Research can be defined as the process of discovering new knowledge. There are three somewhat overlapping types of research:
- Exploratory research is research around a problem that has not yet been clearly defined. It aims to gain a better understanding of the nature of the issues involved with a view of conducting more in-depth research at a later stage.
- Descriptive research creates knowledge by describing the issues according to their characteristics and population. It focuses on the ‘how’ and ‘what’, but not on the ‘why’.
- Explanatory research is aimed at determining how variables interact and at identifying cause-and-effect relationships. It deals with the ‘why’ of research questions and is therefore often based on experiments.
The motivation behind doing research in medicine does, of course, vary but essentially it should be to help advance our knowledge and thus create progress.
I have been a researcher in several areas of medicine: physical medicine and rehabilitation, blood rheology, so-called alternative medicine (SCAM). My kind of research was mostly the explanatory type, i.e. formulating a research question and trying to answer it. Looking back at my ~40 years as an active researcher, I find remarkable differences between doing research in SCAM and the other subjects.
The process of discovering new knowledge is rarely contentious. New knowledge may be useful or useless but it should not generate contention. Of course, there can be debates about the reliability of the findings; this is entirely legitimate, helpful, and necessary. We always need to make sure that results are valid, reproducible, and true. And of course, the debates about the quality of the data can generate a certain amount of tension. Such tensions are stimulating and must be welcomed. I have been lucky to have experienced them in all areas of the research I ever touched.
The tension I experienced while doing SCAM research, however, was of an entirely different nature – so much so that I would not even call it ‘tension’; it was outright hostility. While doing non-SCAM research, it had never been in doubt that my research was honestly aimed at creating progress, this issue became the focal point after I had started SCAM research.
- When my research showed that homeopathy might not be effective, I got PERSONALLY attacked by homeopaths.
- When my research showed that homeopathy might not be safe, I got PERSONALLY attacked by homeopaths.
- When my research showed that chiropractic might not be effective, I got PERSONALLY attacked by chiropractors.
- When my research showed that chiropractic might not be safe, I got PERSONALLY attacked by chiropractors.
- When my research showed that acupuncture might not be effective, I got PERSONALLY attacked by acupuncturists.
- When my research showed that acupuncture might not be safe, I got PERSONALLY attacked by acupuncturists.
- When my research showed that herbalism might not be effective, I got PERSONALLY attacked by herbalists.
- When my research showed that herbalism might not be safe, I got PERSONALLY attacked by herbalists.
- Etc., etc.
Essentially, doing SCAM research felt like doing research not FOR but AGAINST the will of those who should have had the most interest in it.
As I said, one way to describe research is as a process of discovering new knowledge and creating progress. The main difference between doing research in SCAM and non-SCAM areas is perhaps this: in medicine, almost everyone is interested in discovering new knowledge and creating progress, while in SCAM hardly anyone shares this interest. In SCAM, I now tend to feel, research is not understood as a tool for finding the truth, but one for generating more business. To put it even more bluntly: medicine, in general, is open to research and its consequences hoping to make progress; SCAM is mostly anti-science and not interested in progress.
To me, the answer seems obvious: the truth or progress would be bad for the business of SCAM.