Advice to an Arrogant Medical Priesthood: Wash Your Hands
There is an internet cottage industry of physicians and scientists who regularly excoriate alternative medicine and other non-traditional or even fringe approaches to health or to scientific understanding. Steven Novella, Orac, and a host of other faux "defenders of science" decry the danger to the public from vaccine "denial," homeopathy, acupuncture, chiropractic, among others. Now, I agree with my medical colleagues that the scientific basis for most of these practices or viewpoints is missing or minimal. I don't believe that the scientific evidence supports the view that vaccines cause autism. I am not a supporter of "alternative medicine," and I objected when an effort was made some years ago to expand alternative medicine here at Stony Brook. Alternative medicine, like traditional medicine, must be subjected to strict standards of evidence for safety and efficacy. Most types of alternative medicine fail to meet those standards, and therefore should not be endorsed by the medical profession.
Yet there is an irony in the efforts of "defenders of science" to protect the public from treatments and theories that are outside of the mainstream of medical practice. The greatest iatrogenic danger to patients isn't chiropractors or homeopaths or vaccine "deniers." It's the doctors, nurses, and other medical personnel working in the traditional medical paradigm.
The data is uncontestable. Each year in the United States, errors of traditional science-based medical practice kill at least a hundred thousand people, probably substantially more. These errors include medication errors, surgical errors and unnecessary surgery, preventable bedsores, infections caused by poor technique and the failure of medical personnel to practice good hygiene such as hand washing, and many others. Note that none of these deaths are caused by homeopaths, vaccine "deniers," etc.
The harm done by traditional practitioners of medicine is one of the leading causes of death in the United States. Where is the introspection by "skeptics" and "science defenders" like Drs. Novella and Orac about the enormous harm done to patients by themselves -- traditional medical practitioners? What hypocrites.
Simple measures such as hand washing, site-marking prior to surgery to affirm that the patient and the surgery are correct, and computerized pharmacy and prescriptions to avoid errors can make (and are making) big differences in mortality and morbidity associated with medical care. In my own hospital, we have prevented several hundred deaths (based on mortality rates from past years) by such expedients as mandating and facilitating hand washing by doctors and nurses as they move between patient rooms and by a focused effort to reduce hospital acquired pneumonia and blood infections.
Arrogance of scientists and physicians is an old scourge. Alfred Russel Wallace, who helped develop the theory of evolution in the 19th century and who confronted the scientific arrogance of his own day, famously commented on medical arrogance in a different context (i.e. eugenics), calling it
... an arrogant scientific priestcraft. (1)
Despite all of the enormous benefit to mankind conferred by mainstream science and medicine, considerable harm is done as well. Nothing in non-traditional medicine comes any where near the harm done to patients by mainstream medical errors and even malfeasance (e.g. unnecessary surgery). We are beset by an arrogant medical and scientific priestcraft, eager to call ordinary people "idiots" or "anti-science" or "deniers" because they hold viewpoints with which these particular scientists and physicians disagree. I believe that much of the motivation for the "pro-science" priesthood isn't patient safety or a genuine respect for scientific method but ideological hegemony. What bothers materialist ideologues like Novella and Orac is that there are people who challenge their materialist scientific worldview. There is a deep arrogance to the commentary and tactics of these defenders of science.
Far more damage is done to patients by doctors and other mainstream health care providers than is done by vaccine "deniers," acupuncturists, homeopaths, etc. Fatal disease is much more likely to be spread by a doctor's unwashed hands than by some (mostly misguided) parents who fear that a vaccine may harm their child. I've never known a patient to be harmed by a chiropractor. Tens of thousands of patients each year are harmed in preventable ways by their (usually well-intentioned) surgeons.
My advice to Dr. Novella, Orac, and other arrogant medical clergy: go easy on the parents concerned about autism from vaccines, even though the evidence suggests that their fears are unfounded. They're not idiots, and they shouldn't be treated with scorn. A little humility on the part of doctors, and some respect for the right of people to hold other views (even if those views are wrong), and to act on those views, would be a good thing. Respectful discourse with patients who disagree with our advice, not scornful excoriation, is much needed.
Doctors should be less arrogant with our advice and we should denounce faux "skeptics" like Dr. Novella and Orac who exhibit no skepticism about their own dogma and behavior and are coarsening this discourse because of their own ideological commitments rather than for any rational commitment to public health.
We doctors need to wash our own hands.
(1) James Marchant, Alfred Russel Wallace: Letters and Reminiscences (New York: Harper and Brothers, 1916), p 476.