Medliorate

Improving medical students

Confronting Unscientific Beliefs

Posted by medliorator on July 24, 2008

by Steven Novella:

It is not the place of the physician to validate or refute personal religious beliefs.
Non-religious ideological beliefs are the same. The point is that the physician cannot impose their value system onto their patient.

Most experienced clinicians already know to avoid dismissive, insulting, or judgmental statements. In confronting unscientific medical beliefs, it is easy to do so. Simply confine your opinions to the scientific evidence. For example, if a patient asks me about acupuncture for migraine headaches I simply tell them that I have reviewed the published literature which does not support the use of acupuncture for migraines. I therefore do not recommend it. I am then happy to discuss the evidence with the patient as much as they desire. But almost always patients appreciate the fact that I have taken the time to actually read the literature and they respect my opinion.

Sometimes patients ask me about treatments that I believe to be fraudulent and exploitive – for example I am frequently asked about whether or not it is worth it to fly to China to get stem-cell therapy. In these cases I tell my patients, in a very factual and dry manner, that such clinics are fraudulent. What evidence we have shows that their treatments are not safe and that they do not work. In my opinion the people operating the clinic are committing fraud to steal money away from desperate patients. To do anything less is to fail to properly inform a patient.

It is profoundly misguided and harmful to fail to confront pseudoscience or bad science in medicine out of fear of offending a patient.
Given the medical environment today, clinicians are obligated to have a working knowledge not only of science-based medicine but of the unscientific practices and claims with which their patients may be faced. We are obligated, as part of good practice, to know the literature and the nature of unscientific claims and to help our patients navigate through them.

A Guide for Confronting Patients [Science-Based Medicine]

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