Rege,
I appreciate your effort with this post and it’s especially nice to see
someone from the academic community speaking so openly.
I see both Henry and Mel have spoken about your statement (from Smith)
“that only 15% of medical interactions are supported by solid scientific
evidence, and an estimated 10-20% of the techniques that physicians use are
empirically proven.” Henry provided a reference that refutes this quite
effectively (The Evidence for Evidence-Based Medicine by Imrie and Ramey)
which I’d be glad to send your way. The authors point out that White
himself had little confidence in his self-described “arm-chair” survey, and
that it was never intended to evaluate the science of medical practice.
Clearly, this claim should no longer be made, and it probably never should
have been.
I can understand your not knowing of Imrie’s commentary, but find the next
statement troublesome: “One of the problems with science (medicine and
physical therapy) is the fear of moving away from our socialized
Newtonian-Cartesian concept of reality that has imprisoned us for
centuries.” Imprisoned us? Are you suggesting that Newtonian physics are
somehow inadequate? Unless you’re practicing in the presence of immense
gravitation or at extraordinary speed, what Newton taught us should be
enough to explain and predict just about anything you want, and if you
think that the seemingly odd behavior of the sub-atomic world informs us of
our macroscopic existence, you’re simply mistaken (see “The Quantum Scam”
on my web site for more on this). I’m also wondering about your use of the
word “socialized” in this context, but perhaps there’s a clue in my next
comment.
When you speak of a “new reality” I am reminded of Wallace Sampson’s
description of postmodernism (“Dancing in the Dark, or Sleeping with the
Enemy?” The Scientific Review of Alternative Medicine Vol. 5, No. 2 Spring
2001): “Postmodernism demotes rational thought and problem solving to the
significance of mere social interactions-as “just another way of knowing.”
It considers facts as socially constructed-the results of specific cultural
influences. Surprisingly, it considers language as the determinant of
reality, rather than as a tool to describe reality. This has resulted in
the idea that words with specific definitions reveal “bias” One example is
“quackery” for which the term “alternative” was coined…” This kind of
thinking pervades our universities, and in medical practice it’s been a
disaster.
When you say, “It (science and physical therapy) simplifies nature and sees
the world only in terms of analysis, quantification, symmetry, and
mechanism. All of this at the expense of nature's qualities and
unquantifiable values” I must disagree. If we assign the attitude of the
skeptic (which is a process, not a position) to those of us in PT who do
not feel the world is unexplainable, you will find that we know nature to
be in its deepest realms, remarkably bizarre. We accept this because it
makes sense given what we know to be true as the end result of careful
investigation. It is the postmodernist who is much more likely to simplify
things in an effort to “create” the reality they feel comfortable with.
(see “What Went Wrong: Postmodern Thought in Physical Therapy” on my web site)
I’d love to get a reaction to these few thoughts. I have a few more.
Barrett L. Dorko, P.T.
http://barrettdorko.com
Also http://rehabedge.com
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