Saturday, January 6, 2018

"How to Counter the Circus of Pseudoscience"

Maybe one day, once I have decades of experience as a doctor and further training in my area of specialization, I will be able to speak about health matters with the tone of authority of the average naturopath.

That was the thought that crossed my mind recently while I waded through the online world of alternative-health practitioners, wellness bloggers, whole-food chefs and Gwyneth Paltrow.

I did not seek it out at first; it came to me through a social-media algorithm. Facebook offered up a video advertisement from a “female hormonal health specialist” with her own “practice.” Not an endocrinologist but a naturopath. She lectured with confidence on thyroid testing, though much of what she said was wrong. And down the internet rabbit hole I went.

One traditional view of the medical profession is that doctors are commanding and authoritarian, even arrogant. Though some individuals fit that description, in fact, the profession is built on doubt.

Most doctors, especially the good ones, are acutely aware of the limits of their knowledge. I have learned from those much more experienced and qualified than me that humility is something to be cultivated over time, not lost.

Our field is built around trying to prove ourselves wrong. In hospitals we hold morbidity and mortality meetings trying to show where we have failed, what we need to change, how we can do better. Our hospital work is audited to identify where we fell short of our ideals. Through scientific research we try to disprove the effectiveness of treatments. Our failings are exposed from the inside.

The nature of evidence-based health care is that practices change as new evidence emerges.

That is also the case for other health professionals whose practice is based on science, like qualified dietitians, physiotherapists, occupational therapists and psychologists. Guidelines are revised, advice is reversed — on blood pressure, diet, hormone replacement, opioid prescribing. This can be immensely frustrating for patients, even though it is what we must do to provide the best possible treatment...

(Lisa Pryor, continues)

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