My friend Janet has a piece up about what qualifies one to be a philosopher, a piece which is remarkably brief but says much. She points out that get a position at a university, there are certain requirements, but that one can be “off the books”. Anyone can call themselves a philosopher, and if enough of us assent to their claim, well, then they’re a philosopher, no matter how muddled their thinking may or may not be.
In medicine, we have a similar problem—the problem of assent. To become a primary care doctor (a category which includes internists and family physicians) the “official” training is rather rigorous—four years of university, four more of medical school, three or four years of post-graduate training. After that, one would be wise to take board exams and become “board certified”. Then, to practice, one must become licensed—that’s the easiest part of all.
But quacks have a big advantage here. Licensing is easy. If you’ve completed the basic requirements, you can practice, no matter how bad you are, no matter how much you fail to practice in a manner that most doctors would recognize as “competent”.
I’ve been made aware of a local “integrative medicine” practice that exemplifies this problem. They claim to treat all manner of ills. They claim to be “holistic”, treating the “whole patient” rather than…well, I’m not sure.
But they don’t even examine the patient. I’ve spoken to people who have dealt with them, and I’ve called them myself and they acknowledge that their practice (which is a cash practice) asks questions, recommends lab tests and treatments, but does not do a real physical exam. They refer out for that.
This is the height of hypocrisy. To claim to offer a better alternative to real medicine, and then fail to do the most basic thing, this should be criminal.
But it’s not. There is no insurance fraud—they don’t take insurance. The doctor is licensed, and will remain so unless a patient complains. And the patients will never complain. We have given our assent to these quacks—we have granted them the status of “physician” although they don’t merit it by any other standard.
It’s our fault, and we deserve the care we get.