America has a sordid past with less than scientific medical practices. Bloodletting failed to heal our President George Washington on his deathbed, for example, but that was hundreds of years ago. Medicine is a constantly improving science, but occasionally bad ideas stick around or rise to popularity before they can be debunked. It is called pseudoscience because it is specifically misleading in an attempt to sound legitimate.
Alternative medicine is both the most important, and most sensitive, subject in Skepticism. We have had chiropractors show up at our Skeptics In The Pub events with binders full of alternative research articles. We’ve had intense moments between parents and anti-vaxxers. It’s a touchy subject, because admitting you are wrong about homeopathy may also mean admitting you’ve been giving your children sugar pills for years, or throwing away thousands of dollars on elaborate stage theater in the case of touch healers, reiki, and others.
Osteopathy, chiropracters, and ‘Complementary and Alternative Medicine” (CAM) in general is a hot button issue with many of my friends at the moment. A mutual friend of ours was nearly killed from the dubious treatments performed on her by a chiropractor and a doctor of osteopathy. When the subject came up I mentioned the dangers of false medical practitioners and touched the nerves of another friend whose cousin is a Doctor of Osteopathy. Backpeddling, I mentioned the dubious nature of chiropractic adjustments and involved more friends who jumped in with their pro-chiropractic anecdotes. It can be tough, because pseudoscience builds from existing knowledge, then exploits public gaps in that knowledge.
Not sure what a Doctor of Osteopathy is? D.O.s are M.D.s who complete an additional course in medical school, and less than 10% of physicians elect to claim this title. Osteopathy is self-defined by the platitude “Treat the patient, not the disease.” The perspective is equivalent with other red-flag terms; ‘holistic’ ‘whole-body approach’ and ‘healing of body and spirit’. Osteopathic Manipulation is their trademark procedure which amounts to face massage and skull squeezing to treat various unrelated illnesses throughout the body. Does taking a course in debunked ideologies make you a bad doctor? Not necessarily.
Dr. David Gorski, MD, PhD, is an academic surgeon and managing editor of Science-Based Medicine. I asked him about the subject and his response was:
“In the US, most DOs are not distinguishable from MDs. They still learn woo in school but usually don’t use it in practice. Postgraduate training generally weans DOs from the woo, or they learn it because they have to and then forget.”
The tricks behind osteopathic cranial manipulation and chiropractic subluxion adjustments are the same. Find a problem, explain the cause is somehow related to something they can manipulate, then manipulate it. Was the manipulation related at all to the affliction? Was there even an affliction to begin with? The problem is that they often this kind of hands-on pseudoscience with additional sound medical treatment and it can be extremely difficult to know which they’re performing on you. They use similar medical terminology specifically so that you miss the leap in logic they make to complete their argument.
“I guess you think you’re SMARTER than the best doctors in the world then.”
This second quote was received in response to my cartoon and post about aloe vera, and is an extremely common argument. First, this is the fallacy of the expert observer which assumes that professionals do not make mistakes, or that they have time to look into every misleading medical claim. Second, healthy skepticism is not a function of intelligence! Intelligent people can be fooled by an occasional myth and by simple magic tricks just as easily as the rest of us, which is how pseudoscience works, by misdirection. One goal of skepticism is to recognize a few common tricks used to market fraudulent products and practices, and be fooled less often.
Take Biodynamic Cranialsachral Therapy (osteopathic skull squeezing) which can purportedly treat anything from asthma to menstrual cramps. The argument goes like this:
1. The skull is actually made of many connected bones that can flex.
2. Tissue, such as the brain, move with a rhythm along with respiration.
3. By squeezing the skull, a practitioner can interpret and manipulate the “tides” of your body, and resolve trapped forces that underlie disease.
…Can you please explain how that works, but with science?