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, or pretty easily online. 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.
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
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 where 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 chose 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 connected with my clinical work. 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. I have participated as a researcher in clinical trials sponsored by pharmaceutical companies investigating new veterinary medicines. I am also employed by a biotech company studying aging in dogs and hoping to develop therapies to reduce the impact of age-associated diseases. I joined this company in 2020 because of my interest in the work and my confidence in the scientific integrity of the team.
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. I also support disclosure of any financial or other relationships between researchers, clinicians, and the biomedical industry so that any potential conflicts can be openly identified and considered.
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: