Confidence: The Hallmark of a Strong Physician
Posted: under Medical Philosophy, Reviews.
I told a group of people that they need to be careful about alternative treatments. Some are highly effective, while others are entirely bogus and potentially dangerous. One of them asked me to read a book of hers on reflexology1 and let her know what I think of it.
I only needed to read a few pages to confirm my initial reaction. In case you are wondering, reflexology is the practice of massaging hands and feet to affect and heal internal organs. Yes, it is bogus. However, I formed that conclusion before I even knew what it was by discerning the level of confidence the writer of the book displays.
“It should also be noted here that Reflexology is not a panacea . . . it is an adjunctive to medicine and must be regarded as such.” Note the passivity of this sentence from the very beginning of the book; not only the statement itself but the writing tone. I have quoted this exactly as it appears in the book, including the bold “not.”
These next statements are found in the first of five forewords. “It must be said that foot reflexology has not yet been proven as effective.” You will not find a wimpy statement like this in my father’s manual. “For whatever reasons, we do know that patients treated with foot reflexology feel better, function better, and often improve in the biological and psychosocial disorders that lead them to seek help.” For whatever reasons?! This statement is the epitome of subjective standards of evaluating patient improvement. My father did not tolerate subjective standards in his practice. When a patient said “I guess I… I kind of… I don’t know. Maybe I… feel better” that meant “no” according to my father. Furthermore, he measured improvement objectively by comparing speed, fluidity, and range of motion before and after treatment. There is none of that in this book; not even case histories. “Quite probably, it will eventually be shown that foot reflexology alters energy flow in the body.” Now it reveals its true colors. Any treatment dealing with “energy flow” apart from the measurable transmission of nervous electrical impulses or the circulation of nutrients is bogus, without fail. There is no need to bore you with any other details from this book.
We need to scrutinize alternative models and techniques rigorously. We should forcefully reject and oppose the ones that don’t stand up to scrutiny. The problem we have in medicine today is that conventional medicine rejects most alternative treatments, not based on their effectiveness, but based on their philosophy. Meanwhile, alternative medicine accepts almost all alternative treatments, once again not based on their effectiveness, but based on the fact that conventional medicine rejects them. Those of you who are practitioners know this is true. I think it became this way in alternative medicine because few practitioners wanted their own treatments to be scrutinized. They could not stand up to it. So there is an unwritten policy that I will not question yours if you do not question mine.
This practice must stop. We need to start asking the hard questions. How do you know that touching the center of someone’s foot will affect their kidneys? If you do not have a logical, rational, reasonable explanation, then I will reject your model and oppose it. There are large variations in the effectiveness of alternative models and treatments. To build an alternative healthcare system – one that will become the standard system – we must take what works from alternative medicine, and also from conventional medicine, and leave behind what does not.
A confident practitioner should be able to stand up in front of other practitioners and, as my father did, ask for their most difficult patients. It is a bit counterintuitive that this confidence comes from being willing to recognize failure and then taking the necessary steps to improve techniques and adjust the model.
Alexander Typaldos
1 Byers, Dwight C. (1991). Better Health with Foot Reflexology. Saint Petersburg, Florida: Ingham Publishing, Inc.
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Mar 02 2012
