Frequently Asked Questions (FAQ)

Who are you?

It doesn’t matter who I am. My ideas and arguments should be judged on their own strengths and weaknesses, not on the basis of whatever prejudices you may have about me as a person. Am I more likely to be right if I am a woman or a man? Does my analysis of scientific research suddenly become more or less accurate if you discover where I went to school, where I practice, or what color I am? These are irrelevant facts that people use to distract from the points I make rather than deal with them directly. The focus remains on the issues, ideas, and facts under discussion, not on irrelevant personal details about me.

I have no particular desire for attention or notoriety, but I am certainly willing to take responsibility for the statements I make here. While it is (barely) possible to blog completely anonymously, it requires a great deal of effort, and I have not made that effort (though given the amount of angry, even hysterical hate mail I get, I sometimes wish I had). You can find my identity here. But before you do, ask yourself if it is really relevant to the merits of my argument, or if it is just going to make it easier to dismiss what I say by applying your pre-existing biases and prejudices to me.

Have you tried all the methods you criticize for yourself? How can you know if something works or not without trying it?

A core belief that seems to run through all kinds of alternative medicine is that personal experience is the best way to evaluate a medical treatment. This is the central issue that divides scientific medicine from pseudoscience and faith-based medicine. If you believe that the personal experience of pet owners and veterinarians is as reliable, or even better than, objective scientific research, then nothing I say in this blog is going to make any sense to you.

I am often criticized for being arrogant, for thinking that just because I have studied the scientific evidence I know better than people who have practiced or used alternative medicine for years. The truth is that arrogance is believing our own perceptions and impressions are trustworthy and sticking with what we believe regardless of the amount of evidence against it. True humility lies in recognizing our limitations and acknowledging that we are easily fooled, especially by ourselves. We see what we want and expect to see, we notice facts that support our beliefs and ignore those that contradict us, and we cannot suspend or compensate for our own biases just by willpower and honest intentions. Sure, I’ve tried some alternative therapies, and some seemed to help while others didn’t. But I know enough to know that that is not how I should decide whether or not they work!

The history of medicine makes it clear that the scientific method is not simply one of many equally valid ways of looking at heath and disease. It is a more effective way because it compensates for the innate flaws in human perception and judgment. In only a couple hundred years, science has allowed us to double the average life expectancy of human beings (at least where modern nutrition, sanitation, and healthcare practices are available), eliminate some diseases all together (such as smallpox), and make other improvements in health and well-being that were never achieved in the thousands of years we relied on intuition, tradition, and individual experience to evaluate the causes and treatments of disease and the best ways to maintain health. Pre-scientific medicine persisted in practices such as bloodletting, purging, and the use of toxic “natural” medicines such as mercury because they seemed to be effective, although they actually did more harm than good.

In the modern era, many practices that patients and doctors believed were effective based on personal experience and judgment turned out, when studied scientifically, to be worthless or even harmful. Mammary artery ligation surgery and arthroscopic debridement and lavage of arthritic joints are a couple of examples in human medicine. And there are just as many examples in veterinary medicine. For years we gave antibiotics to young cats with blood in their urine because we thought they had urinary tract infections. They almost always got better on the medication, so the vet got the credit and everybody was happy. Unfortunately, controlled scientific researched showed that the cats didn’t really have infections and they would get better just as often and just as fast if we didn’t give them antibiotics, and without the risk of vomiting and diarrhea from the medication.

Personal experience and anecdotes are incredibly powerful and persuasive. They just aren’t reliable guides to the what really works and what doesn’t. And the hardest part of accepting science-based medicine, and all the remarkable successes that have come from it, is having the humility to acknowledge that what seems obvious to us isn’t necessarily so. Below is a collection of resources which I recommend for starting to come to grips with this unpleasant truth.

Books 

Don’t Believe Everything You Think: The 6 Basic Mistakes We Make in Thinking by Thomas Kida

Why People Believe Weird Things
by Michael Shermer.
Becoming a Critical Thinker- A Guide for the New Millenium by Robert T. Carroll

Blog Articles

The Role of Anecdotes in Science-Based Medicine

Why We’re Often Wrong

A Budget of Anecdotes  

Why We Need Science: “I saw it with my own eyes” Is not Enough

Videos

Pitfalls of Thinking: Anecdotal Evidence

 

 

Are you paid by the pharmaceutical industry or commercial pet food companies? Aren’t you just afraid of alternative medicine because it threatens your income?

I am an employee in a private, small animal practice. I get paid a salary, so how much money I make isn’t connected at all with which/how many drugs or other medical products I use or sell. I could also make a lot more money doing other things, but I stick with clinical medicine because I believe it is important and ethical work and because it is challenging, interesting, and satisfying intellectually and emotionally.

I do not receive any money directly from pharmaceutical companies or commercial pet food companies. I do not accept gifts from such companies, though I cannot guarantee that I haven’t ever used a pen or pocket calculator with some company’s logo on it. And I have participated as a researcher in clinical trials sponsored by pharmaceutical companies investigating new veterinary medicines.

I do think there are legitimate and serious concerns about the influence of industry funding on the reliability of scientific research and the practice habits of individual doctors.  As a supporter of the All Trials Initiative, I feel strongly that all the information produced in the course of drug development should be freely available to the public, as should potential sources of bias or conflict of interest.

However, the notion that scientific medicine is all about corporate profit and that alternative medicine is an altruistic labor of love is self-serving nonsense. Providers of alternative therapies make their living selling the products and services they believe in, and so do I. And all those “free” and “unpatented” natural remedies are manufactured and sold by a multi-billion dollar supplement industry that is no more altruistic than any pharmaceutical company. Attempting to dismiss my arguments as financially motivated is inaccurate, lazy and, for anyone who also works in healthcare, hypocritical.

Some more detailed responses to this line of argument:

The David and Goliath Myth

Big CAM, and Getting Bigger

The AHVMA-Bought and Paid for by Big Supplement?

The “pharma shill” Gambit

The Ad Hominem Fallacy

115 Responses to Frequently Asked Questions (FAQ)

  1. Charles Bryant says:

    Thank you so much for the information provided on your website. I have been working for an Internal Medicine Practice for 12 years under 3 Dip. ACVIM doctors. On currently practicing for 47 years. As time goes by more and more of our clients are being stooped into believing non-science based information they read online. Most recently, Glacier Peak Holistic Pet Life Scan. I have provided my client with your review of their rubbish. Thanks again!!!

  2. Johanna van de Woestijne says:

    I’m in the USA and read your review of the causes of death of cats with interest. I constantly argue for keeping cats indoors for public health reasons, and benefits to cats of avoiding traumatic death under car tires. If I’m generalizing, not doing an age breakdown, what would be a fair % to say of outdoor cat deaths due to trauma (such as cars) plus disease or infection due to attacks from other animals such dogs, cats, or wild life? I was using roughly 2/3 outdoor cats (including feral or unowned cats) die traumatic deaths, over all. Is that a fair guess, due you think? Realize I’m usually saying that in the context of opposing the release of feral cats (trap neuter release), also opposing feeding of feral cats (neutered or not), and opposing leaving pet cats to wander (and get hit or attacked).

  3. skeptvet says:

    Unfortunately, I’m not aware of any reliable data on the proportion of owned cats allowed outdoors who die from trauma, infectious disease, and other risks associated with the outdoors. I think it very likely that these risks are common, but there are many variables, especially the temperament and behavior of the cat and the nature of the local outdoor environment. I think it is fair to say these are real and serious risks, but putting a number on it probably implies greater precision than we can claim without more evidence.

  4. Serena says:

    Hello,
    My almost 7 year old Doberman was just diagnosed with Wobblers Disease and my search for alternative treatment to steroids led me to you , What do you recommend as the best treatment for this? I have had suggestions from Gold Bead Therapy to Massage. I am hoping you may have seen successful treatments and would share them.
    Thank you,

  5. I agree with your argument that one should rely on the quality of arguments instead of relying on heuristics we have in virtues of a person. However, as you know, humans are most likely to be persuaded by a person with a head, rather than relying on the abstract information.
    If you rely on deontological notions of ethics, you should do what is right. But I would argue, from a utilitarian point of view, if you persuade more people, more pets would be saved, and their lives and their owner’s life would improve.
    I would say, ends justify the means. I absolutely believe that a physician must use any tools necessary to achieve the best results for the majority.

    To put it in the formal form:
    1. You have knowledge about animal welfare.
    2. Persuading others, about that knowledge, can help improve and save the lives of many.
    3. You should improve and save the lives of many, when you can.
    4. Ends justify the means.
    5. Using superficial methods of persuasion can help more people to be persuaded.

    ?Therefore:
    6. Using superficial methods of persuasion is justified. [2,4,5]
    7. You should use superficial methods of persuasion to persuade other. [1,3,6]

  6. skeptvet says:

    Interesting argument, I guess I am not clear on what you mean by “superficial means of persuasion?” If you are suggesting that I should employ the argument from authority fallacy or other logical fallacies in an attempt to convince others, I would respond that this is contrary to the very purpose of my endeavor, which is to discourage such fallacious reasoning and encourage a more evidence-based epistemology. Even if the end of convincing people would justify the means of using fallacious arguments, I suspect I would not ultimately be changing behavior in the desired direction by using poor reasoning to convince people to eschew poor reasoning.

    I certainly accept that persuasion needs to be effective to be useful, and there is plenty of evidence that evidence alone is seldom persuasive. I have made some changes in my approach over time to try and make my case more effectively. But there is an inherent problem in advocating for science against pseudoscience in that core elements of the persuasive techniques of pseudoscience (reliance on anecdote, authority, logical fallacies, etc) are unavailable to opponents of pseudoscience because they are precisely the kind of reasoning we are trying to discourage. This does give us a disadvantage in the marketplace of ideas, but I don’t see a perfect way around the problem.

  7. I see your point. However, maybe I should have been clearer: Humans don’t like ambiguities. Studies in behavioural economics suggest that to some extent, humans prefer a bad known risk when a better ambiguous choice is available. One of the most important ambiguities one could face is a faceless agent.
    You believe that we should not judge you by gender, color or other prejudices one may have. However, a basic fact of cognitive science is that, we categorize. We assume. and we judge; regardless of what we priorly intend. I do not ask you to rely your reasoning on fallacious ends. But you can make your arguments more user-friendly. Mathematics is much more accurate than natural language. However, many brilliant people hate it, because the language of mathematics is not user-friendly. Still great mathematics professors rely on natural language to make abstract ideas more tactile.
    For example, read the books of Steven Pinker. He explains theories in cognitive science rather more accurately than most textbooks. However, he utilizes anecdotal information, to show the implications of a theory and make it more sensible.

    All this is to say that, you don’t need the flaw your original point, that would be both horrible and successful, in ruining all of this. I’m just saying, that you should consider the power of human intuition when delivering information. A good font is not an argument, however, it makes a good argument, a better one.

  8. Maybe it’s because we are looking at it from different points of view. You mostly have information about when we are wrong. And you want to communicate information, in its most accurate form.
    I’m looking from a cognitivist point of view. I see how brains work, and I care that your messages get received in it’s most accurate form.
    To be clear, I’m not asking you to change your arguments. I’m asking you to add components which makes the original arguments more persuasive in delivery.

  9. skeptvet says:

    So what specifically do your recommend? It sounds like you’re talking mostly about revealing my identity since having a face to put to the arguments will make them more acceptable to some readers. As it happens, my CV is available on the site, and a 1-second Google search will show anyone interested who I am. And, of course, when I speak at conferences or give media interviews, I do so under my real name.

    But my experience, at least, has been that when people refer to this information, they use it as a pretext to dismiss my arguments using an ad hominem of some kind, so I’m not convinced it will make the arguments accepted by a significantly larger number of folks to change how I identify myself on the blog. I think the cognitive dissonance and confirmation bias that impedes believers in alternative medicine from taking in my critiques are far more significant a factor than the issue of how much I personalize myself in making these critiques.

  10. gwen b says:

    nobody bothers to do research on alternative but doesnt means its wrong. all i know is in my case it was a combination of western n homeo plus the five leaf pet pharmacy…everytime we introduced westen meds to my renal failure dog the kidney test got worse. i took that option n as one of the best vet in my country dr marga said there is no correct formula but finding that combination is best. i join the ranks of many whose dog is out of the woods in renal failure with the option to concemtrate on diet homeo hebal subq n probiotic with other homeo fot he enlarged heart. with this the death sentence never came true.

    i took that option in my personal life tumeric n ginger.. n i am healed..no scientif data just experience.

  11. skeptvet says:

    Unfortunately, as compelling as such personal experiences are to those who have them, they aren’t a reliable guide to the way nature actually works or what will be effective or ineffective medical care. Here are many previous discussions of why this is the case (plus a humorous illustration):

    Why Anecdotes Can’t Be Trusted

  12. Jazzlet says:

    Following on from the Tramadol article I would find an overview of pain relief options for dogs extremely useful or direction to where I could find a science based look at the subject.

    My context is a GSD bitch with arthritis already on Meloxicam, I don’t think her pain is under control, my vet recently added Pardale for a couple of weeks to see how she does and has suggested Tramadol and Gabapentin as other possibilities.

    Thank you for providing so much useful information, it really is enormously helpful.

  13. skeptvet says:

    A review of pain control methods for arthritis is a great idea. I have actually collected a number of articles on this subject, but I haven’t updated it in a while, and much of it covers approaches that aren’t very well supported by evidence.

    In general, the evidence for NSAIDs is by far the most persuasive, so these should always be the core of treatment if possible. Other analgesics have considerable less evidence to support them, and as you have seem tramadol is unlikely to be helpful. Evidence for other analgesics (gabapentin, amantidine) is pretty scant and inconclusive. Evidence for laser and physical therapy is also limited, so some potential there and little risk, but unclear how much it helps. Most of the supplements are also theoretical but unproven.

    It might be a good idea to speak with a rehabilitation specialist. They do employ a lot of methods that haven’t been rigorously tested, but they can definitely give you some insight into evaluating comfort consistently, and they have options you can try.

  14. Jazzlet says:

    Thank you!

    Thank you (trying to make comment long enough to post …)

  15. Edward Anzalone says:

    I’m new to this group so I’m not sure what initiated the first few paragraphs of this post. I will say that your advise and other input are invaluable. I have nothing but praise and respect for someone who takes the time to help these beautiful animals. I thank you from the bottom of my heart. Why name is Edward Anzalone and I’m not afraid to discuss with, or take advice from, anyone with caring and love for animals.

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