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.
But why?
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.
But why?
To me, the answer seems obvious: the truth or progress would be bad for the business of SCAM.
3 Responses to A FEW UNPLEASANT THOUGHTS ABOUT DOING (SCAM) RESEARCH
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The ‘bad for business’ is evidenced by the litigation that many alternative ‘medical’ practitioners have instigated against those orthodox scientists or medics who publish negative findings about their claims of efficacy.
precisely! for instance, BCA vs Simon Singh https://en.wikipedia.org/wiki/British_Chiropractic_Association_v_Singh
I think that protecting their business of selling useless products and services is not the only or even the most important reason why SCAM practitioners are often showing an extreme overreaction to criticism of their system of belief.
From what I see, their status as a ‘wise healer’ is just as important to many of these people, and I’ve seen up close how some of them attain a guru-like reputation, complete with devoted followers, or at least blog pages with lots and lots of very positive (not to say fawning) reactions.
Combined with the fact that these people often built their whole life around (and thus invested heavily in) their alternative beliefs, this means that any criticism of those beliefs is often experienced as a huge personal threat: they would become a laughing stock, a real-life example of the proverbial emperor prancing around without clothes – and even worse: it would expose them as a medically incompetent con artist. For many people, this prospect of a severe social downfall is far scarier than just having to admit that your business is not actually based on reality, and consequently look for another occupation.
Then again, I am not a psychologist or sociologist, and the above are just my personal observations – if anyone can think of other reasons(*) why especially alternative practitioners are so prone to overreacting to criticism and resorting to ad-hominems, I’d be most interested.
Also, I wonder what the best way is to deal with the sentiments of these people. I really want to be respectful to anyone and everyone regardless of what they believe, but that becomes a bit complicated when those people respond in a hostile manner when their beliefs are questioned.
*: OK, there’s of course the major problem that they can’t come up with a proper science-based rebuttal to any criticism … But there are bound to be more reasons.