Or as Ben Goldacre put it in a talk: There are millions of medical doctors and Ph.D.s in the world. There is no idea, however completely fucking crazy, that you can’t find some doctor to argue for.
Cute quip, but I doubt it. Find me a Ph.D to argue that the sky is bright orange, that the english language doesn’t exist, and that all humans have at least seventeen arms and a maximum lifespan of ten minutes.
All generalisations are bounded, even when the bounds are not expressed. In the context of his talk, Ben Goldacre was talking about “doctors” being quoted as supporting various pieces of bad medical science.
Many medical doctors around here (germany) offer homeopathy in addition to their medical practice. Now it might be that they respond to market demand to sneak in some medical science in between, or that they actually take it serious.
From what I’ve heard, in Germany and other places where homeopathy enjoys high status and professional recognition, doctors sometimes use it as a very convenient way to deal with hypochondriacs who pester them. Sounds to me like a win-win solution.
I still assume that doctors actually want to help people. (Despite reading the checklist book, and other stuff).
So if I have the choice between: World a) where doctors also do homeopathy, and b) where other ppl. do it, while doctors stay true to science. Than I would prefer a) because at least the people go to a somewhat competent person.
I still assume that doctors actually want to help people
Homeopathy is at best a placebo. It’s rare that there’s no better medical way to help someone. Your assumption is counter to the facts.
Certainly doctors want to help people—all else being equal. But if they practice homeopathy extensively, then they are prioritizing other things over helping people.
If the market condition (i.e. the patients’ opinions and desires) are such that they will not accept scientific medicine, and will only use homeopathy anyway, then I suggest then the best way to help people is for all doctors to publicly denounce homeopathy and thus convince at least some people to use better-than-placebo treatments instead.
Homeopathy is at best a placebo. It’s rare that there’s no better medical way to help someone.
I disagree—at least with the part about “it’s rare that there’s no better medical way to help people”. It’s depressingly common that there’s no better medical way to help people. Things like back pain, tiredness, and muscle aches—the commonest things for which people see doctors—can sometimes be traced to nice curable medical reasons, but very often as far as anyone knows they’re just there.
Robin Hanson has a theory—and I kind of agree with him—that homeopathy fills a useful niche. Placebos are pretty effective at curing these random (and sometimes imagined) aches and pains. But most places consider it illegal or unethical for doctors to directly prescribe a placebo. Right now a lot of doctors will just prescribe aspirin or paracetamol or something, but these are far from totally harmless and there are a lot of things you can’t trick patients into thinking aspirin is a cure for. So what would be really nice, is if there was a way doctors could give someone a totally harmless and very inexpensive substance like water and make the patient think it was going to cure everything and the kitchen sink, without directly lying or exposing themselves to malpractice allegations.
Where this stands or falls is whether or not it turns patients off real medicine and gets them to start wanting homeopathy for medically known, treatable diseases. Hopefully it won’t—there aren’t a lot of people who want homeopathic cancer treatment—but that would be the big risk.
You might implicitly assume that people make a conscious choice to go the unscientific route. That is not the case.
For a layperson there is no perceivable difference between a doctor and a homeopath. (Well. Maybe there is, but lets exaggerate that here.)
From the experience the homeopath might have more time to listen, while doctors often have a approach to treatment speed that reminds me of a fast food place.
If I were a doctor, than the idea to offer homeopathy, so that people at least come to me would make sense both money wise, and to get the effect that they are already at a doctors place for treatment with placebos for trivial stuff, while actual dangerous conditions get check out from a competent person.
Its a case of corrupting your integrity to some degree to get the message heard.
I considered to not go to doctors that offer homeopathy, but then decided against that due to this reasoning.
I considered to not go to doctors that offer homeopathy, but then decided against that due to this reasoning.
You could probably ask the doctor why they offer homeopathy, and base your decision on the sort of answer you get. “Because it’s an effective cure...” is straight out.
tl;dr—if doctors don’t denounce homeopaths, people will start going to “real” homeopaths and other alt-medicine people, and there is no practical limit to the lies and harm done by real homeopaths.
For a layperson there is no perceivable difference between a doctor and a homeopath.
That is so because doctors also offer homeopathy. If almost all doctors clearly denounced homeopathy, fewer people would choose to go to homeopaths, and these people would benefit from better treatment.
From the experience the homeopath might have more time to listen, while doctors often have a approach to treatment speed that reminds me of a fast food place.
This is a problem in its own right that should be solved by giving doctors incentives to listen to patients more. However, do you think that because doctors don’t listen enough, homeopaths produce better treatment (i.e. better medical outcomes)?
they are already at a doctors place for treatment with placebos for trivial stuff, while actual dangerous conditions get check out from a competent person.
Do you have evidence that this is the result produced?
What if the reverse happens? Because the doctors endorse homeopathy, patients start going to homeopaths instead of doctors. Homeopaths are better at selling themselves, because unlike doctors they can lie (“homeopathy is not a placebo and will cure your disease!”). They are also better at listening, can create a nicer (non-clinical) reception atmosphere, they can get more word-of-mough networking benefits, etc.
Patients can’t normally distinguish “trivial stuff” from dangerous conditions until it’s too late—even doctors sometimes get this wrong. The next logical step is for people to let homeopaths treat all the trivial stuff, and go to ER when something really bad happens.
Personal story: my mother is a doctor (geriatrician). When I was a teenager I had seasonal allergies and she insisted on sending me for weekly acupuncture. During the hour-long sessions I had to listen to the ramblings of the acupuncturist. He told me (completely seriously) that, although he personally didn’t have the skill, the people who taught him acupuncture in China could use it to cure my type 1 diabetes. He also once told me about someone who used various “alternative medicine” to eat only vine leaves for a year before dying.
When the acupuncture didn’t help me, my mother said that was my own fault because “I deliberately disbelieved the power of acupuncture and so the placebo effect couldn’t work on me”.
I perceive you as attacking me for having said position, but I am the wrong target.
I know homeopathy is BS, and I don’t use it or advocate it.
What I do understand is doctors who offer it for some reason or another, for the reasons listed above. What you claim as a result is sadly already happening. I have had people getting angry at me for clearly stating my view, and the reasons for it, on homeopathy. (I didn’t say BS, but one of the ppl. was a programmer, if that counts for something.)
Many folks do go to alternative treatments, and forgo doctors as long as possible. People have a weak opinion on the ‘school medicine’ (german term translation for the official medical knowledge and practice.) criticize it—sometimes justified. And use all kind of hyper-skeptical reasoning, that they do not apply to their current favorite. That is bad. And hopefully goes away.
Many still go the double route you listed.
And well, then we have the anti-vaccination front growing. It is bad, and sad, and useless stupidity.
Lets get angry together, and see what can be done about it.
Personal story: i did a lecture on skeptic thinking.
try i dumped everything i knew, and noticed how dealing with the H-topic tends to close people up.
try i cut out a lot, and left the H topic out. still didn’t work
I have no idea what I can do about it, and am basically resigning.
From what I’ve been told from friends, here (Austria) they (meaning: most doctors) do take it serious. This is understandable; when studying medicine, the by far larger part of college is devoted to knowing facts, the craftsmanship (if I may say so), then to doing medical science.
This also makes sense, as execution by using results already requires so much training (it is the only college course here which requires at least six years by default, not including “Turnus” (another three year probation period before somebody may practice without supervisor)).
The problem here is that for the general public the difference between a medical practitioner and any scientist is nil. Strangely enough, they usually do not make this error in engineering fields, for instance electrical engineer vs. physicist. May have to do something with the high status of doctors in society.
I recently found out why doctors cultivate a certain amount of professional arrogance when dealing with patients:
Most patients don’t understand whats behind their specific disease—and usually do not care. So if doctors where open to argument, or would state doubts more openly the patient might loose trust, and not do what he is ordered to do.
To instill an absolute belief in doctors powers might be very helpful for a big size of the population.
A lot of my own frustration in doctors experiences can be attributed to me being a non-standard patient that reads to much.
Find me a Ph.D to argue that the sky is bright orange, that the english language doesn’t exist, and that all humans have at least seventeen arms and a maximum lifespan of ten minutes.
These claims would be beyond the border of lunacy for any person, but still, I’m sure you’ll find people with doctorates who have gone crazy and claim such things.
But more relevantly, Richard’s point definitely stands when it comes to outlandish ideas held by people with relevant top-level academic degrees. Here, for example, you’ll find the website of Gerardus Bouw, a man with a Ph.D. in astronomy from a highly reputable university who advocates—prepare for it—geocentrism: http://www.geocentricity.com/
(As far as I see, this is not a joke. Also, I’ve seen criticisms of Bouw’s ideas, but nobody has ever, to the best of my knowledge, disputed his Ph.D. He had a teaching position at a reputable-looking college, and I figure they would have checked.)
He had a teaching position at a reputable-looking college, and I figure they would have checked.
It looks like no one ever hired him to teach astronomy or physics. He only ever taught computer science (and from the sound of it, just programming languages). My guess is he did get the PhD though.
Also, in fairness to the college he is retired and he’s young enough to make me think that he may have been forced into retirement.
Here, for example, you’ll find the website of Gerardus Bouw, a man with a Ph.D. in astronomy from a highly reputable university who advocates—prepare for it—geocentrism:
Earth’s sun does orbit the earth, under the right frame of reference. What is outlandish about this?
Earth’s sun does orbit the earth, under the right frame of reference. What is outlandish about this?
If you read the site, they alternatively claim that relativity allows them to use whatever reference frame they chose and at other points claim that the evidence only makes sense for geocentrism.
I’m not sure it is completely stupid. Consider the argument in the following fashion:
1) We think your physics is wrong and geocentrism is correct.
2) Even if we’re wrong about 1, your physics still supports regarding geocentrism as being just as valid as heliocentrism.
I don’t think that their argument approaches this level of coherence.
Cute quip, but I doubt it. Find me a Ph.D to argue that the sky is bright orange, that the english language doesn’t exist, and that all humans have at least seventeen arms and a maximum lifespan of ten minutes.
All generalisations are bounded, even when the bounds are not expressed. In the context of his talk, Ben Goldacre was talking about “doctors” being quoted as supporting various pieces of bad medical science.
Many medical doctors around here (germany) offer homeopathy in addition to their medical practice. Now it might be that they respond to market demand to sneak in some medical science in between, or that they actually take it serious.
Or that they respond to market demand and don’t try to sneak any medical science in, based on the principle that the customer is always right.
From what I’ve heard, in Germany and other places where homeopathy enjoys high status and professional recognition, doctors sometimes use it as a very convenient way to deal with hypochondriacs who pester them. Sounds to me like a win-win solution.
I still assume that doctors actually want to help people. (Despite reading the checklist book, and other stuff). So if I have the choice between: World a) where doctors also do homeopathy, and b) where other ppl. do it, while doctors stay true to science. Than I would prefer a) because at least the people go to a somewhat competent person.
Homeopathy is at best a placebo. It’s rare that there’s no better medical way to help someone. Your assumption is counter to the facts.
Certainly doctors want to help people—all else being equal. But if they practice homeopathy extensively, then they are prioritizing other things over helping people.
If the market condition (i.e. the patients’ opinions and desires) are such that they will not accept scientific medicine, and will only use homeopathy anyway, then I suggest then the best way to help people is for all doctors to publicly denounce homeopathy and thus convince at least some people to use better-than-placebo treatments instead.
I disagree—at least with the part about “it’s rare that there’s no better medical way to help people”. It’s depressingly common that there’s no better medical way to help people. Things like back pain, tiredness, and muscle aches—the commonest things for which people see doctors—can sometimes be traced to nice curable medical reasons, but very often as far as anyone knows they’re just there.
Robin Hanson has a theory—and I kind of agree with him—that homeopathy fills a useful niche. Placebos are pretty effective at curing these random (and sometimes imagined) aches and pains. But most places consider it illegal or unethical for doctors to directly prescribe a placebo. Right now a lot of doctors will just prescribe aspirin or paracetamol or something, but these are far from totally harmless and there are a lot of things you can’t trick patients into thinking aspirin is a cure for. So what would be really nice, is if there was a way doctors could give someone a totally harmless and very inexpensive substance like water and make the patient think it was going to cure everything and the kitchen sink, without directly lying or exposing themselves to malpractice allegations.
Where this stands or falls is whether or not it turns patients off real medicine and gets them to start wanting homeopathy for medically known, treatable diseases. Hopefully it won’t—there aren’t a lot of people who want homeopathic cancer treatment—but that would be the big risk.
You might implicitly assume that people make a conscious choice to go the unscientific route. That is not the case. For a layperson there is no perceivable difference between a doctor and a homeopath. (Well. Maybe there is, but lets exaggerate that here.)
From the experience the homeopath might have more time to listen, while doctors often have a approach to treatment speed that reminds me of a fast food place. If I were a doctor, than the idea to offer homeopathy, so that people at least come to me would make sense both money wise, and to get the effect that they are already at a doctors place for treatment with placebos for trivial stuff, while actual dangerous conditions get check out from a competent person. Its a case of corrupting your integrity to some degree to get the message heard.
I considered to not go to doctors that offer homeopathy, but then decided against that due to this reasoning.
You could probably ask the doctor why they offer homeopathy, and base your decision on the sort of answer you get. “Because it’s an effective cure...” is straight out.
tl;dr—if doctors don’t denounce homeopaths, people will start going to “real” homeopaths and other alt-medicine people, and there is no practical limit to the lies and harm done by real homeopaths.
That is so because doctors also offer homeopathy. If almost all doctors clearly denounced homeopathy, fewer people would choose to go to homeopaths, and these people would benefit from better treatment.
This is a problem in its own right that should be solved by giving doctors incentives to listen to patients more. However, do you think that because doctors don’t listen enough, homeopaths produce better treatment (i.e. better medical outcomes)?
Do you have evidence that this is the result produced?
What if the reverse happens? Because the doctors endorse homeopathy, patients start going to homeopaths instead of doctors. Homeopaths are better at selling themselves, because unlike doctors they can lie (“homeopathy is not a placebo and will cure your disease!”). They are also better at listening, can create a nicer (non-clinical) reception atmosphere, they can get more word-of-mough networking benefits, etc.
Patients can’t normally distinguish “trivial stuff” from dangerous conditions until it’s too late—even doctors sometimes get this wrong. The next logical step is for people to let homeopaths treat all the trivial stuff, and go to ER when something really bad happens.
Personal story: my mother is a doctor (geriatrician). When I was a teenager I had seasonal allergies and she insisted on sending me for weekly acupuncture. During the hour-long sessions I had to listen to the ramblings of the acupuncturist. He told me (completely seriously) that, although he personally didn’t have the skill, the people who taught him acupuncture in China could use it to cure my type 1 diabetes. He also once told me about someone who used various “alternative medicine” to eat only vine leaves for a year before dying.
When the acupuncture didn’t help me, my mother said that was my own fault because “I deliberately disbelieved the power of acupuncture and so the placebo effect couldn’t work on me”.
Sorry about your experience.
I perceive you as attacking me for having said position, but I am the wrong target. I know homeopathy is BS, and I don’t use it or advocate it. What I do understand is doctors who offer it for some reason or another, for the reasons listed above. What you claim as a result is sadly already happening. I have had people getting angry at me for clearly stating my view, and the reasons for it, on homeopathy. (I didn’t say BS, but one of the ppl. was a programmer, if that counts for something.) Many folks do go to alternative treatments, and forgo doctors as long as possible. People have a weak opinion on the ‘school medicine’ (german term translation for the official medical knowledge and practice.) criticize it—sometimes justified. And use all kind of hyper-skeptical reasoning, that they do not apply to their current favorite. That is bad. And hopefully goes away. Many still go the double route you listed. And well, then we have the anti-vaccination front growing. It is bad, and sad, and useless stupidity. Lets get angry together, and see what can be done about it.
Personal story: i did a lecture on skeptic thinking.
try i dumped everything i knew, and noticed how dealing with the H-topic tends to close people up.
try i cut out a lot, and left the H topic out. still didn’t work
I have no idea what I can do about it, and am basically resigning.
I didn’t intend to attack you. Sorry I came across that way.
From what I’ve been told from friends, here (Austria) they (meaning: most doctors) do take it serious. This is understandable; when studying medicine, the by far larger part of college is devoted to knowing facts, the craftsmanship (if I may say so), then to doing medical science.
This also makes sense, as execution by using results already requires so much training (it is the only college course here which requires at least six years by default, not including “Turnus” (another three year probation period before somebody may practice without supervisor)).
The problem here is that for the general public the difference between a medical practitioner and any scientist is nil. Strangely enough, they usually do not make this error in engineering fields, for instance electrical engineer vs. physicist. May have to do something with the high status of doctors in society.
I recently found out why doctors cultivate a certain amount of professional arrogance when dealing with patients: Most patients don’t understand whats behind their specific disease—and usually do not care. So if doctors where open to argument, or would state doubts more openly the patient might loose trust, and not do what he is ordered to do. To instill an absolute belief in doctors powers might be very helpful for a big size of the population. A lot of my own frustration in doctors experiences can be attributed to me being a non-standard patient that reads to much.
Emile:
These claims would be beyond the border of lunacy for any person, but still, I’m sure you’ll find people with doctorates who have gone crazy and claim such things.
But more relevantly, Richard’s point definitely stands when it comes to outlandish ideas held by people with relevant top-level academic degrees. Here, for example, you’ll find the website of Gerardus Bouw, a man with a Ph.D. in astronomy from a highly reputable university who advocates—prepare for it—geocentrism:
http://www.geocentricity.com/
(As far as I see, this is not a joke. Also, I’ve seen criticisms of Bouw’s ideas, but nobody has ever, to the best of my knowledge, disputed his Ph.D. He had a teaching position at a reputable-looking college, and I figure they would have checked.)
Here is another one:
http://en.wikipedia.org/wiki/Courtney_Brown_%28researcher%29
It looks like no one ever hired him to teach astronomy or physics. He only ever taught computer science (and from the sound of it, just programming languages). My guess is he did get the PhD though.
Also, in fairness to the college he is retired and he’s young enough to make me think that he may have been forced into retirement.
Earth’s sun does orbit the earth, under the right frame of reference. What is outlandish about this?
If you read the site, they alternatively claim that relativity allows them to use whatever reference frame they chose and at other points claim that the evidence only makes sense for geocentrism.
Oh. Well, that’s stupid then.
I’m not sure it is completely stupid. Consider the argument in the following fashion:
1) We think your physics is wrong and geocentrism is correct. 2) Even if we’re wrong about 1, your physics still supports regarding geocentrism as being just as valid as heliocentrism.
I don’t think that their argument approaches this level of coherence.