have been disproved. They adhere to homeopathy, chiropractic, acupuncture, and reiki despite all the evidence to the contrary. They are, in other words, practicing religion rather than medicine.
Like all the good religions, they are trying to spread the word, and where better to start than in our nation’s medical schools? Medical students are anxious to help and anxious to learn. During the first two years of med school, they have fewer opportunities to help people, but the desire is there. Since the basic science classes can be boring, they may do things like volunteer at a homeless clinic or get involved in student groups—and they are often “tempted” by the song of woo. They get lectures—sanctioned or otherwise—on faith-based practices in a setting that makes them seem endorsed by the school. These practices are easy to latch onto before you learn real medicine—students can easily learn reiki and since they have few other outlets for their altruistic urges, this is a ripe time to “educate” them on “healing”.
I have been fortunate to hear many stories of these conversion attempts. Because of my internet presence, I get emails from doctors, med students, and others, many of them with stories that sound more like a visit from the Jehovah’s Witnesses than a med school experience. Students hear speakers who evangelize for altie practices, and if they raise objections, they are often accused of being “closed-minded” or worse. I’ve heard stories of students being harassed for daring to identify quackery for what it is, of threats to “report” them to their dean if they don’t leave the poor alties alone.
And this threat may be real. Many schools actually incorporate faith-based practices into their curricula, making it mandatory learning. To put, say, reiki on the same level as abdominal surgery (that is, as a legitimate approach to an illness) is to lie to students. To force them to learn from credulous teachers and CAM advocates without any opportunity to fight back is academic abuse.
This war is real. It is a war for the future of medicine and so affects every one of us. This is not a fight we can step away from.