January 07, 2014

Skeptics™ get their own medical outpost — should they be skeptical?

Skeptics™, in case they were still worried about the proliferation of alt-med, or more bluntly, pseudo-medicine woo on the Internet, need worry no longer. There's now the Institute for Science-Based Medicine.

To quote that everyman philosopher, Tevye, "Sounds crazy, no?"

Well, maybe it's a horse, and maybe it's a mule.(Sing it, Topol!)

And, since I'm not part of Skeptics™, I can take a closer look, as well as a snarkier one, at the critter, whether a gift horse or an old Minsk mule. And encourage others, who may be Skeptics™ but not necessarily on the ground floor, to do the same.

And, per the old adage, I can follow the actual, or potential, money.

Let's do just that.

First, some good Skeptic™ could, if Steve Novella hasn't done it, then form an insurance company that would make sure all these preferred providers were in network. In honor of Dan Dennett, we'll call it BlueBrights!

Said insurance company targets Skeptics™ for sales. Tribalism, to which nobody is totally immune, plus the assurance that all doctors, just like all editors and contributors, have indeed been fully vetted, kicks in and Blue Brights takes off.

Proof of that tribalism? Comment No. 2 on the official annoucment page:
I’m now a member. I feel better already.
Well, good for you.

And, said tribalism would tie in with local chapters, membership dues, conventions and more, all of which are under discussion (conventions and chapters) or already in place, apparently (dues) after just six or seven short weeks.

So, let's not stop there.

Question 1 — are their dues or other fees? I'd venture yes, based on this:
We want there to be local branches of the SfSBM, at your medical school, to have your own SBM at the pub, to organize lectures, and to advocate for SBM in your community.

Traditional medical societies have them. That said, if there were dues, and local and regional chapters, all snark aside, a BlueBrights insurance company would be easier to create.

Question 1A — since Question 1 has been answered by Comment No. 3:
I am now a member as well and paid the full price since I am technically no longer a student.
How much are they? I can't find a "join" link, so I don't know.

Question 2 — will there be preferred providers?

Besides local branches, or before enough critical mass is reached to form them, this would be a great way to highlight skeptical doctors for Skeptics™ readers, right? It would also be a great way to make extra money.

Question 3 — what else should we think about money?

There is a PayPal button on the website. And, given that Commenter No. 10 says:
I will gladly attend an SfSBM conference. Cannot wait for that to happen.
Knowing a bit about other Skeptics™ conference prices, swag and its availability and cost, etc., there's more money streams.

Question 4 — Organization. Is this an official nonprofit agency, or not? Like the issue of dues and membership, the site's kind of skeezy on not having information about this.

Question 5 — other reasons we should be skeptical of the skeptics?

Editor & contributor Dr. Harriett Hall says she's tired of doctor-bashing over money. Well, that probably is some degree of problem, but, she's wrong that it's just quacks who are getting richer. There's been plenty of mainstream media stories about how doctors have been using various forms of incorporation and other business tools to increase their income. Hell, the American Academy of Family Practice even has a piece called ....

Wait for it ...

"How to Maximize Income with Minimal Effort." True, your average doctor isn't making what the physics Ph.D. Wall Street quant is, but, they're getting their cut.

As a New York Times blog puts it, doctors can still, to some degree, induce demand.
There is a large school of health economists who believe doctors already do this — and would do much more of it if their ranks increased. They conclude that increasing the supply of doctors without making any other changes to the health care payment system would increase aggregate health spending because doctors, faced with more competition for the same set of patients, would compensate by prescribing more expensive tests and procedures. The prices of individual services might fall, but the mix of services that doctors provide would become more weighted toward the expensive ones.
And, of course, Dr. Hall's piece immunizes (heh, heh) founders of said group when some people, if outsiders can ever find out, raise their eyebrows over dues costs.

So, color me ... er ...

Skeptical! And, again, a deliberate contrarian.

There's yet more reason to raise an eyebrow at this. Among them are:
1. Further atomization of the professional/science-based skeptic movement.
2. Further narrowing of the focus of all such subgroups, and the overall movement, into just science issues instead of broader issues of critical thinking.
3. Related to No. 2, further moving away from the idea of inculcating a philosophy of skepticism, or Skepticism, to refer to the particular school of thought.
4. Is this, per all the "follow the money" angles above, also an attempt to cash in on Obamacare's evidence-based medicine drive?
5.  What happens when a potentially divisive issue comes up, such as psychiatry, alleged overuse of psychotropic medications, incarnations of the DSM and more?

That's not saying that all of the above IS the case. It is saying that all of it could be the case.

One other note to professional skeptics. This isn't about the merits of the site as a bastion against pseudomedicine. If that's all that's up for questioning, I'm totally in favor.

But, without more financial transparency, given all that I noted above, I have both my non-professional skeptical eyebrows raised. And even with such transparency forthcoming, I may still keep both eyebrows raised, depending on what the price points are.

Finally, imagine the ruckus from  Skeptics™if Gnu Atheists did something like this. "Sounds crazy, no?"

Yes. In fact, I encourage Gnu Atheists to start a list of non-faith-based atheist medicine and let's see how much  Skeptics™howl, especially if it promises dues, conferences and tchotchkes.

And, having written all this, before the word becomes overused, I feel a blog post about "tribalism" in my bones.

===

Meanwhile, on the actual medical science issue, there's other things.

Like, when does a small minority view become, or get kicked into becoming, "pseudomedicine"?

"The intellectual problem for Wikipedia, however, is that the Lyme wars are not about a fringe group, but a minority view of bona fine professionals with evidence supporting their view."

That's part of the discussion of this piece on Naked Capitalism, by a person who says that, among other things, autoimmune diseases may actually be caused by infectious agents in some cases. I don't know if that's the case or not, but, knowing how our modern urban environment, with tightly filtered HVAC systems, can cause spores and similar agents to multiply, I suppose its possible. Think if, say, Legionnaires' Disease had been a bit less virulent. Would it have been diagnosed as an autoimmune disorder.

And, there's one related thing.

Given that the p value for medicine, in research and experimentation, is usually still just 0.05, instead of the 0.0001 of physics and other "hard" sciences, medicine is going to have more false negatives, as well as false positives. Skeptical-based medicine, if it goes beyond filtering out and pointing out obvious woo, will need to be mindful of that, I think.

And, snark aside, the seriousness of all of this is why I'm not part of movement skepticism no more than I am of Gnu Atheism. I prefer the term "critical thinker" as a self-descriptor, in fact, because it's so much broader. It involves bringing that mindset to more than just the narrow scientific skepticism, and per a recent Facebook discussion kind of related to this that led to someone unfriending me, it also brings philosophy and philosophical stances into the picture.

I think of another friend, mentioning people whom he ideally hoped would fall in the heart of the Venn diagram intersection of skepticism (broadly practiced), atheism (of a generally non-Gnu type) and liberalism (of a non-neoliberal stripe). Yep, that's where I'm at, too.

No comments: