For years, Margaret McCartney, a GP from Scotland, wrote a weekly column in the BMJ. It was invariably well-worth reading. Recently, she regrettably ended it by publishing her last article entitled A summary of four and a half years of columns in one column. In it, she makes 36 short points. They are all poignant, but the one that made me think most (probably because it is relevant to my work and this blog) reads as follows:
Many people seek to make money from those who don’t understand science. Doctors should call out bollocksology when they see it.
On this blog, I have often discussed people who make money from consumers and patients who are unable to detect the quackery they are being sold. No doubt, the most famous case of me doing this was when, in 2009, I criticised Prince Charles and his ‘Dodgy Originals Detox Tincture’. It made many headlines; the BBC, for instance, reported:
Edzard Ernst, the UK’s first professor of complementary medicine, said the Duchy Originals detox tincture was based on “outright quackery”.
There was no scientific evidence to show that detox products work, he said.
Duchy Originals says the product is a “natural aid to digestion and supports the body’s elimination processes”.
But Professor Ernst of Peninsula Medical School said Prince Charles and his advisers appeared to be deliberately ignoring science, preferring “to rely on ‘make-believe’ and superstition”.
He added: “Prince Charles thus financially exploits a gullible public in a time of financial hardship.”
Marketed as Duchy Herbals’ Detox Tincture, the artichoke and dandelion mix is described as “a food supplement to help eliminate toxins and aid digestion”.
It costs £10 for a 50ml bottle…
At the time, I got a right blocking from my dean, Prof John Tooke, for my audacity. As far as I could see, there was almost no support from the UK medical profession. Since then, the exploitation of the public by quacks has not diminished; on the contrary, I have the feeling that it is thriving. And are doctors calling out bollocksology left right and centre? No, they are not!
Of course, some do occasionally raise their voices (and some do it even regularly). But mostly, it is the group of non-medical sceptics who open their mouths and try their best to prevent harm. Yet, I wholly agree with my friend Margret: doctors have a responsibility and must do more.
And why don’t they?
I think, there are several reasons for their inactivity:
- doctors are frightfully busy,
- doctors often don’t know how much bollocksology is out there,
- doctors don’t (want to) see how dangerous much of this bollocksology is,
- doctors fail to realise that it would be their ethical responsibility to speak out against bollocksology,
- some doctors do not seem to understand science either,
- some doctors are active bollocksologists themselves,
- some doctors simply don’t care.
This clearly is a depressing state of affairs! But, at the same time, it also is a cheerful occasion for me to thank all those doctors who are the laudable exceptions, who do care, who do think critically, who see their ethical responsibility, and who do something about the never-ending flood of bollocksology endangering their patients’ health and wealth.
11 Responses to “Doctors should call out bollocksology when they see it.”
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Challenging bollocksology can be very unfulfilling. Many consumers of alternative treatments think they know more than you do if you point out the problems with their pampering sessions of choice. Many have university degrees (in the humanities or engineering) and are well trained in “Quackspeak”. You will invariably hear “Doctors only treat symptoms” or “Doctors only want to use unnatural drugs”. It is the same mentality as religious faith and does not welcome conflicting information. I am going to continue to try an learn how to be more effective in helping some of these people but having the facts does not seem to be enough. For now it seems a bit like beating your head against a wall. It feels better when you stop.
you are right; it is hard and one can easily upset people.
but, in a way, this makes it all the more important.
“Bollocksology”, another new and useful addition to my vocabulary.
I applaud anyone and everyone who kicks them squarely in their bollocksology.
The harder and more frequently the better.
I think there’s a gene of the bollocksologist that prevents them from ever conceding “I can do no more.” They keep sapping every penny from their customers who – like religions blame their flock for not being faithful enough – keep asserting wisdom.
Of course I have no evidence of this gene, just anecdotes: therefore bollocksologists and I are talking equivalent bollocksologese.
What a brilliant piece! I liked ‘Appraisal is bunk’ and ‘we shouldn’t aim to “raise awareness” but to improve knowledge’. There is an insidius vagueness and timidity creeping into medical terminology these days, no one seems to be able to say it like it is any more, possibly for fear of giving offence or the daft belief that it is not the done thing to suggest a health professional might actually know more about medicine than other people, including patients.
And calling out bollocksology is just as difficult and unpopular in the veterinary profession. Most vets would rather allow animals to be treated for cancer with water and sugar tablets than risk giving offence to a ‘fellow professional’ (most of whom stopped being ‘professional’ the moment they started practicing homeopathy IMHO).
Niall
You make a good and reasonable point Prof. Ernst. The problem as I see it is that a synonym for “Bollocksology” might be Religion as both are based on a faith based belief system. Good luck changing someones religion.
As Niall stated above , in the veterinary profession no amount of evidence seems to be able to turn the tide and growth of quackery. That is why places like this : http://www.tcvm.com/ continue to grow and expand globally into new markets.
Especially concerning is the integration and embracing of pseudoscience in our professional schools. What was once a fringe market, something medical professionals found themselves exploring after graduating is becoming part of the curriculum. https://smallanimal.vethospital.ufl.edu/clinical-services/integrative-medicine-services/
https://healthypets.mercola.com/sites/healthypets/archive/2013/03/13/building-veterinary-schools.aspx
Last night Newsnight covered Anti-Vax. – critically.
Press on, we won’t ‘win’ because the faith centre is so deep in the hypothalamus – but we might stem the tide and must continue to press for folks to have all relevant information, and to think critically.
Richard Rawlins – ‘last night Newsnight covered anti-vax – critically’. Really? I saw it too and it was biased (but to be expected from Mainstream media) I thought it was desperate : Brian Deer – well known for his stance against Andrew Wakefield (I won’t elaborate more on him) and three other participants talking about conspiracy etc etc. In fairness a nurse did say we need all the information on vaccines to deliver to parents – I hope that becomes a reality.
“Brian Deer – well known for his stance against Andrew Wakefield…”
ARE YOU FOR REAL?
he is the investigative journalist who uncovered the fraud committed by the ex-doctor Wakefield!
How can integrity, honesty and reportage of scientific facts be ‘biased’.
What would any such bias be biased against?
Diminishing the taking advantage of gullible and vulnerable people?
Oh dear.
In the US Doctors are embracing this alternative quackery. In many cases they are Gagged from discussing Fact based science, because it could interfere with someone’s belief system. I live in an area with a serious Doctor Shortage, so they conflate actual MDS with Acupuncturists, Chiropractors and anything that comes down the pike. Low income people with no access to good healthcare, in the USA are often Misdiagnosed or postponed, making them ideal candidates for exploitation.