Cult medicine vs. professional medicine

So-called alternative medicine beliefs are an interesting and perhaps inevitable phenomenon. They make use of uniquely human qualities such as our intelligence, our pattern-recognition abilities, and our tendency to over-estimate how well we understand things. Most “science”, including medicine, relies on similar human qualities, but modern science has made some improvements. Medicine used to be based on observation mixed with superstition and other non-evidence based ways of understanding the world. Many of these systems were internally consistent, but ultimately failed to accurately describe the real world.

The gradual transition of medical science (the use of evidence to evaluate medical practice) has revolutionized medicine. We no longer rely on the glorified shamanism that existed before the mid-20th century.

This also means that medicine has become a true “profession”; it isn’t something you can just “pick up”, hang out a shingle, and practice from your front room. I’ve taken to calling practices that aren’t evidence-based “cult medicine“.

This is because many of the practices have charismatic advocates who encourage followers to dedicate their beliefs and their money to non-mainstream (and ineffective) health practices. Cult medicine is full of folks who have simply decided what they think medicine should be.

Medical cults and their leaders make extensive use of denialism. They indulge in logical fallacies and “should-ism”. AIDS, the WTC attacks, the moon landings are events they have difficulty explaining, so rather than getting educated or asking an expert, they ask themselves. They develop (often) internally consistent explanations of phenomena based on their own interpretations of facts, and their own preconceptions of what “should” be true. Partly because no one believes them, they close ranks, and feel conspired against (although to be fair, that thought pattern may begin before the conspiracy theory).

The patterns seen with denialism and cult medicine are very similar. Whether it’s the CIA-Zionist conspiracy to blow up the WTC towers as causus belli, or the Big Pharma/AMA/FDA conspiracy to suppress the “truth” about vaccines, denialists “deny” reality in favor of their own paranoid, Byzantine ideas.

Cult medicine can be humorous (who doesn’t think coffee enemas are funny?) but it is dangerous. It turns people away from real medicine, and enriches all manner of cracks and cranks. And, because it is attractive, it requires constant debunking.

A recent post by Steve Novella at NeuroLogica discusses some of the logical fallacies used by cult medicine, especially the tu quoque of “not everything modern medicine does is evidence-based.” This is usually followed by the non sequitur of “therefore homeopathy (or other woo) is just as good.” It only takes a few seconds of thought to see through this argument. Modern medicine is imperfect. So is cult medicine. This doesn’t mean that they are equally imperfect. Take the following example…

Followers of cult medicine often ask us to believe in the unseen and untestable. But there reasoning is often internally consistent, that is, it follows its own sort of logic, just not one that is closely associated with the, um, facts.

Take, for instance, a Chinese acupuncture chart:


Compare it to something like, say, this:


One of these pictures, and the science it represents, is based on actual dissection, functional observation, electromyography, and, well, science.

The other has centuries of people talking to each other about meridians, and sticking needles into people with the hope of having something good happen.

One allows someone to make a prediction based on functional anatomy, perform surgery, and achieve an easily documented outcome.

One lets you stick needles into people with the hope of having something good happen.

I’m sure there will be argument about this—how acupuncture is really more complex than this, etc. But it really distills down to one being science, and one being hope. It’s just that simple.

Let’s say I have a patient with some type of neuropathy. I ask a surgeon to get me a sural nerve biopsy. Which chart represents a physical reality? Which one imagination? Which one do you want the surgeon to be familiar with? (Please, no smart-ass remarks about the sural nerve being absent from this particular drawing.)

Cult medicine is just that—an irrational belief system based on misfiring of human pattern recognition systems identifying cause and effect where none exists.

Real medicine is science.

Take the real test—who do you call when you have chest pain, the cultist or 911?