Here's a summary of the speech, by Horgan. Here are two of the most heated responses, from Orac and from Steve Novella, both medical doctors of some standing.
Then, here's Horgan's response. And a second.
I don't necessarily agree with everything he said, nor every
bit of the style. I do agree with a fair amount, though. (I have also read, and
favorably reviewed, a couple of Horgan's books. I've also read, and largely
agreed with, broadly similar takes on "movement skepticism" by the
likes of Massimo Pigliucci.)
I had a more specific question, though. How much of the
reaction from a few — well, specifically, Novella and Orac, as far as longer
reactions — does anybody think comes from "ox goring" over Horgan's
comments about medical care in the US?
The nut of my issue is this.
A semi-rhetorical question, as I called it in a comment on Orac's site ... how much of the heat of
criticism is due to ox-goring re Orac and Novella over what Horgan said about
modern medicine, including overtesting driven in part by the fee-for-service
model?
Theoretically, the two of them are above such money-grubbing. I think. Maybe they make extra money off consultancy fees or something, though. (That, mutual backup consultancy agreements with other doctors, is an ugly part of modern American medicine indeed.)
And, even beyond the money, it's their profession, not movement skepticism in general, that they could be upset about as an ox being gored.
And, even beyond the money, it's their profession, not movement skepticism in general, that they could be upset about as an ox being gored.
To be fair, in his link, Orac himself says he and Novella have both written about cancer overscreening.
To which I note: To what effect? There's plenty of doctors who still do it, and plenty of skeptics who still don't write about it.
Plus, overscreening for cancer is but one of several types of overtesting.
And, when it's in one's own skeptical house, as with Dr. David Gorski and mammograms, he may raise one skeptical eyebrow ... but still give one thumbs up.
So, contra people who think this trio, and others, from the medical world are actually mad because Horgan allegedly got a lot wrong, I don't think so. (Skeptics™ folks can tell me if any of the trio has called for single-payer national health care with limits on fee-for-service payments.)
So, contra people who think this trio, and others, from the medical world are actually mad because Horgan allegedly got a lot wrong, I don't think so. (Skeptics™ folks can tell me if any of the trio has called for single-payer national health care with limits on fee-for-service payments.)
Otherwise, especially on people criticizing Horgan's attack for movement skeptics not looking at things like war and economics?
Related to this, Horgan has touted the Cochrane Collaboration as promoting medical research "free from commercial sponsorship and other conflicts of interest," per its website. (Horgan just posted that link recently, but the site and movement's been around some time, and he obviously has a few years' familiarity with it.)
Guess what? No link to it on "Science Based Medicine," the skeptics'-driven blog which has Orac, Novella and Gorski among its main contributors.
And, back to, if not money, then reputation. I got a bit snarky about the "Science Based Medicine" website when it was created ... wondering if we'd have skeptics' medical products for sale or something. No, that's not happened, but per Orac above, it has not commented more about overtesting in general. Nor has it commented about the issues behind that — loose p-values and other statistical standards that it's high time were made more rigorous. Where's the Orac/Novella call for that?
First, I agree with him and have already said so. Steve Pinker's book on the subject was pretty much crap. Of course, Pinker's a Pop Ev Psycher, and the book came in part from that pseudoscience direction.
Probably, a bit of the ox-goring is involved there, too. Pinker himself's not a leader in movement skepticism, but he's simpatico with its work. And, a LOT of movement skeptics still believe in the unfalsifiable, sexist pseudoscience of Pop Ev Psych in general.
Second, it was impolite at best, possibly martyr-feeding at worst, for Jeremy Ian Swiss to not allow Horgan a Q&A time, since he'd deliberately made his speech short enough to allow for this.
Third, sorry Orac, but Horgan's spot-on about tribalism, and you're only exemplifying it. I am sure you care nothing about little old me, but nonetheless ... per the old cliche, I'd put the shovel down and stop digging.
Fourth, I don't think Horgan is "clueless about skepticism," Orac. (See tribalism, holes, and shovels.)
Fifth, I'm surprised that he didn't directly name "scientism" as a problem with movement skeptics. It is, and Horgan's written about the subject, in relation to the humanities, before. (In a Tweet, he noted he's called out Jerry Coyne for it — a link I didn't click because "Coyne.")
That said, John could have mentioned science hype as part of scientism. I'm not anti-GMO, but I am anti-hype when GMOs don't deliver. And, no, scientism-type movement skeptics, they don't always deliver.)
All of this is why, like Pigliucci, who used to be more involved with the "movement," but has drastically distanced himself in the past few years, I take a Marxian (Groucho) type eyeball to it.
That said, John could have mentioned science hype as part of scientism. I'm not anti-GMO, but I am anti-hype when GMOs don't deliver. And, no, scientism-type movement skeptics, they don't always deliver.)
All of this is why, like Pigliucci, who used to be more involved with the "movement," but has drastically distanced himself in the past few years, I take a Marxian (Groucho) type eyeball to it.
I noted above that I don't agree with everything Horgan says.
Above all, I think studies about the possible harms of psychtropic medications — antidepressants, etc. — are somewhat overblown. Not totally, but somewhat. I do agree that we probably need more caution with their use than is practiced today.
(I don't know if Orac, Novella or other MDs at NECSS or in movement skepticism have written about this at all or not.)
It also should be remembered that the first antidepressants were discovered in the 1950s, as was Thorazine for schizophrenia, long before Big Pharma was quite as big as today. And, even if a placebo effect was part of it, they were a godsend to many.
Related to that, I don't think Horgan, or others with his mindset, think about the emotions involved in seeking relief from mental health afflictions. And, if I'm correct in questioning the claim that, on average, they're positively harmful, some relief is better than none until our options become better.
In turn, I encourage general practitioners/internists to become more enlightened on this subject, since they're often, not psychiatrists, the ones providing the pharmaceuticals. Likewise, I encourage them to become more enlightened about addiction, including anti-craving medications. (I sure as hell hope Horgan doesn't have a problem with them.
(I don't know if Orac, Novella or other MDs at NECSS or in movement skepticism have written about this at all or not.)
It also should be remembered that the first antidepressants were discovered in the 1950s, as was Thorazine for schizophrenia, long before Big Pharma was quite as big as today. And, even if a placebo effect was part of it, they were a godsend to many.
Related to that, I don't think Horgan, or others with his mindset, think about the emotions involved in seeking relief from mental health afflictions. And, if I'm correct in questioning the claim that, on average, they're positively harmful, some relief is better than none until our options become better.
In turn, I encourage general practitioners/internists to become more enlightened on this subject, since they're often, not psychiatrists, the ones providing the pharmaceuticals. Likewise, I encourage them to become more enlightened about addiction, including anti-craving medications. (I sure as hell hope Horgan doesn't have a problem with them.
Next, it's funny, if not sad, to see Novella and Orac both accuse Horgan of creating strawmen. I see them, in their replies, doing exactly that.
Finally, Orac showed a degree of "true colors," I guess. Lumping Horgan in the same piece as Mike Adams qualifies as an ad hominem in my book. And, there was no need for it. None.