MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Nobody really likes criticism, I suppose. Yet everyone with a functional brain agrees that criticism is a precondition to making progress. So most of us do listen to it, introspect and try to learn a lesson.

Not so in alternative medicine! The last post by Preston Long was a summary of constructive criticism of his own profession; it brought that message home to me much clearer than previous discussions on this blog (probably because it did not directly concern me) and, after some reflection, I realised that apologists of alternative medicine have developed five distinct strategies to avoid progress that otherwise might develop from criticism (alright, these strategies do exist in other fields too, but I think that many of the comments on this blog demonstrate that they are particularly evident in alternative medicine).

IGNORE

We could also call this method ‘The Prince of Wales Technique of Avoiding Progress’ because HRH is famous for making statements ‘ex cathedra’ without ever defending them or facing his critics or allowing others to directly challenge him. When he advocated the Gerson diet for cancer, for instance, Prof Baum challenged him in an open letter asking him to use his influence more wisely. Like with all other criticism directed to him, he decided to ignore it. This strategy is a safe bet for stalling progress and it has the added advantage that it does not require anything other than ignorance.

BLUFF

As it requires some basic understanding of the issues at hand, this method is a little more demanding. You need to look closely at the criticism and subsequently shoot holes in it. If you cannot find any, invent some. For instance, you might state that your critic misquoted the evidence. Very few people will bother to read up the original data, and you are likely to get away even with fairly obvious lies. To beef your response up a bit, pretend that there is plenty of good evidence demonstrating exactly the opposite of what your critic has said. If asked to provide actual references or sources for your claims, don’t listen. An extreme example of the bluff-method is to sue your critic for libel – but be careful, this can backfire in a major way!

INVALIDATE

A very popular method is to claim that the critic is not actually competent to criticise. The discussion of Long’s post demonstrated that technique in a classic fashion. His detractors argued that he was a failed chiropractor who had an axe to grind and thus had no right to criticise chiropractic (“Preston H Long you are a disgrace to the chiropractic profession…take off your chiropractic hat, you dont deserve to wear it. YOU sir are a shame and a folly!!”). Of course, you need to be a bit simple in order to agree with this type of logic, but lots of people seem to be just that!

BLAME

Even more popular is the blame-game. It involves arguing that, ok not all is rosy on your side of the fence, but the other side is so, so much worse. Before they dare to challenge you, they should look at their own mess; and while it is not sorted, they must simply shut up. For instance, if the criticism is that chiropractors have put hundreds of their patients into wheelchairs with their neck-manipulations, you must point out that doctors with their nasty drugs are much, much worse (“Long discounts the multitudes that chiropractic has… saved from dangerous drugs and surgery. As far as risks of injury from seeing a chiropractor vs. medicine, all one needs to do is compare malpractice insurance rates to see that insurance carriers rate medicine as an exponentially more dangerous undertaking”). Few people will realise that this is a fallacy and that the risks of any therapy must be seen in relation to its potential benefits.

ATTACK

When criticised, you are understandably annoyed; most people will therefore forgive you calling your critic names which are not normally used in polite circles (“who is this idiot, who wouldnt know the first thing about chiropractic”). Ad hominem attacks are the last resort of apologists of alternative medicine which emerges with depressing regularity when they have run out of rational arguments; they are signs of victories of reason over unreason. In the case of those chiropractors who were unable to stomach Long’s critique, the insults were coming thick and fast. The reason for only very few being visible is quite simple: I often delete the worst excesses of such primitive reactions.

5 Responses to Five methods for avoiding progress from criticism

  • Unfortunately, if ignorance is bliss, users of alternative medicines must be wafting in a permanent sea of ecstasy 😉

  • Edzard you should change your name to “A Systematic Review”. Looking at your publications on PubMed you are probably one of the most widely read and knowledgeable individuals on the planet in regard to this topic. On this issue I was in IGNORE for years. Practice going well, getting results, patients appreciative, business as usual. Then I tried to INVALIDATE the critics, which finally led me to thinking. The chiropractic profession, any profession, needs criticism to evaluate what they are doing and evolve. Reasonable Hank in his Australian blog has achieved more in three months of blogging than John Reggars and chiro’s who read journals and think have been unable to achieve in 20 years. The Subluxation true believers who “want to keep it pure” drive me nuts. They may be in the minority but they can be bloody noisy. Talking to them is like talking to a brick wall. Friends who I gripe to just roll their eyes and say “they won’t listen”.
    So medicine has its issues, so what! That is not what is being discussed here. Chiropractic is! The chiropractic professoin can take the criticism onboard and change or it can stagnate. I for one appreciate your criticism, painful as it is! My practice has evolved to include a lot of rehab, exercises, ergonomic advice, lifestyle advice etc etc etc as knowledge progresses so does my practice. It is a never ending process. Subluxation started and stopped 100 years ago!

    Actually, you have been doing it for so long that your name should be “A blog af an update of a systematic review of a systematic review of yet another update”…………”Reviewed”.

  • These are all timeless. However, with ALL medicine there is the problem that studies study ill people mostly. And a lot of those illnesses are medicine-related. It is a bit as if the automobile industry were to only discuss the merits of mobility by analyzing car accidents. It’s time both “conventional” as well as “alternative” medicine began studying those people that stay well away from doctors.

  • CrisisMaven said:

    However, with ALL medicine there is the problem that studies study ill people mostly. And a lot of those illnesses are medicine-related.

    Eh?

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