Many thanks to Steve Eabry for being a mentor, friend, and editor and contributor to the defunct 'The Rub'. This piece, for the most part could have been written yesterday.
Beware the Robes of Science
Steve Eabry
We are a peculiar people, we European/North Americans. We often demand to know why and how something works before we ask if it does. It isn't enough for us to experience something and to accept it. We can't accept something of value until we are convinced that it is logical, that the system fits within some preconceived mechanism or that it has been "proven" (by someone else) to work. We have even developed a unique system, the scientific method, to prove things. Science has become one of the special religions of our culture: it both regulates and comforts us.
Our adherence to the religion of science contrasts with the attitude of most of the world's peoples, who are generally content to know that what they do works and are not interested in the how or why. Bodywork, both here and throughout the world, has been accepted and utilized because it works. People know that. Now, with the desire to be eligible for third party reimbursement, our profession is being challenged to scientifically prove the how and why of what we do, as well as that it works.
In many ways, this is good for us and for our consumers. Not only will it help to support and refine what we do, and give comfort to the people who don't now know the benefits of massage and bodywork, but it will help to establish our niche within the religion. I criticize and poke fun at science, but belief in it is a fact of life in our society. Also, I have worked within the profession of science for the past 35 years. Perhaps it is this experience which allows me to see through the incense and beyond the altar and the robes and to be concerned about the imposition of science upon bodywork.
Don't get me wrong. I am very happy that the National Institutes of Health has gotten involved in the study of alternative forms of health care, including the sponsoring of research. I also am very happy with the recent report that Americans utilize alternative therapies (including massage) to a greater extent than Western medicine, and spend more on it than hospital care.
However, I am bothered when Chinese medicine and ayurvedic techniques (both thousands of years old) and the various forms of bodywork are labeled as "unconventional," "non-traditional," "unorthodox" (isn't that a religious word!), and "alternative," in contrast to modern medicine, which is less than 200 years old. This is only a game of semantics being imposed upon us by the high priests.
Of real concern to me, however, is the imposition of standards by which we must demonstrate the efficacy of our work, particularly when these standards are not equally applied to Western medicine. There is a call now for scientific studies of alternative therapies. While I support this concept, I caution our profession to be vigilant, to keep science as a tool, not a religion. Let's prevent another AMA witchhunt of the 1930s and 1940s that resulted in the outlawing of many important therapies labeled as "quackery," only because they threatened the ruling priests. Many of these have only recently become available again, e.g., ultrasound, the many color and magnetic therapies, and many disease-fighting nutritional systems. Now, however, they are available only underthe robes of mainstream medicine and at very high cost.
While "modern" medicine parades under the religion of science, for the most part it is not scientific. Most therapies applied daily in doctors' offices and hospitals throughout the country have never been tested by the scientific method; their efficacy is unknown. Dr. Richard Smith, editor of the British Medical Journal, recently published an article in the Journal of Medical Ethics challenging the science of medicine. Dr. Smith says, "I want to argue here that the scientific base of medicine is weak and that it would be better for everyone is that fact were more widely recognized." He reviewed the medical literature, concluding that the scientific evidence in it is poor. He cites a Canadian study which evaluated 4,000 recent medical papers. The study applied 28 basic criteria that should be met in scientific studies to these papers. The authors of that survey concluded that only one percent of the papers met all the criteria. They found that only one in 10 papers published on internal medicine were scientifically reliable, one in 20 for general medicine and only one in 25 in the specialty journals were scientifically reliable. Dr. Smith cites other studies which find that only "about 15 percent of medical interventions are supported by solid scientific evidence.....Often statements were notsupported by any evidence at all -- recommendations were grossly oversimplified; the rationale contained logical errors; and some recommendations were actually refuted by this very evidence." Dr. Smith concludes that "doctors wanttobelieve that they know more than they do, both because it feels good andbecause knowledge is power. And the public likes the idea that doctors will cure them or even keep them from death."
The scientific method involves posing a question and designing a protocol within which we collect data to answer the question. We have libraries full of"scientific" studies which ask the wrong question and/or have a faulty protocol. In fact, science often intentionally asks inappropriate questions because we can't design an economical study to address our real concerns. Even when the scientific method is applied appropriately, we must be very cautious. While science assumes that the whole of reality can be analyzed in terms of data points, each with a separate existence, the space between the points if often ofequal or greater importance than the point measured. Additionally, anything that can be seen or heard or measured or handled by scientific instruments is in itself an abstraction, unfolding and isolated from the system or process.
All this is not so much to argue against the science of medicine, or to restrict the scientific testing of the efficacy of bodywork. It is, however,intended to erect a large warning sign for our profession to be very wary of the people approaching us now, wearing the robes of science. We must not accept a standard which isn't applied to the therapies with which we are being compared. Let us understand science well enough so that we can learn what we would like to know about our work and not what others would like to say about us. Let us use science as appropriate and for our needs. Let's not allow our profession to be used by science.
Beware the Robes of Science
Steve Eabry
We are a peculiar people, we European/North Americans. We often demand to know why and how something works before we ask if it does. It isn't enough for us to experience something and to accept it. We can't accept something of value until we are convinced that it is logical, that the system fits within some preconceived mechanism or that it has been "proven" (by someone else) to work. We have even developed a unique system, the scientific method, to prove things. Science has become one of the special religions of our culture: it both regulates and comforts us.
Our adherence to the religion of science contrasts with the attitude of most of the world's peoples, who are generally content to know that what they do works and are not interested in the how or why. Bodywork, both here and throughout the world, has been accepted and utilized because it works. People know that. Now, with the desire to be eligible for third party reimbursement, our profession is being challenged to scientifically prove the how and why of what we do, as well as that it works.
In many ways, this is good for us and for our consumers. Not only will it help to support and refine what we do, and give comfort to the people who don't now know the benefits of massage and bodywork, but it will help to establish our niche within the religion. I criticize and poke fun at science, but belief in it is a fact of life in our society. Also, I have worked within the profession of science for the past 35 years. Perhaps it is this experience which allows me to see through the incense and beyond the altar and the robes and to be concerned about the imposition of science upon bodywork.
Don't get me wrong. I am very happy that the National Institutes of Health has gotten involved in the study of alternative forms of health care, including the sponsoring of research. I also am very happy with the recent report that Americans utilize alternative therapies (including massage) to a greater extent than Western medicine, and spend more on it than hospital care.
However, I am bothered when Chinese medicine and ayurvedic techniques (both thousands of years old) and the various forms of bodywork are labeled as "unconventional," "non-traditional," "unorthodox" (isn't that a religious word!), and "alternative," in contrast to modern medicine, which is less than 200 years old. This is only a game of semantics being imposed upon us by the high priests.
Of real concern to me, however, is the imposition of standards by which we must demonstrate the efficacy of our work, particularly when these standards are not equally applied to Western medicine. There is a call now for scientific studies of alternative therapies. While I support this concept, I caution our profession to be vigilant, to keep science as a tool, not a religion. Let's prevent another AMA witchhunt of the 1930s and 1940s that resulted in the outlawing of many important therapies labeled as "quackery," only because they threatened the ruling priests. Many of these have only recently become available again, e.g., ultrasound, the many color and magnetic therapies, and many disease-fighting nutritional systems. Now, however, they are available only underthe robes of mainstream medicine and at very high cost.
While "modern" medicine parades under the religion of science, for the most part it is not scientific. Most therapies applied daily in doctors' offices and hospitals throughout the country have never been tested by the scientific method; their efficacy is unknown. Dr. Richard Smith, editor of the British Medical Journal, recently published an article in the Journal of Medical Ethics challenging the science of medicine. Dr. Smith says, "I want to argue here that the scientific base of medicine is weak and that it would be better for everyone is that fact were more widely recognized." He reviewed the medical literature, concluding that the scientific evidence in it is poor. He cites a Canadian study which evaluated 4,000 recent medical papers. The study applied 28 basic criteria that should be met in scientific studies to these papers. The authors of that survey concluded that only one percent of the papers met all the criteria. They found that only one in 10 papers published on internal medicine were scientifically reliable, one in 20 for general medicine and only one in 25 in the specialty journals were scientifically reliable. Dr. Smith cites other studies which find that only "about 15 percent of medical interventions are supported by solid scientific evidence.....Often statements were notsupported by any evidence at all -- recommendations were grossly oversimplified; the rationale contained logical errors; and some recommendations were actually refuted by this very evidence." Dr. Smith concludes that "doctors wanttobelieve that they know more than they do, both because it feels good andbecause knowledge is power. And the public likes the idea that doctors will cure them or even keep them from death."
The scientific method involves posing a question and designing a protocol within which we collect data to answer the question. We have libraries full of"scientific" studies which ask the wrong question and/or have a faulty protocol. In fact, science often intentionally asks inappropriate questions because we can't design an economical study to address our real concerns. Even when the scientific method is applied appropriately, we must be very cautious. While science assumes that the whole of reality can be analyzed in terms of data points, each with a separate existence, the space between the points if often ofequal or greater importance than the point measured. Additionally, anything that can be seen or heard or measured or handled by scientific instruments is in itself an abstraction, unfolding and isolated from the system or process.
All this is not so much to argue against the science of medicine, or to restrict the scientific testing of the efficacy of bodywork. It is, however,intended to erect a large warning sign for our profession to be very wary of the people approaching us now, wearing the robes of science. We must not accept a standard which isn't applied to the therapies with which we are being compared. Let us understand science well enough so that we can learn what we would like to know about our work and not what others would like to say about us. Let us use science as appropriate and for our needs. Let's not allow our profession to be used by science.
posted by Rob Flammia | 7:14 PM
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