I appreciate my detractors. By raising unanticipated counter arguments they help me sharpen my focus. They make me think. My recent post on pseudoscience promotion by UCSF drew this anonymous comment:
“RW: I'm somewhat surprised by your vitriol towards the weird alternate crap. As an advocate of evidence-based medicine, you know that a small fraction of what doctors do is proven in any truly scientific way (double blind randomized studies, etc.). Rather, they generally do what they've been trained to and what sort of works . . . isn't that what alternative medicine is based on?In other words, there is no rational basis to choose between competing mythologies.”
I’ve gotten comments like this before with the common theme that alternative woo is no worse than non-evidence based conventional medicine. Many readers think my outrage is selective.
As I tried to explain in this post one important difference lies in the area of scientific plausibility: “Although some conventional methods fail to measure up to best evidence they are at least based on known anatomy and physiology. They have some plausibility in the observable biophysical model in contrast to the ‘vital forces’, nebulous ‘energy fields’ and ‘non-local powers of the mind’ which are characteristic of woo.” Viewed in that context they can hardly be construed as “competing mythologies.”
The commenter needs to understand that although I want doctors to practice evidence based medicine my focus is not on what individual doctors do. It’s the hypocrisy of mainstream medical institutions (journals, medical schools, hospitals) claiming to be all ethical and evidence based while promoting unscientific and even fraudulent claims that has my attention.
My intention is to expose such hypocrisy in mainstream institutions whenever I find it. My hope is that, with occasional help from the big players, the drum beat will grow loud enough to cause some influential person or persons in academic medicine, or perhaps the AAMC, or maybe even the IOM (on second thought, don’t expect that to happen anytime soon) to pound their fist on the table and say “enough’s enough!”