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Complementary and alternative medicine Medicine Quackery Skepticism/critical thinking

FAQ: Woo versus non-woo

I don’t think I could have done it much better, if at all.

Dr. R.W. presents, in FAQ-form, a primer on the difference between woo and conventional medicine, even conventional modalities that are weakly grounded in evidence.

A couple of examples:

Many of mainstream medicine’s conventional treatments are not evidence based. Aren’t they a form of woo?

No. Although some conventional methods fail to measure up to best evidence they are at least based on known anatomy and physiology. They have some plausibility in the observable biophysical model in contrast to the “vital forces”, nebulous “energy fields” and “non-local powers of the mind” which are characteristic of woo.

But most importantly, he describes why it’s important to distinguish woo from non-woo:

Then why make a distinction?

Because of important differences in the ways the problems manifest themselves. Mainstream medicine applies a double standard and that’s what I’m trying to expose. People in the mainstream are appropriately critical of conventional deviations from best evidence and are trying to correct the situation. But due to the nature of the problem—a complex interplay of system and cognitive failures—the fix is not easy. In contrast (and here’s where the real hypocrisy comes in) mainstream medicine uncritically embraces woo, applying to it a much easier evidentiary standard and often no standard at all. The remedy for the problem of woo would be much simpler, too. Mainstream medicine could simply say no. Woo, by definition patently implausible, is easy to spot. There’s nothing complicated about it.

He’s referring to the way that woo is creeping into conventional medicine in our hospitals, in our medical students, and in medical schools themselves, even as mandatory classes. And he’s right; we do apply a different and weaker evidentiary standard to woo, primarily because patients want it, and we don’t want to lose them. Hence, woo becomes a marketing tool.

I know some here probably get tired of hearing me say this, but there should be no such thing as “alternative medicine.” There should just be medicine, and the same standards of biological plausibility, scientific evidence, and clinical evidence should be applied to both.

Is that so wrong?

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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