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A plea to my journalist colleagues: sourcing, sourcing, sourcing

A plea to my journalist colleagues: sourcing, sourcing, sourcing

Picture of Peter Lipson

I'm a physician.  As such, the information I work with has immediate consequences.  I have to get it right every time.  Of course, no one can really get it right every time, but if you want to report health information, you have to try very, very hard.  According to a Pew survey released last fall, over 60% of Americans seek out and act on health information online.  When you put a story out there, people are going to read it and act on it, so you are, in essence, giving health advice without the benefit of a license to practice medicine.

But the media, being essential to democracy, will---and must---continue to report on health issues.  Two pieces in the New York Times over the last week highlighted one of the problems with health journalism: a reliance on the wrong sources.  Both stories were about acupuncture, and both took as a given that acupuncture is safe and effective.  A careful reading of the medical literature belies the effectiveness claim, but more important is where the reporters got their information.  

In researching a medical story, finding the right source can be difficult.  When examining alternative medicine claims, this difficulty is compounded by religious-like sectarian medical beliefs and by significant profit motive amongst those who sell the same services they prescribe.  When researching a piece on chiropractic, for example, the answers one would get from a chiropractor are fairly predictable.  It is unlikely that you would find a chiropractor who would summarize the relevant literature about their practices. 

Both pieces were written by the same reporter.  One piece was an uncritical paeon to acupuncture which sourced an acupuncture researcher.  For the other piece on acupuncture she interviewed a few different people.  The first cited was the director of clinical services at an acupuncture college.   The second source cited was a massage therapist and yoga instructor, the third the director of an acupuncture program. 

The writer also goes on to give the certification requirements for acupunturists in New York State.  Dr. Harriet Hall, a noted medical skeptic, has coined the term "Tooth Fairly Science".  You can do study after study documenting the characteristics of the tooth fairy, including such factors as average price per incisor, usual time of visit, etc.  But none of the studies actually shows whether or not the tooth fairy exists. Similarly, you can train and train in a health care technique, but if the data do not support its use, all the certification exams in the world will not make it work.  

When researching medical stories, it is more important to look for experts in a certain condition, rather than an expert in a particular technique or modality.  Medical science is not about beliefs and systems of belief, but about data. Acupuncture, chiropractic, homeopathy, and other so-called alternative health systems are not based on a modern understanding of the physical world, and restricting oneself to using experts in these fields is analogous to interviewing a PhD in Tooth Fairyology.  If you want to know if acupuncture is effective in the treatment of infertility, as the story claims, then look at the literature, and interview infertility experts, not acupuncturists.  If you want to know if it works for chronic headaches, as claimed, then interview a neurologist.  

In medical science there is not always two sides to every question.  Some ideas are simply wrong, and unless you ask the right expert, you are no longer reporting, but proselytizing. 




Picture of Duncan Echelson

I will certainly agree with Peter that the two pieces on acupuncture that he criticizes are light-weight but with very little effort I can come up with hundreds of light-weight "scientific medicine" articles weekly if not daily. As one who receives regular search results from Google on the keyword "acupuncture", I am amazed at how little reporting on the subject there is.

Peter has put on a white hat and only allows his "opponents" black hats. He labels one person as "an acupuncture researcher" with the clear implication that this is bad.  What Peter fails to mentions is that the acupuncture researcher has a PhD in biomedical engineering and is an Assistant Professor at the Harvard Medical School as well.  While these credentials do not automatically provide proof of the researcher's conclusions, they do make him a least slightly more credible.

These sorts of "my side is good, your side is not" are unproductive and it will be a great day when we all rise above our partisanship and cast a clear critical eye on all forms of medical practice.

The image of "scientific medicine" as always "scientific" is a rhetorical trick. A quote from Dr. Lipson: "Medical science is not about beliefs and systems of beliefs but about data."  This is the dream of many medicines and it is a dream that is continually out of reach.

And will always be out of reach, which should serve to keep us humble in our views and willing to engage in dialogue with others.  It is very hard for a person to intelligently dialogue with others who are viewed as only practicing "tooth fairy medicine."

See this post on MedicalSkeptic for some examples of when the data is not applied in conventional medicine.

Critics of alternative medicine rarely examine the multitude of egregious examples of self-serving fluff reporting in their own fields and even more rarely question them publicly.  Even more rarely do they publicly criticize medical practices that are not based on data. 

There is plenty to criticize in all forms of medicine  and I look forward to a growing number of intelligent critics that use their skills "without fear or favor" to investigate all forms.  

Picture of Peter Lipson

a dream that is continually out of reach.

Really?  See, there really is a right and a wrong, a "black hat" and a "white hat" as you say.  There are practices that are plausible and those that are not.  There are practices supported by the preponderance of good evidence and those that are not.

For example, there is nothing one can say about homeopathy being effective that isn't sheer idiocy.


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