Enemies of Reason: The Irrational Health Service

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Permalink Reply by david rodway on September 19, 2008 at 6:21pm

Primary care is when the patient comes straight to you, not via referral. So GPs, osteopaths,dentists are primary health care practitioners, whereas surgeons and consultants are secondary.
David

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Permalink Reply by Kuno on September 19, 2008 at 8:33pm

We are primary because we make decisions about patient care without having to refer to other practitioners. In short we can diagnose, and MUST diagnose.

Complementary is a term in law which covers us, effectively it means we are supposed to act in a supporting role to medicine - how we let that pass I do not know.

Supplementary covers physiotherapists, who act at the direction of others - ie, they can't diagnose (although they often do).

Alternative is not an official term, but I really like it. We can be Primary care AND alternative - we can make our own clinical decisions. We can do so with our own understanding of what is going on. But if it backfires, we're on our own. If we're complementary, then we think we're making decisions, but just like the guy in the bank we're actually just following strict flowcharts.

We do have an alternative understanding of physiology, it's just that we are not being taught it in college. Today in the Lancet is a report linking paracetemol with asthma, eczema and hay-fever - 46% increase in cases of lifelong debilitating disease where babies were given calpol, in other words. Osteopathic physiology tells us that fever is a healthy process, suppression is folly - we've known this link for years and everybody laughed. Even the box says 'for the relief of symptoms' - the manufacturers make no health claims. Yet still today the medics are saying against all the evidence (this and more) fever is a problem and must be suppressed. Wrong or right, we have our own distinct version.

Anatomy is viewed differently in terms of emphasis, we are interested in the connections and relationships, whereas medical anatomy is concerned with the individual pieces after separating them out. Pathology doesn't exist - it ought to be called pathosophy, because of the anthropomorphic descriptions of microbiology as analogous to society and nation-states at war, shrunk to miniature. We can't actually walk into a room full of blood cells and ask 'what are you doing now', so it is an understanding based on human experience, not a specification, of what is happening. It is not the only way to see these things. Again, this is not being taught.

These things are in the osteopathic texts, but they're a bit old now. It's actually possible to graduate reading medical books only and never reading an osteopathic text.

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Permalink Reply by Andy Cotton on September 19, 2008 at 9:19pm

Kuno, your posts get better all the time.
Bravo.

Andy

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Permalink Reply by Andy Cotton on September 16, 2008 at 8:52am

I agree with Howard, but this is not what is taught in the name of Osteopathy in our schools. Many Osteopaths won't understand what he means by the natural consequences of disturbance, and we Osteopaths actually have a very fractured intellectual body. Perhaps when he has the time, Howard could outline more fully why Osteopathy does not accept medical pathology, or suggest a reference?

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Permalink Reply by Ronan O'Brien on March 26, 2008 at 11:26am

There was another program on BBC last night in a similar vein to Dawkin's program. It's presented by Kathy Sykes, a professor at Bristol University, and explores reflexology. What has this got to do with osteopathy? One of the main topics discussed is how touch can activate the placebo effect.

Those in the UK can watch the program through BBC's iPlayer

The Guardian also have an article about it - It is unscientific to pour wholesale scorn on complementary medicine

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Permalink Reply by Clement Rhein on June 4, 2008 at 12:44am

O my! Don't we just love information like this. For me, the biggest question is where does the funding for this program comes from?
We know alternative therapy is more and more popular, because people are not stupid, they go to what works. I think this is not appreciated by pharmaceuticals (who make drugs out of love ;-)Joel) which are largely, if not only there for the money. So we get programs like this, for business purposes.

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Permalink Reply by Simon Collyer on September 16, 2008 at 8:55am

Interesting discussion. Although I've not seen the program, I have read some of Dawkins' stuff and he is clearly an extremely intelligent and insightful man. However, that doesn't mean that he is right in everything he says.

Some of the comments on this page reminded me of a very interesting series of podcasts, published by CBC. The series is entitled "How to think about science" and consists of a series of interviews with prominent scientists and philosophers, discussing science itself. It looks at our modern methods, things like peer reviewed research, traces their origins and questions their ongoing validity in the face of the evolution of our knowledge. We have created a framework that is able to question everything but itself. Perhaps it is time that it started to change that.

I'm not suggesting that either argument is right or wrong, God knows* that Dawkins is exponentially smarter than I am. I just find it hard to believe that someone as passionate as him can be as open minded as he claims to be.

* Or does he?

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Permalink Reply by Richard Clements on September 16, 2008 at 11:16am

Interesting thread/debate,
Dawkins hates irrationality and despises those who spin irrationality, hence his preacher like zeal against religion. But we do need people like him to stir the pot a little. I find his TV appearances clumsy and somewhat disappointing when compared to his writing. If you get a chance to read his forward to John Diamonds' book "snake oil and other preoccupations", (also printed in "a devil's chaplain"), then you get an idea of where he's coming from. He and john diamond were good mates; when diamond was famously dying of cancer he was inundated by alternative "freaks" promising a cure; and nothing gets dawkins goat more than these guys.
Dawkins doesn't mention osteopaths in his forward, however he does state " Manipulation can undoubtedly be very effective". Even Dawky gets a "cricked neck" occasionally (he, he).

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Permalink Reply by Kuno on September 17, 2008 at 8:59am

What gets Dawkins' goat is I'm afraid not really a scientific measure by his own standards. In the event that I get cancer, there are any number of people I would go to before the NHS. Dawkins, likewise, can go to whoever he chooses and we'll let natural selection decide the outcome.

Not wishing to make assumptions regarding Dawkins' friend, but by the time people reach that stage is not the time to be getting to grips with a whole new health paradigm. Arriving at such a stage unprepared, the default option is medicine, and anything else is confusion.

Funnily enough, medicine's monopoly over cancer care is not a product of science (the results speak for themselves) - it is enshrined in law. If Dawkins believes in rationality he should campaign to have the medical and alternative understanding of cancer evaluated by methods more rigorous than the 'goat' test.

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