Nobody really likes to be criticised; it can be painful. Painful but often necessary! Criticism produces progress. Criticism is therefore important. So, let’s think about criticism for a moment.
Obviously I am not talking of criticism such as ‘YOU ARE AN IDIOT’. In fact, that’s not criticism at all; it’s an insult. I am also not thinking about criticism like ‘YOUR ARGUMENT IS IDIOTIC’. I prefer to focus on criticism that is constructive, well-argued and based on evidence.
In healthcare, there is plenty of that type of criticism – luckily, I hasten to add. Its aim is to improve healthcare of the future. We need criticism to make progress. Without it, things come to a standstill or regress. This is why all the major medical journals are full of it, and many medical conferences are entirely or partly focussed on such aspects . For instance, frequently-cited papers in the BMJ, Lancet, NEJM, etc. point out that:
- much of the current medical research is unreliable,
- many therapies in current use have severe adverse effects,
- patients frequently do not get the optimal treatment in a timely fashion,
- modern medicine is too often inhumane.
The hope is that by disclosing these and many other deficits, appropriate actions can be found and taken to improve the situation and make progress. This process is hardly ever straight forward. All too often it is slow, inadequate and impeded by logistic and other obstacles. Therefore, it is crucial that constructive criticism continues to be voiced. Many clinicians, researchers and other experts have dedicated their lives to this very task.
Now, let’s look at the realm of alternative medicine.
There is certainly not less to criticise here than in conventional medicine. So, are all the journals of alternative medicine full of criticism of alternative medicine? Are there regular conferences focussed on criticism? Are alternative practitioners keen to hear about the weaknesses of their beliefs, practice, etc.?
The short answer is, no!
Yet, advocates of alternative medicine are, of course, not adverse to voicing criticism. In fact, they criticise almost non stop – at least this is the impression I get from reading their comments on this blog and from continually discussing with them since 1993.
But there is a fundamental difference: they criticise (often rightly) conventional medicine, and they criticise those (sometimes rightly) who criticise alternative medicine. When it comes to criticising their own practices, however, there is an almost deafening silence.
In my view, these differences between alternative and conventional medicine are far from trivial. In conventional medicine:
- There is a long tradition of criticism.
- Criticism is published and discussed prominently.
- Criticism is usually well-accepted.
- Criticism is often taken on board and appropriate action follows.
- Criticism thus can and often does lead to progress.
By contrast, in alternative medicine almost nothing of the above ever happens. Criticism is directed almost exclusively towards those who are outside the realm. Criticism from the inside is as good as non-existent.
The consequences of this situation are easy to see for everyone, and they can be dramatic:
- The journals of alternative medicine publish nothing that could be perceived to be negative for the practice of alternative medicine.
- Self-critical thinking has no tradition and has remained an almost alien concept.
- The very few people from the ‘inside’ who dare to criticise alternative practices are ousted and/or declared to be incompetent or worse.
- No action is taken to initiate change.
- The assumptions of alternative medicine remain unaltered for centuries.
- Progress is all but absent.
It is time that the world of alternative medicine finally understands that constructive criticism is a necessary step towards progress!